A Novel Echocardiographic Parameter to Confirm Low-Gradient Aortic Stenosis Severity.

Background: In patients with low-gradient (LG) aortic stenosis (AS), confirming disease severity and indication of intervention often requires dobutamine stress echocardiography (DSE) or aortic valve calcium scoring by computed tomography. We hypothesized that the mean transvalvular pressure gradient to effective orifice area ratio (MG/EOA, in mm Hg/cm) measured during rest echocardiography identifies true-severe AS (TSAS) and is associated with clinical outcomes in patients with low-flow, LG-AS.

Objectives: The purpose of this study was to evaluate the diagnostic and prognostic value of MG/EOA ratio.

Computational simulation model of transcatheter edge-to-edge mitral valve repair: a proof-of-concept study.

Aims: As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in pre-procedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element computational simulation model to predict the results of transcatheter edge-to-edge repair (TEER) interventions.

Methods And Results: We prospectively enrolled patients with secondary mitral regurgitation (MR) referred for a clinically indicated TEER.

Cost-effectiveness of population screening for aortic stenosis.

Background And Aims: Aortic stenosis (AS) is a progressive disease predominantly affecting elderly patients that carries significant morbidity and mortality without aortic valve replacement, the only proven treatment. Our objective was to determine the cost-effectiveness of AS screening using transthoracic echocardiography (TTE) in a geriatric population from the perspective of the publicly funded healthcare system in Canada.

Methods: Markov models estimating the cost-effectiveness ratio (ICER) for AS screening with a one-time TTE were developed.

Aortic valve replacement for aortic stenosis: Influence of centre volume on TAVR adoption rates and outcomes in France.

Background: Transcatheter (TAVR) has supplanted surgical (SAVR) aortic valve replacement (AVR).

Aim: To evaluate whether adoption of this technology has varied according to centre volume at the nationwide level.

Methods: From an administrative hospital-discharge database, we collected data on all AVRs performed in France between 2007 and 2019.

Edge-to-edge with partial band mitral valve repair compared to replacement and undersized restrictive annuloplasty for ischemic mitral regurgitation.

Objective: Evidence supports replacement over repair for ischemic mitral regurgitation due to improved durability; however, the latter often involves an undersized ring annuloplasty that does not include edge-to-edge approximation. The objective of this study was to evaluate the outcomes of replacement, edge-to-edge leaflet approximation with mild-undersized annuloplasty and undersized ring annuloplasty for ischemic mitral regurgitation.

Methods: This is a single-center retrospective study of patients undergoing mitral surgery for moderate-severe or greater ischemic mitral regurgitation, between 2004 and 2020, with mild-undersized annuloplasty, mitral valve replacement, or undersized restrictive annuloplasty (undersized ring annuloplasty).

Impact of the coronavirus disease 2019 pandemic on aortic valve replacement and outcomes in France.

Background: The coronavirus disease of 2019 (COVID-19) pandemic lockdowns limited access to medical care. The impact on surgical (SAVR) and transcatheter (TAVR) aortic valve replacement (AVR) has been poorly described.

Aim: We sought to evaluate the impact of the COVID-19 pandemic on the number and modalities of AVR, patient demographics and in-hospital outcomes at the nationwide level.

The Prevalence and Characteristics of Arrhythmic Mitral Valve Prolapse in Patients With Unexplained Cardiac Arrest.

Background: There is growing evidence that mitral valve prolapse (MVP) is associated with otherwise unexplained cardiac arrest (UCA). However, reports are hindered by the absence of a systematic ascertainment of alternative diagnoses.

Objectives: This study reports the prevalence and characteristics of MVP in a large cohort of patients with UCA.

Arrhythmic Mitral Valve Prolapse: Risk Assessment and Management.

Arrhythmic mitral valve prolapse (MVP) has gained great interest recently because of the increasing recognition of its potential role in unexplained cardiac arrest. Although evidence has accumulated to show the association of arrhythmic MVP (AMVP) with sudden cardiac death (SCD), risk stratification and management remain unclear. Physicians are faced with the challenges of screening for AMVP among MVP patients and the dilemma of when and how to intervene to prevent SCD in these patients.

Unmet needs in valvular heart disease.

Valvular heart disease (VHD) is the next epidemic in the cardiovascular field, affecting millions of people worldwide and having a major impact on health care systems. With aging of the population, the incidence and prevalence of VHD will continue to increase. However, VHD has not received the attention it deserves from both the public and policymakers.

Trends in aortic valve replacement for aortic stenosis: a French nationwide study.

Aims: Transcatheter aortic valve replacement (TAVR) as an alternative to surgical aortic valve replacement (SAVR) has profoundly changed the management of patients with aortic valve stenosis (AS). Large unbiased nationwide data regarding TAVR implementation, impact on SAVR and their respective outcomes are scarce.

Methods And Results: Based on a French administrative hospital-discharge database, we collected data on all consecutive aortic valve replacements (AVRs) performed in France for AS between 2007 and 2019 [106 253 isolated SAVR (49%), 46 514 combined SAVR (21%), and 65 651 TAVR (30%)].

Echocardiographic Evaluation of the Etiology and Mechanism of Native Aortic Valve Regurgitation.

• Understanding the mechanism of AR informs the surgical approach. • A repair-oriented classification of AR is not well appreciated by cardiologists. • Multiple mechanisms of AR frequently coexist.