Catheterization and Cardiovascular Interventions最新文献

{"title":"The Impact of Hydrostatic Pressure on Fractional Flow Reserve in Saphenous Vein Grafts.","authors":"Roel Hoek, Sina Porouchani, Ruben W de Winter, Yvemarie B O Somsen, Pepijn A van Diemen, Ruurt A Jukema, Jos W Twisk, Adriaan Wilgenhof, Alexander W den Hartog, Niels J Verouden, Nils R Planken, Ibrahim Danad, Alexander Nap, Paul Knaapen","doi":"10.1002/ccd.31509","DOIUrl":"https://doi.org/10.1002/ccd.31509","url":null,"abstract":"<p><strong>Background: </strong>The relationship between height differences related to graft anatomy and physiological pressure indices in coronary bypass grafts has not been studied. We sought to study the impact of hydrostatic pressure on fractional flow reserve (FFR) in saphenous vein grafts (SVGs).</p><p><strong>Methods: </strong>Included were 66 symptomatic patients (76 SVGs) with prior coronary artery bypass grafting who underwent coronary computed tomography angiography (CCTA) preceding invasive coronary angiography with FFR interrogation of ≥ 1 SVGs. The graft course and height excursion were reconstructed based on CCTA images. The impact of hydrostatic pressure on FFR (corrected FFR) was calculated by adding or subtracting 0.077 mmHg to the distal coronary pressure for every millimeter height difference in a supine position between the SVG ostium and the pressure wire tip position.</p><p><strong>Results: </strong>The height difference (mm) between the SVG ostium and pressure wire tip position was largest for single SVGs to the circumflex artery (Cx; -55.1 ± 17.0), followed by sequential SVGs to the Cx (-51.8 ± 17.3) and the right coronary artery (RCA; -36.7 ± 21.6). The correlation between height difference and uncorrected FFR was -0.59 (p < 0.001). Corrected FFR was lower as compared to uncorrected FFR in the overall cohort (0.86 ± 0.17 vs. 0.88 ± 0.18), in single SVGs to Cx (0.85 ± 0.17 vs. 0.90 ± 0.18), and in sequential SVGs to Cx (0.92 ± 0.14 vs. 0.96 ± 0.15) and RCA (0.82 ± 0.17 vs. 0.85 ± 0.21) (p < 0.001 for all).</p><p><strong>Conclusions: </strong>Hydrostatic pressure related to height differences along the course anatomy of SVGs can impact FFR measurements, with corrected FFR being significantly lower in SVGs to the Cx and sequential SVGs to the RCA.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological Insight Into the Discordance Between Non-Hyperemic Pressure Ratio-Guided and Fractional Flow Reserve-Guided Revascularization.","authors":"Masahiro Hada, Masahiro Hoshino, Eisuke Usui, Yoshihisa Kanaji, Tatsuhiro Nagamine, Kai Nogami, Hiroki Ueno, Mirei Setoguchi, Kodai Sayama, Takahiro Watanabe, Hikaru Shimosato, Takashi Mineo, Yoshihiro Hanyu, Toru Misawa, Masao Yamaguchi, Tomoyo Sugiyama, Tadashi Murai, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1002/ccd.31517","DOIUrl":"https://doi.org/10.1002/ccd.31517","url":null,"abstract":"<p><strong>Background: </strong>Five-year outcomes from the two major trials indicated higher mortality with instantaneous wave-free ratio (iFR)-guided revascularization compared to fractional flow reserve (FFR)-guidance, despite similar outcomes in deferred patients. This discrepancy likely comes from discordant revascularization decisions. To precisely assess the characteristic differences, including microvascular function, between resting full-cycle ratio (RFR)-guided and FFR-guided strategies, we performed virtual randomization, specially targeting discordant lesions, to simulate RFR-guided and FFR-guided groups. Microvascular resistance reserve (MRR) was utilized to assess microvascular function independently of epicardial stenosis.</p><p><strong>Methods and results: </strong>We retrospectively analyzed 837 intermediate lesions in 620 patients, from our institutional physiological database, with a median follow-up of 6.9 years. Using thresholds of FFR ≤ 0.80 and RFR ≤ 0.89, lesions were categorized into concordant-high (n = 280), high-RFR/low-FFR (n = 105), low-RFR/high-FFR (n = 93), and concordant-low (n = 359) groups. Discordant and concordant lesions were virtually randomized into RFR- and FFR-guided groups. Patients were followed for 6.9 (4.6-9.1) years. Age, sex, percentage diameter stenosis, and MRR differed significantly between the RFR/FFR discordant groups. After randomization, no significant characteristic-based differences were observed between both concordant and discordant virtual RFR/FFR-guided groups. Compared with the patients with FFR-guided would-be-revascularized lesions, those with RFR-guided would-be-revascularized lesions with discordant RFR/FFR results had significantly lower MRR, higher age, and tended to be female. MRR significantly predicted all-cause death in the total and would-be-revascularized cohorts, but not in deferred patients.