JACC. Cardiovascular interventions最新文献

英文中文

Device-Associated Posterior Leaflet Aneurysm and Perforation Following Edge-to-Edge Mitral Repair 器械相关的后小叶动脉瘤和二尖瓣边缘修复后穿孔。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.09.041

Philipp M. Doldi MD, MSc , Michael Näbauer MD , Sebastian Sadoni MD , Lukas Stolz MD , Ludwig Weckbach MD , Thomas J. Stocker MD , Jörg Hausleiter MD

引用次数: 0

Rotational Atherectomy in Older Patients 老年患者的旋转动脉粥样硬化切除术：平衡风险和收益。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.10.029

Jason G. Kaplan MD , Frank Kalaba MD , Angelo Oliva MD , Samantha Sartori PhD , Kenneth F. Smith MPH , Ishita Vasudev MD , Amit Hooda MD , Joseph Sweeny MD , Roxana Mehran MD , Annapoorna Kini MD , Samin K. Sharma MD

引用次数: 0

What Can CT Tell Us About Biventricular Function After TTVR That Echocardiography Cannot? CT能告诉我们什么超声心动图不能告诉我们的TTVR术后双心室功能？

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.10.025

Muhammed Gerçek MD , Felix Rudolph MD

引用次数: 0

Long-Term Outcomes of Patients Requiring PM Implantation After TAVR TAVR术后需要PM植入的患者的长期预后

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.06.042

Nijat Rzayev MD, Laiba Khan MD, Maham Khan MD

引用次数: 0

Hypoattenuated Leaflet Thickening and Reduced Leaflet Motion After Transcatheter Tricuspid Valve Replacement 经导管三尖瓣置换术后小叶增厚减少和小叶运动减少。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.10.026

Hannah Kempton MD , Lukas Stolz MD , Thomas Stocker MD , Philipp M. Doldi MD , Ludwig Weckbach MD , Julia Novotny MD , Jaqueline da Rocha e Silva MD , Dario Grassini MD , Nicola Fink MD , Michael Näbauer MD , Steffen Massberg MD , Jörg Hausleiter MD

Background

Reduced leaflet motion (RLM) induced by hypoattenuated leaflet thickening (HALT) is a known complication after bioprosthetic aortic valve replacement, associated with adverse outcomes. A similar phenomenon has been observed after transcatheter tricuspid valve replacement (TTVR) but remains unclassified.

Objectives

The aim of this study was to introduce a grading system for valve thrombosis and dysfunction after TTVR and describe its clinical and echocardiographic associations.

Methods

Thirty-day follow-up computed tomographic (CT) scans from all patients undergoing orthotopic TTVR were analyzed. Grading systems for RLM_CT severity (none, mild to moderate, and severe) and HALT (0°-4°) were developed. These were correlated with clinical and echocardiographic parameters at 30 days and up to 3 years.

Results

Among 53 patients, 45 had 30-day CT data. Moderate to severe HALT was present in 12 cases (27%). RLM_CT severity was none in 15 (33%), mild to moderate in 21 (74%), and severe in 9 (20%). HALT was correlated with RLM_CT severity (P < 0.001), and both were associated with increased transvalvular gradient (P = 0.032 and P < 0.0001) and reduced NYHA functional class improvement at 30 days (P = 0.002 and P = 0.003). RLM_CT was correlated with echocardiographic RLM (P < 0.0001), but RLM_echo was less sensitive, detecting just 6 of 9 severe cases of RLM. Similarly, severe HALT was detected on echocardiography in just 3 of 7 cases. There was no association between HALT or RLM_CT and anticoagulation strategy.

Conclusions

HALT and RLM_CT are common after TTVR and are associated with elevated gradients and reduced symptomatic alleviation. Transthoracic echocardiography is insensitive for detecting HALT and RLM, and routine CT imaging may aid early diagnosis, but the long-term impact of low-grade HALT and RLM_CT remains unclear.

