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Advances in Interventional Cardiology and Heart Valve Disease Management

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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 April 2022) | Viewed by 10757

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Special Issue Editor

Dr. Giuseppe Santarpino

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Guest Editor

1. Cardiac Surgery Unit, Department of Experimental and Clinical Medicine, University “Magna Graecia”, 88100 Catanzaro, Italy
2. Department of Cardiac Surgery, Paracelsus Medical University, 90471 Nuremberg, Germany
3. Research, Città di Lecce Hospital, 73100 Lecce, Italy
Interests: heart failure; echocardiography; cardiac surgery; pacemakers; cardiovascular diseases; aortic valve; coronary bypass; cardiopulmonary bypass; cardiothoracic surgery; valvular disease
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Special Issue Information

Dear Colleagues,

It is no coincidence that a heart surgeon has decided that he wants to be the Editor of a Special Issue on interventional cardiology and heart valve disease management. In fact, the cardiac surgery world must move ever closer to the cardiological/interventional world in order to provide more and more "shared" choices. In fact, in my opinion, the true "advances" in the management of valve diseases must follow two fundamental principles. The first is the concept of the "heart team", which must be increasingly structured and present in the debate on all patients. Second, in the future, centers must be created that specialize in the exclusive treatment of valvulopathies in order to concentrate patients and guarantee “high volumes” and the most advanced and tailored treatments for patients.

Dr. Giuseppe Santarpino
Guest Editor

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Keywords

aortic valve disease
mitral valve disease
heart failure
heart team

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Published Papers (4 papers)

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Research

12 pages, 1108 KiB

Open AccessArticle

Epidemiological Trends in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair over the Last Decade: Functional vs. Structural Mitral Regurgitation

by Leonhard Schneider, Nicoleta Nita, Tilman Dahme, Sinisa Markovic, Mirjam Keßler, Wolfang Rottbauer and Marijana Tadic

J. Clin. Med. 2022, 11(5), 1422; https://doi.org/10.3390/jcm11051422 - 4 Mar 2022

Cited by 1 | Viewed by 2068

Abstract

Objective: We aimed to investigate the demographic, clinical and hemodynamic characteristics of patients who underwent percutaneous mitral valve (MV) repair over the last decade, as well as to determine the potential changes in trends of these parameters among patients with structural and functional MR (SMR and FMR). Methodology: We analyzed all patients who underwent interventional MV repair in our institution between January 2010 and March 2021. Our study included both SMR and FMR patients. All data were obtained from a local registry. Results: Nine hundred and seventeen patients (357 SMR patients and 563 FMR patients) were involved in this study. We did not find significant differences in demographical, clinical and hemodynamic characteristics among SMR and FMR patients. Left ventricular remodeling and systolic dysfunction were more pronounced in FMR patients. Systemic vascular resistance was the only hemodynamic parameter that differed between SMR and FMR patients; it was higher in SMR group. An evaluation of the trend between the first and last five years of our experience revealed that the number of patients treated with this technique is constantly increasing, but that this is more pronounced in SMR patients. It was also found that the operative risk of SMR and FMR patients was significantly higher in the first five years. Additionally, our results showed change in medical therapy in MR patients over the last decade in terms of increased use of angiotensin II receptor blockers and the introduction of angiotensin receptor II blocker-neprilysin inhibitor. Conclusion: SMR and FMR patients who underwent interventional MV repair have similar clinical and hemodynamic characteristics. The percentage of SMR patients increased more significantly than FMR patients over the last five years. Full article

(This article belongs to the Special Issue Advances in Interventional Cardiology and Heart Valve Disease Management)

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11 pages, 825 KiB

Open AccessArticle

Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center

by Sang-Wook Lee, Sangho Lee and Kyung-Don Hahm

J. Clin. Med. 2021, 10(22), 5365; https://doi.org/10.3390/jcm10225365 - 18 Nov 2021

Cited by 4 | Viewed by 2120

Abstract

Few studies to date have assessed the postoperative pulmonary complications after transcatheter aortic valve implantation (TAVI) according to the anesthesia method. The present study aims to compare the effects of general anesthesia (GA) or monitored anesthesia care (MAC) on postoperative outcomes in patients undergoing TAVI. This retrospective cohort study included 578 patients who underwent TAVI through the trans-femoral approach between August 2011 and May 2019 at a single tertiary academic center. The primary outcome was postoperative pulmonary complications, which were defined as the occurrence of one or more pulmonary complications, such as respiratory failure, respiratory infection, and radiologic findings, within 7 days after TAVI. Secondary outcomes included postoperative delirium, all-cause 30-day mortality rate, 30-day readmission rate, reoperation rate, vascular complications, permanent pacemaker/implantable cardioverter-defibrillator insertion, length of stay in the ICU, hospital stay, and incidence of stroke. Of the 589 patients, 171 underwent TAVI under general anesthesia (GA), and 418 under monitored anesthesia care (MAC). The incidence of postoperative pulmonary complications was significantly higher in the GA than in the MAC group (17.0% vs. 5.3%, p < 0.001). Anesthetic method significantly affected the occurrence of postoperative pulmonary complications, but not of delirium. ICU stay was significantly shorter in the MAC group, as were operation time, the volume of fluid administered during surgery, heparin dose, transfusion, and inotrope requirements. TAVI under MAC can increase the efficiency of medical resources, reducing the lengths of ICU stay and the occurrence of postoperative pulmonary complications, compared with TAVI under GA. Full article

