Publications by authors named "Lauten P"

Background: The impact of systemic inflammation in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is still a matter of debate. The present ECLS-SHOCK sub-study investigates the association of C-reactive protein (CRP) levels with short-term outcomes in patients with AMI-CS.

Methods: Patients with AMI-CS enrolled in the multicenter, randomized ECLS-SHOCK trial between 2019 and 2022 were included.

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  • 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
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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.

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  • 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.
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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.

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Background: The outcomes of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and the efficacy and safety of extracorporeal life support (ECLS) may be affected by the timing of hospital admission.

Objectives: The present ECLS-SHOCK substudy sought to investigate the prognostic impact of on-hours vs off-hours admission and the efficacy of ELCS according to the timing of hospital admission time in AMI-CS.

Methods: Patients with AMI-CS enrolled in the multicenter, randomized ECLS-SHOCK trial from 2019 to 2022 were included.

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Interventional echocardiography (IE) is a relatively new subspecialty in the field of cardiology that has rapidly evolved to occupy a critical role in the treatment of structural heart disease. Despite this, clear competency guidelines are only now being issued, and, of pressing importance, the health risks associated with the profession, particularly occupational radiation exposure, still need to be recognized and appropriately addressed for both specialists and trainees in IE as well as for supporting sonographers. This review will briefly discuss the extensive training interventional echocardiographers need in advanced imaging modalities and will then present standard measures as well as possible innovative devices that can be implemented to reduce ionizing radiation exposure for those working in the field of IE.

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  • Valve-in-Valve (VIV) transcatheter aortic valve replacement (TAVR) shows promise for treating malfunctioning Perceval surgical valves, but data on its effectiveness are limited.
  • A study analyzed 57 patients from various reports, with most being women around 76 years old; results showed a reduction in heart gradient and a low complication rate (15.7%).
  • VIV-TAVR can be done safely with specific valve technologies, but should only be performed by skilled operators familiar with both TAVR and VIV procedures.*
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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.

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In this bicentric study, we report the outcomes of combined transcatheter aortic valve replacement combined with minimally invasive mitral valve surgery. We included a cohort of six patients (79.6 ± 3.

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  • Extracorporeal Life Support (ECLS) is being used more for treating cardiogenic shock related to heart attacks, but its effect on survival rates is unclear.
  • In a multicenter trial, patients with an acute heart attack and planned revascularization were divided into two groups: one receiving ECLS along with standard treatment and the other receiving standard treatment alone, with death rates tracked after 30 days.
  • Results showed no significant difference in mortality between the two groups, but the ECLS group experienced higher rates of bleeding and vascular complications.
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Transcatheter aortic valve implantation (TAVI) is now a commonly used therapy in patients with severe aortic stenosis, even in those patients at low surgical risk. The indications for TAVI have broadened as the therapy has proven to be safe and effective. Most challenges associated with TAVI after its initial introduction have been impressively reduced; however, the possible need for post-TAVI permanent pacemaker implantation (PPI) secondary to conduction disturbances continues to be on the radar.

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  • - This study compares methodologies for measuring calcium scores in aortic stenosis, focusing on the differences between non-contrast (nc) CT and contrast-enhanced (ce) CT scans, revealing significant discrepancies in calcium volume and score measurements.
  • - Results indicate that calcium scores and volumes are generally lower in ce CT compared to nc CT, with the median scores showing a difference of 341 AU and volumes differing by 504 mm across the two methods.
  • - Patients with low-gradient aortic stenosis (LG AS) exhibited lower Agatston scores and calcium volumes compared to those with high-gradient (HG AS), suggesting that reliance solely on calcium scores for diagnosing severe LG AS may be inadequate.
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Background: The axillary artery is an alternative access route for transcatheter aortic-valve implantation (TAVI) in patients who have unfavourable femoral arteries as well as comorbidities which preclude surgery. Transaxillary TAVI (TAx-TAVI), with a complete non-transfemoral approach, is a feasible and safe alternative even if complications like vascular closure device failure with bleeding occurs.

Case Summary: We describe here a simplified non-transfemoral TAx-TAVI approach in a 71-year-old patient with pulmonary oedema due to severe symptomatic aortic stenosis with a prohibitively high surgical risk (Society of Thoracic Surgeons Mortality 11.

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  • - The study aimed to assess the early- and mid-term outcomes of redo surgical aortic valve replacement (SAVR) in patients who previously underwent transcatheter aortic valve implantation (TAVI) from 2013 to 2020.
  • - Out of 5756 TAVI patients, only 28 (0.5%) required redo SAVR, with a significant increase in surgical risk indicated by a higher EuroSCORE at the time of SAVR compared to TAVI.
  • - The in-hospital mortality rate for redo SAVR was 14.3%, with infective endocarditis being the main reason for surgery, while mid-term survival rates were lower for those with infective endocarditis compared
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Background: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement offer an alternative therapy for high risk patients. We aimed to highlight the operative and postoperative results of TMVIV and TMVIR procedures.

Results: We included all patients underwent TMVIV and TMVIR procedures between 2017 and 2020 at two heart centers in Germany.

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: Coronary artery disease (CAD) is a frequent comorbidity in patients undergoing transcatheter aortic valve implantation (TAVI). If significant CAD can be excluded on coronary CT-angiography (cCTA), invasive coronary angiography (ICA) may be avoided. However, a high plaque burden may make the exclusion of CAD challenging, particularly for less experienced readers.

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Objectives: The purpose of this study was to analyze the ability of machine-learning (ML)-based computed tomography (CT)-derived fractional flow reserve (CT-FFR) to further improve the diagnostic performance of coronary CT angiography (cCTA) for ruling out significant coronary artery disease (CAD) during pre-transcatheter aortic valve replacement (TAVR) evaluation in patients with a high pre-test probability for CAD.

Background: CAD is a frequent comorbidity in patients undergoing TAVR. Current guidelines recommend its assessment before TAVR.

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Objectives: This study sought to report the calcification pattern of the mitral valve annulus and its implications for procedural and safety outcomes in transcatheter aortic valve implantation.

Methods: Between November 2018 and September 2019, a total of 305 patients had transcatheter aortic valve implants at our institution. The extent of calcification of the mitral valve annulus was analysed, and the impact on safety outcomes was evaluated.

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Objectives: Aortic wall thrombus (AWT) can affect suitability to endovascular repair, while its most aggressive entity is better known as shaggy aorta syndrome. Primary objective was to study the procedural and clinical outcome with regard to atherothrombotic AWT in transfemoral aortic valve implantation.

Methods: In a retrospective, single-centre analysis, a qualitative 0-10 AWT score classification system was used.

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Background: In acute myocardial infarction complicated by cardiogenic shock the use of mechanical circulatory support devices remains controversial and data from randomized clinical trials are very limited. Extracorporeal life support (ECLS) - venoarterial extracorporeal membrane oxygenation - provides the strongest hemodynamic support in addition to oxygenation. However, despite increasing use it has not yet been properly investigated in randomized trials.

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Background: Significant coronary artery disease (CAD) is a common finding in patients undergoing transcatheter aortic valve implantation (TAVI). Assessment of CAD prior to TAVI is recommended by current guidelines and is mainly performed via invasive coronary angiography (ICA). In this study we analyzed the ability of coronary CT-angiography (cCTA) to rule out significant CAD (stenosis ≥ 50%) during routine pre-TAVI evaluation in patients with high pre-test probability for CAD.

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