目的介绍经导管三尖瓣置换术（TTVR）后瓣膜血栓形成和功能障碍的分级系统，并描述其临床和超声心动图相关性。背景：小叶减薄增厚（HALT）引起的小叶运动减少（RLM）是生物人工主动脉瓣置换术后已知的并发症，与不良结局相关。在TTVR之后也观察到类似的现象，但仍未分类。方法对所有原位TTVR患者随访30天的CT扫描结果进行分析。制定了RLMCT严重程度（无、轻中度、严重）和HALT（0-4°）的分级系统。这些与30天和3年的临床和超声心动图参数相关。结果53例患者中，45例有30天CT资料。12例（27%）出现中重度HALT。RLMCT严重程度为：无15例（33%），轻中度21例（74%），重度9例（20%）。HALT与RLMCT严重程度相关（p<0.001），两者均与经瓣梯度增加（p=0.032; <0.0001）和30天NYHA分级改善减少相关（p=0.002; p=0.003）。RLMCT与超声心动图RLM相关（p<0.0001），但RLMecho不太敏感，仅检测出9例严重RLM中的6例。同样，7例中仅有3例超声检测到严重的HALT。HALT或RLMCT与抗凝策略之间没有关联。结论在TTVR后，shall和RLMCT较为常见，且与梯度升高、症状改善程度降低相关。经胸超声心动图对HALT和RLM不敏感，常规CT可能有助于早期诊断，但低级别HALT和RLMCT的长期影响尚不清楚。

{"title":"Hypoattenuated Leaflet Thickening and Reduced Leaflet Motion After Transcatheter Tricuspid Valve Replacement","authors":"Hannah Kempton MD , Lukas Stolz MD , Thomas Stocker MD , Philipp M. Doldi MD , Ludwig Weckbach MD , Julia Novotny MD , Jaqueline da Rocha e Silva MD , Dario Grassini MD , Nicola Fink MD , Michael Näbauer MD , Steffen Massberg MD , Jörg Hausleiter MD","doi":"10.1016/j.jcin.2025.10.026","DOIUrl":"10.1016/j.jcin.2025.10.026","url":null,"abstract":"<div><h3>Background</h3><div>Reduced leaflet motion (RLM) induced by hypoattenuated leaflet thickening (HALT) is a known complication after bioprosthetic aortic valve replacement, associated with adverse outcomes. A similar phenomenon has been observed after transcatheter tricuspid valve replacement (TTVR) but remains unclassified.</div></div><div><h3>Objectives</h3><div>The aim of this study was to introduce a grading system for valve thrombosis and dysfunction after TTVR and describe its clinical and echocardiographic associations.</div></div><div><h3>Methods</h3><div>Thirty-day follow-up computed tomographic (CT) scans from all patients undergoing orthotopic TTVR were analyzed. Grading systems for RLM<sub>CT</sub> severity (none, mild to moderate, and severe) and HALT (0°-4°) were developed. These were correlated with clinical and echocardiographic parameters at 30 days and up to 3 years.</div></div><div><h3>Results</h3><div>Among 53 patients, 45 had 30-day CT data. Moderate to severe HALT was present in 12 cases (27%). RLM<sub>CT</sub> severity was none in 15 (33%), mild to moderate in 21 (74%), and severe in 9 (20%). HALT was correlated with RLM<sub>CT</sub> severity (<em>P</em> < 0.001), and both were associated with increased transvalvular gradient (<em>P</em> = 0.032 and <em>P</em> < 0.0001) and reduced NYHA functional class improvement at 30 days (<em>P</em> = 0.002 and <em>P</em> = 0.003). RLM<sub>CT</sub> was correlated with echocardiographic RLM (<em>P</em> < 0.0001), but RLM<sub>echo</sub> was less sensitive, detecting just 6 of 9 severe cases of RLM. Similarly, severe HALT was detected on echocardiography in just 3 of 7 cases. There was no association between HALT or RLM<sub>CT</sub> and anticoagulation strategy.</div></div><div><h3>Conclusions</h3><div>HALT and RLM<sub>CT</sub> are common after TTVR and are associated with elevated gradients and reduced symptomatic alleviation. Transthoracic echocardiography is insensitive for detecting HALT and RLM, and routine CT imaging may aid early diagnosis, but the long-term impact of low-grade HALT and RLM<sub>CT</sub> remains unclear.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 2","pages":"Pages 225-235"},"PeriodicalIF":11.4,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373968","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}

