Transcatheter Structural Heart Disease Interventions: Clinical Update—The Second Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 8583

Special Issue Editors

HerzZentrum Hirslanden Zurich, Witellikerstrasse 36, 8008 Zürich, Switzerland
Interests: cardiac surgery; structural heart interventions; transcatheter valve therapy; innovation; novel approaches to treat cardiovascular diseases; transcatheter aortic valve replacement; transcatheter mitral valve intervention; transcatheter tricuspid valve intervention
Special Issues, Collections and Topics in MDPI journals
Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
Interests: cardiac surgery; structural heart interventions; transcatheter valve therapy; cardiac implantable eletronic devices; transcatheter aortic valve replacement; transcatheter mitral valve intervention; transcatheter tricuspid valve intervention

Special Issue Information

Dear Colleagues,

We invite you to participate in the second edition of the JCM Special Issue entitled “Transcatheter Structural Heart Disease Interventions: Clinical Update”. 

Following the success of the first edition, with 13 articles published, covering a broad spectrum of heart disease interventions (https://0-www-mdpi-com.brum.beds.ac.uk/journal/jcm/special_issues/Transcatheter-Structural-Heart-Disease-Interventions), we were encouraged to release this second edition. The main objective of this new edition is to provide other authors and centers with the opportunity to contribute and present their scientific work in the transcatheter heart intervention field.

Considering the unstoppable improvements and developments in novel transcatheter technologies, being part of this evidence generation process by providing a space where recognized authors can share their reviews or original articles is part of the Editors' commitment. 

Together, we know that we can make this second edition as successful as the first. Therefore, we invite all interested authors to explore transcatheter structural heart disease intervention topics, such as aortic, mitral, and tricuspid valve diagnosis and management, left atrial appendage occlusion, atrial or ventricular septum defects, and so on. Both original research papers and comprehensive review papers are welcome.

Dr. Maurizio Taramasso
Dr. Ana Paula Tagliari
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • structural heart interventions
  • transcatheter valve therapy
  • transcatheter aortic valve replacement
  • transcatheter mitral valve intervention
  • transcatheter tricuspid valve intervention
  • imaging in structural heart interventions
  • septal defect
  • paravalvular leak
  • left atrial appendage closure
  • innovation

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Published Papers (5 papers)