</p><p><strong>Conclusions: </strong>In discordant lesions of virtually randomized RFR- and FFR-guided strategies, RFR-guided would-be-revascularized lesions were associated with impaired microvascular function (low MRR) compared with FFR-guided would-be-revascularized lesions, which may underlie the reported increased mortality in iFR-guided revascularized patients.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral Access-Assisted Balloon Trapping: A Novel Approach to Managing Kinked Catheter During Transradial Coronary Intervention-A Case Report.","authors":"Haşim Tüner, Fuat Polat, Özge Özden Kayhan, Ömer Göktekin","doi":"10.1002/ccd.31523","DOIUrl":"https://doi.org/10.1002/ccd.31523","url":null,"abstract":"<p><p>Catheter kinking is a rare but significant complication of trans-radial coronary interventions, often caused by arterial tortuosity, vessel spasm, or improper catheter manipulation. We present a case of catheter kinking that occurred during coronary engagement in a transradial procedure, which could not be resolved using conventional techniques. Given the failure of guidewire advancement and deep inspiration maneuvers, a femoral access-assisted balloon trapping technique was employed. This method allowed for the successful retrieval of the kinked catheter while minimizing vascular trauma and ensuring procedural completion. Catheter kinking during trans-radial coronary interventions poses technical challenges requiring tailored management strategies. This case underscores the effectiveness of femoral access-assisted balloon trapping technique as a viable and minimally invasive solution. Increased awareness and preparedness for such complications can enhance procedural success and patient safety.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Approach and Practical Guide to Using Bolus Thermodilution for Invasive Coronary Microvascular Dysfunction Assessment.","authors":"Jason Galo, Abhishek Chaturvedi, Beni Rai Verma, Kalyan R Chitturi, Haberman Dan, Waiel Abusnina, Itsik Ben-Dor, Ron Waksman, Brian C Case, Hayder D Hashim","doi":"10.1002/ccd.31507","DOIUrl":"https://doi.org/10.1002/ccd.31507","url":null,"abstract":"<p><p>Angina pectoris with non-obstructive coronary arteries (ANOCA) is a prevalent condition, particularly affecting women, and is often associated with coronary microvascular dysfunction (CMD). CMD, the primary cause of ANOCA, is associated with a diminished quality of life and adverse clinical outcomes. Invasive coronary function testing (CFT) now provides a precise diagnosis of CMD through indices such as coronary flow reserve (CFR) and index of microcirculatory resistance (IMR), assessed using the bolus thermodilution technique. This comprehensive review outlines a systematic approach to evaluating CMD, emphasizing practical steps and troubleshooting strategies to ensure accurate measurements of CFR and IMR. CMD phenotypes, including structural, functional, and compensated CMD, are discussed, along with their distinct pathophysiological mechanisms. Common challenges encountered during CMD testing, such as improper guide or wire positioning, waveform artifacts, and injection errors, are addressed with practical solutions. While continuous thermodilution offers enhanced accuracy, bolus thermodilution remains cost-effective and widely utilized. Proficiency in the intricacies of CMD testing is crucial for accurate diagnosis and management, ultimately enhancing clinical outcomes for this underrecognized patient population.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Analysis of 3D Anatomy to Inform Planning of Ductal Arteriosus Stenting.","authors":"Mudit Gupta, Silvani Amin, Alana Cianciulli, Yuval Barak-Corren, Csaba Pinter, Hannah Dewey, Andras Lasso, William Russell, Stephanie Colello, Ari J Gartenberg, Vlad Obsekov, Trevor Williams, Elizabeth Silvestro, Michael L O'Byrne, Andrew C Glatz, Matthew A Jolley","doi":"10.1002/ccd.31510","DOIUrl":"https://doi.org/10.1002/ccd.31510","url":null,"abstract":"<p><strong>Background: </strong>Ductus arteriosus stenting (DAS) is used to palliate infants with ductal-dependent pulmonary blood flow (DD-PBF), however patent ductus arteriosus (PDA) anatomy can be complex and heterogenous.</p><p><strong>Aims: </strong>We developed custom, open-source software to model and quantify PDA anatomy.</p><p><strong>Methods: </strong>We retrospectively identified 33 neonates with DD-PBF with a CTA before DAS. A novel custom workflow was implemented in 3D Slicer and SlicerHeart to semi-automatically extract centerlines of the course of the PDA and surrounding vessels. 3D ductal length, diameter, curvature and tortuosity were automatically calculated (3D automatic) and compared to manually adjusted 3D measurements (3D semi-automatic), and manual measurements of PDA dimensions in 2D projectional angiograms before and after stent angioplasty.</p><p><strong>Results: </strong>Ductal anatomy was successfully modeled and quantified in all subjects. 