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Zhang L, Xie Y, Ren Z, Xie M. Transesophageal echocardiography related complications. Front Cardiovasc Med 2024; 11:1410594. [PMID: 39006165 PMCID: PMC11239508 DOI: 10.3389/fcvm.2024.1410594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/14/2024] [Indexed: 07/16/2024] Open
Abstract
Transesophageal Echocardiography (TEE) is an important imaging method for the evaluation of cardiac structure and function, and it holds significant value in the clinical management of cardiovascular diseases. Unlike transthoracic echocardiography (TTE), which is non-invasive, TEE involves semi-invasive intracavity operations, leading to increasing attention to its safety and potential complications. Especially with the increasing demand for TEE applications in clinical practice and the rapid growth in the number of facilities utilizing it, the standardized application and safe operation of TEE technology have become particularly crucial. This article will review the literature and draw upon personal experience to analyze the complications and safety of TEE examinations from a technical perspective.
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Affiliation(s)
- Linyue Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuji Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Zhaoli Ren
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Kilic T, Ielasi A, Ninios V, Korkmaz L, Panagiotakos D, Yerlikaya G, Ozderya A, Montonati C, Tespili M, Coskun S, Sahin T, Ninios I, Vlasopoulou K, Konus AH, Kul S, Akyuz AR. Clinical outcomes of the Myval transcatheter heart valve system in patients with severe aortic valve stenosis: a two-year follow-up observational study. Arch Med Sci 2024; 20:410-419. [PMID: 38757027 PMCID: PMC11094825 DOI: 10.5114/aoms/176937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/13/2023] [Indexed: 05/18/2024] Open
Abstract
Introduction Limited data exist on long-term follow-up of severe aortic stenosis (SAS) patients who have undergone transcatheter aortic valve implantation (TAVI) with a new generation, balloon expandable Myval transcatheter heart valve (THV). Thus, we sought to investigate the performance and 2-year clinical outcome of the Myval THV system based on Valve Academic Research Consortium-3 (VARC-3) criteria. Material and methods A multi-centre, registry-based, observational study was conducted, which included 207 consecutive degenerative SAS patients, from Turkey (n = 128), Italy (n = 58), and Greece (n = 21) (mean [standard deviation] 81 (7) years, 94 [45%] men; 73% NYHA III or IV; EuroSCORE II 5.2% [2.4%]); all patients underwent TAVI with Myval. Patients were followed up at 1 year and 2 years after implantation. Clinical and procedural outcomes were defined according to VARC-3 criteria. Results Technical success was observed in 204 (99%), device success was observed in 189 (91%), early safety was observed in 161 (78%), and clinical efficacy was observed in 163 (79%) patients. The 30-day death rate was 7.7%; of these, 3.4% were due to cardiovascular reasons. All-cause and cardiovascular mortality rates were 9.7% and 4.3% at 1-year follow-up, and 17.4% and 9.7% at 2-year follow-up, respectively. Incidence of ≥ moderate paravalvular leak (PVL) at 30 days, 1 year and 2 years of follow-up were 3.4%, 4.3% and 4.8%. A total of 11.1% of patients required a permanent pacemaker implantation (PPI) at 30 days after implantation, while the cumulative rate of PPI at 2 years was 12.1%. Conclusions In this cohort of patients with SAS, the Myval was found to be safe and effective in up to 2 years of follow-up.
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Affiliation(s)
- Teoman Kilic
- Department of Cardiology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Alfonso Ielasi
- U.O. Cardiologia Ospedalirea, IRCCSOspedale Galeazzi Sant’Ambrogio, Italy
| | - Vlasis Ninios
- Department of Cardiology, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Levent Korkmaz
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
| | | | - Gokhan Yerlikaya
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
| | - Ahmet Ozderya
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
| | - Carolina Montonati
- U.O. Cardiologia Ospedalirea, IRCCSOspedale Galeazzi Sant’Ambrogio, Italy
| | - Maurizio Tespili
- U.O. Cardiologia Ospedalirea, IRCCSOspedale Galeazzi Sant’Ambrogio, Italy
| | - Senol Coskun
- Department of Cardiology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Tayfun Sahin
- Department of Cardiology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Ilias Ninios
- Department of Cardiology, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Konstantina Vlasopoulou
- Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Ali Hakan Konus
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
| | - Selim Kul
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
| | - Ali Riza Akyuz
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Turkey
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Wang Y, Cao T, Shi J, Liu L, Guo Y. Design and Application of Comprehensive Management System For Patients with Chronic Aortic Valve Disease-A Perspective From West China Hospital. Curr Probl Cardiol 2024; 49:102169. [PMID: 37871710 DOI: 10.1016/j.cpcardiol.2023.102169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Chronic aortic valve disease (AVD) is a prevalent age-related health issue. Current guidelines recommend transthoracic echocardiography as the method of detection. Early screening is crucial to decrease mortality caused by aortic valve disease. However, a lack of consistent and effective guidelines for screening populations with asymptomatic AVD persists. Based on the comprehensive management system (CMS) for AVD developed by West China Hospital of Sichuan University, the objective of this study is to enhance the survival rate and overall quality of life for patients suffering from AVD by integrating early screening into the standardised diagnosis and treatment process. METHODS Three primary study cohorts were established: a community-based population screening cohort, an outpatient and medical examination population cohorts and an AVD inpatient cohorts. For each cohort, important data on clinical diagnosis and treatment were systematically collected and analyzed, evaluating the effectiveness of early screening for AVD. RESULTS The transthoracic echocardiography (TTE) findings of outpatients and medical examination population at West China Hospital of Sichuan University between 1st January 2020 and 31st December 2022 have been examined utilizing CVS. In total, 327,822 outpatients were investigated, identifying 986 patients with aortic stenosis (AS), 2,961 patients with aortic regurgitation (AR), and 549 patients with mixed AS and AR. CONCLUSION The AVD system for comprehensive management facilitates efficient screening, diagnosis and follow-up. In the future, the CVS will fully cover the West China hospital healthcare system and extend to the south-western region of China by leveraging a medical-driven role.
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Affiliation(s)
- Yuqiang Wang
- Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu SC 610041, China
| | - Tingqian Cao
- Department of Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Shi
- Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu SC 610041, China
| | - Lulu Liu
- Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu SC 610041, China
| | - Yingqiang Guo
- Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu SC 610041, China.
