Publications by authors named "Neil P Fam"
Transcatheter Edge-to-Edge Repair in Patients With Complex Tricuspid Valve Anatomy.
JACC Cardiovasc Interv
December 2024
Article Synopsis
- Untreated severe tricuspid regurgitation (TR) is linked to poor health outcomes, making effective treatment essential.
- The study evaluated the 1-year results of transcatheter edge-to-edge repair (TEER) using the TriClip system in patients with complex tricuspid valve issues, finding significant improvements in patient survival and quality of life.
- Results showed that 81% of patients experienced a reduction in TR to moderate or less after one year, with no major adverse effects noted in the first 30 days post-procedure.
Article Synopsis
- - The TRILUMINATE Pivotal trial assessed the effects of tricuspid transcatheter edge-to-edge repair (T-TEER) on reducing tricuspid regurgitation (TR), a significant heart condition linked to increased health risks.
- - Involving 572 patients, mostly elderly women with prior heart conditions, the trial found that T-TEER effectively improved quality of life, with nearly half of those treated experiencing significant improvements in heart health assessments.
- - Results showed that while the treatment and control groups had similar rates of survival and heart-related surgeries, those who underwent T-TEER had notably better outcomes in TR severity and overall quality of life.
Article Synopsis
- 3D intracardiac echocardiography (ICE) is becoming a valuable alternative to transesophageal echocardiography for guiding heart procedures, particularly in structural heart interventions.
- The expert position statement outlines standardized practices for using 3D-ICE, detailing necessary imaging fundamentals, views, and workflows for various procedures like transeptal puncture and device closures.
- Additionally, the paper addresses current challenges, potential future developments, and training needs to ensure that operators are proficient with 3D-ICE, aiming to enhance its safety and effectiveness in clinical settings.
Background: Calcific mitral stenosis (calcific MS) presents a challenge for surgical treatment and is a contraindication for most contemporary transcatheter mitral valve replacement devices (TMVR), rendering patients with very limited therapeutic options.
Aims: This study aims to assess the clinical and hemodynamic follow-up after mitral valve lithotripsy (MVL).
Methods: All consecutive patients who underwent MVL to treat symptomatic calcific MS at St Michael's Hospital, Toronto, Canada, were included.
Background: Transcatheter tricuspid valve replacement (TTVR) abolishes tricuspid regurgitation (TR) and has emerged as a definitive treatment for TR.
Objectives: The purpose of this multicenter, observational study was to determine the clinical characteristics and short-term outcomes of patients with TR screened for TTVR.
Methods: Patients underwent TTVR screening at 7 centers on a compassionate-use basis.
Purpose Of Review: Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a well tolerated and effective therapeutic option for many patients with symptomatic severe tricuspid regurgitation at prohibitive surgical risk. However, there remain several important limitations to clip-based technology in the context of other rapidly emerging percutaneous treatment options for tricuspid regurgitation.
Recent Findings: Tricuspid lesions pose unique challenges to treatment with the current toolbox of transcatheter clip-based technologies.
Cusp overlap method for self-expanding transcatheter aortic valve replacement.
Catheter Cardiovasc Interv
January 2024
Article Synopsis
- Background: Permanent pacemaker (PPM) implantation is a frequent issue after transcatheter aortic valve replacement (TAVR) with self-expanding valves, prompting a comparison of two implantation techniques to assess their impact on PPM rates.
- Aims: The study aimed to compare the rates of new PPM implantation and complete heart block in patients undergoing TAVR with self-expanding valves using either the conventional three-cusp technique or the cusp-overlap technique.
- Results: The cusp-overlap technique significantly reduced in-hospital and 30-day rates of new complete heart block (9.4% vs. 23.4%) and PPM implantation (8% vs. 21%) compared to the standard
Background: The CLASP IID (Edwards PASCAL TrAnScatheter Valve RePair System Pivotal Clinical) trial is the first randomized controlled trial comparing the PASCAL system and the MitraClip system in prohibitive risk patients with significant symptomatic degenerative mitral regurgitation (DMR).
Objectives: The study sought to report primary and secondary endpoints and 1-year outcomes for the full cohort of the CLASP IID trial.
Methods: Prohibitive-risk patients with 3+/4+ DMR were randomized 2:1 (PASCAL:MitraClip).
Background: In the first report from the MitraBridge registry, MitraClip as a bridge to heart transplantation (HTx) proved to be at 1-year an effective treatment strategy for 119 patients with advanced heart failure (HF) who were potential candidates for HTx. We aimed to determine if benefits of MitraClip procedure as a bridge-to-transplant persist up to 2-years.
Methods: By the end of the enrollment period, a total of 153 advanced HF patients (median age 59 years, left ventricular ejection fraction 26.
Background: Continued development of transcatheter mitral repair technologies is needed to address the large and diverse population of high-risk patients with symptomatic mitral regurgitation (MR). The new PASCAL Ace implant system, with its narrower profile, complements the original PASCAL transcatheter valve repair system. The aim of this study is to report 1-year outcomes from the early, compassionate-use observational experience with the novel PASCAL Ace implant system.
View Article and Find Full Text PDFBackground: Transcatheter mitral valve replacement (TMVR) using dedicated devices is an alternative therapy for high-risk patients with symptomatic mitral regurgitation (MR).
Aims: This study aimed to assess the 2-year outcomes and predictors of mortality in patients undergoing TMVR from the multicentre CHOICE-MI Registry.
Methods: The CHOICE-MI Registry included consecutive patients with symptomatic MR treated with 11 different dedicated TMVR devices at 31 international centres.
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) is an effective option for treatment of mitral regurgitation (MR). We previously reported favorable 2-year outcomes for the PASCAL transcatheter valve repair system.
Objectives: We report 3-year outcomes from the multinational, prospective, single-arm CLASP study with analysis by functional MR (FMR) and degenerative MR (DMR).