引用次数: 0

Comparison of Early Outcomes Following Transjugular Transcatheter Tricuspid Valve Replacement Between Large vs Small Annulus 经颈静脉经导管三尖瓣置换术大环与小环早期疗效比较。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.11.013

Fei Chen MD , Xinyue Yang MD , Fan Qiao MD , Yuan Feng MD , Zhengang Zhao MD , Xin Wei MD , Xi Li MD , Tianyuan Xiong MD , Yi Zhang MD , Junbo Ge MD , Fanglin Lu MD , Mao Chen MD, PhD

Background

Transcatheter tricuspid valve replacement (TTVR) is a promising therapy for tricuspid regurgitation (TR), but comprehensive comparison of clinical outcomes stratified by annular size remains understudied.

Objectives

The aim of this study was to evaluate and compare early outcomes in patients treated with transjugular TTVR stratified by annular size.

Methods

Patients with grade ≥3 TR undergoing LuX-Valve Plus TTVR were enrolled across 13 centers from May 2022 to March 2024. They were stratified into a large-annulus group (LAG) (perimeter-derived annular diameter ≥51 mm or maximal annular diameter ≥55 mm) and a small-annulus group (SAG). Early outcomes included device, procedural, or intraprocedural success; TR reduction; and 30-day primary endpoints or clinical success.

Results

Among 159 patients, baseline TR severity was greater in the LAG (n = 42) than the SAG (n = 117). Superior trial-defined device or procedural success (81.0% vs 97.4%; P = 0.001) and Tricuspid Valve Academic Research–defined intraprocedural success (78.6% vs 96.6%; P = 0.001) were observed in the SAG. At 30 days, primary endpoint rates were similar (trial defined, 16.7% vs 14.5% [P = 0.936]; TRISCEND II [Edwards EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy Using a Novel Device] defined, 21.4% vs 22.2% [P = 1.000]), but Tricuspid Valve Academic Research Consortium clinical success favored the SAG (73.8% vs 94.9%; P = 0.001). Severe paravalvular regurgitation (7.1% vs 0.0%; P = 0.017) occurred only in the LAG, while new-onset third-degree atrioventricular block or pacemaker implantation (0.0% vs 9.4%) was exclusive to the SAG. Severe bleeding was comparable between the groups (14.3% vs 9.4%; P = 0.391).

Conclusions

LuX-Valve Plus TTVR appears to be safe and effective in TR patients regardless of annular size, but TR reduction was more significant in the SAG, with specific differences in some major adverse events between groups.

背景：经导管三尖瓣置换术（TTVR）是治疗三尖瓣反流（TR）的一种很有前景的治疗方法，但根据环大小分层的临床结果的综合比较仍有待研究。目的：本研究的目的是评估和比较按环大小分层的经颈静脉TTVR患者的早期预后。方法在2022年5月至2024年3月期间，在13个中心接受LuX-Valve Plus TTVR治疗的≥3级TR患者入组。将患者分为大环组（LAG）和小环组（SAG）。大环组为周源环径≥51 mm或最大环径≥55 mm。早期结果包括器械、手术或术中成功；TR减少;30天的主要终点或临床成功。结果159例患者中，LAG组（n = 42）的基线TR严重程度大于SAG组（n = 117）。在SAG中观察到更好的试验定义的器械或手术成功率（81.0% vs 97.4%, P = 0.001）和三尖瓣学术研究定义的术中成功率（78.6% vs 96.6%, P = 0.001）。30天时，主要终点率相似（试验定义，16.7% vs 14.5% [P = 0.936]； TRISCEND II [Edwards EVOQUE经导管三尖瓣置换术：使用新型装置安全性和临床疗效的关键临床研究]定义，21.4% vs 22.2% [P = 1.000]），但三尖瓣学术研究联盟的临床成功更有利于SAG （73.8% vs 94.9%; P = 0.001）。严重瓣旁反流（7.1% vs 0.0%; P = 0.017）仅发生在LAG，而新发三度房室传导阻滞或起搏器植入（0.0% vs 9.4%）仅发生在SAG。严重出血在两组间具有可比性（14.3% vs 9.4%; P = 0.391）。结论slax - valve + TTVR对TR患者安全有效，与环大小无关，但在SAG中TR减少更为显著，在一些主要不良事件上组间存在特异性差异。