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Rogatinsky J, Recco D, Feichtmeier J, Kang Y, Kneier N, Hammer P, O’Leary E, Mah D, Hoganson D, Vasilyev NV, Ranzani T. A multifunctional soft robot for cardiac interventions. SCIENCE ADVANCES 2023; 9:eadi5559. [PMID: 37878705 PMCID: PMC10599628 DOI: 10.1126/sciadv.adi5559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023]
Abstract
In minimally invasive endovascular procedures, surgeons rely on catheters with low dexterity and high aspect ratios to reach an anatomical target. However, the environment inside the beating heart presents a combination of challenges unique to few anatomic locations, making it difficult for interventional tools to maneuver dexterously and apply substantial forces on an intracardiac target. We demonstrate a millimeter-scale soft robotic platform that can deploy and self-stabilize at the entrance to the heart, and guide existing interventional tools toward a target site. In two exemplar intracardiac procedures within the right atrium, the robotic platform provides enough dexterity to reach multiple anatomical targets, enough stability to maintain constant contact on motile targets, and enough mechanical leverage to generate newton-level forces. Because the device addresses ongoing challenges in minimally invasive intracardiac intervention, it may enable the further development of catheter-based interventions.
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Affiliation(s)
- Jacob Rogatinsky
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
| | - Dominic Recco
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USA
| | | | - Yuchen Kang
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
| | - Nicholas Kneier
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Peter Hammer
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Edward O’Leary
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Douglas Mah
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - David Hoganson
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Nikolay V. Vasilyev
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Tommaso Ranzani
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
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Fraccaro C, Karam N, Möllmann H, Bleiziffer S, Bonaros N, Teles RC, Carrilho Ferreira P, Chieffo A, Czerny M, Donal E, Dudek D, Dumonteil N, Esposito G, Fournier S, Hassager C, Kim WK, Krychtiuk KA, Mehilli J, Pręgowski J, Stefanini GG, Ternacle J, Thiele H, Thielmann M, Vincent F, von Bardeleben RS, Tarantini G. Transcatheter interventions for left-sided valvular heart disease complicated by cardiogenic shock: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the Association for Acute Cardiovascular Care (ACVC) and the ESC Working Group on Cardiovascular Surgery. EUROINTERVENTION 2023; 19:634-651. [PMID: 37624587 PMCID: PMC10587846 DOI: 10.4244/eij-d-23-00473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Valvular heart disease (VHD) is one of the most frequent causes of heart failure (HF) and is associated with poor prognosis, particularly among patients with conservative management. The development and improvement of catheter-based VHD interventions have broadened the indications for transcatheter valve interventions from inoperable/high-risk patients to younger/lower-risk patients. Cardiogenic shock (CS) associated with severe VHD is a clinical condition with a very high risk of mortality for which surgical treatment is often deemed a prohibitive risk. Transcatheter valve interventions might be a promising alternative in this setting given that they are less invasive. However, supportive scientific evidence is scarce and often limited to small case series. Current guidelines on VHD do not contain specific recommendations on how to manage patients with both VHD and CS. The purpose of this clinical consensus statement, developed by a group of international experts invited by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) Scientific Documents and Initiatives Committee, is to perform a review of the available scientific evidence on the management of CS associated with left-sided VHD and to provide a rationale and practical approach for the application of transcatheter valve interventions in this specific clinical setting.
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Affiliation(s)
- Chiara Fraccaro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Nicole Karam
- Heart Valves Unit, Georges Pompidou European Hospital, Université Paris Cité, INSERM, Paris, France
| | - Helge Möllmann
- Department of Cardiology, St. Johannes Hospital, Dortmund, Germany
| | | | - Nikolaos Bonaros
- Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Rui Campante Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental (HSC), Carnaxide, Portugal and Comprehensive Health Research Center (CHRC), Nova Medical School, Lisbon, Portugal
| | - Pedro Carrilho Ferreira
- Cardiology Department, Santa Maria University Hospital, CHULN, CAML, CCUL, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Centre, Freiburg University, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Erwan Donal
- Service de Cardiologie, CCP CHU de Rennes, University of Rennes, INSERM, LTSI-UMR 1099, Rennes, France
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Giovanni Esposito
- Divisions of Cardiology and Cardiothoracic Surgery, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Stephane Fournier
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland and University of Lausanne, Lausanne, Switzerland
| | - Christian Hassager
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Won-Keun Kim
- Department of Cardiology, St. Johannes Hospital, Dortmund, Germany
| | - Konstantin A Krychtiuk
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Julinda Mehilli
- Department of Cardiology, German Centre for Cardiovascular Research (DZHK), Ludwig Maximilian University of Munich, Partner Site Munich Heart Alliance, Munich, Germany
- Medizinische Klinik I, Landshut-Achdorf Hospital, Landshut, Germany
| | - Jerzy Pręgowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Giulio G Stefanini
- Department of Biomedical Sciences Humanitas University, Pieve Emanuele, Italy
- Humanitas Research Hospital IRCCS Rozzano, Milan, Italy
| | - Julien Ternacle
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada and Université Laval, Quebec, QC, Canada
- Haut-Leveque Cardiology Hospital, Bordeaux University, Pessac, France
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, Leipzig, Germany and University of Leipzig, Leipzig, Germany
| | - Matthias Thielmann
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Flavien Vincent
- Service de Cardiologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Sanchez-Luna JP, Martín P, Dager AE, Charry PD, Beltrán JR, Sánchez-Recalde Á, Giannini F, Gómez-Menchero A, Pan M, Ielasi A, Monastyrski A, Barbanti M, Fernandez-Avilés F, Ancona MB, Mussayev A, De Brahi JP, Lamelas P, Sánchez-Pérez A, García Puerta M, Ortiz M, Gonzalez-Gutiérrez JC, Marengo G, Gómez J, Gonzalez-Bartol E, Stepanenko A, Gomez-Salvador I, San Román JA, Amat-Santos IJ. Clinical outcomes of TAVI with the Myval balloon-expandable valve for non-calcified aortic regurgitation. EUROINTERVENTION 2023; 19:580-588. [PMID: 37565470 PMCID: PMC10500190 DOI: 10.4244/eij-d-23-00344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/20/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) in non-calcified aortic regurgitation (NCAR) is an off-label procedure. The balloon-expandable Myval includes extra-large sizes (30.5 mm and 32 mm) of interest in this setting. AIMS We aimed to evaluate the safety and feasibility of Myval in NCAR. METHODS This was an international, multicentre, observational study that enrolled all consecutive patients with symptomatic severe NCAR undergoing TAVR with the Myval device. The images were centrally analysed. RESULTS A total of 113 patients were recruited, 64.6% were men, the mean age was 78.4±7.5 years, and the Society of Thoracic Surgeons score was 2.7±1.7%. Aortic root dilatation was present in 59.3% of patients, 7.1% were bicuspid, and the mean annular area was 638.6±106.0 mm2. The annular area was beyond the recommended range for extra-large sizes in 2.6% of cases, and additional volume was added in 92% (median 4 cc, up to 9 cc). The extra-large sizes were used in 95 patients (84.1%), and the mean oversizing was 17.9±11.0%. The technical success rate was 94.7%; the rate of residual ≥moderate aortic regurgitation was 8.9%, and the pacemaker rate was 22.2%. There were no cases of annular rupture, cardiac tamponade, or aortic dissection, but in 4 patients (3.5%) valve embolisation occurred (1 antegrade and 3 ventricular), all in cases with a tapered left ventricle outflow tract (p=0.007). Thirty-day and 1-year mortality were 5.3% and 9.7%, respectively. Technical success was associated with better survival (97.1% vs 72.7%; p=0.012), and valve embolisation was the main determinant of mortality (p=0.047). CONCLUSIONS Myval is a feasible and safe option for selected non-operable patients with NCAR and demonstrated good midterm outcomes and lack of impact of oversizing on device durability.
