Catheterization and Cardiovascular Interventions最新文献

{"title":"A Case of Venous Tissue Dissection During Transcatheter MitraClip Surgery","authors":"Shumin Ouyang,&nbsp;Yongqiao Zhou,&nbsp;Yongzhao Yao,&nbsp;Guangzhu Liang,&nbsp;Minqi Liao,&nbsp;Suxia Guo","doi":"10.1002/ccd.70614","DOIUrl":"10.1002/ccd.70614","url":null,"abstract":"<p>The MitraClip system has been widely used to treat mitral regurgitation. The complications associated with MitraClip surgery typically include clip detachment and mitral valve injury. However, cases of venous tissue dissection during surgery are relatively rare. This article reports a case of venous tissue dissection during transcatheter MitraClip surgery, aiming to provide a new direction for diagnosing newly formed abnormal structures in the central atrium during MitraClip surgery.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"42-45"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679953","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":"Influence of the Residual Gensini Score on Prognosis of Patients With ST-Elevation Myocardial Infarction","authors":"Batric Popovic,&nbsp;Nassima Djaballah,&nbsp;Mirela Tomic,&nbsp;Renaud Fay,&nbsp;Victorine Fraichot,&nbsp;Florian Eggenspieler,&nbsp;Pierre Adrien Metzdorf,&nbsp;Jeanne Varlot,&nbsp;Edoardo Camenzind","doi":"10.1002/ccd.70633","DOIUrl":"10.1002/ccd.70633","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The residual Gensini score (rGS) was developed to quantify the severity of coronary atheroma burden after coronary revascularisation. The predictive value of the rGS for clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) remains unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our retrospective study included 1034 consecutive patients who presented with STEMI between 2016 and 2020. Patients were stratified based on the third tertile of rGS values: rGS ≤ 16 (Group 1) and rGS &gt; 16 (Group 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with patients in group 1, epicardial and microvascular perfusion were significantly impaired in group 2 as evidenced by poorer final flow grade TIMI 3 (89% vs. 74%, <i>p</i> &lt; 0.0001) and lower complete ST resolution (STR) rates &gt; 70% (56% vs. 49%, <i>p</i> = 0.007). In the unadjusted analysis, excess mortality in group 2 was observed early (45-day mortality rate: 6% vs. 12%, <i>p</i> = 0.0005) and persisted during the 2-year follow-up (9% vs. 18%, <i>p</i> &lt; 0.0001). After stabilized Inverse Exposure Probability Weighting (sIEPW) adjustment, the early mortality of the patients was similar in both groups: 45-day mortality: 10% vs. 9%, <i>p</i> = 0.45, Harrell's c-index 40%. However, the rGS remained associated with worse prognosis thereafter: 1 year mortality: 11% versuss 21%, Harrell's c-index: 61%, <i>p</i> &lt; 0.0001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a real-world cohort of patients with STEMI, rGS is associated with a worse long-term prognosis as from 1 year follow-up, but without significantly stratifying early follow-up. These findings provide important insight with regard to the optimal use of angiography scoring system as prognostic factor. (ClinicalTrials.gov Identifier: NCT05679843).</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"76-83"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794584","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":"Pre-Existing and New-Onset Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valve Implantation","authors":"Kimberley I. Hemelrijk,&nbsp;Astrid C. van Nieuwkerk,&nbsp;Philomene J. Vojacek,&nbsp;Livia Gheorge,&nbsp;Didier Tchétché,&nbsp;Fabio S. de Brito Jr.,&nbsp;Marco Barbanti,&nbsp;Ran Kornowski,&nbsp;Azeem Latib,&nbsp;Augusto D'Onofrio,&nbsp;Flavio Ribichini,&nbsp;Geoffrey Yanes Bowden,&nbsp;Nicolas Dumonteil,&nbsp;Rogerio Sarmento Leite,&nbsp;Samantha Sartori,&nbsp;Paola D'Errigo,&nbsp;Giuseppe Tarantini,&nbsp;Stefano Andreaggi,&nbsp;Katia Orvin,&nbsp;Matteo Pagnesi,&nbsp;Lluis Asmarats,&nbsp;George Dangas,&nbsp;Roxana Mehran,&nbsp;Ronak Delewi","doi":"10.1002/ccd.70632","DOIUrl":"10.1002/ccd.70632","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is a frequent comorbidity in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). In addition, new-onset AF can occur after TAVI. However, data on how AF affects outcomes in patients undergoing TAVI remain conflicting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess clinical outcomes in patients with severe aortic valve stenosis with AF who undergo TAVI in a large real-world global cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The CENTER2-study includes 25,771 patients that underwent TAVI between 2007 and 2022. The database consists of patient-level pooled data from 10 clinical studies. Objectives