Publications by authors named "Luca Nai Fovino"
Right-sided cardiac catheterization (RHC) is selectively recommended in mitral valve transcatheter edge-to-edge (M-TEER) workup because right ventricle (RV) hemodynamic parameters predict adverse outcomes. This study examines the impact of RV hemodynamics and the prognostic value of the 2022 European Society of Cardiology (ESC) pulmonary hypertension definitions on outcomes after M-TEER. Of 152 patients treated with M-TEER for symptomatic severe mitral regurgitation (MR) between December 2014 and February 2024 at our tertiary center, 71 underwent elective RHC before the procedure.
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- In patients undergoing transcatheter aortic valve implantation (TAVI), those with classical low-flow, low-gradient aortic stenosis (cLFLG-AS) showed higher mortality rates long-term compared to paradoxical low-flow, low-gradient (pLFLG-AS) and high-gradient (HG-AS) patients.
- The study analyzed 574 patients, finding that cLFLG-AS had the worst initial survival rates, particularly within the first year, while pLFLG-AS and HG-AS patients had similar long-term outcomes.
- Post-TAVI improvement in left ventricular ejection fraction (LVEF) was linked to better survival rates, indicating that LVEF recovery after the procedure plays a crucial role in patient
Percutaneous Valvular and Structural Heart Disease Interventions.2024 Core Curriculum of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC in collaboration with the European Association of Cardiovascular Imaging (EACVI) and the Cardiovascular Surgery Working Group (WG CVS) of the European Society of Cardiology.
EuroIntervention
August 2024
Article Synopsis
- Percutaneous treatment for structural heart disease is advancing quickly, with the EAPCI's Core Curriculum defining crucial competencies for new interventional cardiologists specializing in this area.
- These specialists, trained in interventional cardiology, manage adult patients and perform various procedures, requiring skills in advanced imaging and planning software, with a focus on the aortic, mitral, and tricuspid valves.
- Comprehensive training in all three areas typically takes at least 18 months, supporting consistent education across Europe, which will eventually influence certifications and patient safety measures.
Percutaneous Valvular and Structural Heart Disease Interventions. 2024 Core Curriculum of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC.
EuroIntervention
August 2024
Article Synopsis
- The percutaneous treatment of structural heart disease (SHD) is advancing quickly, with the EAPCI's Core Curriculum (CC) defining the necessary competencies for newly trained interventional cardiologists (IC).
- SHD interventional cardiologists manage adult patients throughout the entire treatment process, requiring skills in advanced imaging and planning software, as well as proficiency in procedures related to the aortic, mitral, and tricuspid heart valves.
- Completing specialized SHD training typically takes at least 18 months, though it can be shortened to 1 year for focused training on specific areas, with the goal of promoting standardized, high-quality training across Europe for better patient care and future certifications.
STENT PANORAMA is a project carried out by the Young Interventional Cardiologists of Triveneto coordinated by the Italian Society of Interventional Cardiology (GISE) Veneto delegation. The project includes two parts: the first, here reported, is aimed at describing in a standardized and easily usable way the main technological characteristics of the latest generation of the drug eluting stents (DES) that are most widely used in the Italian cath-labs. The second, to follow, will aim to summarize the main scientific evidence regarding the performance of individual devices with particular reference to subgroups of clinical interest.
View Article and Find Full Text PDFBackground: Transcatheter aortic valve implantation (TAVI) is increasingly being used in younger patients and those with lower peri-procedural risk, meaning more patients will live long enough to experience structural valve deterioration (SVD) of the bioprosthesis, indicating repeated TAVI. Experience of repeated TAVI-transcatheter heart valve (THV) implantation into an index THV is limited. This registry aims to assess the peri-procedural and short-term safety, efficacy and durability of repeated TAVI.
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- Acute ischemic stroke is a significant risk following transcatheter aortic valve replacement (TAVR), prompting the development of cerebral embolic protection devices (CEPD) to reduce this risk.
- A study compared patients who underwent TAVR without CEPD (CEPD-) to those with CEPD (CEPD+) to assess characteristics and outcomes related to stroke.
- Findings indicated no significant differences in stroke rates, severity, or disability outcomes between the two groups, although the CEPD+ group had notably different types of strokes, suggesting that the efficacy of CEPD in preventing acute ischemic stroke is still questionable.
