Publications by authors named "Efstratios I Charitos"
Background: Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking.
Objectives: The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves.
Methods: A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively.
Introduction And Objectives: It is unknown whether aortic valve calcium volume, as measured by contrast-enhanced computed tomography angiography (angio-CT), is associated with mortality in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to confirm that contrast-enhanced aortic valve calcium correlates with noncontrast-enhanced calcium score and provides useful prognostic information in patients undergoing TAVI.
Methods: This retrospective observational study included patients from 2 high-volume TAVI centers in Germany, all of whom underwent high-quality angio-CT prior to TAVI.
Article Synopsis
- - New-onset postoperative atrial fibrillation (POAF) is common after cardiac surgery, particularly coronary artery bypass grafting (CABG), with an estimated incidence of about 30%, but it’s often temporary and under-detected.
- - Previous studies on POAF have used intermittent monitoring techniques that may miss many cases, leading to inaccurate assessments of how often arrhythmias occur post-surgery.
- - The CABG-AF study aims to get a clearer picture of AF incidence and patterns after CABG by using continuous monitoring with an insertable cardiac device in 196 patients, tracking episodes over a planned follow-up of three years.
Article Synopsis
- Precise implantation depth is crucial for the success of transcatheter aortic valve replacement (TAVR), but the effects of incorrect depths on the ACURATE NEO2 prosthesis hadn't been previously studied.
- A study of 1,839 patients evaluated outcomes based on three implantation depth categories: high (<3 mm), optimal (3-7 mm), and low (>7 mm), finding no significant differences in technical success or paravalvular regurgitation rates.
- While higher implantation showed better hemodynamics, it also had a higher risk of embolization; low implantation led to more pacemaker needs, suggesting it's better to avoid high placements to minimize risks.
Background: Challenging anatomies and comorbidities have impact on success in transcatheter aortic valve replacement (TAVR). There is controversy whether the extent of the aortic angle (AA) has an impact on procedural outcomes. Matched comparative outcome data of new generation transcatheter heart valves (THVs) in horizontal aorta (HA) are scarce.
View Article and Find Full Text PDFBackground: Transcatheter aortic valve replacement (TAVR) is increasingly being used to treat severe aortic stenosis in younger patients. Accordingly, lifetime management regarding future reintervention and coronary access is a concern.
Aims: To assess the impact of commissural alignment on ACURATE neo2 transcatheter aortic valve (TAV) performance.
The pathophysiology of aortic valve diseases is of predominantly degenerative nature, characterized by calcific aortic valve stenosis, which is associated with a reduction in prognosis. The prevalence of aortic valve insufficiency also increases with advancing age. Timely causal treatment is crucial in the management of aortic valve diseases.
View Article and Find Full Text PDFBackground: Comparative data on transcatheter self-expanding ACURATE neo2 (NEO2) and balloon-expandable SAPIEN 3 Ultra prostheses in technically challenging anatomy of severe aortic valve calcified aortic annuli are scarce.
Methods: A total of 1987 patients with severe native aortic stenosis treated with the self-expanding NEO2 (n=1457) or balloon-expandable SAPIEN 3 Ultra (n=530) from January 2017 to April 2023 were evaluated. The primary end point was procedural outcome according to the Valve Academic Research Consortium 3 definitions.
Article Synopsis
- This study compares the outcomes of two self-expanding transcatheter heart valve systems (ACURATE and EVOLUT) in patients undergoing valve-in-valve (ViV) procedures for degenerated surgical prostheses.
- A total of 835 patients across 20 centers were analyzed, with key outcomes including technical success, device success, and 30-day mortality rates evaluated between the two groups.
- Results showed that while overall procedural outcomes were similar, specific diameter measurements influenced device success differently between the two valve systems.
We demonstrate a modified technique of heterotopic chimney stenting for coronary obstruction during valve-in-valve transcatheter aortic valve replacement With successful end-on cannulation via the stent ostium. Our technique was reproducible on the bench with successful reaccess and without any interaction between the deployed coronary stent and the prosthetic leaflets.
View Article and Find Full Text PDFAims: Cardiac decompensation (CD) in patients with aortic stenosis is a "red flag" for future adverse events. We classified patients undergoing transcatheter aortic valve implantation (TAVI) into those with acute, prior, or no prior CD at the timepoint of TAVI and compared their clinical presentation, prognosis, and effects of the prescribed medication during follow-up.