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Affiliation(s)
| | - Pedro Martín
- Cardiology Department, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Gran Canaria, Spain
| | - Antonio E Dager
- Cardiology Department, Angiografía de Occidente Hospital, Cali, Colombia
| | - Pablo D Charry
- Cardiology Department, Clínica Medilaser, Neiva, Colombia
| | - Javier R Beltrán
- Cardiology Department, Los Comuneros Hospital Universitario de Bucaramanga, Bucaramanga, Colombia
| | | | | | | | - Manuel Pan
- Cardiology Department, Hospital Reina Sofía, Cordoba, Spain and University of Cordoba (IMIBIC), Cordoba, Spain
| | - Alfonso Ielasi
- Cardiology Department, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Andrea Monastyrski
- Cardiology Department, Hospital Universitario Val d'Hebron, Barcelona, Spain
| | - Marco Barbanti
- Cardiology Department, Policlinico-Vittorio Emanuele Hospital, Catania, Italy
| | | | | | - Abdurashid Mussayev
- Cardiology Department, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Juan Pablo De Brahi
- Cardiology Department, Sanatorio de La Trinidad Mitre, Buenos Aires, Argentina
| | - Pablo Lamelas
- Cardiology Department, Instituto Cardiovascular, Buenos Aires, Argentina
| | - Andrés Sánchez-Pérez
- Cardiology Department, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Gran Canaria, Spain
| | | | - Miguel Ortiz
- Cardiology Department, Angiografía de Occidente Hospital, Cali, Colombia
| | | | - Giorgio Marengo
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Javier Gómez
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - Alexander Stepanenko
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Itziar Gomez-Salvador
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, Madrid, Spain
| | - J Alberto San Román
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, Madrid, Spain
| | - Ignacio J Amat-Santos
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, Madrid, Spain
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Ibrahim H, Lowenstern A, Goldsweig AM, Rao SV. Integrating Structural Heart Disease Trainees within the Dynamics of the Heart Team: The Case for Multimodality Training. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100167. [PMID: 37273858 PMCID: PMC10236781 DOI: 10.1016/j.shj.2023.100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/02/2023] [Indexed: 06/06/2023]
Abstract
Structural heart disease is a rapidly evolving field. However, training in structural heart disease is still widely variable and has not been standardized. Furthermore, integration of trainees within the heart team has not been fully defined. In this review, we discuss the components and function of the heart team, the challenges of current structural heart disease models, and possible solutions and suggestions for integrating trainees within the heart team.
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Affiliation(s)
- Homam Ibrahim
- NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA
| | - Angela Lowenstern
- Division of Cardiology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew M. Goldsweig
- Baystate Medical Center and University of Massachusetts-Baystate, Springfield, Massachusetts, USA
| | - Sunil V. Rao
- NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA
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8
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Seth A, Kumar V, Singh VP, Kumar D, Varma P, Rastogi V. Myval: A Novel Transcatheter Heart Valve for the Treatment of Severe Aortic Stenosis. Interv Cardiol 2023; 18:e12. [PMID: 37398875 PMCID: PMC10311401 DOI: 10.15420/icr.2020.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 05/04/2022] [Indexed: 07/04/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) performed using femoral arterial access is now a guideline recommended treatment for severe calcific aortic stenosis (AS) in elderly patients. Technological advancements and procedural refinements have focused on making TAVI simpler, safer, more effective and durable. Myval (Meril Lifesciences) is a new generation balloon-expandable transcatheter heart valve (THV) developed in India that possesses novel features to improve deliverability and aid precise deployment. Following the first-in-human study, Myval was approved in India for commercial implantation in October 2018 and was subsequently given a CE mark in April 2019. This article reviews the science, technology and up-to-date clinical evidence for the Myval THV.
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Affiliation(s)
- Ashok Seth
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
| | - Vijay Kumar
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
| | - Vivudh Pratap Singh
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
| | - Dhananjay Kumar
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
| | - Puneet Varma
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
| | - Vishal Rastogi
- Interventional Cardiology and Structural Therapies, Fortis Escorts Heart Institute New Delhi, India
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Santangelo G, Bursi F, Faggiano A, Moscardelli S, Simeoli PS, Guazzi M, Lorusso R, Carugo S, Faggiano P. The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management. J Clin Med 2023; 12:2178. [PMID: 36983180 PMCID: PMC10054046 DOI: 10.3390/jcm12062178] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Valvular heart disease is a leading cause of cardiovascular morbidity and mortality and a major contributor of symptoms and functional disability. Knowledge of valvular heart disease epidemiology and a deep comprehension of the geographical and temporal trends are crucial for clinical advances and the formulation of effective health policy for primary and secondary prevention. This review mainly focuses on the epidemiology of primary (organic, related to the valve itself) valvular disease and its management, especially emphasizing the importance of heart valve centers in ensuring the best care of patients through a multidisciplinary team.
