Publications by authors named "Rebecca Hahn"
Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.
Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.
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.
Despite the challenges associated with periprocedural imaging, transcatheter tricuspid valve interventions have shown important impact on outcomes. A comprehensive understanding of the anatomy of the right heart and surrounding structures is crucial. One way to optimize these interventions is by identifying the optimal fluoroscopic viewing angles along the S-curve of the tricuspid valve.
View Article and Find Full Text PDFThis case report describes a patient diagnosed with severe secondary tricuspid regurgitation (TR) and pulmonary hypertension. Initial improvement with heart failure therapy was followed by a worsening of TR despite optimal medical management. Transcatheter edge-to-edge repair successfully addressed TR, resulting in marked clinical improvement.
View Article and Find Full Text PDFTranscatheter tricuspid valve replacement (TTVR) has emerged as a promising intervention for the treatment of severe tricuspid regurgitation with complex valve morphology. This consensus document provides a comprehensive overview of the current state of orthotopic TTVR, focusing on patient selection, procedural details, and follow-up care. Clinical outcomes from initial studies and compassionate use cases are discussed, highlighting the effectiveness of TTVR in reducing tricuspid regurgitation, inducing reverse right ventricular remodeling, and enhancing patients' quality of life.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on the impact of tricuspid regurgitation (TR) on heart remodeling, comparing outcomes in patients treated with the TriClip device versus those receiving standard medical therapy in a randomized controlled trial.
- Researchers utilized advanced imaging techniques, including cardiac magnetic resonance and 4D-CT, to assess heart changes at baseline, 30 days, and one year follow-ups.
- Results showed that the TriClip significantly reduced TR volume by 70% at 30 days, leading to notable reductions in right ventricular size and area, with these improvements maintained after one year, unlike the control group.
Tricuspid regurgitation (TR), an underrecognized disease, overlooked by clinicians for many years due to its assumed benign nature. Recent epidemiological studies suggest significant TR may be seen in up to 6% of elderly patients. An increase in prevalence is expected due to the higher incidence of various clinical predictors of TR progression.
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- - This study examined the effects of transcatheter aortic valve replacement (TAVR) on patients with heart failure and moderate aortic stenosis, comparing TAVR with clinical surveillance followed by valve replacement if the condition worsened.
- - A total of 178 patients were randomly assigned to either TAVR or surveillance, and results indicated that TAVR was associated with better clinical outcomes, though the statistical significance was borderline.
- - TAVR led to a more substantial improvement in heart failure symptoms, as measured by the Kansas City Cardiomyopathy Questionnaire, compared to the surveillance group after one year of follow-up.
Article Synopsis
- Severe tricuspid regurgitation (TR) significantly impacts patients' health status, affecting their symptoms, physical and social functions, and overall quality of life, but may improve with a procedure called transcatheter tricuspid valve replacement (TTVR).
- The TRISCEND II trial studied 400 patients with severe TR, comparing outcomes of those receiving TTVR combined with optimal medical therapy (OMT) to those receiving OMT alone, using established health status questionnaires.
- Results showed that patients receiving TTVR+OMT experienced significantly greater improvements in health status at every follow-up, with notable differences in scores indicating enhanced quality of life compared to those who only received
Article Synopsis
- A clinical trial was conducted with 400 patients suffering from severe tricuspid regurgitation, comparing outcomes between those who received transcatheter tricuspid-valve replacement alongside medical therapy and those who received medical therapy alone.
- The primary outcome measured included death rates, hospitalizations due to heart failure, and improvements in quality of life and functional capacity, showing a significant advantage for the valve-replacement group.
- After one year, the valve-replacement group demonstrated better overall health outcomes, although there was a higher incidence of severe bleeding compared to the control group.
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.
Background: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.
Methods: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance.
Background: Transcatheter tricuspid valve intervention (TTVI) has been increasingly adopted in recent years for the treatment of patients with tricuspid regurgitation (TR). However, no dedicated risk stratification has been established for patients undergoing TTVI.
Objectives: The aim of the present study was to propose a dedicated risk score for patients affected by severe TR undergoing TTVI.
EVOQUE Tricuspid Valve Replacement System: State-of-the-Art Screening and Intraprocedural Guidance.
JACC Cardiovasc Interv
September 2024
Article Synopsis
- The transcatheter EVOQUE tricuspid valve replacement system has been recently approved for treating severe tricuspid regurgitation, highlighting the importance of identifying suitable patients and their anatomical features.
- The document outlines necessary procedural steps and imaging techniques that facilitate successful implementation of the device.
- It also addresses how to manage complex situations that may arise during the procedure.