were rates of new-onset AF ≤ 30 days, and differences in mortality and stroke according to AF status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 23,320 patients were included in the current analysis (56.1% female; mean age 81.5 ± 6.7 years). Pre-existing AF was present in 28.2% (<i>n</i> = 6579) of patients. Mortality rates after TAVI were higher in patients with pre-existing AF (19.0% vs. 14.2%, adjusted HR: 1.39, 95% CI: 1.26–1.53, <i>p</i> &lt; 0.001). Strokes at Day 3–30 after TAVI were more frequent in patients with pre-existing AF (1.6% vs. 1.1%, <i>p</i> = 0.004). New-onset AF occurred in 6.2% (<i>n</i> = 681) of patients without pre-existing AF. Mortality rates after TAVI were higher in patients with new-onset AF (adjusted HR 1.75, 95% CI 1.24–2.49, <i>p</i> = 0.002). One-year stroke was more frequently observed in patients with new-onset AF after exclusion of acute periprocedural stroke (6.1% vs. 3.4%, <i>p</i> = 0.04). Major bleeding was also more frequent in patients with new-onset AF (12.0% vs. 6.7%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with pre-existing or new-onset AF had higher mortality compared with patients without AF undergoing transfemoral TAVI. After the acute postprocedural period, 1-year stroke rates were higher in patients with new-onset AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov. Unique identifier NCT03588247.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"114-123"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794643","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":"Comparative Outcomes of Transcatheter Edge-to-Edge Repair and Surgical Mitral Valve Repair or Replacement for Degenerative Mitral Regurgitation: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis","authors":"Yousif Hameed Kurmasha,&nbsp;Khadeeja Ali Hamzah,&nbsp;Eathar Aljubori,&nbsp;Ghadeer Mohammed,&nbsp;Misha Khan,&nbsp;Mohammedsadeq A. Shweliya,&nbsp;Hassan H. Eladl,&nbsp;Khalid M. Al-Dhayani,&nbsp;Abdulrahman Raad AbdulKareem Al-Waeli,&nbsp;Hadi J. Zainy,&nbsp;Ali Saad Al-Shammari,&nbsp;Yasar Sattar","doi":"10.1002/ccd.70592","DOIUrl":"10.1002/ccd.70592","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Traditionally, surgical mitral valve repair or replacement (SMVR) has been the mainstay of treatment for mitral regurgitation (MR), providing a long-lasting way to restore valve competence. On the other hand, transcatheter edge-to-edge repair (TEER) has emerged as an option, especially for high surgical risk patients, demonstrating favorable results from short-term to intermediate-term follow-up. This study aims to evaluate and compare the clinical outcomes of TEER versus SMVR in patients with degenerative mitral regurgitation (DMR). This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was conducted until February 2, 2025. Relevant randomized controlled trials (RCTs) and cohort studies were included in the analysis. The data were extracted, and analysis was conducted using Review Manager (RevMan) version 5.3. Eight studies involving a total of 13,308 patients were included in the analysis. TEER showed a statistically significantly higher risk of 1-year mortality (RR 1.82, 95% CI: 1.04–3.19) and mitral reintervention at ≥ 1-year follow-up (RR 4.52, 95% CI: 3.46–5.91). However showing lower risk of new-onset AF (0.21, 95% CI: 0.07–0.67), blood transfusion (RR 0.21, 95% CI, 0.13–0.34), septicemia (RR 0.13, 95% CI: 0.02–0.70), AKI (RR 0.45, 95% CI: 0.24–0.86), shorter hospital stay (MD −4.44 days, 95% CI: −6.60 to −2.27), and ICU stay (MD −1.00 days, 95% CI: −1.13 to −0.88), when compared to the SMVR group. Survival at ≥ 2-year follow-up was significantly favored in the surgery group (RR 0.72, 95% CI: 0.56–0.93). No significant differences were observed regarding 30-day mortality (RR 0.99, 95% CI: 0.77–1.27), MR grade 1 (RR 1.16, 95% CI: 0.60–2.21), stroke (RR 1.06, 95% CI: 0.37–3.03), HF rehospitalization (RR 2.36, 95% CI: 0.82–6.81), and wound infection (RR, 0.45, 95% CI: 0.05–4.27). TEER was associated with a significantly lower rate of postoperative MR grade 0 (RR 0.20, 95% CI: 0.08–0.49), and significantly higher rates of MR grades 2 (RR 4.82, 95% CI: 1.87–12.40), 3 (RR 8.39, 95% CI: 3.69–19.09), and 4 (RR 4.20, 95% CI: 1.45–12.18), indicating inferior MR resolution. Although TEER is associated with a lower risk of septicemia and may reduce the risk of new-onset AF, hospital stay, and ICU stay, current evidence doesn't support the use of TEER as a substitute for surgery in patients with SMVR, as TEER may be associated with higher 1-year mortality and reduced long-term survival. Further controlled trials are needed to validate these findings and identify patient subgroups that may derive the greatest benefit from TEER.