Pub Date : 2025-12-02DOI: 10.1016/j.shj.2025.100772
Chloe Kharsa MD, MSc , Yasser M. Sammour MD , Rasha Bazari MD , Alba Muñoz Estrella MD , Gal Sella MD , Sahar Samimi MD , Samarthkumar Thakkar MD , Mangesh Kritya MD , Taha Hatab MD , Rody G. Bou Chaaya MD , Syed Zaid MD , Joe Aoun MD , Sherif F. Nagueh MD , William A. Zoghbi MD , Marvin D. Atkins MD , Michael Reardon MD , Nadeen N. Faza MD , Stephen H. Little MD , Gerald Lawrie MD , Neal S. Kleiman MD , Sachin S. Goel MD
Background
A small baseline mitral valve area (MVA) raises concern for iatrogenic mitral stenosis due to increased transmitral pressure gradients (TMPG) after mitral transcatheter edge-to-edge repair (M-TEER). Outcomes in patients with MVA <4.0 cm² remain limited, as this population has been largely excluded from clinical trials.
Methods
We retrospectively analyzed 305 consecutive patients who underwent M-TEER (2014-2022). Patients were stratified by baseline MVA (<4.0 cm2 vs. ≥4.0 cm2). The primary endpoint was 2-year all-cause mortality. Secondary endpoints included heart failure hospitalization (HFH), mitral regurgitation (MR) reduction, New York Heart Association functional class improvement, and postprocedural TMPG.
Results
Of 305 patients, 66 (21.6%) had MVA <4.0 cm². Women were more prevalent in the small MVA group (57.6% vs. 42.7%; p = 0.03). Patients with smaller MVA received fewer clips (1.3 ± 0.07 vs. 1.5 ± 0.04; p = 0.03). Procedural success and in-hospital outcomes were comparable. At discharge, residual MR (<moderate) and New York Heart Association class were similar, although TMPG was higher in the small group (3.9 ± 0.2 vs. 3.3 ± 0.1 mmHg; p = 0.006). At 30 days and 1 year, mortality, HFH, and residual MR rates remained similar. Two-year Kaplan–Meier analyses showed no differences in survival, HFH, or composite outcomes. In multivariable analysis, age, creatinine, and hemoglobin predicted mortality, while age, LVEF, and hemoglobin predicted the composite outcome. Indexed MVA did not predict mortality or elevated TMPG.
Conclusions
M-TEER can be safely and effectively performed in patients with baseline MVA <4.0 cm2 without adverse clinical outcomes through 2 years.
{"title":"Outcomes of Mitral Transcatheter Edge-to-Edge Repair in Patients With Small Mitral Valve Area","authors":"Chloe Kharsa MD, MSc , Yasser M. Sammour MD , Rasha Bazari MD , Alba Muñoz Estrella MD , Gal Sella MD , Sahar Samimi MD , Samarthkumar Thakkar MD , Mangesh Kritya MD , Taha Hatab MD , Rody G. Bou Chaaya MD , Syed Zaid MD , Joe Aoun MD , Sherif F. Nagueh MD , William A. Zoghbi MD , Marvin D. Atkins MD , Michael Reardon MD , Nadeen N. Faza MD , Stephen H. Little MD , Gerald Lawrie MD , Neal S. Kleiman MD , Sachin S. Goel MD","doi":"10.1016/j.shj.2025.100772","DOIUrl":"10.1016/j.shj.2025.100772","url":null,"abstract":"<div><h3>Background</h3><div>A small baseline mitral valve area (MVA) raises concern for iatrogenic mitral stenosis due to increased transmitral pressure gradients (TMPG) after mitral transcatheter edge-to-edge repair (M-TEER). Outcomes in patients with MVA <4.0 cm² remain limited, as this population has been largely excluded from clinical trials.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 305 consecutive patients who underwent M-TEER (2014-2022). Patients were stratified by baseline MVA (<4.0 cm<sup>2</sup> vs. ≥4.0 cm<sup>2</sup>). The primary endpoint was 2-year all-cause mortality. Secondary endpoints included heart failure hospitalization (HFH), mitral regurgitation (MR) reduction, New York Heart Association functional class improvement, and postprocedural TMPG.