Publications by authors named "Nicola Corcione"
Background: Tethering is a common condition of the mitral valve apparatus in the presence of significant regurgitation. Its impact on outcomes of transcatheter edge-to-edge repair (TEER) remains poorly characterized.
Methods: We appraised the prevalence, features, procedural details, and outcomes of patients with or without mitral valve tethering in a prospective multicenter observational study.
Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Severe Low-Flow, Low-Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.
J Am Heart Assoc
November 2024
Article Synopsis
- This study investigates how right ventricular (RV) dysfunction affects the outcomes of patients with low-flow, low-gradient aortic stenosis (LFLG-AS) who are undergoing transcatheter aortic valve replacement (TAVR).
- Utilizing data from two Italian centers, it was found that RV dysfunction is linked to a significantly increased risk of all-cause death and major cardiovascular events after one year.
- The findings suggest that assessing RV dysfunction before TAVR can enhance the ability to predict patient prognosis.
Article Synopsis
- - SARS-CoV-2 spike protein contributes to tissue inflammation by transforming M2 macrophages into a pro-inflammatory state, resembling M1 macrophages, which enhances lymphocyte activation and proliferation.
- - The spike protein activates the STAT1 signaling pathway in macrophages and endothelial cells, leading to increased inflammation and cell death, as indicated by Bax upregulation.
- - Using RGD mimetics like tirofiban can block the negative effects of the spike protein, decreasing inflammation and preventing cell death in both macrophages and endothelial cells.
Article Synopsis
- Transcatheter mitral edge-to-edge repair (TEER) is a minimally invasive option for treating severe mitral regurgitation in patients with high surgical risk, but there are concerns regarding the risk of cerebrovascular accidents (CVAs) after the procedure.
- In a study of 2,238 patients, the incidence of CVAs was found to be low at 1.47%, with the majority occurring after hospital discharge and linked to preexisting conditions like atrial fibrillation and renal dysfunction.
- While CVAs did not significantly increase the risk of long-term or cardiac death, the study suggests the need for proactive antithrombotic therapy for patients at higher risk before and after TEER.
Article Synopsis
- * The experience from 25 years at two hospitals in Italy highlights significant advancements in cardiology, including different types of stents and transcatheter valve procedures, alongside challenges and improvements in patient care.
- * This overview aims to inform readers about the evolution and future trends in interventional cardiology, emphasizing the importance of clinical experiences and research insights in advancing cardiovascular care.
Article Synopsis
- Minimally invasive mitral valve repair using the MitraClip device shows beneficial outcomes in patients with significant mitral regurgitation, including those who have had prior valve repairs.
- A study involving 2,238 patients highlighted that while device and procedural success rates are slightly lower for those with previous valve procedures, overall outcomes such as death and rehospitalization rates remain similar across groups.
- The findings suggest that transcatheter edge-to-edge repair is a viable option for carefully selected patients even after previous mitral valve interventions.
Article Synopsis
- Transcatheter edge-to-edge repair (TEER) is an effective, minimally invasive method for treating significant mitral regurgitation and has seen advancements in device technology, specifically the NT, NTr, and XTr MitraClip devices.
- A study analyzed data from a large patient registry to compare these devices, focusing on patient outcomes after the procedure, specifically looking at complications and hospital discharge.
- Results showed that while the NT group faced worse outcomes initially, adjusted analyses indicated no significant differences in long-term results among the devices, suggesting that newer MitraClip devices provide better outcomes even when used on patients with more complex cases.
Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry.
Cardiovasc Revasc Med
May 2024
Article Synopsis
- * The study analyzed 458 patients from January to October 2022 across five centers, finding that VCs occurred in 6.5% of patients, with no significant differences between the USG (7.3%) and FG (5.4%) groups.
- * Results indicated that both USG and FG access management techniques did not influence the rate of VCs, implying low rates of complications overall
Background There is little evidence about the prognostic role of mitral regurgitation (MR) in patients with low-flow, low-gradient aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). The aim of this study was to assess the prevalence and outcome implications of MR severity in patients with low-flow, low-gradient aortic stenosis undergoing TAVR, and to evaluate whether MR improvement after TAVR could influence clinical outcome. Methods and Results This study included consecutive patients with low-flow, low-gradient aortic stenosis undergoing TAVR at 2 Italian high-volume centers.
