Structural Heart最新文献

{"title":"Aims & Scope","authors":"","doi":"10.1016/S2474-8706(26)00036-9","DOIUrl":"10.1016/S2474-8706(26)00036-9","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100827"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448947","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}

{"title":"Quantification of Alpha-Gal Expression in Commercial BioProsthetic Heart Valves and Its Potential Mitigation","authors":"Andrea Colli MD ,&nbsp;Peter Zilla MD ,&nbsp;Antonio Maria Calafiore MD ,&nbsp;Massimo Padalino MD ,&nbsp;Filippo Naso MLT, BSc ,&nbsp;Isaac George MD","doi":"10.1016/j.shj.2025.100739","DOIUrl":"10.1016/j.shj.2025.100739","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Bioprosthetic heart valves (BHVs) are inherently susceptible to structural degeneration, driven by a combination of mechanical stress, lipid infiltration, glutaraldehyde-induced crosslinking instability, and progressive calcification. Recent evidence has implicated the αGal antigen (galactose-α-1,3-galactose) as an additional contributor to BHV deterioration through activation of innate immune pathways. The present study aims to: 1) perform a quantitative assessment of the residual presence of xenoantigens, specifically αGal, in a range of commercial BHV models; 2) evaluate the efficacy of an experimental polyphenol-based treatment in neutralizing these antigenic determinants; and 3) investigate the long-term stability of glutaraldehyde fixation concerning the potential re-exposure of αGal epitopes.</div></div><div><h3>Methods</h3><div>Twelve distinct BHV models were subjected to in vitro analysis for αGal antigen quantification both before and following application of an experimental polyphenol treatment. Additionally, glutaraldehyde-fixed bovine pericardial tissues were incubated in a physiologically mimetic, blood-like environment for up to 9 years in real-time to simulate the long-term behavior of BHV materials and assess antigen unmasking associated with glutaraldehyde degradation.</div></div><div><h3>Results</h3><div>The average count of the αGal epitope in original pericardial valve models was 4.18 ± 0.72 × 10¹¹/10 mg of tissue, whereas porcine valve-derived prostheses exhibited a higher mean value of 8.51 ± 2.17 × 10¹¹/10 mg. Treatment with the polyphenol formulation resulted in a marked reduction (approximately 99%) in detectable αGal epitopes. Furthermore, glutaraldehyde fixed pericardial tissues subjected to prolonged incubation demonstrated up to 60% re-exposure of previously masked αGal antigens after 9 years, consistent with a progressive compromise of glutaraldehyde crosslinking integrity.</div></div><div><h3>Conclusion</h3><div>The data confirm that commercially available BHVs retain a substantial immunogenic burden attributable to αGal xenoantigens. Importantly, the overtime degradation of glutaraldehyde crosslinks facilitates the gradual re-exhibition of these epitopes, potentially undermining long-term valve performance. The pronounced efficacy of polyphenol-based treatment in inhibiting αGal antigens highlights its promise as a biocompatibility-enhancing pretreatment strategy for next-generation BHVs.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100739"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090676","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}

{"title":"Letter to the Editor Response","authors":"Revathy Sampath-Kumar MD,&nbsp;Ehtisham Mahmud MD","doi":"10.1016/j.shj.2025.100783","DOIUrl":"10.1016/j.shj.2025.100783","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100783"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039307","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}

{"title":"Impact of ICD-10-CM Z-Coded Social Determinants of Health on Transcatheter Aortic Valve Replacement–Related Outcomes","authors":"Ramzi Ibrahim MD ,&nbsp;Matthew Romero BS ,&nbsp;Hoang Nhat Pham MD ,&nbsp;Ahmed K. Mahmoud MD ,&nbsp;Kristen A. Sell-Dottin MD ,&nbsp;John P. Sweeney MD ,&nbsp;F. David Fortuin MD ,&nbsp;Eugene Yang MD, MS ,&nbsp;Kwan Lee MD ,&nbsp;Said Alsidawi MD ,&nbsp;Sadeer Al-Kindi MD ,&nbsp;Chadi Ayoub MBBS, PhD ,&nbsp;Reza Arsanjani MD","doi":"10.1016/j.shj.2025.100789","DOIUrl":"10.1016/j.shj.2025.100789","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100789"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950269","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}