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"52-66"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731231","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":"Conservative Management of Iatrogenic Type a Aortic Dissection Occurring During Percutaneous Coronary Intervention","authors":"Mohamed El Mallouli,&nbsp;Chirine Liu,&nbsp;Romain Van Der Linden,&nbsp;Brahim Berdaoui,&nbsp;Georgiana Pintea Bentea","doi":"10.1002/ccd.70622","DOIUrl":"10.1002/ccd.70622","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Iatrogenic type A aortic dissection (TAAD) during percutaneous coronary intervention (PCI) is a rare but life-threatening complication, usually managed surgically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>We report the case of a 59-year-old patient who developed an ascending aortic dissection extending to the proximal arch during left circumflex (LCX) chronic total occlusion (CTO) recanalization. Stenting of the LCX and left main coronary artery successfully sealed the entry site and stabilized the patient. Computed tomography revealed a false lumen occupying 51% of the aortic diameter, without involvement of supra-aortic branches. Conservative management was initiated with strict anti-impulse therapy and staged dual antiplatelet therapy. At 24 h, the false lumen regressed to 37%, with complete resolution by Day 7.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In selected cases of iatrogenic TAAD during PCI, conservative management following successful sealing of the entry tear may represent a safe alternative to sugery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"12-13"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679921","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":"Unsupervised Agglomerative Cluster Phenotyping of Young Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention","authors":"M. Haisum Maqsood,&nbsp;Rody G Bou Chaaya,&nbsp;Sahar Samimi,&nbsp;Taha Hatab,&nbsp;Fatima Qamar,&nbsp;Chloe Kharsa,&nbsp;Sachin Goel,&nbsp;Alpesh R. Shah,&nbsp;Neal S. Kleiman,&nbsp;Safi U. Khan","doi":"10.1002/ccd.70643","DOIUrl":"10.1002/ccd.70643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Young patients with acute coronary syndrome (ACS) exhibit diverse demographic, clinical and angiographic characteristics. We hypothesized that unsupervised machine learning (ML) can identify phenotypic clusters and predict the prognosis among young patients with ACS who undergo percutaneous coronary intervention (PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the Houston Methodist Young-ACS PCI registry (2010−2022) and performed agglomerative clustering to analyze demographic, clinical, and angiographic variables among young patients (≤ 50 years) treated with PCI for ACS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 452 patients, cluster analysis identified three distinct phenotypes. <i>Low risk</i> (<i>n</i> = 273) exhibited the lowest proportions of heart failure (HF: 10.3%) and peripheral arterial disease (PAD): 5.9%), normal left ventricular ejection fraction (LVEF) (median = 0.60) and shorter median culprit vessel stent length (16 mm). <i>Moderate risk</i> (<i>n</i> = 101) was characterized by moderate rates of diabetes (36.6%), hypertension (77.2%), prior myocardial infarction (16.8%), and prior PCI (18.8%). <i>High risk</i> (<i>n</i> = 78) had the highest proportion of diabetes (67.9%), hypertension (93.6%), HF (65.4%), PAD (17.9%), prior MI (41.0%), prior PCI (46.2%), the lowest median LVEF (0.3) and the most frequent use of mechanical circulatory device (5.1%). All-cause mortality differed significantly, with <i>high-risk</i> cluster showing a fourfold increase in all-cause mortality (HR: 4.50 [1.68−12.1]) compared to <i>low-risk</i> cluster; however <i>moderate</i> and <i>low-risk</i> clusters did not differ significantly (HR: 1.52 [0.44−5.19]). Sensitivity analysis based on two-clusters showed similar outcomes, indicating the robustness of the analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Three distinct phenotypic clusters among young patients with ACS treated with PCI exhibited varying degrees of comorbidity burden and mortality risk, underscoring the potential for phenotype-guided therapeutic approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"206-213"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794788","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":"Clinical and Physiological Predictors of Acetylcholine-Induced Coronary Spasm in ANOCA/INOCA Patients: A Retrospective Cohort Study","authors":"Jeremie Buri,&nbsp;Aurelia Zimmerli,&nbsp;Thabo Mahendiran,&nbsp;Adil Salihu,&nbsp;Victor Weerts,&nbsp;Olivier Muller,&nbsp;David Meier,&nbsp;Stephane Fournier","doi":"10.1002/ccd.70628","DOIUrl":"10.1002/ccd.70628","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A substantial proportion of patients with angina and/or ischemia are found to have non-obstructive coronary arteries (ANOCA/INOCA). Their symptoms can sometimes be explained by coronary microvascular dysfunction and/or vasospasm. Selecting patients for acetylcholine testing remains challenging, and the procedure is not trivial in terms of logistics, cost, and risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this single-center retrospective study was to identify predictors of coronary spasm and define features that may help avoid unnecessary testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All consecutive ANOCA/INOCA patients who underwent intracoronary acetylcholine testing between February 2022 and June 2025 at a tertiary university hospital were included. Baseline clinical variables were analyzed using multivariable logistic regression. A 3-variable exploratory model was then constructed to identify independent predictors of unnecessary acetylcholine testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the study population (<i>n</i> = 47), 46.8% demonstrated a positive spasm response. In the multivariable model, age ≥ 60 years (OR = 0.11, 95% CI [0.02–0.80]; <i>p</i> = 0.029) and dyslipidaemia (OR = 0.12, 95% CI [0.01–0.99]; <i>p</i> = 0.049) were independently associated with lower odds of spasm, whereas IMR ≥ 25 showed a non-significant association with lower odds of spasm (OR = 0.10, 95% CI [0.005–1.9]; <i>p</i> = 0.128). The 3-variable exploratory model showed good discrimination (AUC 0.83, 95% CI 0.68–0.97) and was associated with a reduction in overall ACh testing by 45.2% in complete-case analysis, with a sensitivity of 85.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dyslipidaemia and age ≥ 60 years are independently associated with lower odds of acetylcholine-induced spasm. This model showed good discrimination and may help inform strategies to reduce unnecessary acetylcholine testing, although these findings require external validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 1","pages":"14-20"},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70628","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679894","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":"Around and Through: Successful Mitral Paravalvular Leakage Closure Using Both Anterograde and Retrograde Approaches","authors":"Marco Garaventa,&nbsp;Luca Nai Fovino,&nbsp;Tommaso Fabris,&nbsp;Giuseppe Tarantini","doi":"10.1002/ccd.70604","DOIUrl":"10.1002/ccd.70604","url":null,"abstract":"<p>Paravalvular leak (PVL) is a recognized complication after surgical mitral valve replacement and may cause heart failure, pulmonary hypertension, or hemolysis when moderate or severe. Although redo surgery is the definitive treatment, it carries substantial risk in elderly patients or those with multiple prior cardiac surgeries. Transcatheter PVL closure has therefore emerged as a valuable alternative, albeit with significant technical challenges in the mitral position. We describe the case of a 78-year-old woman with a history of two prior mitral valve replacements using bioprosthetic valves, who presented with progressive dyspnea. Echocardiography demonstrated structural valve degeneration of the mitral bioprosthesis with a large postero-medial mitral PVL causing severe regurgitation. Given the prohibitive surgical risk, percutaneous PVL closure was selected following Heart Team discussion. The procedure was performed under general anesthesia with transesophageal echocardiography and fluoroscopic guidance. An initial antegrade transseptal approach enabled deployment of the first occluder device, but significant residual regurgitation persisted. A second device could not be adequately positioned antegrade and was therefore deployed using a retrograde transaortic approach, which provided improved coaxial alignment. Final imaging showed mild residual regurgitation and a significant reduction in transmitral gradient. The patient had an uneventful recovery with rapid symptomatic improvement and remained clinically stable at 1-month follow-up. This case highlights the feasibility and effectiveness of a hybrid antegrade–retrograde strategy for complex mitral PVL closure and underscores the importance of procedural flexibility and multimodality imaging in achieving optimal outcomes in high-risk patients.