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Affiliation(s)
- Gloria Santangelo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Francesca Bursi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20122 Milan, Italy
| | - Andrea Faggiano
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Silvia Moscardelli
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20122 Milan, Italy
| | - Pasquale Simone Simeoli
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20122 Milan, Italy
| | - Marco Guazzi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20122 Milan, Italy
| | - Roberto Lorusso
- Cardiothoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), The Cardiovascular Research Institute Maastricht (CARIM), 6229 ER Maastricht, The Netherlands
| | - Stefano Carugo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pompilio Faggiano
- Cardiothoracic Department Unit, Fondazione Poliambulanza, Via Leonida Bissolati 57, 25100 Brescia, Italy
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10
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The Heart in the Transcatheter Intervention Era: Where Are We? J Clin Med 2022; 11:jcm11175173. [PMID: 36079102 PMCID: PMC9456719 DOI: 10.3390/jcm11175173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/27/2022] [Indexed: 11/17/2022] Open
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11
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Costanzo P, Bamborough P, Peterson M, Deva DJ, Ong G, Fam N. Transcatheter Aortic Valve Implantation for Severe Pure Aortic Regurgitation with Dedicated Devices. Interv Cardiol 2022; 17:e11. [PMID: 35923768 PMCID: PMC9340575 DOI: 10.15420/icr.2021.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Aortic regurgitation (AR) is not the most common valvular disease; however, its prevalence increases with age, with more than 2% of those aged >70 years having at least moderate AR. Once symptoms related to AR develop, the prognosis becomes poor. Transcatheter aortic valve implantation for patients with pure severe AR and at prohibitive surgical risk is occasionally performed, but remains a clinical challenge due to absence of valvular calcium, large aortic root and increased stroke volume. These issues make the positioning and deployment of transcatheter aortic valve implantation devices unpredictable, with a tendency to prosthesis embolisation or malposition. To date, the only two dedicated transcatheter valves for AR are the J-Valve (JC Medical) and the JenaValve (JenaValve Technology). Both devices have been used successfully via the transapical approach. The transfemoral experience is limited to first-in-human publications and to a clinical trial dedicated to AR, for which the completion date is still pending.
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Affiliation(s)
- Pierluigi Costanzo
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Canada; Division of Cardiology, Royal Papworth Hospital, Cambridge, UK
| | - Paul Bamborough
- Division of Cardiology, Royal Papworth Hospital, Cambridge, UK
| | - Mark Peterson
- Division of Cardiac Surgery, St Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Djeven J Deva
- Department of Medical Imaging, St Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Geraldine Ong
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Neil Fam
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Canada
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12
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Nisar H, Groves L, Cardarelli-Leite L, Peters TM, Chen ECS. Toward Fluoro-Free Interventions: Using Radial Intracardiac Ultrasound for Vascular Navigation. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:1290-1298. [PMID: 35487839 DOI: 10.1016/j.ultrasmedbio.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/23/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
Transcatheter cardiovascular interventions have the advantage of patient safety, reduced surgery time and minimal trauma to the patient's body. Transcathether interventions, which are performed percutaneously, are limited by the lack of direct line of sight with the procedural tools and the patient anatomy. Therefore, such interventional procedures rely heavily on image guidance for navigating toward and delivering therapy at the target site. Vascular navigation via the inferior vena cava, from the groin to the heart, is an imperative part of most transcatheter cardiovascular interventions including heart valve repair surgeries and ablation therapy. Traditionally, the inferior vena cava is navigated using fluoroscopic techniques such as venography and computed tomography venography. These X-ray-based techniques can have detrimental effects on the patient as well as the surgical team, causing increased radiation exposure, leading to risk of cancer, fetal defects and eye cataracts. The use of a heavy lead apron has also been reported to cause back pain and spine issues, thus leading to interventionalist's disc disease. We propose the use of a catheter-based ultrasound augmented with electromagnetic tracking technology to generate a vascular roadmap in real time and perform navigation without harmful radiation. In this pilot study, we used spatially tracked intracardiac echocardiography to reconstruct a vessel from a phantom in a 3-D virtual environment. We illustrate how the proposed ultrasound-based navigation will appear in a virtual environment, by navigating a tracked guidewire within the vessels in the phantom without any radiation-based imaging. The geometric accuracy is assessed using a computed tomography scan of the phantom, with a Dice coefficient of 0.79. The average distance between the surfaces of the two models comes out to be 1.7 ± 1.12 mm.
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Affiliation(s)
- Hareem Nisar
- Robarts Research Institute, Western University, London, Ontario, Canada; Department of Biomedical Engineering, Western University, London, Ontario, Canada.
| | - Leah Groves
- Robarts Research Institute, Western University, London, Ontario, Canada; Department of Biomedical Engineering, Western University, London, Ontario, Canada
| | | | - Terry M Peters
- Robarts Research Institute, Western University, London, Ontario, Canada; Department of Biomedical Engineering, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Elvis C S Chen
- Robarts Research Institute, Western University, London, Ontario, Canada; Department of Biomedical Engineering, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
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13
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Bose R, Montealegre-Gallegos M, Mitchell JD, Sharkey A, Sehgal S, Krajewski ML, Robitaille MJ, Katsiampoura A, Haering JM, Laham R, Mahmood F. Curriculum for Subspecialty Anesthesia Training in Adult Structural Heart Disease Imaging: A Single-Center Experience. J Cardiothorac Vasc Anesth 2022; 36:3469-3474. [DOI: 10.1053/j.jvca.2022.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 11/11/2022]
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14
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Galili L, White Zeira A, Marom G. Numerical biomechanics modelling of indirect mitral annuloplasty treatments for functional mitral regurgitation. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211464. [PMID: 35242347 PMCID: PMC8753151 DOI: 10.1098/rsos.211464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/14/2021] [Indexed: 05/03/2023]
Abstract
Mitral valve regurgitation (MR) is a common valvular heart disease where an improper closure leads to leakage from the left ventricle into the left atrium. There is a need for less-invasive treatments such as percutaneous repairs for a large inoperable patient population. The aim of this study is to compare several indirect mitral annuloplasty (IMA) percutaneous repair techniques by finite-element analyses. Two types of generic IMA devices were considered, based on coronary sinus vein shortening (IMA-CS) to reduce the annulus perimeter and based on shortening of the anterior-posterior diameter (IMA-AP). The disease, its treatments, and the heart function post-repair were modelled by modifying the living heart human model (Dassault Systèmes). A functional MR pathology that represents ischaemic MR was generated and the IMA treatments were simulated in it, followed by heart function simulations with the devices and leakage quantification from blood flow simulations. All treatments were able to reduce leakage, the IMA-AP device achieved better sealing, and there was a correlation between the IMA-CS device length and the reduction in leakage. The results of this study can help in bringing IMA-AP to market, expanding the use of IMA devices, and optimizing future designs of such devices.