Article Synopsis
- The study explores how a deep learning model can predict the risk of developing aortic stenosis (AS) from the early stage of aortic valve sclerosis by assessing diastolic dysfunction (DD).
- Researchers evaluated data from 898 participants in the ARIC cohort and validated their findings in two other groups, showing a significant correlation between high DD risk and the development of AS or related health interventions.
- The results indicate that using deep learning to measure DD effectively stratifies risk in patients, providing a better understanding of how AS progresses.
Background: Tricuspid regurgitation (TR) is a common valve disease that has a significant impact on patients' quality of life.
Objectives: This study sought to report the final 3-year outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) with the TriClip (Abbott) implant from the TRILUMINATE (TRILUMINATE Study With Abbott Transcatheter Clip Repair System in Patients With Moderate or Greater TR) study for the treatment of severe symptomatic TR.
Methods: The TRILUMINATE study (N = 98 subjects) is an international, prospective, single-arm, multicenter study to investigate the safety and performance of T-TEER with the TriClip implant in patients with symptomatic moderate or greater TR.
Article Synopsis
- The TRILUMINATE Pivotal trial investigated the impact of tricuspid regurgitation (TR) on end-organ function and the effectiveness of transcatheter edge-to-edge repair (TEER) compared to medical therapy alone in patients with severe TR.
- The study included 572 patients who were split into TEER and control groups, examining how changes in end-organ function correlate with hospitalizations for heart failure (HF) and mortality over 12 months.
- Results showed that while TEER did not significantly differ from medical therapy alone in overall end-organ function improvements, successful TEER did lead to enhanced function in specific patient subgroups, indicating potential benefits in targeted treatment.
Background: Two subtypes of atrial functional mitral regurgitation (AFMR) have been described, one is characterized by Carpentier type I and the other by Carpentier type IIIb leaflet motion.
Objectives: The authors sought to analyze echocardiographic characteristics and outcomes of AFMR subtypes undergoing mitral valve transcatheter edge-to-edge repair (M-TEER).
Methods: Of 1,047 consecutive patients who underwent M-TEER, the authors identified those with isolated mitral annulus dilation (Carpentier I), termed AFMR-IAD, and those with atriogenic hamstringing characterized by restricted posterior mitral leaflet motion (Carpentier IIIb), termed AFMR-AH.
Article Synopsis
- Tricuspid regurgitation (TR) is common in patients undergoing transcatheter aortic valve replacement (TAVR), but specific management guidelines are not clearly defined.
- A study analyzed data from over 312,000 TAVR patients, finding that severe TR correlated with higher mortality rates both in-hospital and at one and three years post-procedure.
- The research also indicated that a significant number of patients (76.4%) with severe TR improved after TAVR, and several factors predicted this improvement, although ongoing severe TR was linked to increased mortality.
Article Synopsis
- Doctors are studying how a procedure called transcatheter tricuspid valve interventions (TTVI) affects patients with heart issues, specifically focusing on something called mitral regurgitation (MR) after the procedure.
- They looked at data from a big group of patients and found that many showed improvement in MR after the procedure, but some got worse.
- They discovered that certain factors, like successful procedures and specific treatments, could help predict whether a patient’s MR would improve or get worse after TTVI.
3-Year Outcomes of Balloon-Expandable Valves: 20-mm vs Larger Valves (≥23 mm).
JACC Cardiovasc Interv
September 2024
Background: A prior Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry-based analysis reported similar 1-year clinical outcomes with small (20-mm) vs large (≥23-mm) balloon-expandable valves (BEV).
Objectives: The aim of this study was to describe mid-term 3-year clinical outcomes for small vs large BEV and the relationship between discharge echocardiographic mean gradient (MG) and different definitions of prothesis-patient mismatch (PPM) with clinical outcomes.
Methods: Using the TVT Registry with Centers for Medicare and Medicaid Services linkage, a propensity-matched analysis of patients receiving 20- vs ≥23-mm BEVs was performed.
Article Synopsis
- Pathologic left ventricular remodeling and valvular heart disease can worsen heart failure symptoms and reduce the effectiveness of standard treatments.
- Surgical options like ventricular restoration and valve repair are effective, but transcatheter (minimally invasive) interventions are emerging as viable alternatives for patients who still suffer symptoms despite optimal medical therapy.
- This statement will explore current and experimental percutaneous approaches to treat heart failure related to left ventricular cardiomyopathies and valve issues.
Article Synopsis
- Limited data on strain changes after TAVI in patients with aortic regurgitation (AR) was explored in this study.
- Three patients experienced an initial decrease in global longitudinal strain (GLS) after TAVI, but showed significant improvement within the first year.
- The results suggest that GLS may be a better indicator than left ventricular end-diastolic diameter ratio for evaluating patients with severe volume overload.