Structural Heart最新文献

{"title":"WATCHMAN Complications Revisited Using Ultra-High Resolution Photon-Counting Computed Tomography","authors":"Alexander Diamant MD , Connor P. Murray MBBS , Joseph Hanna MBBS","doi":"10.1016/j.shj.2025.100753","DOIUrl":"10.1016/j.shj.2025.100753","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100753"},"PeriodicalIF":2.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584351","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":"Mission M-Possible: Mitral Transcatheter Edge-to-Edge Repair in Mitral Annular Calcification Using the Crab-Walk Technique","authors":"John Abdelmalek MD ,&nbsp;Muhammad Qudrat-Ullah MD ,&nbsp;Ahmed Souka MD ,&nbsp;Sibi Thomas DO ,&nbsp;Ralph Matar MD ,&nbsp;Lee Hafen MD ,&nbsp;Karim Al-Azizi MD","doi":"10.1016/j.shj.2025.100736","DOIUrl":"10.1016/j.shj.2025.100736","url":null,"abstract":"<div><h3>Background</h3><div>Mitral annular calcification (MAC) complicates transcatheter interventions for degenerative mitral regurgitation (DMR), particularly with small mitral valve orifice areas (MVOAs).</div></div><div><h3>Case Summary</h3><div>An 83-year-old woman with severe DMR, severe MAC, and MVOA of 3.8 cm² presented post-heart failure hospitalization with declining function. High surgical risk and unfavorable transcatheter mitral valve replacement anatomy (neo-LVOT 0.30 cm²) limited options to transcatheter edge-to-edge repair (TEER). Using the Edwards PASCAL precision system and the “Crab-Walk” technique (independent leaflet clasp manipulation for MAC-related challenges), TEER reduced mitral regurgitation to mild (1+), with a 2 mmHg gradient at 3 months. The patient was weaned off oxygen and remains asymptomatic at 1 year.</div></div><div><h3>Discussion</h3><div>This first reported mitral TEER case in DMR with significant MAC and small MVOA highlights the “Crab-Walk” technique’s innovation.</div></div><div><h3>Take-Home Messages</h3><div>TEER with novel techniques is viable for DMR with MAC when transcatheter mitral valve replacement is prohibitive.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100736"},"PeriodicalIF":2.8,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570579","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":"2025-10-29","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":"The Impact of Prosthesis-Patient Mismatch on Bioprosthetic Valve Durability After Transcatheter Aortic Valve Replacement","authors":"Revathy Sampath-Kumar MD,&nbsp;Erika Padilla BS,&nbsp;David Torres Barba MD, PhD,&nbsp;Niki Aramburo CVT,&nbsp;Ori Ben-Yehuda MD,&nbsp;Ehtisham Mahmud MD","doi":"10.1016/j.shj.2025.100741","DOIUrl":"10.1016/j.shj.2025.100741","url":null,"abstract":"<div><h3>Background</h3><div>Prosthesis-patient mismatch (PPM) is associated with structural valve deterioration after surgical aortic valve replacement. Limited evidence exists regarding its impact on hemodynamic valve deterioration (HVD) and bioprosthetic valve failure (BVF) following transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>Patients who underwent TAVR from 2013 to 2022 at UC San Diego Health with echocardiographic follow-up were retrospectively analyzed. PPM, determined by measured indexed effective orifice area, and outcomes of moderate or severe HVD and BVF were defined per Valve Academic Research Consortium 3 guidelines. Fine and Gray regression, with all-cause death as a competing risk, was used to compare the cumulative incidence of outcomes in patients with and without PPM.</div></div><div><h3>Results</h3><div>A total of 555 patients (38.7% female, median age 81 years, median Society of Thoracic Surgeons risk score 4.2%, 96.8% balloon-expandable valves) were included. PPM occurred in 66 (11.9%) patients and was associated with higher initial post-implant mean gradient (15 mmHg IQR: 10-22 vs. 11 mmHg IQR: 8-15; <em>p</em> &lt; 0001) and peak velocity (2.6 m/s IQR: 2.2-3.2 vs. 2.3 m/s IQR: 1.9-2.6; <em>p</em> &lt; 0.001). Valve-in-valve TAVR (adjusted odds ratio: 7.84; 95% CI: 3.37-18.20; <em>p</em> &lt; 0.001) and valve diameter ≤23 mm (adjusted odds ratio: 2.39; 95% CI: 1.12-5.10; <em>p</em> = 0.024) were independent predictors of PPM. The adjusted cumulative incidence of moderate or severe HVD (adjusted hazard ratio: 2.10; 95% CI: 1.02-4.30; <em>p</em> = 0.04) and BVF (adjusted hazard ratio: 4.32; 95% CI: 1.81-10.31; <em>p</em> = 0.001) was higher with PPM. Aortic valve reintervention was higher with PPM (4.5 vs. 0.6%; <em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>In this single-center cohort, PPM was associated with an over two-fold increased risk of moderate or severe HVD and an over four-fold increased risk of BVF following TAVR, emphasizing the importance of pre-implant prevention.