Methods: Retrospective analysis of patients of one center fulfilling the criteria of 30-day device success after transfemoral TAVI.
Background: Third-generation transcatheter heart valves (THVs) are designed to improve outcomes. Data on the new intra-annular self-expanding NAVITOR are scarce.
Aims: The aim of this analysis was to compare outcomes between the PORTICO and the NAVITOR systems.
Background: High-grade AV block (HAVB) is the most frequent adverse event after transcatheter aortic valve implantation (TAVI). In rare cases, HAVB is associated with hemodynamic compromise (HC) followed by syncope or application of cardiopulmonary resuscitation (CPR), but data on this severe complication are scarce. The aim of the present study was to investigate the incidence and predictors of HC due to HAVB in patients undergoing TAVI.
View Article and Find Full Text PDFBackground: Severe calcification of the ascending aorta increases the peri-operative risk for neurological complications in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) seems to be an optimal treatment option in these patients. However, the impact of the extent of aortic calcification on procedural and neurological outcomes during TAVI is unclear.
View Article and Find Full Text PDFArticle Synopsis
- Relevant pressure recovery (PR) improves aortic valve function and reduces left ventricular load, but its significance in the pulmonary artery post-Ross surgery was less understood.
- A study of 92 patients using Doppler echocardiography revealed that increased pulmonary artery diameter is associated with a decrease in PR, which significantly increased the effective orifice area of the homograft and decreased both homograft resistance and transvalvular stroke work.
- Findings indicated that not accounting for PR can lead to overestimating homograft stenosis severity, misclassifying patients' conditions, and potentially resulting in unnecessary surgical interventions.
Article Synopsis
- Postoperative atrial fibrillation (POAF) is a frequent complication post-cardiac surgery, affecting about one-third of patients, and the study evaluates various risk and protective factors associated with it through existing meta-analyses.
- The review analyzed data from 47 studies, confirming that the transfemoral transcatheter aortic valve replacement (TAVR) significantly helps prevent POAF, while notable protective factors include amiodarone, b-blockers, and certain surgical techniques.
- The findings suggest a need for further research on the effects of statins, glucocorticoids, and colchicine in preventing POAF, alongside emphasizing the importance of managing preoperative hypertension.
Background: Few data exist on immediate outcomes of the next-generation Acurate neo2 prosthesis (Boston Scientific), which is distinguished by an active sealing mechanism. We sought to determine procedural outcomes of transfemoral transcatheter aortic valve replacement using the neo2 in comparison with its predecessor, the Acurate neo.
Methods: In this retrospective analysis, consecutive neo2 and neo cases were compared from 2 high-volume centers.
Surgical reconstruction of a giant left ventricular aneurysm with prior unloading using a microaxial pump.
Interact Cardiovasc Thorac Surg
August 2022
Article Synopsis
- - A 46-year-old man experienced heart failure caused by a large aneurysm in the left ventricle after an unnoticed heart attack.
- - To help his heart, a microaxial pump was used temporarily to relieve pressure until surgery could be done.
- - The surgery went well, and the heart's function in the lower sections remained intact.
The left axillary artery is an attractive alternative access route for transcatheter aortic valve replacement (TAVR) and may provide better outcomes compared to other alternatives. Nevertheless, there remain concerns about vascular complications, lack of compressibility, and thorax-related complications. Between March 2019 and March 2021, 13 patients underwent transaxillary TAVR for severe aortic stenosis at the University Hospital Bonn.
View Article and Find Full Text PDFEffects of renin-angiotensin system inhibitor type and dosage on survival after transcatheter aortic valve implantation.
Eur Heart J Cardiovasc Pharmacother
December 2022
Aims: The objective of the study was to determine the effect of renin-angiotensin system inhibitors (RASI) on the survival of subgroups of patients with aortic stenosis after transcatheter aortic valve implantation (TAVI) and to assess the impact of types and dosages of RASI on outcomes.
Methods And Results: This single-centre, retrospective analysis included 2862 patients (n = 2227 with RASI and n = 635 without RASI) after successful TAVI. Propensity score matching established comparable patient populations (n = 625 per group).