</div></div><div><h3>Results</h3><div>Of 305 patients, 66 (21.6%) had MVA <4.0 cm². Women were more prevalent in the small MVA group (57.6% vs. 42.7%; p = 0.03). Patients with smaller MVA received fewer clips (1.3 ± 0.07 vs. 1.5 ± 0.04; <em>p</em> = 0.03). Procedural success and in-hospital outcomes were comparable. At discharge, residual MR (<moderate) and New York Heart Association class were similar, although TMPG was higher in the small group (3.9 ± 0.2 vs. 3.3 ± 0.1 mmHg; <em>p</em> = 0.006). At 30 days and 1 year, mortality, HFH, and residual MR rates remained similar. Two-year Kaplan–Meier analyses showed no differences in survival, HFH, or composite outcomes. In multivariable analysis, age, creatinine, and hemoglobin predicted mortality, while age, LVEF, and hemoglobin predicted the composite outcome. Indexed MVA did not predict mortality or elevated TMPG.</div></div><div><h3>Conclusions</h3><div>M-TEER can be safely and effectively performed in patients with baseline MVA <4.0 cm<sup>2</sup> without adverse clinical outcomes through 2 years.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 2","pages":"Article 100772"},"PeriodicalIF":2.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.shj.2025.100752
Knut Qvale Søndenaa , Ola Alexander Schei , Rasmus Bach Sindre , Christian Engelsen Berg-Hansen MD , Barbara Rogge MD, PhD , Cecilie Linn Aas MD , Stig Urheim MD, PhD , Jon Herstad MD , Erik Packer MD, PhD , Vegard Tuseth MD, PhD , Dana Cramariuc MD, PhD
Background
More than mild residual mitral regurgitation (MR) is associated with reduced survival after transcatheter edge-to-edge mitral valve repair (M-TEER). However, whether the morphology of the residual MR (rMR) jet affects long-term clinical outcomes has not been reported. The purpose of the study was to assess the impact of eccentric rMR (erMR) at discharge on long-term mortality and heart failure hospitalizations after M-TEER.
Methods
We analyzed preprocedural, intraprocedural, and early postprocedural echocardiographic data (1-2 days post-TEER) in patients treated by M-TEER at our institution between 2012 and 2022. Eccentric rMR was defined as a nonsymmetric, wall-hugging MR jet.
Results
Among 125 patients with early residual jets, erMR was present in 30% and more commonly in those with medially placed devices and in severe rMR (p < 0.05). Eccentric jets were equally frequent in patients with originally functional or degenerative MR. During 49 (26-79) months follow-up, the median survival was 29 months in patients with erMR vs. 65 months in patients without erMR (p < 0.001). In Cox regression analysis, erMR predicted a 2.2-fold higher risk of death (95% CI 1.3-3.7, p < 0.05) after adjustment for MR severity, age, mean blood pressure, atrial fibrillation, left ventricular and left atrial size, and device position. Eccentric rMR also predicted a 1.8-fold (95% CI 1.1-3.1, p = 0.02) higher adjusted risk of heart failure hospitalization post-M-TEER.
Conclusions
Presence of erMR at discharge is associated with reduced long-term survival after M-TEER independent of the severity of rMR. Our findings shed light on the importance of preprocedural and intraprocedural planning to avoid eccentric jets and mitigate unfavorable long-term outcomes after M-TEER.
