Publications by authors named "Iliadis C"
Atrial Secondary Tricuspid Regurgitation: Insights Into the EuroTR Registry.
JACC Cardiovasc Interv
December 2024
Article Synopsis
- Atrial secondary tricuspid regurgitation (A-STR) is a subtype of secondary tricuspid regurgitation (STR) that is often treated with transcatheter tricuspid valve edge-to-edge repair (T-TEER), showing distinct patient characteristics and treatment outcomes.
- A study involving 641 patients revealed that 31% had A-STR, which was linked to better heart function, a higher presence of atrial fibrillation, and more effective TR reduction post-procedure compared to nonatrial STR patients.
- A-STR patients experienced improved survival rates and lower symptomatic burdens after treatment; only 38% remained symptomatic (NYHA class ≥III) after 2 years, compared to 46
Aims: Conventional parameters of right ventricular (RV) function are load-dependent and therefore do not accurately reflect contractility in patients with relevant tricuspid regurgitation (TR). RV adaptability to load has been characterized using the Dandel's index in patients with heart failure, but its prognostic value in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) has not been investigated so far.
Methods And Results: From the EuroTR registry (2019 to 2022), patients with complete datasets and a minimum of 2-years of follow-up were included.
Article Synopsis
- The study examined the effects of pulmonary hypertension (PH) on patients receiving transcatheter tricuspid valve edge-to-edge repair (T-TEER), focusing on survival rates and heart failure hospitalization outcomes.
- Results showed that higher systolic pulmonary artery pressure (sPAP) was linked to increased risks of death or hospitalization within two years, with a notable threshold of sPAP > 46 mmHg identifying those at greater risk.
- However, both the severity of heart failure symptoms and tricuspid regurgitation improved after T-TEER, regardless of whether patients had pre- or postcapillary PH.
Background: Tricuspid valve transcatheter edge-to-edge repair has emerged as a valuable treatment option for patients with severe tricuspid regurgitation (TR).
Objectives: This study aims to investigate the safety and effectiveness of the PASCAL transcatheter valve repair system in treating severe TR in a real-world patient population.
Methods: The PASTE (PASCAL for Tricuspid Regurgitation-a European registry) study is an investigator-initiated, multicenter, retrospective, and prospective observational cohort analysis conducted across 16 European heart valve centers including consecutive patients treated with the PASCAL transcatheter valve repair system from February 2019 to November 2023.
Background: Two subtypes of atrial functional mitral regurgitation (AFMR) have been described, one is characterized by Carpentier type I and the other by Carpentier type IIIb leaflet motion.
Objectives: The authors sought to analyze echocardiographic characteristics and outcomes of AFMR subtypes undergoing mitral valve transcatheter edge-to-edge repair (M-TEER).
Methods: Of 1,047 consecutive patients who underwent M-TEER, the authors identified those with isolated mitral annulus dilation (Carpentier I), termed AFMR-IAD, and those with atriogenic hamstringing characterized by restricted posterior mitral leaflet motion (Carpentier IIIb), termed AFMR-AH.
Article Synopsis
- This study investigates how intraprocedural residual mitral regurgitation (rMR) and mean mitral valve gradient (MPG) affect outcomes for patients with primary mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER).
- Researchers analyzed data from 1,509 patients in the PRIME-MR registry, focusing on differences in 2-year outcomes based on the severity of rMR and MPG levels.
- Results indicated that higher levels of rMR (≥2+) were linked to worse clinical outcomes, while MPG did not significantly impact patient prognosis after the procedure.
Background: A novel echocardiography-based definition of atrial functional tricuspid regurgitation (A-FTR) has shown superior outcomes in patients undergoing conservative treatment or tricuspid valve transcatheter edge-to-edge repair. Its prognostic significance for transcatheter tricuspid valve annuloplasty (TTVA) outcomes is unknown.
Objectives: This study sought to investigate prognostic, clinical, and technical implications of A-FTR phenotype in patients undergoing TTVA.
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.
Aims: Data on the prognostic impact of residual tricuspid regurgitation (TR) after tricuspid transcatheter edge-to-edge repair (T-TEER) are scarce. The aim of this analysis was to evaluate 2-year survival and symptomatic outcomes of patients in relation to residual TR after T-TEER.
Methods And Results: Using the large European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry) we investigated the impact of residual TR on 2-year all-cause mortality and New York Heart Association (NYHA) functional class at follow-up.
