Early Outcomes With Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement in Patients With Atrial Fibrillation.

Background: Limited studies are available which aim to identify patient populations that would potentially benefit from the use of cerebral embolic protection devices (CPDs) during transcatheter aortic valve replacement (TAVR). We aimed to analyze the impact of CPD use during TAVR among patients with atrial fibrillation (AF).

Methods: Data on adult TAVR patients with a concomitant diagnosis of AF was obtained from the 2017-2020 National Readmissions Database.

Cut-off matters in the interpretation of myositis antibodies by line immunoassay.

Objectives: To evaluate the performance of a commercial line immunoassay (LIA) in cohorts of healthy controls (HC), disease controls (DC), and patients with idiopathic inflammatory myopathies (IIMs), and investigate whether different cut-offs would enhance the accuracy of myositis antibodies (MAs) by LIA.

Methods: Sera from patients with positive MAs (n = 118), DC (n = 124) and HC (n = 60), were analysed for MAs using EUROLINE Myopathies 16 Ag LIA (EUROIMMUN).

Results: The newly established MAs cut-offs resulted in significantly lower both false-positive and multiple positive rates compared with the manufacturer's single cut-off, from 36.

Outcomes and Predictors of Different Flow-Gradient Patterns of Aortic Stenosis After Transcatheter Aortic Valve Replacement.

This study sought to explore the clinical factors associated with classical low-flow low-gradient (C-LFLG) and normal-flow low-gradient (NFLG) aortic stenosis (AS) compared with high-gradient (HG) AS. We also compared clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) across flow-gradient patterns. Patients with C-LFLG AS have a higher mortality rate after TAVR than those with HG AS.

Elastic Recoil and Deployment Asymmetry of the Transcatheter Heart Valve in Bicuspid Versus Tricuspid Anatomy.

Background: Data supporting the use of transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) is limited compared to tricuspid aortic valve (TAV) anatomy, as the BAV anatomy poses unique challenges to prosthesis expansion and symmetric deployment.

Aims: We aim to compare the acute recoil and asymmetry of the SAPIEN-3 valve between BAV and TAV anatomies and their impact on procedural outcomes.

Methods: We conducted a single-center study of patients who underwent TAVR with the SAPIEN-3 valve.

Novel Leaflet Modification of the Native Anterior Mitral Valve Leaflet for Transcatheter Mitral Valve Replacement.

Valve-in-mitral annular calcification presents a great challenge with a risk of left ventricular outflow tract obstruction (LVOTO). We demonstrate the first-in-human experience of performing percutaneous electrosurgery-guided perforation and balloon dilation of the anterior mitral valve leaflet followed by transcatheter valve implantation to prevent LVOTO.

Outcomes of a patient support programme for subcutaneous immunoglobulin therapy in patients with primary or secondary immunodeficiencies or chronic inflammatory demyelinating polyneuropathy.

Background: Subcutaneous immunoglobulin (SCIg) therapy is important in the treatment of primary (PID) and secondary immunodeficiencies (SID) and chronic inflammatory demyelinating polyneuropathy (CIDP). Patient support programmes (PSPs) help patients self-administer medication regimens and play a more active role in the self-management of their medical conditions.

Aim: To describe the effectiveness of the CSL Behring CARES PSP in optimising the quality use of SCIg in a hospital-free environment.

Single vs Double Lung Transplantation in Older Adults: A Propensity-Matched Analysis.

Background: Single lung transplantation (SLT) has been shown to be associated with worse long-term outcomes than bilateral lung transplantation (BLT), but often is performed in older adults at risk of not tolerating BLT.

Research Question: How do the outcomes of SLT and BLT compare among older adult recipients?

Study Design And Methods: The Scientific Registry of Transplant Recipients database (2005-2022) was queried for lung transplant recipients aged 65 years older. Patients were stratified by whether they underwent BLT or SLT and were propensity matched.

The Australasian Registry for Severe Cutaneous Adverse Reactions (AUS-SCAR) - Providing a roadmap for closing the diagnostic, patient, and healthcare gaps for a group of rare drug eruptions.

Background: Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the prevention, diagnosis and treatment of SCAR.

Real-time lung weight measurement during clinical ex vivo lung perfusion.

Background: Real-time lung weight (LW) measurement is a simple and noninvasive technique for detecting extravascular lung water during ex vivo lung perfusion (EVLP). We investigated the feasibility of real-time LW measurement in clinical EVLP as a predictor of transplant suitability and post-transplant outcomes.

Methods: In our clinical acellular EVLP protocol, real-time LW was measured in 117 EVLP cases from June 2019 to June 2022.

Strategic testing following toxic epidermal necrolysis allows reintroduction of chemotherapy in a patient with progressive myeloma.

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome belong to a family of severe cutaneous adverse reactions that can be life-threatening and carry a risk of significant morbidity and potential mortality in the event of re-exposure. Lifelong avoidance of the culprit agent is mandated, which can lead to the exclusion of multiple medications if the trigger is unclear. This can result in adverse health outcomes analogous to that of a penicillin allergy label.

Comparison of Contemporary Treatment Strategies in Patients With Cardiogenic Shock Due to Severe Aortic Stenosis.

Background: The aims of this study were to understand the incidence and outcomes of patients with cardiogenic shock (CS) due to severe aortic stenosis (AS), and the impact of conventional treatment strategies in this population.

Methods And Results: All patients admitted to the Cleveland Clinic cardiac intensive care unit between January 1, 2010 and December 31, 2021 with CS were retrospectively identified and categorized into those with CS in the setting of severe AS versus CS without AS. The impact of various treatment strategies on mortality was further assessed.

Outcomes and treatment strategy of transcatheter aortic valve replacement with balloon-expandable valve in borderline-size annulus.

Background: Candidates for transcatheter aortic valve replacement (TAVR) occasionally have a "borderline-size" aortic annulus between 2 transcatheter heart valve sizes, based on the manufacturer's sizing chart. Data on TAVR outcomes in such patients are limited.

Methods: We retrospectively reviewed 1816 patients who underwent transfemoral-TAVR with balloon-expandable valve (BEV) at our institution between 2016 and 2020.

The degree of permanent pacemaker dependence and clinical outcomes following transcatheter aortic valve implantation: implications for procedural technique.

Aims: Conduction abnormalities necessitating permanent pacemaker (PPM) implantation remain the most frequent complication post-transcatheter aortic valve implantation (TAVI), yet reliance on PPM function varies. We evaluated the association of right-ventricular (RV)-stimulation rate post-TAVI with 1-year major adverse cardiovascular events (MACE) (all-cause mortality and heart failure hospitalization).

Methods And Results: This retrospective cohort study of patients undergoing TAVI in two high-volume centers included patients with existing PPM pre-TAVI or new PPM post-TAVI.