Article Synopsis
- - The study investigates the safety and effectiveness of the ultrathin Coroflex ISAR NEO polymer-free sirolimus-eluting stent (PF-SES) for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), addressing concerns about long-term issues with traditional drug-eluting stents.
- - Conducted as a multicenter, prospective registry in Italy, the CAESAR study evaluated 425 patients, focusing on outcomes such as target-lesion revascularization (TLR) and major adverse cardiovascular events (MACE) over one year.
- - Results showed excellent clinical outcomes, with only 0.5% needing additional procedures for ischemia-induced TLR and a low rate of
Article Synopsis
- - The study focused on evaluating the performance of the ACURATE Neo2 transcatheter heart valve (THV) in patients with a horizontal aorta (HA), which is linked to worse outcomes after heart valve procedures.
- - Results showed that while both ACURATE Neo and Neo2 valves had similar success rates, the Neo2 valve significantly reduced the occurrence of moderate or severe paravalvular leak (PVL) compared to the Neo valve (5% vs. 15%).
- - The findings suggest that the Neo2 valve is a better option for patients with HA, offering improved PVL rates without compromising device success in the shorter term follow-up.
Objective: The European Society of Cardiology guidelines have recently defined new cut-offs for pulmonary hypertension (PH) and pulmonary vasculature resistance (PVR; median pulmonary artery pressure (mPAP) >20 instead of 25 mm Hg and PVR >2 instead of 3 Wood unit). The prognostic value of this updated classification after transcatheter aortic valve implantation (TAVI) is unknown.
Methods: 579 consecutive patients treated by TAVI with preprocedural right heart catheterisation evaluation were included.
Significant coronary artery disease (CAD) is a frequent finding in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), and the management of these two conditions becomes of particular importance with the extension of the procedure to younger and lower-risk patients. Yet, the preprocedural diagnostic evaluation and the indications for treatment of significant CAD in TAVI candidates remain a matter of debate. In this clinical consensus statement, a group of experts from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Society of Cardiology (ESC) Working Group on Cardiovascular Surgery aims to review the available evidence on the topic and proposes a rationale for the diagnostic evaluation and indications for percutaneous revascularisation of CAD in patients with severe aortic stenosis undergoing transcatheter treatment.
View Article and Find Full Text PDFObjectives: To assess the impact of conventional transcatheter heart valve (THV) commissural alignment techniques on THV/coronary overlap and coronary access (CA) after transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BAV).
Background: Specific Evolut Pro/Pro + and Acurate Neo2 THV orientations are associated with reduced neo-commissural overlap with coronary ostia in tricuspid aortic anatomy. Whether standard orientation techniques are effective also in the setting of BAV anatomy has not been studied.
Background: Despite advances in transcatheter aortic valve replacement (TAVR), periprocedural acute ischemic stroke remains a concern.
Objectives: The aims of this study were to investigate acute ischemic stroke complicating TAVR (AISCT) and to describe the indications and outcomes of interventions to treat AISCT.
Methods: An international multicenter registry was established focusing on AISCT within 30 days of TAVR.
Transcatheter aortic valve replacement (TAVR) is increasingly being performed in younger and lower surgical risk patients. Given the longer life expectancy of these patients, the bioprosthetic valve will eventually fail, and aortic valve reintervention may be necessary. Although currently rare, redo-TAVR will likely increase in the future as younger patients are expected to outlive their transcatheter bioprosthesis.
View Article and Find Full Text PDFBackground: Data on left main (LM) percutaneous coronary interventions (PCI) have mostly been obtained in studies using drug-eluting stent (DES) platforms without dedicated large-vessel devices and with limited expansion capability.
Aims: Our study aimed to investigate the safety and efficacy of LM PCI with the latest-generation Resolute Onyx DES.
Methods: ROLEX (Revascularization Of LEft main with resolute onyX) is a prospective, multicentre study (ClinicalTrials.
Background: The impact of transcatheter aortic valve replacement (TAVR) leaflet design on long-term device performance is still unknown. This study sought to compare the clinical and hemodynamic outcomes of intra- (IA) versus supra-annular (SA) TAVR designs up-to 10-years following implantation.
Methods: Consecutive patients with at least 5-years follow-up following TAVR for severe symptomatic aortic stenosis from June 2007 to December 2016 were included.