Transapical Mitral Valve Replacement: 1-Year Results of the Real-World Tendyne European Experience Registry.

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.

Ultrahigh-Spatial-Resolution Photon-counting Detector CT Angiography of Coronary Artery Disease for Stenosis Assessment.

Background Coronary CT angiography is a first-line test in coronary artery disease but is limited by severe calcifications. Photon-counting-detector (PCD) CT improves spatial resolution. Purpose To investigate the effect of improved spatial resolution on coronary stenosis assessment and reclassification.

Photon-Counting Detector CT Virtual Monoenergetic Images for Coronary Artery Stenosis Quantification: Phantom and In Vivo Evaluation.

Calcium blooming causes stenosis overestimation on coronary CTA. The purpose of this article was to evaluate the impact of virtual monoenergetic imaging (VMI) reconstruction level on coronary artery stenosis quantification using photon-counting detector (PCD) CT. A phantom containing two custom-made vessels (representing 25% and 50% stenosis) underwent PCD CT acquisitions without and with simulated cardiac motion.

Cardiac CT Beyond Coronaries: Focus on Structural Heart Disease.

Purpose Of Review: Cardiac computed tomography (CT) is an established non-invasive imaging tool for the assessment of coronary artery disease. Furthermore, it plays a key role in the preinterventional work-up of patients presenting with structural heart disease.

Recent Findings: CT is the gold standard for preprocedural annular assessment, device sizing, risk determination of annular injury, coronary occlusion or left ventricular outflow tract obstruction, calcification visualization and quantification of the target structure, and prediction of a co-planar fluoroscopic angulation for transcatheter interventions in patients with structural heart disease.

Optimization of Kernel Type and Sharpness Level Improves Objective and Subjective Image Quality for High-Pitch Photon Counting Coronary CT Angiography.

(1) Background: Photon-counting detector (PCD) CT offers a wide variety of kernels and sharpness levels for image reconstruction. The aim of this retrospective study was to determine optimal settings for coronary CT angiography (CCTA). (2) Methods: Thirty patients (eight female, mean age 63 ± 13 years) underwent PCD-CCTA in a high-pitch mode.

Survival benefit of overweight patients undergoing MitraClip® procedure in comparison to normal-weight patients.

Background: The number of MitraClip® implantations increased significantly in recent years. Data regarding the impact of weight class on survival are sparse.

Hypothesis: We hypothesized that weight class influences survival of patients treated with MitraClip® implantation.

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience.

Aims: Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real-world data have not yet been reported. This study aimed to assess procedural and 30-day outcomes of TMVI in a real-world patient cohort.

Transgastric imaging-The key to successful periprocedural TEE guiding for edge-to-edge repair of the tricuspid valve.

Intraprocedural transesophageal echocardiography (TEE) guidance plays an essential role in transcatheter repair therapy of the tricuspid valve (TV). So far, several different imaging concepts are in use. We propose an imaging protocol that fully addresses the morphological complexity of the TV and further offers efficacious workarounds for the frequently occurring restrictions of TV imaging in edge-to-edge repair of the TV.

Early symptomatic benefit indicates long-term prognosis after transcatheter mitral valve edge-to-edge repair in functional and degenerative etiology.

Background: Mitral regurgitation (MR) is common in patients with heart failure and constitutes an independent risk factor for adverse prognosis besides NYHA-class. The predictive value of dyspnea reduction after transcatheter mitral valve repair (TMVr) on outcome has not been investigated up to now.

Methods And Results: We enrolled 627 consecutive patients (47.

Dynamic Myocardial Perfusion CT for the Detection of Hemodynamically Significant Coronary Artery Disease.

Objectives: In this international, multicenter study, using third-generation dual-source computed tomography (CT), we investigated the diagnostic performance of dynamic stress CT myocardial perfusion imaging (CT-MPI) in addition to coronary CT angiography (CTA) compared to invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR).

Background: CT-MPI combined with coronary CTA integrates coronary artery anatomy with inducible myocardial ischemia, showing promising results for the diagnosis of hemodynamically significant coronary artery disease in single-center studies.

Methods: At 9 centers in Europe, Japan, and the United States, 132 patients scheduled for ICA were enrolled; 114 patients successfully completed coronary CTA, adenosine-stress dynamic CT-MPI, and ICA.

Complications Following MitraClip Implantation.

Purpose Of Review: To provide a detailed overview of complications associated with MitraClip therapy and its development over time with the aim to alert physicians for early recognition of complications and to offer treatment strategies for each complication, if possible.

Recent Findings: The MitraClip system (MC) is the leading transcatheter technique to treat mitral regurgitation (MR) and has been established as a safe procedure with very low adverse event rates compared to mitral surgery at intermediate to high risk or in secondary MR. Lately, the fourth MC generation has been launched with novel technical features to facilitate device handling, decrease complication rates, and allow the treatment of even complex lesions.