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2179-2182"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597408","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":"A Novel 3D Wiring Technique—ZOLUTION Zero Degree OverLap View Universal Three DimensIONal CTO Wiring","authors":"Eugene B. Wu,&nbsp;Calvin Leung,&nbsp;Wataru Nagamatsu,&nbsp;Kambis Mashayekhi,&nbsp;Shunsuke Matsuno,&nbsp;Scott A. Harding,&nbsp;Sidney Lo,&nbsp;Soo Teik Lim,&nbsp;Lei Ge,&nbsp;Ji-Yan Chen,&nbsp;Jie Qian,&nbsp;Seung-Whan Lee,&nbsp;Hsien-Li Kao,&nbsp;Arun Kalyanasundaram,&nbsp;Muenpetch Muenkaew,&nbsp;Henry Jian-Fang Luo,&nbsp;Emmanouil S. Brilakis","doi":"10.1002/ccd.70575","DOIUrl":"10.1002/ccd.70575","url":null,"abstract":"<p>We present a novel simple and easy-to-use 3D wiring technique for coronary chronic total occlusions (CTOs) named ZOLUTION—Zero OverLap View Universal Three dimensIONal wiring. ZOLUTION can be used for: (1) Distal cap puncture, (2) CTO body wiring, (3) Retrograde wiring, and (4) Reverse controlled antegrade and retrograde tracking (reverse CART). The four steps of ZOLUTION are: (1) Find the zero-degree overlap fluoroscopic view where the wire shaft and the vessel target are overlapping. (2) Straighten the wire tip by minuscule rotation. (3) Move to a coaxial view 35–70 degrees away (Secondary view) to check that the wire is pointing toward the target (if not, rotate the wire 180 degrees and re-straighten the wire tip in ZOV). (4) In the secondary view puncture forward with the wire toward the target. ZOLUTION does not require formation of a mental map, specific angiographic views of that coronary segment, or fluoroscopic views to be 90-degree apart. It is superior to traditional 3D wiring as it provides a precise angle that is aimed at the target increasing its success rate. We believe ZOLUTION can be universally adopted due to its simplicity and could greatly improve CTO PCI efficiency and safety.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2168-2178"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597469","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":"Implementing Intravascular Imaging–Guided Percutaneous Coronary Intervention: A Scoping Review Using the Consolidated Framework for Implementation Research","authors":"Fahad Raja Khan,&nbsp;Abid Ullah,&nbsp;Syed Alishan,&nbsp;Fazal Akbar,&nbsp;Kamran Aslam","doi":"10.1002/ccd.70595","DOIUrl":"10.1002/ccd.70595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can improve percutaneous coronary intervention (PCI) by refining the sizing, lesion preparation, and stent optimization; however, their adoption varies widely across health systems. Map determinants, strategies, and implementation outcomes for IVUS/OCT-guided PCI using the Consolidated Framework for Implementation Research (CFIR) and Proctor's taxonomy. Map determinants, strategies, and implementation outcomes for IVUS/OCT-guided PCI using the Consolidated Framework for Implementation Research (CFIR) and Proctor's taxonomy. We conducted a PRISMA-ScR-aligned scoping review through March 15, 2025. Eligible primary studies (randomized trials, pre-specified substudies, registries, and prospective cohorts) evaluated IVUS and/or OCT during PCI and reported at least one CFIR determinant or one Proctor outcome (adoption/penetration, feasibility, fidelity, sustainability, and cost). Two reviewers screened and charted the data in duplicate, and the clinical outcomes were treated as contextual. We narratively synthesized the findings and organized them by era, modality, and policy setting. From 1218 records, 17 studies were included (14 primary and 3 contextual/workflow sources). The recurrent facilitators were explicit quantitative optimization thresholds, protocolized use, operator training/mentorship, and audit/feedback. Policy/reimbursement consistently enabled higher penetration and sustained usage. Minimal-contrast IVUS protocols are feasible in high-risk cohorts, achieving large reductions in contrast without compromising the procedural success. Quantitative expansion indices (e.g., minimal stent area or area-based expansion) functioned as fidelity targets and were associated with clinical events across data sets. Cost signals were nuanced; early randomized economics favored IVUS-guided strategies via fewer reinterventions and lower cumulative costs, whereas physiology-first strategies were more efficient than OCT-first strategies for intermediate lesions. Successful imaging programs appear bundle-dependent: pairing access to IVUS/OCT with explicit thresholds, standardized pre-/post-deployment runs, team training, and feedback within supportive policies yields more reliable performance and scalable value. Priorities include hybrid effectiveness–implementation studies, standardized fidelity dashboards, cross-vendor validation of thresholds, equity-minded rollout pathways, and prospective evaluation of AI-enabled OCT to test whether workflow gains translate into patient benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2240-2251"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625251","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}