Catheterization and Cardiovascular Interventions最新文献

{"title":"Progression of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Replacement: A Quantitative Coronary Angiography and Quantitative Flow Ratio Analysis","authors":"Jason Galo,&nbsp;Abdullah Al Qaraghuli,&nbsp;Cheng Zhang,&nbsp;Gal Peleg,&nbsp;Kalyan R. Chitturi,&nbsp;Yonathan Hasin,&nbsp;Idit Avrahami,&nbsp;Shaan A. Ahmed,&nbsp;Pablo M. Rubio,&nbsp;Abhishek Chaturvedi,&nbsp;Beni Verma,&nbsp;Itsik Ben-Dor,&nbsp;Ron Waksman","doi":"10.1002/ccd.70704","DOIUrl":"10.1002/ccd.70704","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The progression of coronary artery disease (CAD) following transcatheter aortic valve replacement (TAVR) is poorly understood. Changes in coronary hemodynamics after TAVR and their relationship with atherosclerosis remain an active area of investigation. Quantitative coronary angiography (QCA) and quantitative flow ratio (QFR) offer objective, reproducible assessments of coronary disease burden, hemodynamics, and progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate anatomic and hemodynamic progression of CAD in select patients undergoing TAVR using QCA and QFR, and to compare outcomes by valve type—self-expanding valves (SEV) versus balloon-expandable valves (BEV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 92 patients who underwent TAVR and had both pre- and post-TAVR invasive coronary angiography (CA) were retrospectively analyzed. QCA and QFR analyses were performed on major coronary arteries. CAD progression was defined in 2 ways: (1) QCA diameter stenosis (DS) increase ≥ 10% or baseline &lt; 50% and follow‑up ≥ 50%; (2) QFR decrease ≥ 0.05 or baseline QFR &gt; 0.80 and follow-up ≤ 0.80. Clinical and echocardiographic data, statin use, and antiplatelet therapy were assessed longitudinally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 756 days (IQR 254–1302), CAD progression in patients with clinically indicated post-TAVR CA was observed in 96.6% of patients using QCA and in 85.6% of patients using QFR. Among vessel subsegments, CAD progression by QCA was greatest in the LAD proximal and mid segments (60.99% and 58.46%, respectively), and lowest in distal LCX and distal RCA (37.63%, 39.04%, respectively). CAD progression by QFR was significantly greater in SEV when compared to BEV (1-year: 39.4% vs. 21.9%; 2-year: 47.4% vs. 39.3%, log rank <i>p </i>= 0.038). There was no statistically significant difference in the QCA-defined CAD progression between SEV and BEV, though a numerically higher progression was seen in SEV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most TAVR recipients undergoing clinically indicated repeat CA demonstrate CAD progression on serial angiography. By QFR, progression is influenced by valve type, while by QCA and QFR, trended with baseline disease severity. Further investigation into coronary progression following TAVR is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"760-775"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335513","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":"Novel Application of the Jailed Balloon Anchor Technique to Improve Guiding Catheter Stability During Intravascular Ultrasound Guided Ostial Coronary Stenting","authors":"Yu Saito,&nbsp;Hideto Sangen","doi":"10.1002/ccd.70689","DOIUrl":"10.1002/ccd.70689","url":null,"abstract":"<div>\u0000 \u0000 <p>Precise stent positioning during percutaneous coronary intervention (PCI) for coronary ostial lesions is technically important but often challenging. During ostial stenting, the guiding catheter (GC) frequently requires slight disengagement from the coronary ostium, which may result in catheter instability caused by cardiac motion and respiratory fluctuation. Such instability can interfere with reliable intravascular ultrasound (IVUS)-guided landmark recognition and controlled stent deployment. Although accurate stent placement at the coronary ostium is clinically important, few practical strategies specifically address GC instability during IVUS-guided ostial PCI. We describe a modified jailed balloon anchor technique (JBAT) used to stabilize the GC during IVUS-guided ostial stenting. In this technique, a small balloon positioned in a side branch is gently inflated at low pressure to function as an anchor, thereby mechanically coupling the GC and coronary artery and reducing relative displacement during cardiac motion. This maneuver facilitated stable IVUS landmark recognition and controlled stent positioning in a case with substantial catheter movement.