背景：轻度残留二尖瓣返流（MR）与经导管边缘到边缘二尖瓣修复（M-TEER）后存活率降低有关。然而，残留MR （rMR）射流的形态是否影响长期临床结果尚未报道。本研究的目的是评估出院时偏心rMR （erMR）对M-TEER术后长期死亡率和心力衰竭住院的影响。方法分析2012年至2022年在我院接受M-TEER治疗的患者术前、术中和术后早期超声心动图数据（teer后1-2天）。偏心磁流变被定义为非对称的抱壁磁流变射流。结果125例早期残留喷流患者中，erMR发生率为30%，其中放置器械者和严重rMR者发生率更高（p < 0.05）。在49（26-79）个月的随访中，erMR患者的中位生存期为29个月，而无erMR患者的中位生存期为65个月（p < 0.001）。在Cox回归分析中，在校正MR严重程度、年龄、平均血压、心房颤动、左室和左房大小以及装置位置后，erMR预测死亡风险高出2.2倍（95% CI 1.3-3.7, p < 0.05）。偏心rMR还预测m - teer后心力衰竭住院的调整风险增加1.8倍（95% CI 1.1-3.1, p = 0.02）。结论出院时erMR的存在与M-TEER术后长期生存率降低相关，与rMR的严重程度无关。我们的研究结果阐明了术前和术中规划的重要性，以避免偏心射流和减轻M-TEER术后不良的长期后果。
{"title":"Impact of Eccentric Residual Mitral Regurgitation on Long-Term Survival After Transcatheter Edge-to-Edge Mitral Valve Repair","authors":"Knut Qvale Søndenaa , Ola Alexander Schei , Rasmus Bach Sindre , Christian Engelsen Berg-Hansen MD , Barbara Rogge MD, PhD , Cecilie Linn Aas MD , Stig Urheim MD, PhD , Jon Herstad MD , Erik Packer MD, PhD , Vegard Tuseth MD, PhD , Dana Cramariuc MD, PhD","doi":"10.1016/j.shj.2025.100752","DOIUrl":"10.1016/j.shj.2025.100752","url":null,"abstract":"<div><h3>Background</h3><div>More than mild residual mitral regurgitation (MR) is associated with reduced survival after transcatheter edge-to-edge mitral valve repair (M-TEER). However, whether the morphology of the residual MR (rMR) jet affects long-term clinical outcomes has not been reported. The purpose of the study was to assess the impact of eccentric rMR (erMR) at discharge on long-term mortality and heart failure hospitalizations after M-TEER.</div></div><div><h3>Methods</h3><div>We analyzed preprocedural, intraprocedural, and early postprocedural echocardiographic data (1-2 days post-TEER) in patients treated by M-TEER at our institution between 2012 and 2022. Eccentric rMR was defined as a nonsymmetric, wall-hugging MR jet.</div></div><div><h3>Results</h3><div>Among 125 patients with early residual jets, erMR was present in 30% and more commonly in those with medially placed devices and in severe rMR (<em>p</em> < 0.05). Eccentric jets were equally frequent in patients with originally functional or degenerative MR. During 49 (26-79) months follow-up, the median survival was 29 months in patients with erMR vs. 65 months in patients without erMR (<em>p</em> < 0.001). In Cox regression analysis, erMR predicted a 2.2-fold higher risk of death (95% CI 1.3-3.7, <em>p</em> < 0.05) after adjustment for MR severity, age, mean blood pressure, atrial fibrillation, left ventricular and left atrial size, and device position. Eccentric rMR also predicted a 1.8-fold (95% CI 1.1-3.1, <em>p</em> = 0.02) higher adjusted risk of heart failure hospitalization post-M-TEER.</div></div><div><h3>Conclusions</h3><div>Presence of erMR at discharge is associated with reduced long-term survival after M-TEER independent of the severity of rMR. Our findings shed light on the importance of preprocedural and intraprocedural planning to avoid eccentric jets and mitigate unfavorable long-term outcomes after M-TEER.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100752"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.shj.2025.100754
Daryoush Samim MD , Matthias Siepe MD , Peter Jüni MD , Aakriti Gupta MD , Hasan Jilaihawi MD , Michael A. Borger MD-PhD , Raj R. Makkar MD , Martin B. Leon MD , Stephan Windecker MD
Bicuspid aortic valve (BAV) disease is the most common congenital heart abnormality, which affects up to 2% of the population and significantly increases the lifetime risk of aortic stenosis and the need for valve replacement. While surgical aortic valve replacement (SAVR) remains the standard of care in low surgical-risk patients, transcatheter aortic valve implantation (TAVI) is increasingly used as a treatment alternative with favorable outcomes in well-selected BAV patients. To date, randomized controlled trials comparing TAVI and SAVR have excluded patients with BAV, except the UK TAVI and the more recent The NOrdic Aortic Valve IntervenTION-2 trial. Of note, in The NOrdic Aortic Valve IntervenTION-2 trial, there was a numerical imbalance in the BAV subgroup, with more events observed in the TAVI group than in the SAVR group for the composite outcome (all-cause mortality, stroke, and rehospitalization) at 1- and 3-year follow-up, although the risk estimates were imprecise due to the limited number of events. The upcoming TraNscatheter Aortic Valve Implantation versus surGical AorTic valvE replacement in patients with Bicuspid aortic valve stenosis (NAVIGATE Bicuspid) and Bicuspid aortic valve replacement: EvaLuatIon of transcathetEr VERsus Surgery (BELIEVERS) trials will directly compare TAVI and SAVR in BAV populations. These trials are designed to provide robust, adequately powered estimates of the comparative safety and effectiveness of both interventions over extended follow-up and are expected to inform future guideline recommendations in the setting of BAV anatomy.
