Publications by authors named "Himbert D"
Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. This study aimed to determine the rate, factors associated with, and prognostic value of poor functional status (NYHA class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
Methods: This multicenter study included 6,363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I-II vs.
Background: Transcatheter tricuspid valve intervention (TTVI) has been increasingly adopted in recent years for the treatment of patients with tricuspid regurgitation (TR). However, no dedicated risk stratification has been established for patients undergoing TTVI.
Objectives: The aim of the present study was to propose a dedicated risk score for patients affected by severe TR undergoing TTVI.
Article Synopsis
- Doctors are studying how a procedure called transcatheter tricuspid valve interventions (TTVI) affects patients with heart issues, specifically focusing on something called mitral regurgitation (MR) after the procedure.
- They looked at data from a big group of patients and found that many showed improvement in MR after the procedure, but some got worse.
- They discovered that certain factors, like successful procedures and specific treatments, could help predict whether a patient’s MR would improve or get worse after TTVI.
Article Synopsis
- * It found that patients with mild residual TR had an 85% survival rate, while those with moderate and severe TR had significantly lower rates of 70% and 44%, respectively.
- * The research emphasizes the need for a more detailed classification of TR severity to better predict patient outcomes and highlights the goal of achieving at least mild to moderate residual TR for successful interventions.
Article Synopsis
- The study examines the effectiveness of the TRI-SCORE in predicting outcomes for patients undergoing transcatheter tricuspid valve intervention (TTVI), using data from a large, international registry called TriValve.
- Among the 634 patients analyzed, those with a TRI-SCORE of 8 or higher were found to have a significantly increased risk of all-cause mortality and complications within 30 days of the procedure, compared to those with lower TRI-SCOREs.
- Despite indicating a higher risk for severe outcomes, the TRI-SCORE overall showed limited effectiveness in predicting clinical results following TTVI, as improvements in patient functional class were observed across all TRI-SCORE levels.
Aims: T-TEER is an effective therapy for the treatment of tricuspid regurgitation (TR). However, the effects of leaflets clipping on tricuspid valve annulus (TA) have not been investigated in detail. The aim of this study is to investigate the effects of tricuspid transcatheter edge-to-edge repair (T-TEER) on TA diameter.
View Article and Find Full Text PDFBackground: There is currently no established recommendation for antithrombotic treatment following transcatheter mitral valve replacement (TMVR). However, based on the analogy with surgical mitral bioprosthesis, vitamin K antagonists (VKAs) are predominantly used.
Objectives: The purpose of this study was to compare bleeding and thrombotic events associated with direct oral anticoagulants (DOACs) or VKAs in a prospective cohort of TMVR patients.
Mitral regurgitation is the second most frequent heart valve disease in Europe and the most frequent in the US. Although surgery is the therapy of choice when intervention is indicated, transcatheter mitral valve repair or replacement are alternatives for patients who are not eligible for surgery. However, the development of transcatheter mitral valves is slower than expected.
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- The study aimed to compare the characteristics and outcomes of patients with atrial STR (ASTR) and ventricular STR (VSTR) who underwent transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR).
- Patients were categorized into ASTR or VSTR based on specific cardiac criteria, and a total of 298 were included in the analysis, with similar procedural success rates for both groups.
- Results showed that while T-TEER effectively reduced TR in both ASTR and VSTR patients, survival rates at 12 months were significantly higher for ASTR (91%) compared to VSTR (72%).
Cardiac Death After Transcatheter Aortic Valve Replacement With Contemporary Devices.
JACC Cardiovasc Interv
September 2023
Article Synopsis
- This study examined the rates and causes of sudden cardiac death (SCD) and heart failure (HF)-related deaths in 5,421 patients who underwent transcatheter aortic valve replacement (TAVR) using newer devices.
- Findings revealed that 18% of patients died within two years, with over half of those deaths attributed to cardiovascular issues, notably advanced HF and SCD.