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"776-780"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355502","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":"Prosthesis-Patient Mismatch in All-Comer Patients Undergoing Newer-Generation Self-Expanding Transcatheter Aortic Valve Replacement","authors":"Xander Jacquemyn,&nbsp;Takuya Ogami,&nbsp;Irsa Hasan,&nbsp;Dustin Kliner,&nbsp;Derek Serna-Gallegos,&nbsp;Catalin Toma,&nbsp;Amber Makani,&nbsp;David West,&nbsp;Ibrahim Sultan","doi":"10.1002/ccd.70698","DOIUrl":"10.1002/ccd.70698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) may affect outcomes, but its incidence and impact with contemporary self-expanding valves remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Evaluate the frequency, predictors, and long-term outcomes of PPM in a real-world TAVR population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed patients ≥ 18 years undergoing TAVR with current-generation self-expanding valves (Evolut FX/FX+, PRO/PRO+, Navitor, Navitor Vision) from a prospectively maintained institutional database (2017–2025). Predicted PPM was defined according to VARC-3 criteria, with all-cause mortality and heart failure hospitalization as the primary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2989 patients (median age 80 [75−85], 50.8% female) receiving Evolut (83.3%) or Navitor (16.7%) valves, PPM occurred in 5.0% (moderate 3.7%, severe 1.3%) and declined from 6.5% in 2017 to 2.7% in 2025 (<i>p</i> = 0.002). Independent predictors of PPM included female sex (OR 2.04, 95% CI 1.06−3.99, <i>p</i> = 0.035) and valve-in-valve procedures (OR 9.60, 95% CI 3.82−25.64, <i>p</i> &lt; 0.001), whereas use of the Navitor valve was associated with markedly lower odds (OR 0.07, 95% CI 0.00−0.32, <i>p</i> = 0.009). Patients with PPM demonstrated significantly higher post-procedural transvalvular gradients and reduced aortic valve areas (both <i>p</i> &lt; 0.001). PPM was not associated with adverse long-term clinical outcomes, with no significant differences in 5-year all-cause mortality (HR 0.84, 95% CI 0.45−1.57, <i>p</i> = 0.592) or heart failure hospitalization (HR 1.22, 95% CI 0.84−1.77, <i>p</i> = 0.295).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this contemporary TAVR cohort, PPM was infrequent, and its incidence declined over time. Female sex and valve-in-valve procedures independently predicted PPM. Despite adverse hemodynamic profiles, PPM was not associated with early or long-term adverse clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"721-731"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298748","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":"Case Report: Therapy of an Enormous Extracranial Carotid Artery Aneurysm With a Covered Coronary Stent in an Infant and Review of Literature","authors":"Theresa Baumeister,&nbsp;Anja Tengler,&nbsp;Guido Mandilaras,&nbsp;Nikolaus Alexander Haas","doi":"10.1002/ccd.70695","DOIUrl":"10.1002/ccd.70695","url":null,"abstract":"<div>\u0000 \u0000 <p>Infectious pseudoaneurysms, though rare, pose a serious complication with mortality rates up to 77%. To date, and due to the rare incidence, no evidence-based treatment guidelines for pediatric patients are published. Different approaches have been outlined in the literature including conservative, surgical, or endovascular treatment. We report a case of a 2-year-old boy with chronic cervical lymphadenopathy for about 2 months. In an elective lymphadenectomy, a large aneurysmal bulge was noticed. MR and CT angiography revealed a particularly pronounced pseudoaneurysm of the left internal carotid artery (ICA), causing significant compression of the naso- and oropharynx. After interdisciplinary consultation with vascular surgeons, pediatric surgeons and neurosurgeons, surgical intervention was judged not possible due to its proximity to the skull base; hence, ligation of the ICA was proposed. Based on our interventional experience and to maintain perfusion of the left ICA, we opted for endovascular stenting. Implantation of a covered coronary stent was successfully performed with no perioperative neurologic or cardiopulmonary complications. Follow-up imaging 6 years after stent implantation showed moderate in-stent stenosis that was treated successfully with a percutaneous transluminal angioplasty. As of today, the patient remains well beside the residual mild and incomplete Horner's syndrome, which was pre-existing before intervention. Endovascular treatment of extracranial carotid artery pseudoaneurysms with covered coronary stent systems can be used as a safe and efficacious approach also in pediatric patients with excellent outcome 6 years after the intervention.