This study sought to elucidate the clinical impact and prognosis of stent graft (SG) thrombosis.
Transcatheter aortic valve replacement (TAVR) is approved for all patient risk profiles and is an option for all patients irrespective of age. However, patients enrolled in the low- and intermediate-risk trials were in their 70s, and those in the high-risk trials were in their 80s. TAVR has never been systematically tested in young (<65 years), low-risk patients. Unanswered questions remain, including the safety and effectiveness of TAVR in patients with bicuspid aortic valves; future coronary access; durability of transcatheter heart valves; technical considerations for surgical transcatheter heart valve explantation; management of concomitant conditions such as aortopathy, mitral valve disease, and coronary artery disease; and the safety and feasibility of future TAVR-in-TAVR. The authors predict that balancing these questions with patients’ clear preference for less invasive treatment will become common. In this paper, the authors consider each of these questions and discuss risks and benefits of theoretical treatment strategies in the lifetime management of young patients with severe aortic stenosis.
The purpose of this study was to examine the impact of residual mitral regurgitation (MR) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR).
No standardized algorithm exists to identify patients at risk of bleeding after transcatheter aortic valve replacement (TAVR). The aim of this study was to generate and validate a useful predictive model.
Objectives The aim of this study was to investigate whether the degree of aortic angulation (AA) affects outcomes after transcatheter aortic valve replacement (TAVR) using newer-generation transcatheter heart valves (THVs).
Objectives The aim of this study was to define predictors of prosthesis-patient mismatch (PPM) and its impact on mortality after transcatheter aortic valve replacement (TAVR) with self-expandable valves (SEVs) in patients with small annuli.
Objectives The aim of this study was to assess 30-day outcomes of transcatheter edge-to-edge repair with the MitraClip XTR for significant tricuspid regurgitation (TR), relative to baseline coaptation gap sizes (CGS).
Objectives The aim of this study was to assess the impact of residual mitral regurgitation (resMR) on mortality with respect to left ventricular dilatation (LV-Dil) or right ventricular dysfunction (RV-Dys) in patients with secondary mitral regurgitation (SMR) who underwent mitral valve transcatheter edge-to-edge repair (TEER).
Objectives The aim of this study was to investigate whether transradial (TR) percutaneous coronary intervention (PCI) is superior to transfemoral (TF) PCI in complex coronary lesions with large-bore guiding catheters with respect to clinically relevant access site–related bleeding or vascular complications.
A significant proportion of lesions treated with transcatheter interventions in the coronary and peripheral vascular beds exhibit moderate to severe calcific plaques known to portend lower procedural success rates, increased peri-procedural adverse events, and unfavorable clinical outcomes compared with noncalcific plaques. Adapted from lithotripsy technology used for treatment of ureterorenal calculi, intravascular lithotripsy (IVL) is a novel technique for the treatment of severely calcific plaque lesions that uses acoustic shockwaves in a balloon-based delivery system. Shockwaves induce calcium fractures, which facilitate stent expansion and luminal gain. In this review, the authors summarize the physics, preclinical and clinical data on IVL use in the coronary and peripheral vasculature, and future directions of IVL in transcatheter cardiovascular therapies.
Objectives The purpose of this study was to evaluate tip-to-base intentional laceration of the anterior mitral leaflet to prevent left ventricular outflow tract obstruction (LAMPOON) in patients undergoing transcatheter mitral valve replacement (TMVR) in annuloplasty rings or surgical mitral valves.
Objectives The aim of this study was to examine the association between percutaneous left atrial appendage occlusion (LAAO) procedural volume and in-hospital outcomes.
Objectives The long-term outcomes after transcatheter closure of atrial septal defects (ASD) in adults are reported and compared between age groups and against population control patients.
Introduction BASILICA (bioprosthetic aortic scallop intentional laceration to prevent coronary artery obstruction) can prevent coronary obstruction following transcatheter aortic valve replacement (TAVR) (1). Transcatheter aortic valve (TAV)–in–TAV may pose the highest risk for obstruction because of narrow residual sinuses, tall leaflets, and supra-annular designs. Bench testing suggests that certain TAV devices exhibit inadequate leaflet “splay” following traditional BASILICA (2). In cases risking inadequate splay (heavily calcified leaflets, very small valve-to-coronary distance, TAV-in-TAV), we have performed balloon-assisted BASILICA. This expands the traversal point outward by inflating a balloon across the leaflet(s) prior to laceration and increases leaflet splay (Figure 1A). Herein, we describe the first reported case.
Introduction Tricuspid valve repair with the MitraClip system (Abbott Vascular, Santa Clara, California) remains challenging despite increased adoption. In this procedure, clips are used to facilitate coaptation of the tricuspid leaflets and reduce regurgitation (1,2). Here, we describe how left-sided femoral vein access, a novel and straightforward modification, can simplify the procedure and improve results. The mis-key technique, previously described, is one method to overcome anatomic obstacles inherent to tricuspid interventions. With this method, the clip delivery system is rotated counterclockwise by 90° (“mis-keyed”) before inserting into the guide, and A-knob is primarily used for steering (3,4). The guide is also rotated approximately 180° to center the clip in the right atrium. Once the guide is positioned appropriately, A-knob steers the clip to the valve, although trajectory and height often remain problematic. With the addition of left-sided access, the guide and clip delivery system shift away from the valve due to the trajectory from the left femoral vein to the right atrium. This positions the clip higher in the atrium and farther from the septum to maximize device height and maneuverability
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