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Affiliation(s)
- Lee Galili
- School of Mechanical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Adi White Zeira
- School of Mechanical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Gil Marom
- School of Mechanical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
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15
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Coffey S, Roberts-Thomson R, Brown A, Carapetis J, Chen M, Enriquez-Sarano M, Zühlke L, Prendergast BD. Global epidemiology of valvular heart disease. Nat Rev Cardiol 2021; 18:853-864. [PMID: 34172950 DOI: 10.1038/s41569-021-00570-z] [Citation(s) in RCA: 182] [Impact Index Per Article: 60.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 02/05/2023]
Abstract
Valvular heart disease (VHD) is a major contributor to loss of physical function, quality of life and longevity. The epidemiology of VHD varies substantially around the world, with a predominance of functional and degenerative disease in high-income countries, and a predominance of rheumatic heart disease in low-income and middle-income countries. Reflecting this distribution, rheumatic heart disease remains by far the most common manifestation of VHD worldwide and affects approximately 41 million people. By contrast, the prevalence of calcific aortic stenosis and degenerative mitral valve disease is 9 and 24 million people, respectively. Despite a reduction in global mortality related to rheumatic heart disease since 1900, the death rate has remained fairly static since 2000. Meanwhile, deaths from calcific aortic stenosis have continued to rise in the past 20 years. Epidemiological data on other important acquired and congenital forms of VHD are limited. An ageing population and advances in therapies make an examination of the changing global epidemiology of VHD crucial for advances in clinical practice and formulation of health policy. In this Review, we discuss the global burden of VHD, geographical variation in the presentation and clinical management, and temporal trends in disease burden.
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Affiliation(s)
- Sean Coffey
- Department of Medicine - HeartOtago, University of Otago, Dunedin, New Zealand
| | - Ross Roberts-Thomson
- Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- University of Adelaide, Adelaide, SA, Australia
| | - Alex Brown
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- University of Adelaide, Adelaide, SA, Australia
| | - Jonathan Carapetis
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia and Perth Children's Hospital, Perth, WA, Australia
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Liesl Zühlke
- Division of Paediatric Cardiology, Department of Paediatrics, Red Cross War Memorial Children's Hospital, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
- Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
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16
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[ESC/EACTS guidelines 2021 on the management of valvular heart diseases : What are the most important innovations?]. Herz 2021; 47:19-30. [PMID: 34609559 DOI: 10.1007/s00059-021-05068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
In August 2021 the European Society for Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) updated their guidelines on the management of valvular heart disease. Since the publication of the previous version in 2017 new evidence regarding epidemiology, diagnosis and treatment of valvular heart diseases has been accumulating, which led to reassessment of several recommendations. Most importantly, the critical role of the heart team in treatment decision-making was reemphasized, the criteria for choosing the mode of aortic valve interventions were clarified, the definition of severe secondary mitral regurgitation was revised and the recommendation for transcatheter edge-to-edge mitral valve repair in patients with this condition was upgraded. Additionally, antithrombotic therapeutic regimens in patients with native valvular heart diseases and bioprostheses were reappraised, the indications for early surgery in selected asymptomatic patient groups were expanded and the potential of transcatheter tricuspid valve interventions in inoperable and high-risk patients was acknowledged, although the latter needs to be further evaluated. This review article summarizes the most important recommendations of the new guidelines.
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17
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Margonato D, Ancona F, Ingallina G, Melillo F, Stella S, Biondi F, Boccellino A, Godino C, Margonato A, Agricola E. Tricuspid Regurgitation in Left Ventricular Systolic Dysfunction: Marker or Target? Front Cardiovasc Med 2021; 8:702589. [PMID: 34262955 PMCID: PMC8273168 DOI: 10.3389/fcvm.2021.702589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 12/28/2022] Open
Abstract
Far from being historically considered a primary healthcare problem, tricuspid regurgitation (TR) has recently gained much attention from the scientific community. In fact, in the last years, robust evidence has emerged regarding the epidemiological impact of TR, whose prevalence seems to be similar to that of other valvulopathies, such as aortic stenosis, with an estimated up to 4% of people >75 years affected by at least moderate TR in the United States, and up to 23% among patients suffering from heart failure with reduced ejection fraction. This recurrent coexistence of left ventricular systolic dysfunction (LVSD) and TR is not surprising, considered the multiple etiologies of tricuspid valve disease. TR can complicate heart failure mostly as a functional disease, because of pulmonary hypertension (PH), subsequent to elevated left ventricular end-diastolic pressure, leading to right ventricular dilatation, and valve tethering. Moreover, the so-called "functional isolated" TR can occur, in the absence of PH, as a result of right atrial dilatation associated with atrial fibrillation, a common finding in patients with LVSD. Finally, TR can result as a iatrogenic consequence of transvalvular lead insertion, another frequent scenario in this cohort of patients. Nonetheless, despite the significant coincidence of these two conditions, their mutual relation, and the independent prognostic role of TR is still a matter of debate. Whether significant TR is just a marker for advanced left-heart disease, or a crucial potential therapeutical target, remains unclear. Aim of the authors in this review is to present an update concerning the epidemiological features and the clinical burden of TR in the context of LVSD, its prognostic value, and the potential benefit for early tricuspid intervention in patients affected by contemporary TR and LVSD.
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Affiliation(s)
- Davide Margonato
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Cardiology Department, University of Pavia, Pavia, Italy
| | - Francesco Ancona
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Ingallina
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Melillo
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Stella
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Federico Biondi
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Boccellino
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Cosmo Godino
- Department of Clinical Cardiology, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Margonato
- Department of Clinical Cardiology, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Eustachio Agricola
- Echocardiography Laboratory, Istituto di Ricerca a Cura e Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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18
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Vajapey R, Kwon D. Guide to functional mitral regurgitation: a contemporary review. Cardiovasc Diagn Ther 2021; 11:781-792. [PMID: 34295705 PMCID: PMC8261742 DOI: 10.21037/cdt-20-277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 11/16/2020] [Indexed: 11/06/2022]
Abstract
Functional mitral regurgitation (FMR) occurs in the absence of organic mitral valve (MV) disease and is a result of LV dysfunction due to ischemic vs. non ischemic etiologies. The prevalence of FMR is increasing, as 2.0-2.5 million people in the USA were diagnosed with FMR in 2000-and this number is expected to double to 4 million by 2030. FMR tends to develop in a significant number of patients after myocardial infarction (MI) and many develop heart failure (HF) subsequently with mortality rates ranging from 15-40% at 1 year. Therefore, there has been much interest and effort to develop optimized methods for quantifying and classifying the severity of FMR, as well as developing effective therapeutic interventions to improve outcomes in patients with significant FMR. Echocardiogram is typically the primary diagnostic method of assessment, however, there have been various technological advances including cardiac CT and cardiac MRI that can better guide quantification and management of this disease. Management of this disease is mostly aimed at optimizing left ventricular (LV) remodeling with surgical and transcatheter management gaining more popularity with recent times. The purpose of this paper is to provide a comprehensive review of the current evaluation methods and interventional strategies for FMR.