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"658-661"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267941","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":"Delirium Among Adults Undergoing Transcatheter Structural Heart Intervention: Incidence, Risk, and Clinical Phenotypes","authors":"Yasser Jamil,&nbsp;Nadim Jaafar,&nbsp;Armin Nouri,&nbsp;Francisco B. Alexandrino,&nbsp;Kassem Farhat,&nbsp;Shefa Arya Nezhad,&nbsp;Zafer Akman,&nbsp;Raiza Rossi,&nbsp;Matthew W. Sherwood,&nbsp;Wayne B. Batchelor,&nbsp;Abdulla A. Damluji,&nbsp;Michael G. Nanna","doi":"10.1002/ccd.70709","DOIUrl":"10.1002/ccd.70709","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Delirium is an underrecognized geriatric complication after transcatheter structural heart interventions, with limited descriptive data across procedures and an uncertain association with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To quantify incidence, identify predictors, and evaluate in‑hospital outcomes of delirium after transcatheter aortic valve replacement (TAVR), transcatheter edge-to-edge mitral repair (TEER), transcatheter tricuspid valve replacement/repair (TTVR), and left atrial appendage occlusion (LAAO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the National Inpatient Sample, we performed a retrospective analysis of adults undergoing TAVR, TEER, TTVR, or LAAO identified by ICD‑10 codes. Delirium was captured through validated diagnostic codes. Multivariable logistic and linear regression adjusted for demographic, clinical, and in‑hospital covariates to evaluate predictors of delirium and the independent association of delirium with clinical outcomes of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 151,455 weighted hospitalizations (86,940 TAVR, 15,305 TEER, 1250 TTVR, and 47,960 LAAO), delirium occurred in 2.8%, 4.0%, 4.4%, and 0.6% of cases, respectively. Delirium was independently associated with increased in-hospital mortality across all procedures (TAVR: aOR 4.5, 95% CI 2.9–6.9; TEER: aOR 2.7, 95% CI 1.1–6.6; TTVR: aOR 27.7, 95% CI 5.6–137.3; LAAO: aOR 24.5, 95% CI 5.4–110.8). Patients with delirium also had higher rates of mechanical ventilation and cardiac arrest, longer length of stay, and greater hospitalization costs. Geriatric-specific conditions, including frailty, dementia, malnutrition, and high comorbidity burden, were among the strongest predictors of delirium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Delirium after transcatheter structural heart interventions is strongly associated with adverse clinical outcomes and greater resource utilization. These findings underscore the importance of incorporating delirium risk stratification and targeted prevention strategies into structural heart pathways to preserve the net clinical benefit of these interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"709-717"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280649","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":"Early Outcomes Between the Two Latest Generation Mitral Valve Transcatheter Edge-to-Edge Repair Devices: OCEAN-Mitral Registry","authors":"Yusuke Enta,&nbsp;Masanori Yamamoto,&nbsp;Hirofumi Hioki,&nbsp;Shunsuke Kubo,&nbsp;Mike Saji,&nbsp;Masahiko Asami,&nbsp;Shinichi Shirai,&nbsp;Masaki Izumo,&nbsp;Shingo Mizuno,&nbsp;Yusuke Watanabe,&nbsp;Yuki Izumi,&nbsp;Makoto Amaki,&nbsp;Kazuhisa Kodama,&nbsp;Hisao Otsuki,&nbsp;Daisuke Hachinohe,&nbsp;Toru Naganuma,&nbsp;Hiroki Bota,&nbsp;Yohei Ohno,&nbsp;Shinya Okazaki,&nbsp;Hiroshi Ueno,&nbsp;Gaku Nakazawa,&nbsp;Toshiaki Otsuka,&nbsp;Kentaro Hayashida,&nbsp;OCEAN-Mitral investigators","doi":"10.1002/ccd.70702","DOIUrl":"10.1002/ccd.70702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The PASCAL (PASCAL Precision, Edwards Lifesciences) device for mitral valve transcatheter edge-to-edge repair (M-TEER) was recently introduced in Japan for treating primary mitral regurgitation (PMR). This multicenter study aimed to compare the clinical outcomes of the latest-generation M-TEER systems: PASCAL and MitraClip (Generation 4, Abbott Vascular).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 150 consecutive patients with significant PMR who underwent M-TEER with the PASCAL were extracted from the Japanese OCEAN-Mitral registry. The early procedural safety and clinical outcomes of PASCAL were compared with those of a historical cohort of 679 patients treated with MitraClip for PMR. Propensity score (PS)-matching analysis was performed to minimize differences in baseline characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the PASCAL cohort, one case of 30-day non-cardiac mortality occurred, with no deployment failures or need for additional surgery. A single leaflet device attachment (SLDA) case occurred after releasing one of the two PASCAL lockline sutures; however, successful retrieval of the device resulted in no final SLDA cases. After PS-matching, the rates of MR grade ≤ 2+ were comparable between the groups at 30-day (92.3% vs. 92.1%, <i>p</i> = 0.89). Similarly, rates of MR ≤ 1+ showed no significant differences at 30-day (71.6% vs. 65.8%, <i>p</i> = 0.18). Both the device and clinical success rates were similar between the groups (95.0% vs. 92.1%, <i>p</i> = 0.33; 93.5% vs. 87.8%, <i>p</i> = 0.10, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed no significant differences in the early clinical outcomes after M-TEER between the latest-generation devices. The PASCAL system, with its distinctive structure, may be associated with a low incidence of SLDA and may represent a potential alternative option for the treatment of PMR.