- Key predictors for HF-related death included atrial fibrillation and reduced heart function, while factors linked to increased SCD risk included certain procedural complications like periprocedural ventricular arrhythmias.*
Background: Transcatheter mitral valve implantation (TMVI) may be attractive to treat high-risk patients with mitral bioprosthesis or annuloplasty ring failure or severe mitral annular calcification.
Aim: To report the outcomes of patients after valve-in-valve/ring/mitral annular calcification TMVI using balloon expandable transcatheter aortic valves, according to the degree of urgency of the procedure.
Methods: All patients who underwent TMVI in our centre from 2010 to 2021 were classified into three groups: elective, urgent or emergent/salvage TMVI.
Article Synopsis
- This study examines the relationship between tricuspid valve gradient (TVG) and clinical outcomes in patients who underwent tricuspid transcatheter edge-to-edge repair (TEER) for significant tricuspid regurgitation.
- Researchers analyzed data from 308 patients and categorized them into quartiles based on their mean TVG at discharge.
- The results showed no significant differences in mortality or heart failure hospitalizations across the TVG quartiles one year post-procedure, indicating that higher discharge TVG was not linked to worse outcomes.
Background: The potential benefit of using larger or smaller transcatheter heart valves (THV) in patients with borderline aortic annulus measurement (BAM) remains uncertain. The objective of this study was to evaluate the clinical outcomes associated with the selection of larger or smaller THV in the context of BAM.
Methods: This was a multicenter observational study including patients who underwent transcatheter aortic valve replacement with the SAPIEN 3 or SAPIEN 3 Ultra-valve systems (Edwards Lifesciences, Irvine, CA) from April 2014 to June 2021.
Background: Transcatheter aortic valve implantation now has a major role in the treatment of patients with severe aortic stenosis. However, evidence is scarce on its feasibility and safety to treat patients with pure aortic regurgitation.
Aims: We sought to evaluate the results of transcatheter aortic valve implantation using the balloon-expandable SAPIEN 3 transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA) in patients with pure aortic regurgitation on native non-calcified valves.
Aims: The impact of sexuality in patients with significant tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI) is unknown. The aim of this study was to investigate sex-specific outcomes in patients with significant TR treated with TTVI vs. medical therapy alone.
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- The study examined patients with prosthetic valve endocarditis (PVE) after transcatheter aortic valve implantation (TAVI), focusing on those with absent vs. evident echocardiographic signs of infective endocarditis (IE).
- Among 578 patients, 15.1% had no echocardiographic signs, mostly treated via transfemoral access and showing more complications compared to those with evident signs.
- Patients with absent imaging had higher rates of infections from Staphylococcus aureus and enterococci but similar in-hospital and one-year mortality risks, indicating they still represent a high-risk group for IE despite negative imaging.
Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex.
Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.
Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.
View Article and Find Full Text PDFBackground: Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR).
Objective: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR.
Methods: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR.
Objectives: This study evaluated the incidence, management, and outcome of patients who experienced MitraClip (Abbott Vascular) failure secondary to loss of leaflet insertion (LLI), single leaflet detachment (SLD), or embolization.
Background: Transcatheter edge-to-edge repair with MitraClip is an established therapy for the treatment of mitral regurgitation (MR), but no data exist regarding the prevalence and outcome according to the mode of clip failure.
Methods: Between January 2009 and December 2020, we retrospectively screened 4,294 procedures of MitraClip performed in 19 centers.
Background: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.
Objectives: The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB).
Methods: Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE.
Article Synopsis
- The study examined the relationship between right ventricular (RV) and pulmonary arterial (PA) function, focusing on how effectively the RV works against the pressure in the PA in patients with tricuspid regurgitation (TR) undergoing valve repair or replacement.
- Researchers measured the RV-PA coupling ratio by using echocardiograms before and after the procedure, with a key focus on the impact of this ratio on 1-year mortality.
- Findings showed that a higher RV-PA coupling ratio was linked to lower mortality rates, indicating that improved RV function is crucial for better outcomes post-surgery in patients with TR.
Background: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients.
Methods: This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR.