Publications by authors named "Sabah Skaf"
This updated Heart Valve Collaboratory framework addresses the growing concern for transcatheter valve failure (TVF) following transcatheter aortic valve replacement (TAVR). With the increasing volume of redo-TAV and surgical TAV explantation, there is a critical need for standardized pathways and protocols for evaluating TVF using echocardiography and cardiac computed tomography (CT) angiography. This document clarifies prior definitions of bioprosthetic valve deterioration and bioprosthetic valve failure in a practical, imaging directed context for TAVR.
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- The study examines the outcomes of mitral transcatheter edge-to-edge repair (TEER) performed during off-hours (before 7:30 am, after 5:30 pm, or on weekends/holidays) to see how they compare to procedures done during regular hours.
- The analysis included 1,177 procedures, with 117 (9.9%) occurring off-hours; off-hours procedures were often urgent and involved higher-risk patients, yet technical success was high in both groups.
- Although baseline MR severity and functional class improved for both groups, off-hours patients experienced higher rates of deaths and heart failure hospitalizations, with no procedural timing linked to outcomes in matched comparisons, suggesting experienced interventionalists can conduct these procedures safely regardless
Background: Prognostically meaningful tricuspid regurgitation (TR) is not well-defined in the mitral transcatheter edge-to-edge repair arena. We aimed to explore the prevalence, correlates, and consequences of TR grades and postprocedural trends in this setting.
Methods And Results: A single-center registry of isolated, first-time interventions was retrospectively assessed for pre-, intra-, and postprocedural aspects up to 1 year, of them the primary composite outcome of all-cause deaths or heart failure (HF) hospitalizations, all according to TR severity at baseline and at 1 month following mitral transcatheter edge-to-edge repair.
Article Synopsis
- The trial tested the ShortCut device, aimed at improving safety and effectiveness before TAVI in patients at risk for coronary artery obstruction.
- In a study with 60 patients, 100% successfully underwent leaflet splitting with minimal procedure time and high safety rates; 98.3% were free from major adverse events like stroke or mortality at discharge.
- The results suggest that using ShortCut for modifying failed bioprosthetic aortic valves is safe and leads to positive outcomes for patients facing coronary obstruction during TAVI.
Aims: Left ventricular global longitudinal strain (LVGLS) is a known outcome predictor in transcatheter edge-to-edge repair (TEER) for functional mitral regurgitation (MR). We aimed to assess its prognostic yield in the setting of TEER for chronic primary MR.
Methods And Results: We conducted a single-centre, retrospective analysis of 323 consecutive patients undergoing isolated, first-time procedures.
Background: There are scarce data regarding mitral transcatheter edge-to-edge repair (TEER) in individuals aged 90 years and above. We aimed to evaluate patient characteristics, procedural aspects, and outcomes in this rapidly growing group.
Methods: We retrospectively studied a single-centre database of 967 isolated, first-time interventions, 103 (10.
Background: Limited data exist regarding the impact of mitral annular calcification (MAC) on outcomes of transcatheter edge-to-edge repair for mitral regurgitation (MR).
Methods: We retrospectively analyzed 968 individuals (median age, 79 [interquartile range, 70-86] years; 60.0% males; 51.
Introduction And Objectives: Limited data exist on the prognostic usefulness of transthoracic echocardiography preceding MitraClip for chronic primary mitral regurgitation (MR). We evaluated the predictive ability of transthoracic echocardiography in this setting.
Methods: A total of 410 patients (median age, 83 years, 60.
Background: Little is known about mitral transcatheter edge-to-edge repair (TEER) in patients with mitral annular disjunction (MAD).
Objectives: The authors sought to explore TEER for degenerative mitral regurgitation (MR) according to MAD status.
Methods: We retrospectively analyzed 271 consecutive patients (median age 82 [Q1-Q3: 75-88] years, 60.
Article Synopsis
- Iatrogenic mitral stenosis can occur after transcatheter edge-to-edge mitral valve repair, and while mean transmitral pressure gradient has been studied, the relationship between small mitral valve orifice area (MVA) and long-term outcomes is less understood.
- Researchers analyzed 279 patients using 3D transesophageal echocardiography to categorize postprocedural MVA and found that those with small MVA had a higher risk of all-cause mortality, particularly in the degenerative mitral regurgitation (MR) group.
- The study concluded that postprocedural small MVA is a significant predictor of poor prognosis after the procedure for patients with degenerative MR, but not for those with functional MR.
Background: Tricuspid regurgitation (TR) adversely affects prognosis following mitral transcatheter edge-to-edge repair (TEER). We aimed to derive a risk stratification tool for patients undergoing TEER for mitral regurgitation while exhibiting significant TR.