</p>\u0000 \u0000 <p><b>Clinical trials:</b> OCEAN-Mitral registry (UMIN-ID: UMIN000023653).</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"696-708"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267981","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":"Novel Application of the Dedicated Radial Ventriculography Pigtail Catheter for Selective Pulmonary Artery Engagement in Percutaneous Thrombectomy for Acute Pulmonary Embolism","authors":"Joshua H. Arnold,&nbsp;Zaid Zayyad,&nbsp;Mladen I. Vidovich","doi":"10.1002/ccd.70701","DOIUrl":"10.1002/ccd.70701","url":null,"abstract":"<div>\u0000 \u0000 <p>The dedicated radial ventriculography pigtail catheter was originally engineered to facilitate left ventriculography through the radial arterial approach by incorporating a multi-angulated design optimized for rapid aortic valve traversal. This report describes a novel, descriptive application of this catheter for selective engagement of the left and right pulmonary arteries during percutaneous thrombectomy in acute pulmonary embolism. The catheter's angulation, shaft support, and torque characteristics enable simplified navigation of the right ventricular outflow tract and pulmonary artery bifurcation. This report outlines the rationale, technical approach, and early procedural observations supporting this technique.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"655-657"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255547","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":"One Anatomy, Multiple Valve Choices: Interobserver Agreement in Selecting Transcatheter Pulmonary Valve","authors":"Camilo E. Pérez-Cualtán,&nbsp;Jaime Cabrales,&nbsp;Francisco Garay,&nbsp;Carlos Eduardo Guerrero-Chalela,&nbsp;Marcelo Rivarola,&nbsp;Juan P. Rozo,&nbsp;Juan Carlos Samayoa,&nbsp;Jenny Zablah,&nbsp;Javier Navarro-Rueda,&nbsp;Juan C. Briceño Triana,&nbsp;Luis Felipe Giraldo","doi":"10.1002/ccd.70708","DOIUrl":"10.1002/ccd.70708","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter pulmonary valve replacement (TPVR) requires selecting the optimal device type, size, and position. Variability in anatomical shape may affect procedural planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate interobserver agreement (IOA) in TPVR device selection using 3D patient-specific anatomies and explore a framework for determining agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six experienced observers from three regions of the Americas independently assessed valve type (self-expanding [S-E], balloon-expandable [B-E], surgical approach [SA]), size, and position for 60 3D reconstructed anatomies (pediatric and adult) derived from cardiac magnetic resonance images. Agreement was quantified using Cohen's and Fleiss' Kappa coefficients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Discussion</h3>\u0000 \u0000 <p>Overall, IOA was fair to moderate in the adult group and slight to fair in the pediatric group. Perfect agreement occurred in only eight cases, seven involving S-E valves and one SA. S-E valves were generally selected for anatomies with regular geometry but variable curvature, while SA valves were mainly chosen for markedly large or small anatomies. B-E selections showed no consistent pattern. One consideration of this study is that not all transcatheter therapies were available across the regions, which may have influenced decision-making. Additionally, interventionists typically rely on 2D imaging for procedural planning, and the use of 3D reconstructions without clinical data may also have influenced the results. Coronary anatomy was not included in the assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Agreement in selecting TPVR devices is limited for the pediatric group but moderate for adults. Variation in preferences among observers highlights the need for equitable access to diverse valve solutions across different RVOT-PA anatomies and demographic contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 3","pages":"781-791"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70708","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Pacemaker Implantation in Transcatheter Aortic Valve Replacement With Self-Expanding Prosthesis","authors":"Francesco De Felice,&nbsp;Luca Paolucci,&nbsp;Marco Stefano Nazzaro,&nbsp;Carmine Musto,&nbsp;Diana Chin,&nbsp;Rocco Stio,&nbsp;Mauro Pennacchi,&nbsp;Domenico Gabrielli,&nbsp;Mauro Massussi,&nbsp;Giuliano Chizzolla,&nbsp;Marianna Adamo,&nbsp;Marco De Carlo,&nbsp;Cristina Giannini,&nbsp;Giulia Costa,&nbsp;Antonio Sisinni,&nbsp;Luca Testa,&nbsp;Barbara Bellini,&nbsp;Matteo Montorfano,&nbsp;Giuseppe