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.
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.
This review aims to investigate the safety of recurrent laryngeal nerve (RLN) by comparing robotic thyroidectomy (RT) versus open thyroidectomy (OT) in Western and Asian populations. Two main outcomes of this review were (1) the safety of RLN comparing the robotic and OT assessing transient and permanent laryngeal nerve (PLN) palsy as a postoperative complication in each surgical procedure and (2) the safety of RLN comparing the robotic and OT assessing transient and permanent laryngeal nerve (PLN) palsy as a postoperative complication between studies conducted in USA/Europe and Asia. We searched relevant literature in electronic databases such as PubMed, MEDLINE, Cochrane CENTRAL, ScienceDirect, and Cumulative Index to Nursing & Allied Health (CINAHL) up to September 2022.
View Article and Find Full Text PDFBackground: Severe tricuspid regurgitation (TR) is associated with chronic volume overload and right ventricular remodeling (RVR). Transcatheter tricuspid valve repair (TTVr) reduces TR and can improve quality of life (QoL), but the role of preprocedural RVR on TTVr outcomes remains unclear.
Aims: To investigate the role of RVR on outcomes after TTVr for severe TR.
Background: Bleeding is the most common complication after percutaneous leaflet-based tricuspid valve repair and associated with acute kidney injury (AKI) and adverse outcome. TTVA with the Cardioband system is a technically more complex procedure; however, frequency and prognostic impact of postinterventional bleeding and renal complications have not been thoroughly examined.
Aims: This study was performed to determine the incidence and clinical impact of bleeding complications (MVARC criteria) and acute kidney injury (KDIGO criteria) following transcatheter tricuspid valve annuloplasty (TTVA).
Background: Frailty is common in elderly and multimorbid patients and associated with increased vulnerability to stressors.
Methods: In a single centre study frailty according to Fried criteria was assessed in consecutive patients before transcatheter mitral and tricuspid valve repair. Postprocedural infections, blood transfusion and bleeding and renal failure were retrospectively assessed from records.
Aims: Achieving optimized guideline-directed medical therapy (GDMT) is recommended prior to transcatheter mitral valve edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR). We aimed to propose and validate an easy-to-use score for assessing the quality of GDMT in patients with heart failure with reduced ejection fraction (HFrEF) undergoing M-TEER.
Methods And Results: Among the 1641 EuroSMR patients enrolled in the EuroSMR Registry who underwent M-TEER, a total of 1072 patients [median age 74, interquartile range (IQR) 67-79 years, 29% female] had complete data on GDMT and a left ventricular ejection fraction ≤ 40% and were included in the current study.
Background: C HIV/AIDS infection is characterized by a very low number of T lymphocytes (CD4), which makes sufferers vulnerable to various infections, and so they seek continuous care in Special Infections Units.
Objective: The purpose of the survey is to investigate the factors that contribute to the satisfaction derived from the health services provided to people living with the human immunodeficiency virus; and they are monitored at the Special Infections Unit of the University General Hospital of Alexandroupoli.
Methods: All patients who came to the Special Infections Unit of the University General Hospital of Alexandroupoli during the period June - July 2021 were asked to complete an anonymous questionnaire on satisfaction derived from the health services provided (E - PQ - SPCSS) and satisfaction derived from their work and quality of life (Occupational Stress Questionnaire, JCQ).
Background: Transcatheter repair emerges as a treatment option in patients with tricuspid regurgitation (TR) and high surgical risk.
Aims: This study aimed to compare leaflet-based and annuloplasty-based transcatheter repair in patients with TR.
Methods: In a retrospective analysis consecutive patients undergoing either transcatheter edge-to-edge repair (TEER) or direct annuloplasty (AP) for relevant TR at 2 centers were compared with respect to baseline characteristics, procedural efficacy and safety (death, myocardial infarction, procedure or device-related cardiothoracic surgery, or stroke at 30 days).
Background And Aims: Benefit of tricuspid regurgitation (TR) correction and timing of intervention are unclear. This study aimed to compare survival rates after surgical or transcatheter intervention to conservative management according to a TR clinical stage as assessed using the TRI-SCORE.
Methods: A total of 2,413 patients with severe isolated functional TR were enrolled in TRIGISTRY (1217 conservatively managed, 551 isolated tricuspid valve surgery, and 645 transcatheter valve repair).