Publications by authors named "Anna S Petronio"
Background: Limited data exist on the impact of polyvascular disease (PolyVD) on clinical outcomes in female patients undergoing transcatheter aortic valve replacement (TAVR). We therefore sought to investigate clinical outcomes in women with versus without PolyVD undergoing TAVR.
Methods: Female participants from the multicentre Women's International Transcatheter Aortic Valve Implantation (WIN-TAVI) registry were categorized based on the presence or absence of PolyVD.
Background: The self-expanding, supra-annular Evolut valve is an established platform for Transcatheter Aortic Valve Implantation (TAVI). Evolut PRO introduced an outer sealing wrap to mitigate paravalvular leakage. We evaluated the 3-year clinical outcomes and valve performance of the Evolut PRO in standard clinical practice for severe aortic stenosis (AS) patients at intermediate or higher risk for surgery.
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- The study investigates the impact of baseline left ventricular ejection fraction (LVEF) on outcomes for women undergoing transcatheter aortic valve implantation (TAVI).
- Among the 944 patients analyzed, most had preserved LVEF, but those with reduced LVEF experienced a higher incidence of safety issues at 1-year, including all-cause mortality and major vascular complications.
- Overall, while reduced LVEF did not significantly affect efficacy outcomes, it was linked to a worse safety profile compared to those with preserved or mildly reduced LVEF.
Article Synopsis
- Historically, women with aortic stenosis have been underdiagnosed and faced worse outcomes compared to men, leading to the need for better treatment recognition and participation in clinical trials.
- The SMART trial aimed to compare the clinical and hemodynamic outcomes of women with small aortic annuli receiving either self-expanding valves (SEVs) or balloon-expandable valves (BEVs) during transcatheter aortic valve replacement.
- In a study of 621 women, no significant differences were observed in the main clinical outcomes between the SEV and BEV groups after 12 months, but SEVs showed a lower rate of bioprosthetic valve dysfunction.
Article Synopsis
- The study examines the characteristics and outcomes of patients with tapered raphe-type bicuspid aortic valve (BAV) when undergoing trans-catheter aortic valve replacement (TAVR), focusing on the safety and effectiveness of modern heart valves.
- Researchers analyzed data from 897 patients, finding that those with tapered configurations showed similar success rates and safety between two sizing strategies: annular and supra-annular.
- The results indicate that TAVR is a safe and effective procedure for these patients, regardless of the sizing method used, maintaining a high rate of clinical efficacy at mid-term follow-up.
Article Synopsis
- Patients with mitral regurgitation (MR) and significant mitral annular calcification (MAC) face limited treatment options, making transcatheter mitral valve replacement (TMVR) an interesting area of study.
- The research involved 279 patients, revealing that those with MAC had higher rates of post-procedural bleeding and renal failure but similar overall survival rates and functional improvement compared to those without MAC.
- The findings suggest that while TMVR can be performed in MAC patients, it comes with increased complications, highlighting the need for more research on tailored TMVR devices for this group.
Background: Right ventricular impairment is common among patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation (SMR). Adherence to guideline-directed medical therapy (GDMT) for heart failure is poor in these patients.
Objectives: The aim of this study was to evaluate the impact of GDMT on long-term survival in this patient cohort.
Article Synopsis
- Minimally invasive mitral valve repair using the MitraClip device shows beneficial outcomes in patients with significant mitral regurgitation, including those who have had prior valve repairs.
- A study involving 2,238 patients highlighted that while device and procedural success rates are slightly lower for those with previous valve procedures, overall outcomes such as death and rehospitalization rates remain similar across groups.
- The findings suggest that transcatheter edge-to-edge repair is a viable option for carefully selected patients even after previous mitral valve interventions.
A randomised multicentre study of angiography- versus physiologyguided percutaneous coronary intervention in patients with coronary artery disease undergoing TAVI: design and rationale of the FAITAVI trial.
EuroIntervention
April 2024
Article Synopsis
- The FAITAVI study is investigating how to best treat coronary artery disease in patients with severe aortic valve stenosis who are undergoing transcatheter aortic valve implantation (TAVI), comparing angiography-guided and physiology-guided strategies.