{"title":"Sheltering From the Storm: Advancing Radiation Protection in Interventional Echocardiography","authors":"Nishath Quader MD ,&nbsp;Renuka Jain MD","doi":"10.1016/j.shj.2025.100784","DOIUrl":"10.1016/j.shj.2025.100784","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100784"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448945","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}

{"title":"Performance of a Dedicated Radioprotection Cabin for the Interventional Echocardiographer During Structural Heart Procedures","authors":"François Magniez MD ,&nbsp;Luis Ammour PhD ,&nbsp;Pierre-Guillaume Piriou MD ,&nbsp;Nicolas Piriou MD ,&nbsp;David Stevant MD ,&nbsp;Quentin Bernard MD ,&nbsp;Laurianne Le Gloan MD ,&nbsp;Philippe Jaafar MD ,&nbsp;Vincent Letocart MD ,&nbsp;Julien Plessis MD ,&nbsp;Thibaut Manigold MD ,&nbsp;Robin Le Ruz MD ,&nbsp;Pierre Yves Turgeon MD ,&nbsp;Patrice Guerin MD, PhD","doi":"10.1016/j.shj.2025.100756","DOIUrl":"10.1016/j.shj.2025.100756","url":null,"abstract":"<div><h3>Background</h3><div>Structural heart procedures performed under fluoroscopy and transesophageal echocardiography guidance require the expertise of an interventional echocardiographer in the heart team. Due to the proximity with the radiation source, the physician might be exposed to high radiation doses. This study aims to assess the interventional echocardiographer radioprotection by means of a dedicated cabin and evaluate its ergonomic characteristics.</div></div><div><h3>Methods</h3><div>This is an observational nonrandomized study comparing cumulative radiation exposure between a control arm, consisting of a standard lead glass panel, and the experimental arm using the dedicated radioprotective Echosafe cabin. All structural heart procedures requiring transesophageal echocardiography between July 2021 and April 2022 were included. Cumulative radiation exposure of the interventional echocardiographer was collected by the body part and the satisfaction of the heart team with the cabin was assessed with a questionnaire.</div></div><div><h3>Results</h3><div>A total of 64 procedures were included (24 controls and 40 with the cabin). The irradiation (as estimated by dose area product per procedure) was similar between the two groups (<em>p</em> = 0.94). The use of the cabin resulted in a numerically lower cumulative radiation dose to each body part. The mean overall reduction in radiation dose was estimated to be between 56 and 78% with the cabin. The most frequent negative aspects reported by the cabin users included difficulty moving the transesophageal echocardiography probe and the physical burden associated with initial installation.</div></div><div><h3>Conclusions</h3><div>This preliminary study suggests that radioprotection of the interventional echocardiographer can be increased during structural procedures by using a dedicated cabin. Further studies with larger sample sizes and different design will be needed to confirm the reduction in irradiation of the echocardiographer.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100756"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448948","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}

{"title":"Impact of Changes in Renal Function on Outcomes Following Mitral Transcatheter Edge-To-Edge Repair","authors":"Parth N. Patel MD ,&nbsp;Olivia L. Hulme MD ,&nbsp;Marc Allard-Ratick MD ,&nbsp;Jay Khambhati MD ,&nbsp;Amanda Stebbins MPH ,&nbsp;Andrzej S. Kosinski PhD ,&nbsp;Sreekanth Vemulapalli MD ,&nbsp;Sammy Elmariah MD, MPH","doi":"10.1016/j.shj.2025.100747","DOIUrl":"10.1016/j.shj.2025.100747","url":null,"abstract":"<div><h3>Background</h3><div>Hemodynamic changes following mitral transcatheter edge-to-edge repair (mTEER) may impact estimated glomerular filtration rate (eGFR), but whether changes in eGFR following mTEER are associated with subsequent clinical outcomes is not known. The objective of the study was to investigate procedure-related changes in eGFR and clinical outcomes following mTEER.</div></div><div><h3>Methods</h3><div>We studied patients in the Transcatheter Valve Therapy registry undergoing mTEER between 2013 and 2022 with available baseline and discharge eGFR. Multivariable linear regression identified baseline characteristics associated with changes in eGFR following mTEER. Cox proportional hazards models examined the adjusted association between improved (≥10% increase in eGFR), unchanged, and worsened renal function (≥10% decrease in eGFR) and survival at 1 year.</div></div><div><h3>Results</h3><div>Among 48,472 patients undergoing mTEER, 15.7% experienced improved renal function and 13.7% had worsened renal function. Cardiogenic shock within 24 hours, age &gt;80, Black race, diabetes, heart failure within 2 weeks, and female sex were strongly associated with worsened renal function after mTEER. Compared to the group with no change in renal function, improved renal function was associated with a decreased risk of 1-year mortality (adjusted hazard ratio: 0.77; 95% CI 0.69-0.86, <em>p</em> &lt; 0.001), whereas worsened renal function was associated with an increased risk of death at 1 year (adjusted hazard ratio: 2.85; 95% CI 2.64-3.08, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Approximately 30% of patients experience marked changes in renal function following mTEER.</div><div>A greater than 10% increase or decrease in eGFR is independently associated with differences in 1-year survival. Careful attention to patients at greatest risk for worsened renal function after mTEER is warranted.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100747"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183688","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}

