JACC. Cardiovascular interventions最新文献

英文中文

In Vitro Validation of Robotic Transcatheter Edge-to-Edge Repair Procedure 机器人经导管边缘到边缘修复术的体外验证。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.06.010

Da Zhu MD , Shouzheng Wang MD , Xiangbin Pan MD

引用次数: 0

Transcaval Impella-Assisted CHIP-PCI and Transcaval TAVR With Impella Removal in Freshly Implanted TAVR 经腔静脉Impella辅助CHIP-PCI和经腔静脉TAVR与新植入TAVR的Impella移除。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.014

Michael Chiang MBBS, Alvin H.Y. Ko MBChB, Cheuk Bong Ho MBBS, Esmond Y.H. Fong MBBS, Ivan Wong MBBS, Shing Fung Chui MBChB, Ka Chun Alan Chan MBBS, Chi Yuen Wong MBBS, Kam Tim Chan MBBS, Kang Yin Michael Lee MBBS

引用次数: 0

Transcatheter Aortic Valve Replacement for Aortic Stenosis With Double-Chambered Right Ventricle 经导管主动脉瓣置换术治疗右心室双腔主动脉瓣狭窄。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.021

Keishiro Izaki MD , Fumiaki Yashima MD, PhD , Masatoshi Sato MD , Nobuhiro Yoshijima MD, PhD , Hikaru Tsuruta MD, PhD , Kenichi Hashizume MD, PhD

引用次数: 0

Single-Leaflet Device Attachment After Mitral Transcatheter Edge-to-Edge Repair 二尖瓣经导管边对边修补术后的单叶器械附着：系统综述与 Meta 分析。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.008

Kirtipal Bhatia MD , Soumya Gupta MD , Kristen Carter MD , Marija Petrovic MD , Samantha V. Shetty DO, MS , Devika Aggarwal MBBS , Abel Casso Dominguez MD , Stamatios Lerakis MD, PhD , Edgar Argulian MD, MPH

引用次数: 0

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IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/S1936-8798(24)01460-2

引用次数: 0

Long-Term Outcomes After Edge-to-Edge Repair of Secondary Mitral Regurgitation 继发性二尖瓣反流边缘到边缘修复术后的长期疗效：欧洲二尖瓣反流注册的 5 年结果。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.016

Thomas J. Stocker MD , Lukas Stolz MD , Nicole Karam MD, PhD , Daniel Kalbacher MD , Benedikt Koell MD , Teresa Trenkwalder MD , Erion Xhepa MD , Marianna Adamo MD , Maximilian Spieker MD , Patrick Horn MD , Christian Butter MD , Ludwig T. Weckbach MD , Julia Novotny MD , Bruno Melica MD , Christina Giannini MD , Ralph Stephan von Bardeleben MD , Roman Pfister MD , Fabien Praz MD , Philipp Lurz MD, PhD , Volker Rudolph MD , Francisco Sampaio MD

Background

Mitral valve transcatheter edge-to-edge repair (M-TEER) reduces secondary mitral regurgitation (MR) in heart failure and impacts survival in selected patients as demonstrated in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial. However, long-term outcome data after M-TEER under real-world conditions are lacking.

Objectives

This study sought to assess long-term efficacy and survival after M-TEER in a large real-world registry.

Methods

We analyzed patients with significant secondary MR undergoing M-TEER from the EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry. Long-term MR reduction, functional outcomes, survival rate, and predictors for all-cause mortality were assessed.

Results

In this study, 1,628 patients undergoing M-TEER (mean age 73.8 years, mean EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 6.9%, 86.6% NYHA functional class ≥III) with available long-term data were included. Five-year survival was 35.0%. Long-term MR reduction (MR grade ≤2+: baseline 4.1%, discharge 92.2%, 5-year follow-up 85.5%; P < 0.001) and functional improvement (NYHA ≤II: baseline 13.4%, 5-year follow-up 60.1%; P < 0.001) was observed. The degree of residual MR was associated with 5-year survival (residual MR grade ≤1+: 38.6%; 2+: 30.5%; ≥3+: 22.6%; P < 0.001). Independent predictors for 5-year all-cause mortality post–M-TEER included age, renal function, residual MR, NYHA functional class, left ventricular ejection-fraction, and COAPT trial eligibility (P < 0.01 for all).

