Leaflet Perforation During TAVR for Pure Aortic Regurgitation: Importance of the Annulo-Aortic Angulation.

Leaflet Perforation During TAVR for Pure Aortic Regurgitation: Importance of the Annulo-Aortic Angulation.

Transcatheter Annuloplasty Using the Cardioband System: Insights From a European Multicenter Registry (TITAN Registry).

Narayana Health City performs India’s first TAVI for pure aortic valve leakage using Hanchor valve - The New Indian Express

Narayana Health City performs India’s first TAVI for pure aortic valve leakage using Hanchor valve  The New Indian Express

Legal & General Group Plc Has $376.46 Million Stake in Edwards Lifesciences Corporation $EW - MarketBeat

Legal & General Group Plc Has $376.46 Million Stake in Edwards Lifesciences Corporation $EW  MarketBeat

Jefferies Financial Group Inc. Cuts Stake in Edwards Lifesciences Corporation $EW - MarketBeat

Jefferies Financial Group Inc. Cuts Stake in Edwards Lifesciences Corporation $EW  MarketBeat

Predictors of Procedural and Clinical Outcomes Following Transcatheter Tricuspid Edge-to-Edge Repair: An Expert Overview.

Tricuspid transcatheter edge-to-edge repair alleviates symptoms, but survival benefit remains inconsistent. The authors conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant systematic review and meta-analysis (CRD42024600438) to identify multivariable predictors of procedural success and adverse outcomes. PubMed, Scopus, the Cochrane Library, and Google Scholar were searched (from January 2008 to March 2025) for adjusted predictors of mortality, heart failure hospitalization, major adverse cardiovascular events, and procedural success. Random-effects meta-analysis was performed when ≥2 independent cohorts reported comparable estimates. Fifty-nine studies met the inclusion criteria. Baseline tricuspid regurgitation severity (OR: 2.50; 95% CI: 1.33-4.71), nonanteroseptal jet location (OR: 2.46; 95% CI: 1.08-5.60), and increasing coaptation gap (HR: 1.19 per mm; 95% CI: 1.07-1.33) predicted residual tricuspid regurgitation. Residual tricuspid regurgitation ≥3+ was the only predictor suitable for pooled synthesis across endpoints and was associated with all-cause mortality (HR: 2.19; 95% CI: 1.60-3.00) and major adverse cardiovascular events (HR: 1.84; 95% CI: 1.37-2.48) (I2 = 0%-2%.) Renal dysfunction, impaired right ventricular function and remodeling, pulmonary hypertension, and right ventricular-pulmonary arterial uncoupling reflect advanced disease substrate and demonstrated consistent associations with adverse outcomes. Among surgical risk models, the European System for Cardiac Operative Risk Evaluation II score showed limited discrimination, whereas the TRI-SCORE performed better; tricuspid transcatheter edge-to-edge repair-specific clinical models remain limited, and validated procedural prediction models are emerging. Limited data suggest that an intermediate disease profile may derive the greatest benefit, but this finding is confined to single-registry analyses. Further work is required to define optimal disease-stage thresholds and develop integrated risk models incorporating procedural outcome predictors.

FOOPAS Study: Functional Assessment and Prognostic Value in Aortic Valve Replacement for Patients ≥ 75 Years.

Background: Because of demographic changes, the number of older patients undergoing cardiac interventions has increased. The most common indication in this group is aortic valve stenosis, treated with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVR), with good outcomes. Our study investigated whether the heart team's choice of intervention (TAVI, SAVR, or conservative) is influenced by geriatric assessment results. Methods: This study was a single-centre, prospective, longitudinal case-control study conducted over 12 months and did not affect routine diagnostic examinations or clinical decisions. After risk stratification and clinical evaluation, patients were assigned to undergo TAVI, SAVR, or conservative management. Cardiological evaluation and geriatric assessment were performed for up to 12 months. Results: Of 135 patients (mean age 81 ± 4.6 years), 60% underwent TAVI, 29% SAVR, and 11% conservative therapy. Age, Frailty Score, cognition, and nutritional status were significantly associated with the heart team's decision, whereas EuroSCORE II remained the only independent predictor of one-year mortality (OR 1.58, 95% CI 1.13-2.19, p = 0.007). One-year mortality was 9.9% (n = 11). Compared to the literature, one-year mortality was lower than expected, particularly in the intervention group. Conclusions: Single assessment tools did not have the power to predict mortality. Similar to other trials, a combination of different scores can assess the risk of mortality.

