Publications by authors named "Reardon M"
Purpose To investigate the determinants and effect of right ventricular (RV) dysfunction in aortic regurgitation (AR) using cardiac MRI. Materials and Methods This study included patients with moderate or severe AR who were enrolled in the DEBAKEY-CMR registry between January 2009 and June 2020. Patients with previous valve intervention, cardiomyopathy deemed unrelated to AR, severe aortic stenosis, and other confounders were excluded.
View Article and Find Full Text PDFAn 86-year-old male with multiple medical comorbidities was referred for an elective transcatheter aortic valve replacement (TAVR) for severe symptomatic aortic stenosis with an ejection fraction of 35%. A self-expanding valve was deployed successfully, but intraoperative transesophageal echocardiography (TEE) confirmed an acute type A aortic dissection (ATAAD), necessitating immediate intervention. Multiple intraoperative imaging modalities were utilized for deployment of a conformable GORE TAG (cTAG) stent graft for thoracic endovascular aortic repair (TEVAR).
View Article and Find Full Text PDFSex Differences in Patients Undergoing FFR-Guided PCI or CABG in the FAME 3 Trial.
JACC Cardiovasc Interv
November 2024
Background: Outcomes in women after fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) using current-generation drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) are unknown.
Objectives: This study sought to evaluate differences in clinical outcomes according to sex after FFR-guided PCI with current generation DES compared with CABG.
Methods: The FAME 3 trial was an investigator-initiated, randomized controlled trial, comparing FFR-guided PCI with current generation DES or CABG in patients with 3-vessel coronary artery disease.
Article Synopsis
- The study examined differences in echocardiographic assessments of native and bioprosthetic aortic valves between core laboratories and clinical centers, finding clinically relevant discrepancies.
- Data was collected from the PERIGON trial, which involved patients undergoing surgical aortic valve replacement, and involved comparing echocardiographic results from centers to independent analysis by a core lab.
- Results showed that while some continuous measurements had high agreement (around 0.90), there were notable variances, particularly in left ventricular outflow tract area and stroke volume, indicating the need for standardized evaluation practices.
Article Synopsis
- * The J-Valve device, developed by JC Medical, shows promising outcomes, particularly in patients with complex anatomical challenges.
- * Two successful cases of transcatheter aortic valve replacement using the J-Valve were reported in patients who had significant aortic angulation.
Background: The cost-effectiveness of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) has previously been reported across the spectrum of surgical mortality risk. We present an updated analysis specific to the UK based on 4-year data from the Evolut Low Risk Trial, which showed a maintained numerical survival benefit with TAVI.
View Article and Find Full Text PDFMeta-Analysis of Dedicated vs Off-Label Transcatheter Devices for Native Aortic Regurgitation.
JACC Cardiovasc Interv
January 2025
Background: Transcatheter aortic valve replacement (TAVR) for high surgical risk patients with severe native aortic regurgitation (AR) presents unique challenges. Dedicated devices such as the JenaValve (JenaValve Technology) and J-Valve (JC Medical Inc) show promising results in addressing these challenges.
Objectives: This study compares the safety and efficacy of dedicated vs off-label devices among high surgical risk patients with pure native AR.
Objectives: Safety, efficacy and durability are important considerations when selecting a bioprosthesis for aortic valve replacement (AVR). This study assessed 7-year clinical outcomes and haemodynamic performance of the Avalus bioprosthesis.
Methods: Patients indicated for surgical AVR were enrolled in this prospective, nonrandomized trial, conducted across 39 sites globally.
Redo-TAVI with the SAPIEN 3 valve in degenerated calcified CoreValve/Evolut explants.
EuroIntervention
November 2024
Article Synopsis
- Redo-transcatheter aortic valve implantation (TAVI) is often needed for failed aortic valves, specifically examining SAPIEN 3 (S3) valves in degenerated CoreValve/Evolut (CV/EV) valves, which is not fully understood.
- The study assessed the performance of S3 valves following implantation in calcified CV/EV valves through various hydrodynamic tests, measuring factors like mean gradient, effective orifice area, and leaflet behaviors.
- Results indicated that S3 valves generally performed well, showing decreased mean gradient and acceptable effective orifice area, but issues like underexpansion, leaflet pinwheeling, and calcium protrusion were noted, highlighting the need for further research on long
Background: The impact of mitral annular calcification (MAC) on the clinical outcomes of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains unclear. This meta-analysis aims to evaluate the clinical outcomes of MTEER among patients with moderate to severe MAC compared to those with mild or no MAC.
Methods: We systematically searched PubMed, EMBASE, and Cochrane CENTRAL databases through March 31st, 2024, comparing clinical outcomes of MTEER among patients with moderate/severe (MAC+) versus no/mild MAC (MAC-).