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100741"},"PeriodicalIF":2.8,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617325","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 Central vs. Noncentral Predominant Jet Location on Clinical Outcomes: Results From the EXPANDed Studies","authors":"Jason H. Rogers MD ,&nbsp;Matthew J. Price MD ,&nbsp;Gagan D. Singh MD ,&nbsp;Paul Mahoney MD ,&nbsp;Mathew Williams MD ,&nbsp;Paolo Denti MD ,&nbsp;Anita Asgar MD ,&nbsp;Janani Aiyer MS ,&nbsp;Rong Huang MS ,&nbsp;Jose Luis Zamorano MD ,&nbsp;Federico M. Asch MD ,&nbsp;Francesco Maisano MD ,&nbsp;Saibal Kar MD ,&nbsp;Ralph Stephan von Bardeleben MD ,&nbsp;Evelio Rodriguez MD","doi":"10.1016/j.shj.2025.100743","DOIUrl":"10.1016/j.shj.2025.100743","url":null,"abstract":"<div><h3>Background</h3><div>Mitral transcatheter edge-to-edge repair (M-TEER) is a treatment option for patients with severe mitral regurgitation (MR) at a high surgical risk. Although most MR involves central A2P2 jets, a subset present with noncentral jets, which may introduce procedural complexity and influence outcomes. The objective of the study was to evaluate the impact of main MR jet location (central [A2P2] versus noncentral [A1/P1 or A3/P3]) on procedural success and clinical outcomes following M-TEER.</div></div><div><h3>Methods</h3><div>This analysis used the EXPANDed data set, which included patients undergoing M-TEER with MitraClip G3/G4 systems and echocardiographic core laboratory-assessed main MR jet location. One-year clinical, echocardiographic, and functional outcomes were assessed.</div></div><div><h3>Results</h3><div>A total of 1785 patients had main jets at A2P2 and 81 at A1P1 or A3P3 (non-A2P2). Non-A2P2 patients more frequently had degenerative MR, prior mitral valve procedures, and better left ventricular function. Procedural success was high and comparable (A2P2: 95.9%, non-A2P2: 92.5%; <em>p</em> = 0.15), with low 30-day major adverse event rates in both (A2P2: 4.2%, non-A2P2: 7.4%; <em>p</em> = 0.16). MR ≤ 1+ was achieved in both groups at 1 year (A2P2: 91%, non-A2P2: 84%, <em>p</em> = 0.11). New York Heart Association class ≤ II improved through 1 year in both groups (A2P2: 81%, non-A2P2: 88%). Kansas City Cardiomyopathy Questionnaire overall summary improved significantly with no difference between groups at 1 year (A2P2: Δ13 points, non-A2P2: Δ20 points). One-year all-cause mortality was similar (10.7 vs. 13.7%; <em>p</em> = 0.47).</div></div><div><h3>Conclusions</h3><div>In this largest analysis to date of patients with severe MR, main MR jet location did not affect the safety or effectiveness of the MitraClip system. These findings support the use of M-TEER across a range of anatomical presentations, including non-A2P2 MR jets.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100743"},"PeriodicalIF":2.8,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570581","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 Transvalvular Cardiac Implantable Electronic Devices on Outcomes Following Tricuspid Transcatheter Edge-to-Edge Repair","authors":"Salman Zahid MD ,&nbsp;Muhammad Ahmad MBBS ,&nbsp;Saket Sanghai MD ,&nbsp;Charles A. Henrikson MD ,&nbsp;Scott Chadderdon MD ,&nbsp;Firas Zahr MD","doi":"10.1016/j.shj.2025.100744","DOIUrl":"10.1016/j.shj.2025.100744","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100744"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790692","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":"Transcatheter Versus Surgical Aortic Valve Replacement in Women of Childbearing Age in the United States","authors":"Mahmoud Ismayl MBBS ,&nbsp;Hasaan Ahmed MD ,&nbsp;Andrew M. Goldsweig MD, MS ,&nbsp;Mayra Guerrero MD","doi":"10.1016/j.shj.2025.100746","DOIUrl":"10.1016/j.shj.2025.100746","url":null,"abstract":"<div><h3>Background</h3><div>Women of childbearing age occasionally require aortic valve replacement (AVR), sometimes performed with transcatheter AVR (TAVR). Outcomes of TAVR versus surgical AVR (SAVR) in women of childbearing age have not been evaluated. We aimed to evaluate the contemporary use and outcomes of TAVR versus SAVR in women of childbearing age in the United States.</div></div><div><h3>Methods</h3><div>Women aged 18-50 years hospitalized for isolated AVR were identified in the Nationwide Readmissions Database (2016-2022). In-hospital outcomes of TAVR versus SAVR were compared using propensity-score matching. Readmissions were compared using the Cox proportional hazards regression model.