(This article belongs to the Special Issue Advances in Interventional Cardiology and Heart Valve Disease Management)

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11 pages, 2515 KiB

Open AccessArticle

Head-to-Head Comparison of Different Software Solutions for AVC Quantification Using Contrast-Enhanced MDCT

by Ruben Evertz, Sebastian Hub, Sören J. Backhaus, Torben Lange, Karl Toischer, Johannes T. Kowallick, Gerd Hasenfuß and Andreas Schuster

J. Clin. Med. 2021, 10(17), 3970; https://doi.org/10.3390/jcm10173970 - 2 Sep 2021

Cited by 6 | Viewed by 2851

Abstract

Aortic valve calcification (AVC) in aortic stenosis patients has diagnostic and prognostic implications. Little is known about the interchangeability of AVC obtained from different multidetector computed tomography (MDCT) software solutions. Contrast-enhanced MDCT data sets of 50 randomly selected aortic stenosis patients were analysed using three different software vendors (3Mensio, CVI42, Syngo.Via). A subset of 10 patients were analysed twice for the estimation of intra-observer variability. Intra- and inter-observer variability were determined using the ICC reliability method, Bland-Altman analysis and coefficients of variation. No differences were revealed between the software solutions in the AVC calculations (3Mensio 941 ± 623, Syngo.Via 948 mm³ ± 655, CVI42 941 ± 637; p = 0.455). The best inter-vendor agreement was found between the CVI42 and the Syngo.Via (ICC 0.997 (CI 0.995–0.998)), followed by the 3Mensio and the CVI42 (ICC 0.996 (CI 0.922–0.998)), and the 3Mensio and the Syngo.Via (ICC 0.992 (CI 0.986–0.995)). There was excellent intra- (3Mensio: ICC 0.999 (0.995–1.000); CVI42: ICC 1.000 (0.999–1.000); Syngo.Via: ICC 0.998 (0.993–1.000)) and inter-observer variability (3Mensio: ICC 1.000 (0.999–1.000); CVI42: ICC 1.000 (1.000–1.000); Syngo.Via: ICC 0.996 (0.985–0.999)) for all software types. Contrast-enhanced MDCT-derived AVC scores are interchangeable between and reproducible within different commercially available software solutions. This is important since sufficient reproducibility, interchangeability and valid results represent prerequisites for accurate TAVR planning and its widespread clinical use. Full article

(This article belongs to the Special Issue Advances in Interventional Cardiology and Heart Valve Disease Management)

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9 pages, 1115 KiB

Open AccessArticle

Comparison between Surgical Access and Percutaneous Closure Device in 787 Patients Undergoing Transcatheter Aortic Valve Replacement

by Dennis Eckner, Francesco Pollari, Giuseppe Santarpino, Jürgen Jessl, Johannes Schwab, Kristinko Martinovic, Helmut Mair, Matthias Pauschinger, Theodor Fischlein and Ferdinand Vogt

J. Clin. Med. 2021, 10(7), 1344; https://doi.org/10.3390/jcm10071344 - 24 Mar 2021

Cited by 10 | Viewed by 2617

Abstract

Background: The vascular access in transcatheter aortic valve replacement (TAVR) was initially dominated by a surgical approach. Meanwhile, percutaneous closure systems became a well-established alternative. The aim of this study was to compare the clinical outcome between the two approaches. Methods: In this retrospective study, we observed 787 patients undergoing a TAVR-Procedure between 2013 and 2019. Of those, 338 patients were treated with surgical access and 449 with the Perclose ProGlide™-System (Abbott, Chicago, IL, USA). According to the Bleeding Academic Research Consortium (BARC) and Valve Academic Research Consortium (VARC) criteria, the primary combined endpoints were defined. Results: Overall hospital mortality was 2.8% with no significant difference between surgical (3.8%) and percutaneous (2.2%) access (p = 0.182). Major vascular complications or bleeding defined as the primary combined endpoint was not significantly different in either group (Surgical group 5.3%, ProGlide group 5.1%, p = 0.899). In the ProGlide group, women with pre-existing peripheral artery disease (PAD) were significantly more often affected by a vascular complication (p = 0.001 for female sex and p = 0.03 for PAD). Conclusions: We were able to show that the use of both accesses is safe. However, the surgical access route should also be considered in case of peripheral artery disease. Full article

(This article belongs to the Special Issue Advances in Interventional Cardiology and Heart Valve Disease Management)

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