Conclusions

This extensive multicenter registry underscores the long-term efficacy of M-TEER in real-world clinical practice and identifies predictors for long-term survival. These findings contribute valuable insights for optimizing patient selection in routine clinical interventions.

背景：二尖瓣经导管边缘到边缘修补术（M-TEER）可减少心衰患者的继发性二尖瓣反流（MR），并影响特定患者的生存，COAPT（MitraClip经皮疗法治疗功能性二尖瓣反流心衰患者的心血管效果评估）试验证明了这一点。然而，M-TEER术后在真实世界条件下的长期疗效数据还很缺乏：本研究试图在一个大型真实世界登记处评估 M-TEER 术后的长期疗效和存活率：我们分析了 EuroSMR（欧洲继发性二尖瓣反流经导管修复注册）注册机构中接受 M-TEER 的严重继发性 MR 患者。评估了MR的长期缓解情况、功能预后、存活率以及全因死亡率的预测因素：在这项研究中，共纳入了1628名接受M-TEER的患者（平均年龄73.8岁，平均EuroSCORE II[欧洲心脏手术风险评估系统II]6.9%，86.6%的NYHA功能分级≥III），这些患者均有长期数据。五年生存率为 35.0%。观察到长期 MR 减少（MR 等级≤2+：基线 4.1%，出院 92.2%，5 年随访 85.5%；P < 0.001）和功能改善（NYHA ≤II：基线 13.4%，5 年随访 60.1%；P < 0.001）。残留 MR 的程度与 5 年生存率相关（残留 MR 等级≤1+：38.6%；2+：30.5%；≥3+：22.6%；P <0.001）。M-TEER术后5年全因死亡率的独立预测因素包括年龄、肾功能、残余MR、NYHA功能分级、左心室射血分数和COAPT试验资格（P<0.01）：这项广泛的多中心登记强调了M-TEER在实际临床实践中的长期疗效，并确定了长期生存的预测因素。这些发现为优化常规临床干预中的患者选择提供了有价值的见解。

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引用次数: 0

Mitral Transcatheter Edge-to-Edge Repair 二尖瓣经导管边缘到边缘修复术：长期结果一瞥。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.09.006

Andrea Scotti MD, Azeem Latib MD

引用次数: 0

First-in-Man Experience of Telerobotic Transcatheter Edge-to-Edge Repair With Pure Echo Guidance 纯回声引导下的远程经导管边缘到边缘修补术的首次人体实验。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.026

Shouzheng Wang MD , Da Zhu MD , Jiaqi Dai MD , Xiangbin Pan MD

引用次数: 0

Mitral Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation With Preserved Left Ventricular Function 经导管二尖瓣边缘到边缘修复术治疗继发性二尖瓣反流并保留左心室功能。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-11 DOI: 10.1016/j.jcin.2024.08.031

Chetan P. Huded MD, MSc , Adnan K. Chhatriwalla MD , Miloni A. Shah MPH , Sreekanth Vemulapalli MD , Andrzej Kosinski PhD , David J. Cohen MD, MSc

Background

Outcomes of mitral transcatheter edge-to-edge repair (MTEER) in patients with secondary mitral regurgitation (sMR) and preserved left ventricular ejection fraction (LVEF) are uncertain.

Objectives

This study sought to describe outcomes of MTEER for sMR with preserved LVEF.

Methods

Using the STS/ACC TVT (Society of Thoracic Surgeons–American College of Cardiology Transcatheter Valve Therapy) Registry, we evaluated the risk-adjusted outcomes of MTEER for sMR with LVEF >50% by the severity of residual mitral regurgitation (MR), and we compared these outcomes to patients undergoing MTEER for sMR with LVEF of 20% to 50%.