3D automatic and semi-automatic measurements of straight-line aortic to pulmonary artery length were not significantly different than 2D measurements. Semi-automatic 3D measurements were similar to 2D measurements of the total length. Minimum and maximum ductal diameters were not significantly different by 3D automatic and 2D measurements, however semi-automatic 3D diameters were significantly larger. Inter-reader reliability of ductal length and diameter was higher with manual adjustment of 3D centerlines compared to standard measurement of 2D angiograms. These differences were consistent across PGE doses between CTA and DAS.</p><p><strong>Conclusions: </strong>Automatic PDA modeling is feasible and efficient, enabling reproducible quantification of ductal anatomy for procedural planning of DAS in patients with DD-PBF. Further development is needed as well as investigation of whether 3D modeling-derived measurements influence procedural duration or outcome.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischaemic Heart Disease Masquerading as Headache: A Case Series.","authors":"Ibrahim Antoun, Ayman Helal, Nancy Wassef, Mohsin Farooq","doi":"10.1002/ccd.31521","DOIUrl":"https://doi.org/10.1002/ccd.31521","url":null,"abstract":"<p><p>Headache is a rare yet clinically significant presentation of ischaemic heart disease (IHD). While chest pain is the hallmark symptom of myocardial ischaemia (MI), some patients present with atypical symptoms, such as headaches, which lead to diagnostic challenges and potential delays in treatment. This case series highlights the diagnostic complexity and clinical significance of headache-predominant presentations of both acute and chronic coronary syndromes, emphasizing the need for a comprehensive differential diagnosis in patients with cardiovascular risk factors. We present two cases where headache was the primary symptom of MI. The first case describes an acute ischaemic event wherein the headache preceded the onset of classic cardiac symptoms, leading to the identification of an occluded obtuse marginal artery. This was the second case in our institution where a previous patient presented with exertion-induced headaches, ultimately diagnosed as a chronic total occlusion of the left anterior descending (LAD) artery, which was successfully revascularised. Two years later, the same patient re-presented with acute coronary syndrome secondary to disease in a different coronary artery and his presentation was solely with headache. Both cases were successfully managed with percutaneous revascularisation, resulting in the resolution of symptoms and reinforcing the link between headache and CAD. These cases underscore the importance of considering ACS and chronic stable angina in patients presenting with unexplained headaches, particularly when symptoms are exertional or pressure-like. Early cardiac assessment, including ECG and further imaging when indicated, is essential for timely intervention. Raising the awareness of exertional headache as a potential ischaemic symptom may facilitate earlier diagnosis and prevent adverse outcomes. Further research is required to elucidate the mechanisms underlying headaches in MI and refine diagnostic approaches for atypical cardiac presentations.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Unloading in Nonischemic Dilated Cardiomyopathy Improves Coronary Haemodynamic Reserve.","authors":"Samer Fawaz, Rohini Ramaseshan, Sarosh Khan, John R Davies, Carlos Collet, Grigoris V Karamasis, Christopher M Cook, Daniel A Jones, Anthony Mathur, Thomas R Keeble","doi":"10.1002/ccd.31514","DOIUrl":"https://doi.org/10.1002/ccd.31514","url":null,"abstract":"<p><strong>Background: </strong>The Impella CP is a catheter-based ventricular assist device used in the management of cardiogenic shock and to support high-risk percutaneous coronary interventions (PCI). Despite its growing use, the effects of Impella CP on coronary flow dynamics as measured by intracoronary continuous thermodilution have not been fully quantified.</p><p><strong>Aims: </strong>This study aimed to evaluate the impact of percutaneous ventricular unloading (PVU) with Impella CP on coronary flow reserve (CFR) and microvascular resistance reserve (MRR) in patients with severe nonischemic dilated cardiomyopathy undergoing intracoronary infusion of autologous bone-marrow derived mononuclear cells (BMMNCs).</p><p><strong>Methods: </strong>Coronary flow (Q) was assessed using intracoronary continuous thermodilution both at rest (Qrest) and during hyperemia (Qhyper) before and after PVU with the Impella CP. Measurements were performed in the left anterior descending (LAD) artery using a dedicated pressure/thermistor coronary guidewire. CFR and MRR were calculated post-hoc.</p><p><strong>Results: </strong>Nine patients underwent investigation with continuous thermodilution. Initiation of LV unloading with Impella CP resulted in a significant increase in CFR (from 2.72 ± 0.76, to 3.9 ± 1.84, p = 0.049) and MRR (from 3.09 ± 0.97, to 4.50 ± 1.93 p = 0.022). A decrease in mean Qrest and an increase in mean Qhyper was also noted.