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Affiliation(s)
- Ramya Vajapey
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Deborah Kwon
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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19
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Khan MZ, Munir MB, Khan MU, Khan SU, Vasudevan A, Balla S. Contemporary Trends and Outcomes of Prosthetic Valve Infective Endocarditis in the United States: Insights from the Nationwide Inpatient Sample. Am J Med Sci 2021; 362:472-479. [PMID: 34033810 DOI: 10.1016/j.amjms.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/18/2020] [Accepted: 05/19/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prosthetic valve endocarditis (PVE) carries high mortality and morbidity as compared to native valve endocarditis (NVE). Contemporary data on PVE are lacking, we aimed to study contemporary trends, outcomes, and burden of PVE using nationally representative data. METHODS We used the National Inpatient Sample from 2000 to 2017 to identify patients admitted with PVE using ICD-9-CM and ICD-10 codes. Risk-adjusted rates were calculated using an Analysis of Covariance (ANCOVA) with the Generalized Linear Model (GLM). Trends were assessed with linear regression and Pearson's Chi-square when appropriate. Binomial logistic regression was used to assess predictors of in-hospital mortality. RESULTS We identified 43,602 hospitalizations for PVE. PVE hospitalizations increased from 1803 in 2000 to 3450 in 2017. Risk-adjusted mortality decreased from 10.7% in 2002 to 7.3% in 2017 (P<0.01). Logistic regression analysis on mortality showed increase association with age (OR, 1.021, 95%CI [1.017-1.024], p<0.01), Hispanics (OR, 1.493, 95%CI [1.296-1.719], p<0.01) and patients with drug abuse(OR, 1.233, 95%CI [1.05-1.449], p=0.01). Co-morbid conditions like congestive heart failure (OR, 1.511, 95%CI [1.366-1.673], p<0.01), renal failure (OR, 1.572, 95%CI [1.427-1.732], p<0.01) and weight loss (OR, 1.425, 95%CI [1.093-1.419], p<0.01) were also associated with higher mortality. CONCLUSIONS Over the years the adjusted in-hospital mortality in PVE has trended down but the average cost of stay has increased despite decrease in length of stay.
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Affiliation(s)
- Muhammad Zia Khan
- Department of Medicine, West Virginia University, Morgantown, West Virginia.
| | - Muhammad Bilal Munir
- Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia; Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California
| | - Muhammad U Khan
- Department of Medicine, West Virginia University, Morgantown, West Virginia
| | - Safi U Khan
- Department of Medicine, West Virginia University, Morgantown, West Virginia
| | - Archana Vasudevan
- Division of Infectious Diseases, Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri
| | - Sudarshan Balla
- Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
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20
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Complex interventions in the failing heart. Curr Opin Organ Transplant 2021; 26:267-272. [PMID: 33938462 DOI: 10.1097/mot.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Heart failure is a complex clinical syndrome with a substantial disease burden. We aim to review the interventional aspects of management of advanced heart failure, focusing on the role of management of coronary artery disease, valvular heart disease, and mechanical circulatory support. RECENT FINDINGS The patients with coronary artery disease and heart failure requiring revascularization are at higher risk than the rest of the general population. Coronary artery bypass grafting or percutaneous intervention can be used depending on varied patient characteristics and coronary anatomy. Transcatheter aortic valve implantation, Mitraclip and transcatheter ventricular restoration help in tackling the valvular and left ventricular remodeling concerns often seen in this patient population. Temporary hemodynamic circulatory support helps stabilizing patients in cardiogenic shock while long-term support can help bridge them to more definitive therapies. SUMMARY The management strategies in this disease state are ever evolving with robust evidence coming in support of interventional therapies whenever deemed appropriate. It is the multidisciplinary patient-centered approach, which yields maximum benefit out of these complex interventions.
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21
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Nikolou E, Bilkhu R, Kafil TS, Demetrescu C, Kotta PA, Lucchese G, Tzemos N, Grapsa J. Multimodality Imaging in Transcatheter Mitral Interventions. Front Cardiovasc Med 2021; 8:638399. [PMID: 33718458 PMCID: PMC7950542 DOI: 10.3389/fcvm.2021.638399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/29/2021] [Indexed: 11/21/2022] Open
Abstract
Multimodality imaging is of imperative value for the planning and guidance of transcatheter mitral valve interventions. This review employs the value of different imaging modalities and future implications for clinical practice.
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Affiliation(s)
- Evgenia Nikolou
- Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Rajdeep Bilkhu
- Department of Cardiothoracic Surgery, Guys and St Thomas NHS Hospitals Trust, London, United Kingdom
| | - Tahir S. Kafil
- Department of Cardiology, Western University, London, ON, Canada
| | - Camelia Demetrescu
- Department of Cardiology, Guys and St Thomas NHS Hospitals Trust, London, United Kingdom
| | - Prasanti Alekhya Kotta
- Department of Cardiology, Guys and St Thomas NHS Hospitals Trust, London, United Kingdom
| | - Gianluca Lucchese
- Department of Cardiothoracic Surgery, Guys and St Thomas NHS Hospitals Trust, London, United Kingdom
| | - Nikolaos Tzemos
- Department of Cardiology, Western University, London, ON, Canada
| | - Julia Grapsa
- Department of Cardiology, Guys and St Thomas NHS Hospitals Trust, London, United Kingdom
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22
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Sengottuvelu G, Kumar V, Seth A. The Myval Transcatheter Heart Valve System for the Treatment of Severe Aortic Stenosis - Current Evidence and Future Directions. Heart Int 2020; 14:86-91. [PMID: 36276512 PMCID: PMC9524723 DOI: 10.17925/hi.2020.14.2.86] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/17/2020] [Indexed: 08/29/2023] Open
Abstract
Transcatheter aortic valve replacement has revolutionised the treatment of aortic valve disease. The Myval™ device (Meril Life Sciences Pvt. Ltd., Gujarat, India) is a CE-marked, next-generation balloon-expandable transcatheter heart valve, designed for the treatment of severe aortic valve stenosis. This review illustrates the salient technical features of this transcatheter valve, pre-clinical studies and evidence from the first-in-human trial. We also provide a brief overview of planned clinical trials and registries.