Over a decade of randomized controlled trial data demonstrate excellent outcomes with transcatheter aortic valve replacement or surgical aortic valve replacement for patients with symptomatic severe aortic stenosis regardless of surgical risk. The 2020 American College of Cardiology/American Heart Association guidelines recommend both options for low-risk AS patients aged 65 to 80 years. However, the fastest growing population of patients receiving transcatheter aortic valve replacement in the United States is <65 years old, with little data to support the practice.
View Article and Find Full Text PDFArticle Synopsis
- The study explored the impact of residual transmitral mean pressure gradient (TMPG) after mitral transcatheter edge-to-edge repair (M-TEER) on patient outcomes, focusing on all-cause mortality and hospitalizations related to heart failure.
- Higher baseline TMPG was found to predict increased residual TMPG post-procedure, with patients in the highest quartile experiencing significantly worse outcomes, including higher risks of mortality and heart failure hospitalization over three years.
- The findings suggest that efforts should be made to minimize residual TMPG after M-TEER, particularly in patients with primary mitral regurgitation (MR).
Purpose: Men with high-risk prostate cancer (PCa) are treated with androgen deprivation therapy (ADT) and radiation therapy, but the disease reoccurs in 30% of patients. Biochemical recurrence of PCa after treatment is influenced by tumor hypoxia. Tumors with high levels of hypoxia are aggressive, resistant to treatment, and have increased metastatic capacity.
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- A study compared transcatheter aortic valve replacement (TAVR) with traditional surgery in low-risk patients under 75 years old with severe aortic stenosis to evaluate safety and effectiveness over three years.* -
- Results showed that TAVR patients had similar overall mortality rates but significantly fewer disabling strokes (0.6%) compared to surgery patients (2.9%), while TAVR also resulted in better valve performance.* -
- Both treatment options had comparable low rates of valve reinterventions, but TAVR patients experienced higher rates of pacemaker implantation (21.0% vs. 7.1%).*
We present one of the inaugural transcatheter aortic valve implantation procedures using the latest Medtronic platform, Evolut FX+. Successful coronary angiography was achieved within 28 seconds and 1 minute 49 seconds for the left and right coronary arteries, respectively. Postoperative cardiac computed tomography scan demonstrated optimal commissural and diamond-coronary alignment.
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- The study investigates the significance of measuring pulmonary venous flow (PVF) patterns during mitral transcatheter edge-to-edge repair (TEER) to predict patient outcomes, focusing on systolic dominant-PVF (SD-PVF) morphology.
- Researchers analyzed data from 187 patients and found that those with SD-PVF had lower rates of severe residual mitral regurgitation (MR) and were less likely to experience all-cause mortality or heart failure hospitalization within one year.
- The findings suggest that post-TEER PVF morphology could serve as an effective and straightforward prognostic tool, but more large-scale studies are needed to validate its impact further.
Solid tumours are complex and heterogeneous systems, which exist in a dynamic biophysical microenvironment. Conventional cancer research methods have long relied on two-dimensional (2D) static cultures which neglect the dynamic, three-dimensional (3D) nature of the biophysical tumour microenvironment (TME), especially the role and impact of interstitial fluid flow (IFF). To address this, we undertook a transcriptome-wide analysis of the impact of IFF-like perfusion flow using a spheroid-on-chip microfluidic platform, which allows 3D cancer spheroids to be integrated into extracellular matrices (ECM)-like hydrogels and exposed to continuous perfusion, to mimic IFF in the TME.
View Article and Find Full Text PDFBackground: We aimed to perform a meta-analysis of randomized trials comparing long-term outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) for severe aortic stenosis. The short-term efficacy and safety of TAVR are proven, but long-term outcomes are unclear.
Methods: We included randomized controlled trials comparing TAVR vs SAVR at the longest available follow-up.
Background: Emerging adults (EAs; age 18-30 years) with type 1 diabetes (T1D) have more challenges with diabetes management and glycemic control than other age groups. Living in a rural community introduces additional unique diabetes care challenges due to limited access to specialty care and ancillary support services. Yet, few interventions have been developed to improve diabetes management in rural-dwelling EAs with T1D.
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- - The Navitor IDE study examines the safety and effectiveness of the Navitor valve for patients with severe aortic stenosis who are at high surgical risk, focusing on the connection between patient factors and the rate of new permanent pacemaker implantation (PPI) within 30 days post-surgery.
- - Researchers analyzed data from 260 patients, excluding those with prior pacemakers, and found that specific conduction abnormalities, like first-degree atrioventricular block and right bundle branch block, increased the likelihood of new PPI, while the depth of the valve implantation also played a significant role.
- - The study concludes that both existing conduction issues and the surgical technique (implant depth) are critical predictors of whether patients will need a new pacemaker
Background: Outcomes from transcatheter aortic valve replacement (TAVR) in low-surgical risk patients with bicuspid aortic stenosis beyond 2 years are limited.
Objectives: This study aimed to evaluate 3-year clinical and echocardiographic outcomes from the Evolut Low Risk Bicuspid Study.
Methods: The Evolut Low Risk Bicuspid Study is a prospective, multicenter, single-arm study conducted in 25 U.