Results

Among 12,083 patients, LVEF was >50% in 3,011 (24.9%) and 20% to 50% in 9,072 (75.1%). Technical success, in-hospital complications, the 1-year death rate, and the 1-year Kansas City Cardiomyopathy Questionnaire score were similar in patients with LVEF >50% vs LVEF of 20% to 50%. The 1-year adjusted risk of heart failure hospitalization was lower in patients with LVEF >50% vs LVEF of 20% to 50% (adjusted HR: 0.81; 95% CI: 0.68-0.97; P = 0.02). Among patients with LVEF >50%, residual MR was ≤ mild in 76.0% and moderate in 19.0%. Compared with ≤ mild MR, moderate residual MR was associated with increased 1-year risks of death (adjusted HR: 1.46; 95% CI: 1.01-2.10; P = 0.04) and heart failure hospitalization (adjusted HR: 1.82; 95% CI: 1.32-2.52; P < 0.001). At 1 year, the KCCQ score improved in patients with LVEF >50% treated with MTEER (residual MR grade ≤ mild, 28.7 ± 26.8; moderate MR, 25.7 ± 27.2; > moderate MR, 21.6 ± 12.0; all P < 0.05).

Conclusions

In patients with sMR and preserved LVEF, MTEER was associated with a high rate of technical success, a low rate of complications, and large improvements in health status.

背景：继发性二尖瓣反流（sMR）和左心室射血分数（LVEF）保留患者的二尖瓣经导管边缘到边缘修补术（MTEER）疗效尚不确定：本研究旨在描述保留左心室射血分数（LVEF）的继发性二尖瓣反流（sMR）患者的 MTEER 治疗效果：方法：利用 STS/ACC TVT（胸外科医师协会-美国心脏病学会经导管瓣膜治疗）注册表，我们按照二尖瓣反流（MR）残留的严重程度，评估了 LVEF >50% 的二尖瓣反流 MTEER 的风险调整后疗效，并将这些疗效与 LVEF 为 20% 至 50%、接受 MTEER 治疗的二尖瓣反流患者进行了比较：在12,083名患者中，3,011人（24.9%）的LVEF>50%，9,072人（75.1%）的LVEF在20%至50%之间。LVEF>50%与LVEF为20%至50%的患者的技术成功率、院内并发症、1年死亡率和1年堪萨斯城心肌病问卷评分相似。LVEF >50%与LVEF为20%至50%的患者1年调整后心衰住院风险较低（调整后HR：0.81；95% CI：0.68-0.97；P = 0.02）。在 LVEF >50% 的患者中，76.0% 的残留 MR ≤ 轻度，19.0% 为中度。与≤轻度MR相比，中度残余MR与1年死亡风险增加（调整后HR：1.46；95% CI：1.01-2.10；P = 0.04）和心衰住院风险增加（调整后HR：1.82；95% CI：1.32-2.52；P < 0.001）有关。1年后，LVEF>50%的患者接受MTEER治疗后，KCCQ评分有所改善（残余MR分级≤轻度，28.7±26.8；中度MR，25.7±27.2；>中度MR，21.6±12.0；所有P均<0.05）：结论：对于sMR和LVEF保留的患者，MTEER技术成功率高，并发症发生率低，健康状况改善幅度大。

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引用次数: 0

1-Year Outcomes of Transcatheter Aortic Valve Replacement Using a Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve. 使用自扩张与球囊扩张经导管主动脉瓣置换术的 1 年疗效对比。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2024-11-06 DOI: 10.1016/j.jcin.2024.09.042

Won-Keun Kim, Costanza Pellegrini, Clemens Eckel, Matthias Renker, Christina Grothusen, Yeong-Hoon Choi, Efstratios I Charitos, Charlotte Duesmann, Johannes Blumenstein, Tobias Rheude, Samuel Sossalla, Michael Joner, Helge Möllmann

Background: Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking.

Objectives: The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves.

Methods: A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively. The primary endpoint was the composite of all-cause mortality, stroke, and rehospitalization at 1 year. Secondary endpoints were the individual components of the primary endpoint at 1 year. To adjust for baseline differences, nearest neighbor propensity score matching was used.

Results: After matching (702 pairs), baseline characteristics were similar between groups. Device success was more common in the neo2 group (87.5% vs 82.3%; P = 0.007), irrespective of matching. DP mean after the procedure was higher for Ultra (13 mm Hg [Q1-Q3: 10-15 mm Hg] vs 8 mm Hg [Q1-Q3: 6-11] mm Hg; P < 0.001). Rates of paravalvular leakage, device embolization, and multiple valve implantations were more common in the neo2 arm, whereas major cardiac structural complications and major vascular complications occurred more frequently in the Ultra group. All other in-hospital complication rates were similar between the 2 groups. At 1 year, the cumulative incidence of the primary endpoint (14.1% for neo2 vs 14.5% for Ultra; P = 0.819) was similar between the groups. Likewise, the individual components showed no difference between the groups.