Prognostic Impact of Baseline Albumin-Bilirubin Score on Mortality After Transcatheter Edge-to-Edge Mitral Repair.

Background and Objectives: Transcatheter edge-to-edge repair (TEER) has emerged as an effective treatment option for patients with severe mitral regurgitation who are at high surgical risk. However, clinical outcomes after TEER remain heterogeneous and are influenced not only by cardiac parameters but also by systemic comorbidities and multiorgan dysfunction. The albumin-bilirubin (ALBI) score, derived from serum albumin and bilirubin levels, has recently been proposed as a simple marker of hepatic dysfunction and cardio-hepatic interaction. This study aimed to evaluate the prognostic value of baseline ALBI score in predicting long-term mortality after TEER. Materials and Methods: In this single-center retrospective cohort study, 106 consecutive patients with symptomatic moderate-to-severe or severe mitral regurgitation who underwent TEER between January 2019 and December 2025 were included. Baseline ALBI score was calculated using pre-procedural serum albumin and bilirubin levels. Cox proportional hazards regression analysis was used to identify predictors of long-term mortality. Variable selection was performed using least absolute shrinkage and selection operator (LASSO) regression, followed by ridge-penalized multivariable Cox modeling to minimize overfitting. The incremental prognostic value of ALBI was assessed using concordance index (C-index) comparison between predictive models. Receiver operating characteristic (ROC) analysis and Kaplan-Meier survival analysis were also performed. Results: During a median follow-up of 17.9 months, 30 patients (28.3%) died. Higher baseline ALBI scores were significantly associated with increased mortality risk. In multivariable analysis, ALBI score (HR 3.35, 95% CI 1.46-7.71; p = 0.004), left atrial volume index (LAVI) (HR 1.02, 95% CI 1.01-1.03; p = 0.005), and log-transformed B-type natriuretic peptide (BNP) (HR 1.37, 95% CI 1.02-1.86; p = 0.039) remained independent predictors of mortality. Addition of the ALBI score improved model discrimination, increasing the C-index from 0.845 to 0.886. ROC analysis demonstrated good predictive performance of the ALBI score (area under the curve [AUC] = 0.877), with an optimal cut-off value of -1.67. Conclusions: Baseline ALBI score is independently associated with long-term mortality after TEER and may provide potential incremental prognostic information. However, the observed improvement is modest and should be interpreted cautiously. These findings support a potential role of ALBI as a complementary marker, which requires validation in larger prospective studies.

Current and Emerging Treatments for Isolated Aortic Stenosis and Concomitant Mitral Stenosis: A Comprehensive Narrative Review.

Aortic stenosis (AS) and mitral stenosis (MS) are progressive valvular heart diseases associated with substantial morbidity and mortality once symptoms develop. Over the past decade, the management of isolated AS has undergone profound evolution, driven by refinements in surgical aortic valve replacement, the adoption of minimally invasive techniques, and the rapid expansion of transcatheter aortic valve replacement across all surgical risk categories. In contrast, patients with concomitant AS and MS represent a complex and understudied population, frequently excluded from randomized trials and only marginally addressed in contemporary clinical practice guidelines. The management requires individualized guideline-directed decision-making led by a multidisciplinary Heart Team. The paucity of high-quality data in combined AS-MS underscores the need for dedicated prospective studies and international registries. The aim of this narrative review is to describe current strategies to treat AS both when isolated and concomitant with MS. We also discuss the need for updated, specific guidelines.

The Legacy of the First Valve: Outcomes of Redo Surgical Aortic Valve Replacement After Prior Transcatheter Versus Prior Surgical Aortic Valve Replacement-A Narrative Review.