Impact of Mitral Annular Dilation on Edge-to-Edge Therapy With MitraClip-XTR.

[Figure: see text].

Analysis of left ventricular function, left ventricular outflow tract and aortic valve area using computed tomography: Influence of reconstruction parameters on measurement accuracy.

Objectives: Computed tomography (CT) allows reproducible assessment of left ventricular (LV) function, left ventricular outflow tract area (LVOT) and aortic valve area (AVA). We evaluated the influence of image reconstruction parameters on these measurements.

Methods: We analyzed 45 contrast-enhanced, retrospectively ECG-gated CT datasets acquired on a third-generation dual source system.

Minimizing Paravalvular Regurgitation With the Novel SAPIEN 3 Ultra TAVR Prosthesis: A Real-World Comparison Study.

We investigated performance and outcome of the latest-generation balloon-expandable SAPIEN 3 Ultra prosthesis (S3U) compared to the established SAPIEN 3 prosthesis (S3) in a real-world cohort, with focus on paravalvular regurgitation (PVR). PVR is an adverse prognostic indicator of short- and long-term survival after transcatheter aortic valve replacement (TAVR). The S3U has been designed to improve sealing.

Determination of optimal fluoroscopic angulations for aorto-coronary ostial interventions from coronary computed tomography angiography.

Background: An optimal aorto-coronary angiographic projection, characterized by an orthogonal visualization of the proximal coronary artery, is crucial for interventional success. We determined the distribution of optimal C-arm positions and assessed their feasibility by invasive coronary angiography.

Methods: Orthogonal aorto-coronary ostial angulations were determined in 310 CT data sets.

Computed tomography imaging needs for novel transcatheter tricuspid valve repair and replacement therapies.

Transcatheter tricuspid valve therapies are an emerging field in structural heart interventions due to the rising number of patients with severe tricuspid regurgitation and the high risk for surgical treatment. Computed tomography (CT) allows exact measurements of the annular plane, evaluation of adjacent structures, assessment of the access route, and can also be used to identify optimal fluoroscopic projection planes to enhance periprocedural imaging. This review provides an overview of current transcatheter tricuspid valve repair and replacement therapies and to what extent CT can support these interventions.

Dual-axis rotational coronary angiography versus conventional coronary angiography: a randomized comparison.

Background: Dual-axis of rotational coronary angiography (RA), with one single cine acquisition during continuous C-arm motion along a pre-described path, is an alternative to conventional coronary angiography (CA). We assessed the performance of RA versus CA in a modern, experienced cath lab setting.

Methods: Sixty-seven patients with suspected coronary artery disease undergoing invasive coronary angiography were randomized to CA (n = 35) or dual-axis RA (n = 32).

Magnetic resonance phase contrast velocity mapping for flow quantification in irregular heart rhythms using radial k-space ultrashort echo time imaging.

Background: Phase contrast velocity mapping sequences utilising ultrashort echo time (UTE) radial k-space sequences have been used to reduce intravoxel dephasing at high velocities. We evaluated the accuracy of the UTE flow sequence for mitral regurgitation (MR) quantification, including patients with atrial fibrillation.

Methods: Forty patients underwent cardiac MRI for indirect MR quantification by assessment of aortic flow using a UTE phase contrast sequence (TE 0.

Fully Automated CT Quantification of Epicardial Adipose Tissue by Deep Learning: A Multicenter Study.

Purpose: To evaluate the performance of deep learning for robust and fully automated quantification of epicardial adipose tissue (EAT) from multicenter cardiac CT data.

Materials And Methods: In this multicenter study, a convolutional neural network approach was trained to quantify EAT on non-contrast material-enhanced calcium-scoring CT scans from multiple cohorts, scanners, and protocols ( = 850). Deep learning performance was compared with the performance of three expert readers and with interobserver variability in a subset of 141 scans.

Quantification of epicardial adipose tissue by cardiac CT: Influence of acquisition parameters and contrast enhancement.

Purpose: While computed tomography (CT) is frequently used to quantify epicardial adipose tissue (EAT), the effect of different acquisition parameters on EAT volume has not been systematically reported. We assessed the influence of low-voltage acquisition and contrast enhancement on EAT quantification.

Method: Two independent cohorts (100 and 127 patients) referred for routine coronary CT were included.

CT support of cardiac structural interventions.

Due to its high temporal and isotropic spatial resolution, CT has become firmly established for pre-procedural imaging in the context of structural heart disease interventions. CT allows to very exactly measure dimensions of the target structure, CT can provide information regarding the access route and, as a very valuable addition, volumetric CT data sets can be used to identify fluoroscopic projection angulations to optimally visualize the target structure and place devices. This review provides an overview of current methods and applications of pre-interventional CT to support adult cardiac interventions including transcatheter aortic valve implantation, percutaneous mitral valve intervention, left atrial appendage occlusion and paravalvular leak closure.