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引用次数: 0

Transcatheter Valve-in-Valve Replacement After Transcatheter Tricuspid Valve Replacement 经导管三尖瓣置换术后的经导管瓣内置换术。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.11.020

Jiawei Zhou MD, Yuehuan Li MD, JianGang Wang MD, Haibo Zhang MD

引用次数: 0

TTVR in Large or Small Annuli 大环或小环的TTVR：我们知道的越多，我们害怕的就越少。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.11.014

Antonio Mangieri MD , Francesco Tartaglia MD

引用次数: 0

PFO Closure for Secondary Stroke Prevention in Patients >60 Years PFO关闭对60岁以下患者二级卒中预防的作用

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.06.045

Anastasios Apostolos MD, MSc , Nikolaos Ktenopoulos MD, MSc , Ioannis Skalidis MD, PhD , Konstantinos Tsioufis MD, PhD , Konstantinos Toutouzas MD, PhD

引用次数: 0

Radiation Exposure to Operators in Coronary Procedures Between Left Distal and Right Conventional Radial Access 冠状动脉手术操作者在左远端和右常规桡动脉通路之间的辐射暴露。

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions

Pub Date : 2026-01-26 DOI: 10.1016/j.jcin.2025.10.028

Oh-Hyun Lee MD , Ji Woong Roh MD, PhD , Yongcheol Kim MD, PhD , Seok-Jae Heo PhD , Sang Yeub Lee MD, PhD , Jung-Hee Lee MD, PhD , Eui Im MD , Deok-Kyu Cho MD

Background

Distal radial access (DRA) may improve vascular complications, patient comfort, and hemostasis time. DRA-associated operator radiation exposure data are limited.

Objectives

The aim of this study was to compare operator radiation exposure between left DRA and right transradial access (TRA).

Methods

In this prospective, multicenter, open-label trial, 1,010 patients scheduled to undergo coronary procedures were randomly assigned in a 1:1 ratio to either the left DRA or right TRA group. The primary endpoint was operator radiation exposure, measured using a set of 3 real-time radiation detection dosimeters on the left wrist, head, and chest by 5 experienced DRA operators. The secondary endpoints included the incidence of access-site crossover, total fluoroscopy time, total procedure time, and total contrast volume used.

Results

The primary endpoint analysis included 1,001 patients (501 in the left DRA group and 500 in the right TRA group). No significant differences were observed in operator radiation exposure to left wrist (4.76 μSv vs 5.20 μSv; P = 0.342), head (2.00 μSv vs 1.83 μSv; P = 0.416), and chest (1.28 μSv vs 1.07 μSv; P = 0.199) between the left DRA and right TRA groups. The incidence of crossover (6.6% vs 5.2%; P = 0.416), fluoroscopy time (4.5 minutes vs 4.2 minutes; P = 0.673), procedure time (16.0 minutes vs 15.0 minutes; P = 0.314), and contrast volume (80.0 mL vs 80.0 mL; P = 0.222) were not significantly different between the 2 groups.

Conclusions

During coronary procedures, no significant differences were observed in the operator radiation exposure at the left wrist, head, and chest between the left DRA and right TRA groups.