Transcatheter Aortic Valve Replacement (TAVR) has transformed aortic stenosis management across the full risk spectrum, but expansion into younger populations makes valve failure and reintervention central to lifetime planning. There are two pathways to follow when TAVR fails: redo transcatheter implantation and surgical explantation with surgical aortic valve replacement (SAVR), termed TAVR-SAVR. This narrative review synthesizes evidence from four studies (35,677 patients, 2011-2024) examining the association between prior valve type and redo SAVR outcomes versus redo SAVR after prior surgical prosthesis (SAVR-SAVR). TAVR-SAVR volume grew at up to 144.6% annually, projected to surpass SAVR-SAVR by approximately 2029 based on linear extrapolation from limited registry and single-center data. Operative mortality was 12.3-17% in TAVR-SAVR versus 1.1-9% in SAVR-SAVR, persisting after propensity matching in both comparative studies (11.3% vs. 6.7%, OR 1.7; and 12.0% vs. 1.1%, OR 12.5). Observed-to-expected mortality ratios exceeded 1.0 across all risk strata, including low-risk patients (O/E up to 5.48), while SAVR-SAVR demonstrated a remarkably low ratio of 0.22-0.33. Renal failure, failure to rescue, and prolonged ventilation were significantly higher following TAVR-SAVR; stroke and pacemaker rates were comparable. Paradoxically, shorter bypass and cross-clamp times in TAVR-SAVR despite worse outcomes are consistent with cumulative organ injury, rather than operative complexity, as a predominant contributor to excess mortality, though this mechanistic explanation remains hypothetical. STS risk models, developed for standard surgical populations, showed limited applicability in this population, with observed mortality consistently exceeding predicted values. These findings raise important considerations regarding TAVR-first strategies in operable patients aged 65-80 years, although causality cannot be established from observational data alone. In the era of expanding TAVR indications, the legacy of the first valve cannot be ignored.

Percutaneous Annuloplasty Followed by TEER for Tricuspid Regurgitation: A Multicenter Experience.

Impact of Coronary Artery Disease and Revascularization on Outcomes After Transcatheter Tricuspid Edge-to-Edge Repair.

BACKGROUND: Coronary artery disease (CAD) is common in patients treated for structural heart disease, but its prevalence, prognostic impact, and optimal management in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) remain uncertain. OBJECTIVES: The aim of this study was to examine whether the presence of CAD, its anatomical complexity, and the extent of revascularization influence outcomes after T-TEER. METHODS: In this observational study, 361 consecutive T-TEER patients underwent preprocedural coronary angiography with SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) scoring. CAD was defined as ≥70% stenosis (≥50% for the left main coronary artery). Residual SYNTAX score was calculated if revascularization was performed. The primary endpoint was 12-month all-cause mortality. RESULTS: Obstructive CAD was present in 124 patients (34.3%), with low lesion complexity (median SYNTAX score 6; Q1-Q3: 3-9.75). Among CAD patients, 33.9% underwent revascularization, reducing the residual SYNTAX score to 4 (Q1-Q3: 2-7). During the 12-month follow-up period, 16.7% of patients died. Survival over the follow-up period did not differ significantly according to the presence of obstructive CAD, baseline SYNTAX score, or residual SYNTAX score (12-month mortality for CAD vs no CAD 17.5% vs 16.3%; log-rank P = 0.616). Interaction analysis revealed effect modification by procedural risk determined by TRI-SCORE: in patients at low and intermediate risk, elevated residual SYNTAX score was associated with lower survival over follow-up (12-month mortality 20.8% vs 6.4%; log-rank P = 0.016), whereas no association was observed in high-risk patients (27.6% vs 27.1%; log-rank P = 0.927). Adding residual SYNTAX to the TRI-SCORE improved risk stratification in low- and intermediate-risk CAD patients (ΔC = +0.099). CONCLUSIONS: Obstructive CAD is common but typically low in complexity among T-TEER candidates. In low- and intermediate-risk patients, a higher residual SYNTAX score is associated with reduced survival.

Use of TriClip steerable guide catheter for MitraClip: from bench to case.

Tricuspid Transcatheter Edge-to-Edge Repair Device Entrapment on a Right Ventricular Pacing Lead.

FDA confirms Class I recall for vascular device used by cardiologists and surgeons - Cardiovascular Business

FDA confirms Class I recall for vascular device used by cardiologists and surgeons  Cardiovascular Business