- The study involves 320 participants across 15 sites in Italy and focuses on determining when to perform percutaneous coronary intervention (PCI) based on specific physiological measurements like fractional flow reserve (FFR).
- Patients will be monitored for 24 months post-procedure to evaluate outcomes related to serious complications such as death, heart attack, and stroke, aiming to define a more effective approach to treatment.
Aims: This study aims to assess the applicability of the mitral regurgitation (MR) proportionality concept in patients with atrial functional mitral regurgitation (aFMR) treated with transcatheter edge-to-edge repair (M-TEER). We hypothesized that patients with disproportionate MR (higher MR relative to left ventricular size) would exhibit different outcomes compared to those with proportionate MR, despite undergoing M-TEER.
Methods And Results: We retrospectively analysed 98 patients with aFMR from the EuroSMR registry who underwent M-TEER between 2008 and 2019.
Background: Patients with severe aortic stenosis and a small aortic annulus are at risk for impaired valvular hemodynamic performance and associated adverse cardiovascular clinical outcomes after transcatheter aortic-valve replacement (TAVR).
Methods: We randomly assigned patients with symptomatic severe aortic stenosis and an aortic-valve annulus area of 430 mm or less in a 1:1 ratio to undergo TAVR with either a self-expanding supraannular valve or a balloon-expandable valve. The coprimary end points, each assessed through 12 months, were a composite of death, disabling stroke, or rehospitalization for heart failure (tested for noninferiority) and a composite end point measuring bioprosthetic-valve dysfunction (tested for superiority).
Background: Early studies of the Tendyne transcatheter mitral valve replacement (TMVR) showed promising results in a small selective cohort.
Objectives: The authors present 1-year data from the currently largest commercial, real-world cohort originating from the investigator-initiated TENDER (Tendyne European Experience) registry.
Methods: All patients from the TENDER registry eligible for 1-year follow-up were included.
Background: Similar to procedures requiring general anesthesia, current guidelines recommend fasting for 6 hours for solids and for 2 hours for liquids prior to coronary angiography, but without data supporting such recommendation. The CORO-NF study aimed at assessing whether a shorter fasting period prior to elective coronary angiography associates with improved patient satisfaction without more complications compared with the standard fasting approach.
Methods: We conducted a single-center, randomized, prospective, pragmatic study in 2 sequential phases: a "conventional protocol phase," continuing the usual practice (F Group); and an "experimental phase" (NF Group), reducing minimum fasting duration to 2 hours.
European Society of Cardiology quality indicators for the care and outcomes of adults undergoing transcatheter aortic valve implantation.
Eur Heart J Qual Care Clin Outcomes
December 2024
Aims: To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing transcatheter aortic valve implantation (TAVI).
Methods And Results: We followed the European Society of Cardiology (ESC) methodology for the development of QIs. Key domains were identified by constructing a conceptual framework for the delivery of TAVI care.
Given the expanding indications toward younger patients at lower surgical risk, transcatheter aortic valve replacement (TAVR) simplification and streamlining are gaining increasing importance. Patients who underwent TAVR from the year 2015 to 2020 were prospectively enrolled. The patients were divided in time tertiles according to the date of intervention.
View Article and Find Full Text PDFBackground: Transcatheter aortic valve implantation is an effective treatment for patients with aortic stenosis; however, complications related to paravalvular leakage (PVL) persist, including increased risk of mortality, cardiovascular mortality, and rehospitalisation.
Aims: We sought to evaluate the clinical outcomes and valve performance at 1 year in patients with severe aortic stenosis treated with the ACURATE neo2 valve in a post-market clinical setting.
Methods: Valve Academic Research Consortium-2 safety events were assessed up to 1 year.
Article Synopsis
- The study investigates the effects of mitral valve-in-valve (ViV) procedures on patient outcomes, particularly focusing on device position and asymmetry.
- Researchers analyzed data from 222 patients in the VIVID Registry and found that residual mitral valve stenosis was common, affecting 50% of participants, whereas left ventricular outflow tract (LVOT) obstruction was rare, occurring in 3.2% of cases.