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Research

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10 pages, 789 KiB  
Article
Clinical Performance of the Gore Septal Occluder in Patent Foramen Ovale Closure in Different Septal Anatomies: 1-Year Results from a Single-Center Experience
by Giuseppe Verolino, Dario Calderone, Mara Gavazzoni, Davide Sala and Paolo Sganzerla
J. Clin. Med. 2023, 12(18), 5936; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12185936 - 13 Sep 2023
Viewed by 745
Abstract
Background: PFO (Patent foramen ovale) is a common defect that affects about 25% of the population. Although its presence is asymptomatic in the majority of the cases, the remaining part becomes overt with different symptoms, including cryptogenic stroke. PFO closure is currently a [...] Read more.
Background: PFO (Patent foramen ovale) is a common defect that affects about 25% of the population. Although its presence is asymptomatic in the majority of the cases, the remaining part becomes overt with different symptoms, including cryptogenic stroke. PFO closure is currently a widely available procedure in complex anatomy, with Amplatzer PFO Occluder (APO) being the most commonly used tool. However, the performance of another device, the GORE Septal Occluder (GSO), has not been completely explored with regard to different septal anatomies. Methods: From March 2012 to June 2020, 118 consecutive patients with an indication of PFO closure were treated using the GSO system, included in a prospective analysis, and followed. After 12 months, every patient underwent transcranial Doppler ultrasound to evaluate the effectiveness of treatment. Results: Of 111 patients evaluated, 107 showed effective PFO closure (96.4%), and 4 showed a residual shunt (3.6%). To better evaluate the device performance, the overall population was sorted into two clusters based on the echocardiographic characteristics. The main difference between groups was for PFO width (4.85 ± 1.8 vs. 2.9 ± 1 mm, p < 0.001) and PFO tunnel length (12.6 ± 3.8 vs. 7.2 ± 2, p < 0.001), allowing complex and simple anatomies to be identified, respectively. Regardless of the aforementioned cluster, the GSO performance required to reach an effective closure was independent of anatomy type and the chosen device size. Conclusion: The GSO device showed a high closure rate at 1-year follow-up in patients, with at least one anatomical factor of complexity of PFO irrespective of the level of complexity itself. Full article
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15 pages, 1862 KiB  
Article
Infective Endocarditis Risk with Melody versus Sapien Valves Following Transcatheter Pulmonary Valve Implantation: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
by Akshay Machanahalli Balakrishna, Danielle B. Dilsaver, Ahmed Aboeata, Ramesh M. Gowda, Andrew M. Goldsweig, Saraschandra Vallabhajosyula, Jason H. Anderson, Trevor Simard and Aravdeep Jhand
J. Clin. Med. 2023, 12(15), 4886; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12154886 - 25 Jul 2023
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Abstract
Background: Transcatheter pulmonary valve implantation (TPVI) is an effective non-surgical treatment method for patients with right ventricle outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are the two valves approved for use in TPVI. Since TPVI patients are typically younger, even [...] Read more.
Background: Transcatheter pulmonary valve implantation (TPVI) is an effective non-surgical treatment method for patients with right ventricle outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are the two valves approved for use in TPVI. Since TPVI patients are typically younger, even a modest annual incidence of infective endocarditis (IE) is significant. Several previous studies have shown a growing risk of IE after TPVI. There is uncertainty regarding the overall incidence of IE and differences in the risk of IE between the valves. Methods: A systematic search was conducted in the MEDLINE, EMBASE, PubMed, and Cochrane databases from inception to 1 January 2023 using the search terms ‘pulmonary valve implantation’, ‘TPVI’, or ‘PPVI’. The primary outcome was the pooled incidence of IE following TPVI in Melody and Sapien valves and the difference in incidence between Sapien and Melody valves. Fixed effect and random effect models were used depending on the valve. Meta-regression with random effects was conducted to test the difference in the incidence of IE between the two valves. Results: A total of 22 studies (including 10 Melody valve studies, 8 Sapien valve studies, and 4 studies that included both valves (572 patients that used the Sapien valve and 1395 patients that used the Melody valve)) were used for the final analysis. Zero IE incidence following TPVI was reported by eight studies (66.7%) that utilized Sapien valves compared to two studies (14.3%) that utilized Melody valves. The pooled incidence of IE following TPVI with Sapien valves was 2.1% (95% CI: 0.9% to 5.13%) compared to 8.5% (95% CI: 4.8% to 15.2%) following TPVI with Melody valves. Results of meta-regression indicated that the Sapien valve had a 79.6% (95% CI: 24.2% to 94.4%, p = 0.019; R2 = 34.4) lower risk of IE incidence compared to the Melody valve. Conclusions: The risk of IE following TPVI differs significantly. A prudent valve choice in favor of Sapien valves to lower the risk of post-TPVI endocarditis may be beneficial. Full article
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11 pages, 1262 KiB  
Article
Global Longitudinal Strain Predicts Outcomes in Patients with Reduced Left Ventricular Function Undergoing Transcatheter Edge-to-Edge Mitral Repair
by Estefania Fernandez-Peregrina, Luis Asmarats, Rodrigo Estevez-Loureiro, Isaac Pascual, Diana Bastidas, Tomas Benito-González, Berenice Caneiro-Queija, Pablo Avanzas, Jose Alberto De Agustin, Felipe Fernández-Vazquez, Manuel Barreiro-Pérez, Victor Leon, Luis Nombela-Franco, Carmen Garrote, Chi-Hion Li, José Antonio Baz, Antonio Adeba, Jordi Sans-Roselló, Javier Gualis and Dabit Arzamendi
J. Clin. Med. 2023, 12(12), 4116; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12124116 - 18 Jun 2023
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Abstract
Background: The timing and selection of optimal candidates for mitral transcatheter edge-to-edge valve repair remains to be fully determined, especially in cases with severely depressed left ventricular ejection fraction (LVEF). The objective of this study is to evaluate the prognostic value of myocardial [...] Read more.
Background: The timing and selection of optimal candidates for mitral transcatheter edge-to-edge valve repair remains to be fully determined, especially in cases with severely depressed left ventricular ejection fraction (LVEF). The objective of this study is to evaluate the prognostic value of myocardial strain (LVGLS) in this setting. Methods: Retrospectively, 172 consecutive patients with LVEF ≤40% and severe MR treated with MitraClip were included. Four groups were generated according to the LVEF (<30% or 30%) and median LVGLS. The primary end-point was cardiovascular mortality. Results: Procedural success was high (96.5%) and complications were rare. At one-year follow-up, 82.5% of patients maintained MR grade ≤2, 79.2% were at a NYHA class ≤II and a reduction of 80% in heart failure admissions was observed in all groups. Interestingly, among patients with a more depressed LVEF, LVGLS was found to be an independent predictor for cardiovascular mortality (HR: 3.3; 95% CI: 1.1–10, p = 0.023). Conclusions: Mitral valve repair with MitraClip is safe and it improves the mid-term functional class of patients regardless of LVEF. LVGLS can help in the selection of optimal candidates and timing for this procedure, as well as in the recognition of those patients with worse prognoses. Full article
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19 pages, 2159 KiB  
Article
Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry
by Pierre Deharo, Lionel Leroux, Alexis Theron, Jérome Ferrara, Antoine Vaillier, Nicolas Jaussaud, Alizée Porto, Pierre Morera, Vlad Gariboldi, Bernard Iung, Thierry Lefevre, Philippe Commeau, Margaux Gouysse, Florence du Chayla, Nicolas Glatt, Guillaume Cayla, Herve Le Breton, Hakim Benamer, Sylvain Beurtheret, Jean Philippe Verhoye, Helene Eltchaninoff, Martine Gilard, Jean Philippe Collet, Nicolas Dumonteil, Frederic Collart, Thomas Modine and Thomas Cuissetadd Show full author list remove Hide full author list
J. Clin. Med. 2022, 11(20), 6117; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11206117 - 17 Oct 2022
Cited by 13 | Viewed by 2677
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based [...] Read more.
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up. Full article
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Review

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14 pages, 2105 KiB  
Review
New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023
by Ana Paula Tagliari and Maurizio Taramasso
J. Clin. Med. 2023, 12(4), 1342; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12041342 - 08 Feb 2023
Cited by 5 | Viewed by 2679
Abstract
Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious [...] Read more.
Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious sedation, and the avoidance of invasive lines becoming the new standards. Here, we discuss the minimalist TAVI approach and how we incorporate it into our current clinical practice. Full article
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