This review summarizes current data on the use of TAVI in patients with severe BAV stenosis, evaluates anatomical and procedural complexities, and outlines the design and rationale of upcoming randomized controlled trials addressing this critical knowledge gap.
{"title":"Transcatheter Treatment of Bicuspid Aortic Valve Stenosis: From Observational Studies to Randomized Clinical Trials","authors":"Daryoush Samim MD , Matthias Siepe MD , Peter Jüni MD , Aakriti Gupta MD , Hasan Jilaihawi MD , Michael A. Borger MD-PhD , Raj R. Makkar MD , Martin B. Leon MD , Stephan Windecker MD","doi":"10.1016/j.shj.2025.100754","DOIUrl":"10.1016/j.shj.2025.100754","url":null,"abstract":"<div><div>Bicuspid aortic valve (BAV) disease is the most common congenital heart abnormality, which affects up to 2% of the population and significantly increases the lifetime risk of aortic stenosis and the need for valve replacement. While surgical aortic valve replacement (SAVR) remains the standard of care in low surgical-risk patients, transcatheter aortic valve implantation (TAVI) is increasingly used as a treatment alternative with favorable outcomes in well-selected BAV patients. To date, randomized controlled trials comparing TAVI and SAVR have excluded patients with BAV, except the UK TAVI and the more recent The NOrdic Aortic Valve IntervenTION-2 trial. Of note, in The NOrdic Aortic Valve IntervenTION-2 trial, there was a numerical imbalance in the BAV subgroup, with more events observed in the TAVI group than in the SAVR group for the composite outcome (all-cause mortality, stroke, and rehospitalization) at 1- and 3-year follow-up, although the risk estimates were imprecise due to the limited number of events. The upcoming TraNscatheter Aortic Valve Implantation versus surGical AorTic valvE replacement in patients with Bicuspid aortic valve stenosis (NAVIGATE Bicuspid) and Bicuspid aortic valve replacement: EvaLuatIon of transcathetEr VERsus Surgery (BELIEVERS) trials will directly compare TAVI and SAVR in BAV populations. These trials are designed to provide robust, adequately powered estimates of the comparative safety and effectiveness of both interventions over extended follow-up and are expected to inform future guideline recommendations in the setting of BAV anatomy.</div><div>This review summarizes current data on the use of TAVI in patients with severe BAV stenosis, evaluates anatomical and procedural complexities, and outlines the design and rationale of upcoming randomized controlled trials addressing this critical knowledge gap.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100754"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.shj.2025.100771
Cheuk Bong Ho MBBS, Hon Yeung Ko MBChB, Michael Chi Shing Chiang MBBS, Shing Fung Chui MBChB, Ka Chun Chan MBBS, Kam Tim Chan MBBS, Eric Chi Yuen Wong MBBS, Michael Kang Yin Lee MBBS
{"title":"Aortic Valve Trans-Leaflet Lithotripsy for Targeted Periannular Calcium Modification Prior to TAVI","authors":"Cheuk Bong Ho MBBS, Hon Yeung Ko MBChB, Michael Chi Shing Chiang MBBS, Shing Fung Chui MBChB, Ka Chun Chan MBBS, Kam Tim Chan MBBS, Eric Chi Yuen Wong MBBS, Michael Kang Yin Lee MBBS","doi":"10.1016/j.shj.2025.100771","DOIUrl":"10.1016/j.shj.2025.100771","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 2","pages":"Article 100771"},"PeriodicalIF":2.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-16DOI: 10.1016/j.shj.2025.100758
Jennifer von Stein MD , Nina C. Wunderlich MD , Maria Isabel Körber MD , Stephan Baldus MD , Juan F. Granada MD , Roman Pfister MD , Christos Iliadis MD , Philipp von Stein MD
{"title":"Impact of Different Transcatheter Edge-to-Edge Repair Systems on Tricuspid Annular Dimensions: A Three-Dimensional Imaging Analysis","authors":"Jennifer von Stein MD , Nina C. Wunderlich MD , Maria Isabel Körber MD , Stephan Baldus MD , Juan F. Granada MD , Roman Pfister MD , Christos Iliadis MD , Philipp von Stein MD","doi":"10.1016/j.shj.2025.100758","DOIUrl":"10.1016/j.shj.2025.100758","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100758"},"PeriodicalIF":2.8,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/j.shj.2025.100759
Karim Al-Azizi MD , Mohamad Bader Abo Hajar MD , Taylor Pickering DO , Ghadi Moubarak MD , Cody W. Dorton DO , Kyle A. McCullough MD , Jonathan Ladner BS , Maya Elias BS , Colleen Parro BS , Shelby L. McCoy BS , Uzair Saeed MS , Tsung-Wei Ma PhD , Sarah Hale CRRC , Swapnil Gupta MPH , Katherine B. Harrington MD , Justin M. Schaffer MD , Asim Mohiuddin MD , William T. Brinkman MD , Amro Alsaid MD , Janaki Manne MD , Michael J. Mack MD
Background
While patient–prosthesis mismatch (PPM) after transcatheter aortic valve implantation (TAVI) has not been associated with increased mortality, its impact on quality of life (QoL) remains unclear.
