Volume 16 of Issue 21 | JACC. Cardiovascular interventions
Authors: Simonato M, Whisenant BK, Unbehaun A, Kempfert J, Ribeiro HB, Kornowski R, Erlebach M, Bleiziffer S, Windecker S, Pilgrim T, Tomii D, Guerrero M, Ahmad Y, Forrest JK, Montorfano M, Ancona M, Adam M, Wienemann H, Finkelstein A, Villablanca P, Codner P, Hildick-Smith D, Ferrari E, Petronio AS, Shamekhi J, Presbitero P, Bruschi G, Rudolph T, Cerillo A, Attias D, Nejjari M, Abizaid A, Felippi de Sá Marchi M, Horlick E, Wijeysundera H, Andreas M, Thukkani A, Agrifoglio M, Iadanza A, Baer LM, Nanna MG, Dvir D
BACKGROUND
Mitral valve-in-valve (ViV) is associated with suboptimal hemodynamics and rare left ventricular outflow tract (LVOT) obstruction.
OBJECTIVES
This study aimed to determine whether device position and asymmetry are associated with these outcomes.
METHODS
Patients undergoing SAPIEN 3 (Edwards Lifesciences) mitral ViV included in the VIVID (Valve-in-Valve International Data) Registry were studied. Clinical endpoints are reported according to Mitral Valve Academic Research Consortium definitions. Residual mitral valve stenosis was defined as mean gradient ≥5 mm Hg. Depth of implantation (percentage of transcatheter heart valve [THV] atrial to the bioprosthesis ring) and asymmetry (ratio of 2 measures of THV height) were evaluated.
RESULTS
A total of 222 patients meeting the criteria for optimal core lab evaluation were studied (age 74 ± 11.6 years; 61.9% female; STS score = 8.3 ± 7.1). Mean asymmetry was 6.2% ± 4.4%. Mean depth of implantation was 19.0% ± 10.3% atrial. Residual stenosis was common (50%; mean gradient 5.0 ± 2.6 mm Hg). LVOT obstruction occurred in 7 cases (3.2%). Implantation depth was not a predictor of residual stenosis (OR: 1.19 [95% CI: 0.92-1.55]; P = 0.184), but more atrial implantation was protective against LVOT obstruction (0.7% vs 7.1%; P = 0.009; per 10% atrial, OR: 0.48 [95% CI: 0.24-0.98]; P = 0.044). Asymmetry was found to be an independent predictor of residual stenosis (per 10% increase, OR: 2.30 [95% CI: 1.10-4.82]; P = 0.027).
CONCLUSIONS
Valve stenosis is common after mitral ViV. Asymmetry was associated with residual stenosis. Depth of implantation on its own was not associated with residual stenosis but was associated with LVOT obstruction. Technical considerations to reduce postdeployment THV asymmetry should be considered.
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Research square
Authors: Yuan Y, Knight KR, Weeks J, King S, Olsen P, Kushel M
Annals of clinical and translational neurology
Authors: Schoeps VA, Zhou X, Horton MK, Zhu F, McCauley KE, Nasr Z, Virupakshaiah A, Gorman MP, Benson LA, Weinstock-Guttman B, Waldman A, Banwell BL, Bar-Or A, Marrie RA, van Domselaar G, O'Mahony J, Mirza AI, Bernstein CN, Yeh EA, Casper TC, Lynch SV, Tremlett H, Baranzini S, Waubant E, US Network of Pediatric MS Centers
Nature medicine
Authors: Montassier E, Kitsios GD, Radder JE, Le Bastard Q, Kelly BJ, Panzer A, Lynch SV, Calfee CS, Dickson RP, Roquilly A
Nature medicine
Authors: Mohammadi A, Etemad B, Zhang X, Li Y, Bedwell GJ, Sharaf R, Kittilson A, Melberg M, Crain CR, Traunbauer AK, Wong C, Fajnzylber J, Worrall DP, Rosenthal A, Jordan H, Jilg N, Kaseke C, Giguel F, Lian X, Deo R, Gillespie E, Chishti R, Abrha S, Adams T, Siagian A, Dorazio D, Anderson PL, Deeks SG, Lederman MM, Yawetz S, Kuritzkes DR, Lichterfeld MD, Sieg S, Tsibris A, Carrington M, Brumme ZL, Castillo-Mancilla JR, Engelman AN, Gaiha GD, Li JZ
BMC medical research methodology
Authors: Pignolo RJ, Al Mukaddam M, Baujat G, Brown MA, De Cunto C, Hsiao EC, Keen R, Le Quan Sang KH, Grogan DR, Marino R, Strahs AR, Kaplan FS
JAMA neurology
Authors: Kluger BM, Katz M, Galifianakis NB, Pantilat SZ, Hauser JM, Khan R, Friedman C, Vaughan CL, Goto Y, Long SJ, Martin CS, Dini M, McQueen RB, Palmer L, Fairclough D, Seeberger LC, Sillau SH, Kutner JS
Environmental research
Authors: Hazlehurst MF, Dearborn LC, Sherris AR, Loftus CT, Adgent MA, Szpiro AA, Ni Y, Day DB, Kaufman JD, Thakur N, Wright RJ, Sathyanarayana S, Carroll KN, Moore PE, Karr CJ
Biology of sex differences
Authors: Bruce LK, Kasl P, Soltani S, Viswanath VK, Hartogensis W, Dilchert S, Hecht FM, Chowdhary A, Anglo C, Pandya L, Dasgupta S, Altintas I, Gupta A, Mason AE, Smarr BL
The American journal of drug and alcohol abuse
Authors: Tierney HR, Ma Y, Bacchetti P, Adimora AA, Chandran A, Kempf MC, Collins LF, DeHovitz J, DiClemente RJ, French AL, Jones DL, Sharma A, Spence AB, Hahn JA, Price JC, Tien PC