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- Transcatheter aortic valve replacement (TAVR) is effective for severe aortic valve stenosis, even in patients with low left ventricular ejection fraction (LVEF), but the effectiveness of specific TAVR devices in this group is unclear.
- The LOSTAVI study analyzed 923 patients with varying levels of LVEF (<25%, 25-30%, 31-35%) and found that while in-hospital mortality rates were similar, patients with extremely low LVEF experienced more major adverse events.
- At 12 months, reduced LVEF significantly impacted mortality and adverse events, confirming its importance in patient prognosis, while TAVR device type did not influence these outcomes.*
Article Synopsis
- - The study aimed to evaluate the long-term effectiveness of the Portico valve in transcatheter aortic valve implantation (TAVI) for elderly patients with severe aortic valve stenosis, focusing on outcomes like death and complications.
- - Data from 803 patients, mainly older adults with a median age of 82, showed that over three years, 37.5% experienced major adverse events, with all-cause death at 35.1% and low rates for stroke (3.4%) and myocardial infarction (1.0%).
- - Results indicate that the Portico valve provides favorable long-term outcomes, though risk factors such as peripheral artery disease and chronic obstructive pulmonary disease significantly influenced patient prognosis. *
Aim: Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic stenosis in patients with intermediate to prohibitive surgical risk. When a single TAVI device fails and cannot be retrieved, TAVI-in-TAVI must be performed acutely, but outcomes of bailout TAVI-in-TAVI have been incompletely appraised. We aimed at analyzing patient, procedural and outcome features of patients undergoing bailout TAVI-in-TAVI in a multicenter registry.
View Article and Find Full Text PDFBackground: The clinical impact of coronary artery disease (CAD) on the prognosis of patients undergoing MitraClip implantation is still unclear.
Methods: One thousand nine hundred fifty-three patients undergoing MitraClip implantation included in the multicenter GIOTTO Registry were stratified according to CAD. Endpoints were all-cause death, cardiac death, and re-hospitalization for heart failure at follow-up (median 15.
Article Synopsis
- Long-term right ventricular pacing (VP) can lead to negative outcomes like heart failure and cardiovascular mortality in patients who have undergone transcatheter aortic valve replacement (TAVR).
- The PACE-TAVI registry studied 377 TAVR patients with pacemakers, comparing those with VP below 40% to those at or above 40% to see how this affects their health outcomes.
- Results showed that patients with VP ≥40% had a significantly higher risk of cardiovascular death and heart failure hospitalization, emphasizing the need for closer monitoring of these patients after TAVR.
Background: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI.
Aims: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV).
Methods: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers.
Background: Transcatheter aortic valve implantation (TAVI) has revolutionized the management of aortic stenosis. We aimed at appraising effectiveness of a new self-expandable TAVI device.
Methods: We retrospectively analyzed our institutional experience with Allegra (Biosensors, Morges, Switzerland) for TAVI, focusing on procedural outcomes and 1-month adverse events.
Article Synopsis
- * Noninvasive imaging techniques like duplex ultrasound, computed tomography angiography, and magnetic resonance angiography are commonly used to evaluate carotid stenoses, along with invasive methods like digital subtraction angiography.
- * The review focuses on the key features of carotid artery plaques and the most effective imaging methods for evaluating them to ensure proper diagnosis and patient care.
Article Synopsis
- Transcatheter aortic valve implantation (TAVI) using a percutaneous axillary approach is being evaluated for its safety and effectiveness compared to traditional surgical access.
- An international study analyzed data from 432 patients, revealing that while the percutaneous approach had a higher rate of primary hemostasis failure, it led to shorter hospital stays and lower risks of major complications.
- The findings suggest that percutaneous axillary access is as effective or potentially superior to surgical access for TAVI, especially for patients who cannot use the femoral approach.
Article Synopsis
- Transcatheter aortic valve implantation (TAVI) using the Navitor, a third-generation device, showed positive outcomes in patients with severe aortic stenosis between June and December 2021.
- The study included 39 patients with an average age of 80, achieving device and procedural success in all, with a hospital stay averaging 6.6 days and only one needing a permanent pacemaker.
- Follow-up results at one month indicated no cases of moderate or severe aortic regurgitation, suggesting the Navitor device has the potential to broaden TAVI applications and improve patient outcomes.