Methods
We retrospectively analyzed 3013 patients undergoing TAVI (2012-2022) within a large health care system. Patients were stratified by effective orifice area indexed to body surface area (EOAi) into no (EOAi >0.85 cm2/m2), moderate (EOAi >0.65 cm2/m2 or ≤0.85 cm2/m2), or severe (EOAi ≤0.65 cm2/m2) PPM, with lower cutoffs for obese patients (body mass index ≥30 kg/m2).
Results
The median age was 80.0 (73.0; 86.0) years, and 55.6% were female with a median Society of Thoracic Surgery risk score of 4.70% (2.66; 7.64). Overall, TAVI led to significant improvements in New York Heart Association and Kansas City Cardiomyopathy Questionnaire scores at 30 days and 1 year. Severe predicted and severe measured PPm was not associated with inferior QoL outcomes improvement (all p > 0.05).
Conclusion
In this large cohort, TAVI yielded substantial and durable QoL gains, regardless of PPM severity or valve type. These findings suggest that moderate or severe PPM does not diminish functional recovery and should not be a primary determinant in valve selection or procedural strategy at 1 year.
{"title":"Impact of Measured and Predicted Patient–Prosthesis Mismatch on Quality of Life Following Transcatheter Aortic Valve Implantation","authors":"Karim Al-Azizi MD , Mohamad Bader Abo Hajar MD , Taylor Pickering DO , Ghadi Moubarak MD , Cody W. Dorton DO , Kyle A. McCullough MD , Jonathan Ladner BS , Maya Elias BS , Colleen Parro BS , Shelby L. McCoy BS , Uzair Saeed MS , Tsung-Wei Ma PhD , Sarah Hale CRRC , Swapnil Gupta MPH , Katherine B. Harrington MD , Justin M. Schaffer MD , Asim Mohiuddin MD , William T. Brinkman MD , Amro Alsaid MD , Janaki Manne MD , Michael J. Mack MD","doi":"10.1016/j.shj.2025.100759","DOIUrl":"10.1016/j.shj.2025.100759","url":null,"abstract":"<div><h3>Background</h3><div>While patient–prosthesis mismatch (PPM) after transcatheter aortic valve implantation (TAVI) has not been associated with increased mortality, its impact on quality of life (QoL) remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 3013 patients undergoing TAVI (2012-2022) within a large health care system. Patients were stratified by effective orifice area indexed to body surface area (EOAi) into no (EOAi >0.85 cm<sup>2</sup>/m<sup>2</sup>), moderate (EOAi >0.65 cm<sup>2</sup>/m<sup>2</sup> or ≤0.85 cm<sup>2</sup>/m<sup>2</sup>), or severe (EOAi ≤0.65 cm<sup>2</sup>/m<sup>2</sup>) PPM, with lower cutoffs for obese patients (body mass index ≥30 kg/m<sup>2</sup>).</div></div><div><h3>Results</h3><div>The median age was 80.0 (73.0; 86.0) years, and 55.6% were female with a median Society of Thoracic Surgery risk score of 4.70% (2.66; 7.64). Overall, TAVI led to significant improvements in New York Heart Association and Kansas City Cardiomyopathy Questionnaire scores at 30 days and 1 year. Severe predicted and severe measured PPm was not associated with inferior QoL outcomes improvement (all <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>In this large cohort, TAVI yielded substantial and durable QoL gains, regardless of PPM severity or valve type. These findings suggest that moderate or severe PPM does not diminish functional recovery and should not be a primary determinant in valve selection or procedural strategy at 1 year.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100759"},"PeriodicalIF":2.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号