Conclusions: Despite differing immediate results, the outcomes at 1 year, including the composite of all-cause mortality, stroke, or hospitalization, were similar for neo2 and Ultra transcatheter heart valves.

背景：ACURATE neo2经导管心脏瓣膜和球囊扩张型SAPIEN 3 Ultra的中期比较数据尚缺：目前尚缺乏自扩张型 ACURATE neo2 经导管心脏瓣膜和球囊扩张型 SAPIEN 3 Ultra 的中期比较数据：本研究旨在比较这两种瓣膜经导管主动脉瓣置换术后的 1 年疗效：方法：对来自 3 个中心（neo2，n = 1,166; Ultra，n = 940）的 2,106 名接受经导管主动脉瓣置换术的患者进行回顾性分析。主要终点是1年内全因死亡率、中风和再次住院的综合指数。次要终点是 1 年后主要终点的各个组成部分。为了调整基线差异，采用了近邻倾向评分匹配法：匹配后（702对），各组间的基线特征相似。无论匹配与否，neo2 组的设备成功率更高（87.5% vs 82.3%；P = 0.007）。Ultra 组术后 DP 平均值更高（13 mm Hg [Q1-Q3: 10-15 mm Hg] vs 8 mm Hg [Q1-Q3: 6-11] mm Hg; P < 0.001）。neo2组发生瓣膜旁漏、装置栓塞和多瓣膜植入的比例更高，而Ultra组发生主要心脏结构并发症和主要血管并发症的比例更高。两组的所有其他院内并发症发生率相似。1 年后，两组的主要终点累积发生率（neo2 组为 14.1%，Ultra 组为 14.5%；P = 0.819）相似。同样，两组的单项指标也无差异：结论：尽管即时结果不同，但 neo2 和 Ultra 经导管心脏瓣膜 1 年后的结果（包括全因死亡率、中风或住院治疗的综合结果）相似。

{"title":"1-Year Outcomes of Transcatheter Aortic Valve Replacement Using a Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve.","authors":"Won-Keun Kim, Costanza Pellegrini, Clemens Eckel, Matthias Renker, Christina Grothusen, Yeong-Hoon Choi, Efstratios I Charitos, Charlotte Duesmann, Johannes Blumenstein, Tobias Rheude, Samuel Sossalla, Michael Joner, Helge Möllmann","doi":"10.1016/j.jcin.2024.09.042","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.09.042","url":null,"abstract":"<p><strong>Background: </strong>Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking.</p><p><strong>Objectives: </strong>The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves.</p><p><strong>Methods: </strong>A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively. The primary endpoint was the composite of all-cause mortality, stroke, and rehospitalization at 1 year. Secondary endpoints were the individual components of the primary endpoint at 1 year. To adjust for baseline differences, nearest neighbor propensity score matching was used.</p><p><strong>Results: </strong>After matching (702 pairs), baseline characteristics were similar between groups. Device success was more common in the neo2 group (87.5% vs 82.3%; P = 0.007), irrespective of matching. DP mean after the procedure was higher for Ultra (13 mm Hg [Q1-Q3: 10-15 mm Hg] vs 8 mm Hg [Q1-Q3: 6-11] mm Hg; P < 0.001). Rates of paravalvular leakage, device embolization, and multiple valve implantations were more common in the neo2 arm, whereas major cardiac structural complications and major vascular complications occurred more frequently in the Ultra group. All other in-hospital complication rates were similar between the 2 groups. At 1 year, the cumulative incidence of the primary endpoint (14.1% for neo2 vs 14.5% for Ultra; P = 0.819) was similar between the groups. Likewise, the individual components showed no difference between the groups.</p><p><strong>Conclusions: </strong>Despite differing immediate results, the outcomes at 1 year, including the composite of all-cause mortality, stroke, or hospitalization, were similar for neo2 and Ultra transcatheter heart valves.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":""},"PeriodicalIF":11.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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