</p><p><strong>Conclusions: </strong>PVU with Impella CP led to a significant increase CFR and MRR, suggesting an improvement in coronary haemodynamic reserve. Further studies are needed to validate these findings in a larger patient population.</p><p><strong>Trial registration: </strong>Clinicaltrials. org: DCM Support NCT03572660.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Resting Hyperemic Pressure Assumptions in the Angio-IMR Formula: Insights From the MAGIC Trial.","authors":"Zhi H Teoh, Joseph O'Brien, Adam J Brown, Derek P Chew, Tom Ford, Andy Yong, Dennis T L Wong","doi":"10.1002/ccd.31516","DOIUrl":"https://doi.org/10.1002/ccd.31516","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Allergy to Angina: A Unique Presentation of Kounis Syndrome.","authors":"Momen Ali, Ayman Helal, Mohammad El-Din, Ibrahim Antoun","doi":"10.1002/ccd.31522","DOIUrl":"https://doi.org/10.1002/ccd.31522","url":null,"abstract":"<p><p>Kounis syndrome (KS) is a rare condition characterized by acute coronary syndrome (ACS) triggered by an allergic reaction. This report presents a case of high-risk ACS associated with a food allergy. A 53-year-old male with no prior medical history presented to the emergency department with itching, facial swelling, chest tightness, shortness of breath, and presyncope after consuming peanut butter and grapefruit juice. His past medical history included an allergy to codeine/paracetamol, causing angioedema. Initial vitals were stable, and examination revealed minimal lip swelling, a pruritic rash, and clear auscultation. A baseline electrocardiogram (ECG) demonstrated subtle ST-segment depression with T-wave inversion in inferior leads, which progressed to significant ST depression and deep T-wave inversion. Serial troponin levels showed a significant rise (20.2 to 39.2 ng/L). Coronary angiography revealed no significant coronary artery disease. Cardiac magnetic resonance (CMR) excluded myocardial infarction or fibrosis. The patient was diagnosed with KS based on clinical presentation, dynamic ECG changes, and elevated troponins in the absence of obstructive coronary artery disease. Management included antihistamines, steroids, nitroglycerin, and standard acute coronary syndrome treatment. He was discharged on oral antihistamines after a brief coronary care unit observation.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Trifecta^TM and Epic^TM Valve-in-Valve Registry: Insights Into Clinical & Hemodynamic Outcomes.","authors":"Matthias Raschpichler, Mohamed Abdel-Wahab, Nick Curzen, Manuel Wilbring, Christoph Dubois, Kayan Lam, Gloria Faerber, Jana Nagel, Holger Thiele, Michael A Borger","doi":"10.1002/ccd.31492","DOIUrl":"https://doi.org/10.1002/ccd.31492","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the clinical and hemodynamic outcome of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) for failed Trifecta surgical aortic bioprotheses.</p><p><strong>Aims: </strong>We aimed to compare outcomes of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR into failed Trifecta^TM vs. ViV-TAVR into a standard aortic bioprosthetic valve with internally mounted leaflets (Epic^TM, Abbott, Minneapolis, MN).</p><p><strong>Methods: </strong>Data of consecutive patients who underwent ViV-TAVR into either failed Trifecta^TM or Epic^TM bioprostheses between October 2015 and June 2020 were retrospectively collected within the International Trifecta and Epic Valve-in-Valve Registry, and analyzed for a primary composite outcome of 30-day mortality and/or coronary obstruction (CO), defined as: (1) CO resulting in myocardial infarction and/or cardiogenic shock, or (2) CO requiring emergent coronary intervention.</p><p><strong>Results: </strong>A total of 76 patients (49 Trifecta, 27 Epic) with a median age of 80 years (interquartile range [IQR] 75.0; 82.0]) and a median Society of Thoracic Surgeons-score of 5.4 (IQR 4.0; 9.8) were identified. Coronary protection techniques were more frequently performed in Trifecta than Epic patients (29.6% vs. 0%, p = 0.01). The primary composite outcome was observed in three Trifecta versus five Epic cases (6.1% vs. 20%, p = 0.1), which included one case of CO following ViV-TAVR into Epic requiring stenting. Increased rates of patient-prosthesis mismatch (PPM) following valve-in-Epic were found (41.7% vs. 75%, p = 0.08). Survival at a median of 365 days was 86.2% and did not differ between groups (log-rank p = 0.37).</p><p><strong>Conclusions: </strong>Compared to a stented prosthesis without increased risk of CO, ViV-TAVR into Trifecta prostheses can be performed with low risk of CO and acceptable short-term clinical outcomes. As the rate of post-ViV PPM is substantial for both prostheses, careful patient selection is warranted. (NCT05389631).</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}