桡骨远端通路（DRA）可改善血管并发症、患者舒适度和止血时间。与dra相关的操作员辐射暴露数据是有限的。目的比较左桡动脉放射治疗（DRA）和右桡动脉放射治疗（TRA）的操作者辐射暴露情况。方法在这项前瞻性、多中心、开放标签的试验中，我们将1010名计划接受冠状动脉手术的患者按1:1的比例随机分配到左DRA组或右TRA组。主要终点是操作者的辐射暴露（μSv），由5名经验丰富的DRA操作者使用3套实时辐射检测剂量计在左手腕、头部和胸部测量。次要终点包括通路交叉发生率、总透视时间、总手术时间和使用的总造影剂体积。结果主要终点分析纳入1001例患者（左DRA组501例，右TRA组500例）。左、右TRA组操作者在左手腕（4.76 vs. 5.20 μSv， P=0.342）、头部（2.00 vs. 1.83 μSv， P=0.416）、胸部（1.28±vs. 1.07 μSv， P=0.199）的辐射暴露量差异无统计学意义。两组间交叉发生率（6.6% vs. 5.2%， P=0.416）、透视时间（4.5 vs. 4.2 min， P=0.673）、手术时间（16.0 vs. 15.0 min， P=0.314）、造影剂体积（80.0 vs. 80.0 mL， P=0.222）差异无统计学意义。结论在冠状动脉手术过程中，左DRA组和右TRA组的操作者在左手腕、头部和胸部的辐射暴露无显著差异。

{"title":"Radiation Exposure to Operators in Coronary Procedures Between Left Distal and Right Conventional Radial Access","authors":"Oh-Hyun Lee MD , Ji Woong Roh MD, PhD , Yongcheol Kim MD, PhD , Seok-Jae Heo PhD , Sang Yeub Lee MD, PhD , Jung-Hee Lee MD, PhD , Eui Im MD , Deok-Kyu Cho MD","doi":"10.1016/j.jcin.2025.10.028","DOIUrl":"10.1016/j.jcin.2025.10.028","url":null,"abstract":"<div><h3>Background</h3><div>Distal radial access (DRA) may improve vascular complications, patient comfort, and hemostasis time. DRA-associated operator radiation exposure data are limited.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare operator radiation exposure between left DRA and right transradial access (TRA).</div></div><div><h3>Methods</h3><div>In this prospective, multicenter, open-label trial, 1,010 patients scheduled to undergo coronary procedures were randomly assigned in a 1:1 ratio to either the left DRA or right TRA group. The primary endpoint was operator radiation exposure, measured using a set of 3 real-time radiation detection dosimeters on the left wrist, head, and chest by 5 experienced DRA operators. The secondary endpoints included the incidence of access-site crossover, total fluoroscopy time, total procedure time, and total contrast volume used.</div></div><div><h3>Results</h3><div>The primary endpoint analysis included 1,001 patients (501 in the left DRA group and 500 in the right TRA group). No significant differences were observed in operator radiation exposure to left wrist (4.76 μSv vs 5.20 μSv; <em>P</em> = 0.342), head (2.00 μSv vs 1.83 μSv; <em>P</em> = 0.416), and chest (1.28 μSv vs 1.07 μSv; <em>P</em> = 0.199) between the left DRA and right TRA groups. The incidence of crossover (6.6% vs 5.2%; <em>P</em> = 0.416), fluoroscopy time (4.5 minutes vs 4.2 minutes; <em>P</em> = 0.673), procedure time (16.0 minutes vs 15.0 minutes; <em>P</em> = 0.314), and contrast volume (80.0 mL vs 80.0 mL; <em>P</em> = 0.222) were not significantly different between the 2 groups.</div></div><div><h3>Conclusions</h3><div>During coronary procedures, no significant differences were observed in the operator radiation exposure at the left wrist, head, and chest between the left DRA and right TRA groups.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 2","pages":"Pages 160-170"},"PeriodicalIF":11.4,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374024","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}

引用次数: 0

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

JACC. Cardiovascular interventions

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