</div></div><div><h3>Results</h3><div>Of 6926 weighted hospitalizations for isolated AVR in women aged 18-50 years, 897 (13.0%) included TAVR, and 6029 (87.0%) included SAVR. From 2016-2022, the proportion of AVR performed using TAVR increased from 7.4% to 16.3% in women aged 18-50 years (p_trend&lt;0.001). Compared with SAVR, TAVR was associated with lower in-hospital mortality (&lt;1.4 vs. 3.5%, <em>p</em> = 0.03), acute kidney injury (9.0 vs. 16.8%, <em>p</em> = 0.002), and need for blood transfusion (7.1 vs. 19.1%, <em>p</em> ​&lt; ​0.001), but higher heart block (23.5 vs. 9.7%, <em>p</em> ​&lt; ​0.001) and vascular complications (5.0 vs. 2.1%, <em>p</em> = 0.03). Length of stay was shorter (2 vs. 7 days, <em>p</em> ​&lt; ​0.001) and nonhome discharges were lower (16.2 vs. 56.7%, <em>p</em> ​&lt; ​0.001) with TAVR compared with SAVR. Ninety-day all-cause readmissions were similar between TAVR and SAVR (12.6 vs. 13.3%, <em>p</em> = 0.78).</div></div><div><h3>Conclusions</h3><div>This nationwide observational analysis found that TAVR is increasingly performed among women aged 18-50 years with lower in-hospital mortality and resource utilization and similar readmissions compared with SAVR.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100746"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570582","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":"Transcatheter Aortic Valve Implantation in Latin America: Lessons From Chile’s Limited Access","authors":"Gonzalo J. Martínez MD, MPhil ,&nbsp;Marilaura Nuñez MD ,&nbsp;Olivia Sanhueza MSc ,&nbsp;Pedro Villablanca MD ,&nbsp;Mario Araya MD ,&nbsp;Felipe Norambuena MD ,&nbsp;Juan Francisco Bulnes MD ,&nbsp;Alejandro Martínez MD ,&nbsp;Paula Muñoz-Venturelli MD, PhD","doi":"10.1016/j.shj.2025.100745","DOIUrl":"10.1016/j.shj.2025.100745","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100745"},"PeriodicalIF":2.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682104","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":"2025-10-13","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":"Long-Term Outcomes of Indirect Annuloplasty for Functional Mitral Regurgitation: Interim Results From the CINCH Registry","authors":"Stephan Fichtlscherer MD ,&nbsp;Sergiu Hicea MD ,&nbsp;Fabian Barbieri MD ,&nbsp;Murat Yildiz MD ,&nbsp;Elvis Ypi MD ,&nbsp;Humam Al-Kadah MD ,&nbsp;Dietrich Pfeiffer MD ,&nbsp;Steven L. Goldberg MD ,&nbsp;Klaus K. Witte MD ,&nbsp;Horst Sievert MD ,&nbsp;CINCH Investigators","doi":"10.1016/j.shj.2025.100738","DOIUrl":"10.1016/j.shj.2025.100738","url":null,"abstract":"<div><h3>Background</h3><div>Functional mitral regurgitation (FMR) has limited effective treatment options. As a transcatheter indirect annuloplasty, the Carillon Mitral Contour System reduces FMR and improves symptoms, but long-term safety and effectiveness are incompletely characterized.</div></div><div><h3>Methods</h3><div>This prospective, multicenter CINCH registry enrolled heart failure patients with FMR treated with the Carillon Mitral Contour System across 22 centers in Germany. Main outcomes included change in New York Heart Association (NYHA) class and MR severity, heart failure hospitalization (HFH), all-cause mortality rates, and device- or procedure-related serious adverse events at 1 year. Median follow-up was 2.0 years (range, 0-5 years).</div></div><div><h3>Results</h3><div>Among 228 patients (age 78 ± 8 years; 51% female; 51% with left ventricular ejection fraction ≥50%), Carillon implantation improved clinical and echocardiographic variables. The rate of NYHA class III or IV symptoms decreased from 81 to 29% at 1 year, and the rate of moderate-to-severe MR (grade 3+/4+) decreased from 84 to 9% at 1 year, with ≥92% showing stable or improved NYHA class and ≥97% showing stable or improved MR grade over 5 years. Decreases in MR grade were associated with improvements in NYHA class (<em>p</em> = 0.048). Kaplan–Meier estimates over 5 years were 54.0% for HFH, 46.9% for all-cause mortality, and 68.3% for the composite of HFH or death. The proportion of patients experiencing any serious device- or procedure-related serious adverse event at 1 year was 1.8%.</div></div><div><h3>Conclusions</h3><div>The CINCH registry provides real-world evidence supporting the long-term safety, effectiveness, and durability of the Carillon Mitral Contour System in treating FMR.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 12","pages":"Article 100738"},"PeriodicalIF":2.8,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570580","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}