Bruschi,&nbsp;Bruno Merlanti,&nbsp;Arnaldo Poli,&nbsp;Erica Ferrara,&nbsp;Tiziana Attisano,&nbsp;Tullio Palmerini,&nbsp;Damiano Regazzoli","doi":"10.1002/ccd.70652","DOIUrl":"10.1002/ccd.70652","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the progressively increasing number of low-risk patients undergoing transcatheter aortic valve replacement (TAVR), the number of those who will be long-time pacemaker (PM) carriers is expected to increase. To date, conflicting data is available regarding the association between PM and mortality following TAVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate the association between PM and mortality in patients undergoing TAVR with self-expandable bio-prosthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients undergoing TAVR between 2007 and 2014 in 10 Italian centers were considered. Two analyses were performed: one comparing patients with and without pre-TAVR PM (primary) and one comparing those with and without post-TAVR PM (secondary). The primary endpoint was all-cause mortality; the secondary endpoint was re-hospitalization to the cardiac ward. Clinical outcomes were assessed at the longest available follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 1779 patients were included in the primary analysis and 1465 in the secondary one. Pre-TAVR PM implantation was not associated with an increased risk of all cause death in both the primary (adj. HR 0.93, 95% CI 0.76−1.13; <i>p</i> = 0.475) and secondary analysis (adj. HR 0.83, 95% CI 0.71−0.98; <i>p</i> = 0.029). Regarding hospitalization to cardiac ward, pre-TAVR PM was not associated with the outcome (adj. HR 1.10, 95% CI 0.85−1.42, <i>p</i> = 0.254), while post-TAVR PM implantation was related with an increased risk (adj. HR 1.94, 95% CI 1.56−2.41; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PM implantation is not associated with an increased risk of mortality in patients undergoing TAVR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"314-322"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877103","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":"Development and Validation of NICVD-NQ Score for Predicting Short-Term Outcomes After Primary PCI","authors":"Rajesh Kumar,&nbsp;Ali Ammar,&nbsp;Maria Noor Siddiqui,&nbsp;Kubra Rahooja,&nbsp;Maryam Samad,&nbsp;Danish Qayum,&nbsp;Romana Awan,&nbsp;Mustajab Mujtaba,&nbsp;Ali Bin Naseer,&nbsp;Muhammad Rasool,&nbsp;Abiha Urooj,&nbsp;Rameez Ahmed,&nbsp;Muhammad Farhan Ali,&nbsp;Abdul Hakeem Shaikh,&nbsp;Ayaz Mir,&nbsp;Nadeem Qamar,&nbsp;Tahir Saghir,&nbsp;Jawaid Akbar Sial,&nbsp;Musa Karim,&nbsp;Abdul Hakeem","doi":"10.1002/ccd.70657","DOIUrl":"10.1002/ccd.70657","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite advances in primary percutaneous coronary intervention (PCI), patients with ST-elevation myocardial infarction (STEMI) continue to experience major adverse cardiovascular events (MACE) in the contemporary era. Existing risk scores (TIMI, GRACE, PAMI, CADILLAC) are outdated, mortality-focused, and largely derived in the fibrinolytic era from high-income settings, limiting their global relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This prospective study aimed to develop a novel model to predict short-term (approximately 8 months) MACE after primary PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>STEMI patients presenting at the largest cardiac care center in Pakistan were prospectively enrolled to develop a model for predicting short-term (approximately 8 months) MACE. The predictive performance of the newly developed model was compared with the existing scores in the 20% testing cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The complete cohort comprised 2839 patients, of whom 2250 (79.3%) were men, with a mean age of 55.6 ± 11.2 years. A total of 580 patients (20.4%) were randomly assigned to the testing cohort. At a median follow-up of 244 [175–393] days, MACE was documented in 521 patients (18.4%), with 97 (16.7%) in the testing cohort and 424 (18.8%) in the training cohort. The new additive model yielded an AUC of 0.772 [95% CI: 0.72–0.83] with the NRI (net reclassification improvement) of 0.239 (<i>p</i> = 0.003), 0.268 (<i>p</i> = 0.001), 0.086 (<i>p</i> = 0.322), and 0.061 (<i>p</i> = 0.445) against TIMI, PAMI, CADILLAC, and GRACE scores, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The NICVD predictive instrument outperformed the existing TIMI and PAMI scores and showed accuracy comparable to that of the GRACE and CADILLAC scores in predicting short-term MACE after primary PCI. And the model's enhanced predictive accuracy makes it a valuable tool for clinicians, enabling more enhanced risk stratification of STEMI patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"343-356"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937107","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}