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Affiliation(s)
| | - Vijay Kumar
- Fortis Escorts Heart Institute, New Delhi, India
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi, India
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23
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Mathur M, Meador WD, Jazwiec T, Malinowski M, Timek TA, Rausch MK. Tricuspid Valve Annuloplasty Alters Leaflet Mechanics. Ann Biomed Eng 2020; 48:2911-2923. [PMID: 32761558 PMCID: PMC8000450 DOI: 10.1007/s10439-020-02586-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Tricuspid valve regurgitation is associated with significant morbidity and mortality. Its most common treatment option, tricuspid valve annuloplasty, is not optimally effective in the long-term. Toward identifying the causes for annuloplasty's ineffectiveness, we have previously investigated the technique's impact on the tricuspid annulus and the right ventricular epicardium. In our current work, we are extending our analysis to the anterior tricuspid valve leaflet. To this end, we adopted our previous strategy of performing DeVega suture annuloplasty as an experimental methodology that allows us to externally control the degree of cinching during annuloplasty. Thus, in ten sheep we successively cinched the annulus and quantified changes to leaflet motion, dynamics, and strain in the beating heart by combining sonomicrometry with our well-established mechanical framework. We found that successive cinching of the valve enforced earlier coaptation and thus reduced leaflet range of motion. Additionally, leaflet angular velocity during opening and closing decreased. Finally, we found that leaflet strains were also reduced. Specifically, radial and areal strains decreased as a function of annular cinching. Our findings are critical as they suggest that suture annuloplasty alters the mechanics of the tricuspid valve leaflets which may disrupt their resident cells' mechanobiological equilibrium. Long-term, such disruption may stimulate tissue maladaptation which could contribute to annuloplasty's sub-optimal effectiveness. Additionally, our data suggest that the extent to which annuloplasty alters leaflet mechanics can be controlled via degree of cinching. Hence, our data may provide direct surgical guidelines.
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Affiliation(s)
- Mrudang Mathur
- Department of Mechanical Engineering, University of Texas at Austin, 204 E Dean Keeton Street, Austin, TX, 78712, USA
| | - William D Meador
- Department of Biomedical Engineering, University of Texas at Austin, 107 W Dean Keeton Street, Austin, TX, 78712, USA
| | - Tomasz Jazwiec
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Centre for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
- Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, MI, 49503, USA
| | - Marcin Malinowski
- Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, MI, 49503, USA
- Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Tomasz A Timek
- Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, MI, 49503, USA
| | - Manuel K Rausch
- Departments of Aerospace Engineering & Engineering Mechanics, Biomedical Engineering, University of Texas at Austin, 2617 Wichita Street, Austin, TX, 78712, USA.
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Patterson T, Allen CJ, Aroney N, Redwood S, Prendergast B. The Future of Transcatheter Interventions. JACC Case Rep 2020; 2:2281-2282. [PMID: 34317155 PMCID: PMC8299840 DOI: 10.1016/j.jaccas.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Tiffany Patterson
- Cardiovascular Department, King's College London, London, United Kingdom
| | | | - Nicholas Aroney
- Cardiovascular Department, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Simon Redwood
- Cardiovascular Department, King's College London, London, United Kingdom
| | - Bernard Prendergast
- Cardiovascular Department, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom
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25
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Yoganathan A, Khan SNM, Khan H, Thirunavukarasu SA, Elghanam MA, Harky A. Tricuspid valve diseases: Interventions on the forgotten heart valve. J Card Surg 2020; 36:219-228. [PMID: 33135830 DOI: 10.1111/jocs.15159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/15/2020] [Indexed: 01/09/2023]
Abstract
Over the past few decades, the tricuspid valve (TV) interventions have been relatively lower compared to other cardiac valvular disease in terms of pathophysiology and management, especially regarding surgical intervention and therapy. However, recent crucial advances in assessment and management of the TV disease have resulted in a renewed interest in the "forgotten valve." The medical treatment aims to cure the underlying disease and address the presentation of the right heart failure. Surgical interventions have proven to yield good outcomes for those for whom surgery is indicated. For those who are not suitable for surgery, transcatheter surgery may prove to be a suitable replacement. Best practice with regard to surgical techniques is still in question due to limited data. This has been slowing the introduction of transcatheter interventions into common practical guidelines. The aim of this literature review is to discuss new insights on the pathophysiology, diagnosis, and interventions of TV disease, highlighting the surgical management and emerging transcatheter therapies. In addition, this review will provide an overview of the current state of the literature surrounding TV interventions and providing suggestions for future directives.
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Affiliation(s)
| | | | - Haariss Khan
- School of Medicine, St George's University of London, London, UK
| | | | | | - Amer Harky
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.,Department of Cardiac Surgery, Alder Hey Children Hospital, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
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26
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Goyal A, Krishnaswamy A. Percutaneous Valve Interventions in Heart Failure. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2020. [DOI: 10.1007/s11936-020-00841-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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27
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Litwinowicz R, Mazur P, Burysz M, Filip G, Wasilewski G, Kapelak B, Bartus K. Why should cardiac surgeons occlude the left atrial appendage percutaneously? J Card Surg 2020; 35:3458-3464. [PMID: 32939852 DOI: 10.1111/jocs.14991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Percutaneous left atrial appendage (LAA) occlusion (LAAO) is a procedure dominated by cardiologists. The aim of our study was to present the results of percutaneous LAAO performed solely by cardiac surgeons. METHODS Two hundred twenty-three consecutive patients with nonvalvular atrial fibrillation underwent percutaneous LAAO in two cardiac surgery sites. In the first center, all 84 LAAO procedures were performed with the endocardial LAA occluders: 60 cases with the Amulet and 24 cases with the LAmbre. In the second center, all 139 LAAO procedures were performed with the LARIAT epicardial device. RESULTS The mean CHA2 DS2 -VASc-score was 3.7 ± 1.8 points, and mean HAS-BLED score was 3.6 ± 1.2 points. The procedure was successful in 97.3% of cases. Procedural or device-related adverse events were noted in 4.4% (n = 10) of cases: one periprocedural cardiac arrest, one aortic injury, one gastrointestinal bleeding, three cases of vascular access complications, and four cardiac tamponades. After a follow-up of 40.3 ± 17.3 months, 78.4% of patients were alive, with the annual mortality rate of 5.3%. Compared to the predicted risk, the observed incidence of thromboembolism was lower by 71%, and the bleeding incidence was lower by 69%. CONCLUSIONS Percutaneous LAAO procedures can be safely performed by cardiac surgeons, with no cardiological assistance. LAAO done by surgeons is safe and effective, and periprocedural and long-term outcomes are excellent. Cardiac surgeons should be trained in both types of LAAO: endocardial and epicardial.