- Key findings included that greater asymmetry of the transcatheter heart valve was linked to higher rates of residual stenosis, while deeper atrial implantation seemed to reduce the likelihood of LVOT obstruction.
Article Synopsis
- The study focused on primary mitral regurgitation (PMR) and how cardiac remodeling affects patient selection for transcatheter edge-to-edge repair (TEER).
- Researchers analyzed data from 654 patients with PMR, looking at extra-mitral valve (MV) cardiac involvement and tracking outcomes over two years.
- Results showed that patients with left or right heart involvement had significantly worse survival rates compared to those with no cardiac involvement, highlighting the importance of assessing cardiac involvement for better risk stratification.
Background: The risks of prefrail and frail women undergoing transcatheter aortic valve replacement (TAVR) have not been fully examined. The aim of the analysis was to assess the prognostic impact of prefrailty and frailty in women undergoing TAVR.
Methods: Women at intermediate or high surgical risk with severe aortic stenosis undergoing TAVR from the prospective multicentre WIN-TAVI (Women's International Transcatheter Aortic Valve Implantation) registry were stratified based on the number of Fried frailty criteria (weight loss, exhaustion, low physical activity, slow gait, weakness) met: nonfrail (no criteria), prefrail (1 or 2 criteria), or frail (3 or more criteria).
Background: Limited data are available on transcatheter heart valves (THVs) durability in bicuspid aortic valve (BAV) stenosis.
Aims: To evaluate evaluating 4-year clinical and echocardiographic outcomes of patients with BAV undergoing transcatheter aortic valve implantation (TAVI).
Methods: The bicuSpid TAvi duraBILITY (STABILITY) registry is an Italian multicentre registry including all consecutive patients with BAV and severe aortic stenosis (AS), treated by means of TAVI between January 2011 and December 2017.
Symptoms of aortic stenosis (AS) are not proportional to its severity and patients with very severe AS (VSAS) remain asymptomatic for a long time. The appropriate time for intervention in patients with VSAS and the effects of transcatheter aortic valve implantation (TAVI) on left ventricular hypertrophy (LVH) remain debated. Our aim was to compare the procedural and 30-day outcomes of TAVI between patients with VSAS and patients with severe AS (SAS) and the changes in LVH.
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- - The study focused on evaluating the performance of the ACURATE Neo2 transcatheter heart valve (THV) in patients with a horizontal aorta (HA), which is linked to worse outcomes after heart valve procedures.
- - Results showed that while both ACURATE Neo and Neo2 valves had similar success rates, the Neo2 valve significantly reduced the occurrence of moderate or severe paravalvular leak (PVL) compared to the Neo valve (5% vs. 15%).
- - The findings suggest that the Neo2 valve is a better option for patients with HA, offering improved PVL rates without compromising device success in the shorter term follow-up.
Despite the growing experience with MitraClip in the broad spectrum of mitral regurgitation (MR), limited data are available regarding the independent prognostic role on survival of different mitral regurgitation etiology subtypes. We sought to evaluate the impact of flail leaflet etiology in a large series of patients with primary MR (PMR) who underwent MitraClip treatment. The study included 588 patients with significant PMR from the multicenter GIOTTO (Italian Society of Interventional Cardiology [GIse] registry Of Transcatheter treatment of mitral valve regurgitaTiOn), stratified into 2 groups according to MR etiology: flail (n = 300) and flail (n = 288).
View Article and Find Full Text PDFBackground: Transcatheter mitral valve replacement (TMVR) using dedicated devices is an alternative therapy for high-risk patients with symptomatic mitral regurgitation (MR).
Aims: This study aimed to assess the 2-year outcomes and predictors of mortality in patients undergoing TMVR from the multicentre CHOICE-MI Registry.
Methods: The CHOICE-MI Registry included consecutive patients with symptomatic MR treated with 11 different dedicated TMVR devices at 31 international centres.
Background: Transcatheter mitral valve replacement (TMVR) is an emerging therapeutic alternative for patients with secondary mitral regurgitation (MR). Outcomes of TMVR versus guideline-directed medical therapy (GDMT) have not been investigated for this population. This study aimed to compare clinical outcomes of patients with secondary MR undergoing TMVR versus GDMT alone.
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