{"title":"Aortic Valve Trans-Leaflet Lithotripsy for Targeted Periannular Calcium Modification Prior to TAVI","authors":"Cheuk Bong Ho MBBS,&nbsp;Hon Yeung Ko MBChB,&nbsp;Michael Chi Shing Chiang MBBS,&nbsp;Shing Fung Chui MBChB,&nbsp;Ka Chun Chan MBBS,&nbsp;Kam Tim Chan MBBS,&nbsp;Eric Chi Yuen Wong MBBS,&nbsp;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":"2026-02-01","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}

{"title":"Radiation Realities: Radiation Safety Practices and Awareness Among Interventional Echocardiographers in the United States","authors":"Priscilla Wessly MD ,&nbsp;Enrique Garcia-Sayan MD ,&nbsp;Nishath Quader MD ,&nbsp;Stephen Little MD ,&nbsp;Omar Khalique MD ,&nbsp;Renuka Jain MD","doi":"10.1016/j.shj.2025.100785","DOIUrl":"10.1016/j.shj.2025.100785","url":null,"abstract":"<div><h3>Background</h3><div>With the rise of structural heart interventions (SHIs), interventional echocardiographers (IEs) face significant radiation exposure in catheterization laboratories. However, US-specific radiation safety practices remain understudied. This study aims to address radiation safety practices and concerns among US IEs, focusing on occupational risks and sex-specific challenges.</div></div><div><h3>Methods</h3><div>A 21-item online survey was conducted from March to June 2025, targeting US IEs through a multifaceted recruitment strategy. It assessed demographics, SHI frequency, radiation monitoring, shielding practices, and reproductive health concerns. Descriptive statistics summarized responses, with sex-specific analyses for female IEs.</div></div><div><h3>Results</h3><div>Of 69 respondents (64% [n = 44] men, 36% [n = 25] women), 88% (n = 61) worked in tertiary care settings and 46% (n = 32) guided SHIs several times weekly. Key gaps were identified, including 18% (n = 17) not using dosimeters, 64% (n = 44) never receiving exposure notifications, and 80% (n = 55) lacking awareness of their personal annual radiation dose. In addition, 30% (n = 21) had no radiation safety training, and 75% (n = 52) reported insufficient radiation protection in their catheterization laboratory. Reproductive health concerns affected 71% (n = 49) of IEs. Among female IEs, 56% (n = 14) reported an influence on pregnancy planning, 32% (n = 8) noted career concerns owing to maternity, and 63% of those who had had a pregnancy (n = 12/19) performed SHIs during pregnancy, with 7% taking no additional precautions.</div></div><div><h3>Conclusions</h3><div>US IEs face critical radiation safety gaps, including inadequate monitoring, training, and shielding, with pronounced reproductive and career concerns among female IEs. Tailored protocols, enhanced shielding, and pregnancy-specific precautions are urgently needed to ensure the safety and well-being of IEs.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 2","pages":"Article 100785"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927500","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}

{"title":"Pushing the Limits of Transcatheter Edge-to-Edge Repair: How Small Can the Mitral Valve Area Go?","authors":"Gaspard Suc MD, PhD","doi":"10.1016/j.shj.2025.100782","DOIUrl":"10.1016/j.shj.2025.100782","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 2","pages":"Article 100782"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078716","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}