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Affiliation(s)
- Radoslaw Litwinowicz
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland.,Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
| | - Piotr Mazur
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland.,Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
| | - Marian Burysz
- Department of Cardiac Surgery, Regional Specialist Hospital, Grudziadz, Poland
| | - Grzegorz Filip
- Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
| | - Grzegorz Wasilewski
- Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
| | - Boguslaw Kapelak
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland.,Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
| | - Krzysztof Bartus
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland.,Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
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28
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Bonow RO, O'Gara PT, Adams DH, Badhwar V, Bavaria JE, Elmariah S, Hung JW, Lindenfeld J, Morris A, Satpathy R, Whisenant B, Woo YJ. 2019 AATS/ACC/SCAI/STS expert consensus systems of care document: Operator and institutional recommendations and requirements for transcatheter mitral valve intervention: A joint report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons Endorsed by the Heart Failure Society of America. J Thorac Cardiovasc Surg 2020; 160:72-92. [PMID: 32539993 DOI: 10.1016/j.jtcvs.2019.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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29
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Bonow RO, O'Gara PT, Adams DH, Badhwar V, Bavaria JE, Elmariah S, Hung JW, Lindenfeld J, Morris A, Satpathy R, Whisenant B, Woo YJ. 2019 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Mitral Valve Intervention: A Joint Report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons. Ann Thorac Surg 2020; 110:316-335. [PMID: 31857066 DOI: 10.1016/j.athoracsur.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022]
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30
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2019 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Mitral Valve Intervention. J Am Coll Cardiol 2020; 76:96-117. [DOI: 10.1016/j.jacc.2019.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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31
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Mitral valve regurgitation: a disease with a wide spectrum of therapeutic options. Nat Rev Cardiol 2020; 17:807-827. [DOI: 10.1038/s41569-020-0395-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 12/30/2022]
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32
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Chen S, Grossi EA. Commentary: More than 2 sides to the coin-the Goldilocks paradigm. J Thorac Cardiovasc Surg 2020; 160:99-100. [PMID: 32539994 DOI: 10.1016/j.jtcvs.2020.04.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Stacey Chen
- Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY
| | - Eugene A Grossi
- Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY.
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33
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Freitas-Ferraz AB, Bernier M, Vaillancourt R, Ugalde PA, Nicodème F, Paradis JM, Champagne J, O’Hara G, Junquera L, del Val D, Muntané-Carol G, O’Connor K, Beaudoin J, Rodés-Cabau J. Safety of Transesophageal Echocardiography to Guide Structural Cardiac Interventions. J Am Coll Cardiol 2020; 75:3164-3173. [DOI: 10.1016/j.jacc.2020.04.069] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/09/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022]
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34
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Lüscher TF. From TAVI to tricuspid cliping: fine-tuning the management of valvular heart disease. Eur Heart J 2020; 41:1863-1866. [PMID: 33216904 DOI: 10.1093/eurheartj/ehaa459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Professor of Cardiology, Imperial College and Director of Research, Education & Development, Royal Brompton and Harefield Hospitals London, UK.,Professor and Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, 8032 Zurich, Switzerland
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35
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Wang YH, Ke HY, Cheng CC, Lin TC, Tsai CS, Lin CY. Cardiac Tamponade after Removal of a Temporary Pacing Wire for Transcatheter Aortic Valve Implantation: A Case Report. ACTA CARDIOLOGICA SINICA 2020; 36:276-278. [PMID: 32425444 DOI: 10.6515/acs.202005_36(3).20191211a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ying-Hsiang Wang
- Division of Cardiovascular Surgery, Department of Surgery, Division of Cardiology
| | - Hung-Yen Ke
- Division of Cardiovascular Surgery, Department of Surgery, Division of Cardiology
| | | | - Tzu-Chiao Lin
- Department of Internal Medicine, Tri-Service General Hospital
| | - Chien-Sung Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Division of Cardiology
| | - Chih-Yuan Lin
- Division of Cardiovascular Surgery, Department of Surgery, Division of Cardiology.,Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
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36
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Badhwar V. Transcatheter mitral valve intervention: Consensus, quality, and equipoise. J Thorac Cardiovasc Surg 2020; 160:93-98. [PMID: 32389460 DOI: 10.1016/j.jtcvs.2020.03.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/01/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
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37
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Bonow RO, O'Gara PT, Adams DH, Badhwar V, Bavaria JE, Elmariah S, Hung JW, Lindenfeld J, Morris A, Satpathy R, Whisenant B, Woo YJ. Multisociety expert consensus systems of care document 2019 AATS/ACC/SCAI/STS expert consensus systems of care document: Operator and institutional recommendations and requirements for transcatheter mitral valve intervention: A Joint Report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons. Catheter Cardiovasc Interv 2020; 95:866-884. [DOI: 10.1002/ccd.28671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | | | - Sammy Elmariah
- Society for Cardiovascular Angiography and Interventions
| | | | | | | | - Ruby Satpathy
- Society for Cardiovascular Angiography and Interventions
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38
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Abstract
New developments in transcatheter valve technologies including aortic valve replacement and mitral valve and tricuspid valve interventions are described. Recent studies evaluating the success rate, patient outcomes, and anesthesiologic management of the procedures are discussed.
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Affiliation(s)
- Michael A Ackermann
- Department of Anesthesiology and Intensive Care Medicine, Heart Centre Leipzig, Struempellstr 39, Leipzig 04289, Germany
| | - Jörg K Ender
- Department of Anesthesiology and Intensive Care Medicine, Heart Centre Leipzig, Struempellstr 39, Leipzig 04289, Germany.
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39
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Tamburino C, Piazza N, Baumbach A, Windecker S, Maisano F, Prendergast BD. 2019 – A leap year for valvular heart disease. EUROINTERVENTION 2019; 15:821-823. [DOI: 10.4244/eijv15i10a154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Lüscher TF. TAVI is on the move! Results in low-risk patients, those with mitral disease, and those with cerebral protection. Eur Heart J 2019; 40:1309-1312. [PMID: 33215646 DOI: 10.1093/eurheartj/ehz237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Professor of Cardiology, Imperial College and Director of Research, Education & Development, Royal Brompton and Harefield Hospital Trust, London, UK.,Professor and Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, European Heart Journal, Editorial Office, Zurich Heart House, Hottingerstreet 14, Zurich, Switzerland
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41
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Lüscher TF. Grown-up congenital heart disease: building evidence where it is badly needed. Eur Heart J 2019; 40:1027-1030. [PMID: 33215635 DOI: 10.1093/eurheartj/ehz156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Professor of Cardiology, Imperial College and Director of Research, Education & Development, Royal Brompton and Harefield Hospitals London, UK.,Professor and Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, Zurich, Switzerland
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42
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Lüscher TF. What happened this year in heart failure? Moving towards a more individualized approach. Eur Heart J 2019; 40:637-639. [PMID: 33215674 DOI: 10.1093/eurheartj/ehz073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Professor of Cardiology, Imperial College and Director of Research, Education & Development, Royal Brompton and Harefield Hospitals London, UK.,Professor and Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, Zurich, Switzerland
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