Methods: This is a single-center, retrospective analysis of 217 consecutive individuals referred to an isolated mitral TEER who had moderate-to-severe or greater TR at baseline.
Correlates and prognostic implications of LVEF reduction after transcatheter edge-to-edge repair for primary mitral regurgitation.
Eur Heart J Cardiovasc Imaging
December 2023
Aims: To explore the characteristics and outcomes of patients undergoing transcatheter edge-to-edge repair (TEER) for primary mitral regurgitation (MR) according to the presence of left ventricular ejection fraction (LVEF) reduction post-procedure.
Methods And Results: We retrospectively analysed 317 individuals [median age 83 (interquartile range, 75-88) years, 197 (62.1%) males] treated with an isolated, first-time TEER that was concluded by a successful clip deployment.
Current guidelines, supported by limited data, prioritize the use of cardiac resynchronization therapy (CRT) over mitral transcatheter edge-to-edge repair (TEER) in eligible patients. To examine TEER results and outcomes in CRT-eligible patients with functional mitral regurgitation (MR) according to CRT status, we conducted a single-center, retrospective analysis of 126 consecutive patients who underwent TEER while fulfilling guideline criteria for CRT before the procedure. The primary outcome was the composite of all-cause mortality or heart failure hospitalizations at 1 year.
View Article and Find Full Text PDFBackground: There is scarce data on transcatheter edge-to-edge repair (TEER) for chronic functional mitral regurgitation (FMR) in the setting of very severe left ventricular dysfunction (LVD), defined by a left ventricular ejection fraction (LVEF) of <20%.
Methods: We retrospectively explored periprocedural characteristics and one-year clinical and echocardiographic outcomes of consecutive patients with chronic FMR and very severe LVD who underwent an isolated, first-time TEER. The composite of all-cause mortality or heart failure hospitalizations constituted the primary outcome.
Background There are limited data on repeat mitral transcatheter edge-to-edge repair for recurrent significant mitral regurgitation (MR). Methods and Results We conducted a single-center, retrospective analysis of consecutive patients referred to a second mitral transcatheter edge-to-edge repair after a technically successful first procedure. Clinical, laboratory, and echocardiographic measures were assessed up to 1 year after the intervention.
View Article and Find Full Text PDFBackground: There are scarce data regarding the post-mitral transcatheter edge-to-edger repair (TEER) course in different racial groups.
Objective: To assess the impact of race on outcomes following TEER for mitral regurgitation (MR).
Methods: This is a single-center, retrospective analysis of consecutive TEER procedures performed during 2013-2020.
Aims: To assess whether intraprocedural transesophageal echocardiographic (TEE)-derived haemodynamic parameters predict outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR).
Methods And Results: This is a single-centre, retrospective analysis encompassing 458 (IQR, 104-1035) days of follow-up after 926 consecutive patients [481 (52%) with functional MR] referred to an isolated mitral TEER between 2013 and 2020. Cases without actual clip deployment, or in whom prior mitral procedures had taken place, were excluded.
Background: A surrogate of right ventricular-pulmonary arterial coupling, the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) has been associated with outcomes across a wide range of cardiac pathologies and interventions. The aim of this study was to assess the prognostic significance of baseline TAPSE/PASP ratio in patients undergoing mitral transcatheter edge-to-edge repair.
Methods: This was a single-center, retrospective analysis encompassing 448 days (interquartile range, 86-958 days) of follow-up after 707 consecutive isolated, first-time mitral transcatheter edge-to-edge repair procedures.
Assessment of left ventricular (LV) systolic function is essential in patient selection for transcatheter edge-to-edge repair (TEER) in secondary mitral regurgitation (MR). Although LV ejection fraction (EF) is mostly used for assessing LV function, it represents the change of LV chamber size, but not myocardial contractility. LV global longitudinal strain (GLS) provides an alternative to assess LV systolic function in patients with secondary MR.
View Article and Find Full Text PDFBackground: Transcatheter edge-to-edge repair (TEER) has been increasingly used for selected patients with mitral regurgitation (MR), but limited data are available regarding clinical outcomes in patients with varied etiology and mechanism of MR.
Objectives: The aim of this study was to evaluate the outcomes of TEER according to etiology and left ventricular (LV) and left atrial remodeling.
Methods: Consecutive patients who underwent TEER between 2007 and 2020 were included in the analysis.
We present a rare case of a young patient who underwent a bioprosthetic mitral valve replacement and subsequently experienced a left ventricular pseudoaneurysm complicated by valve dehiscence and paravalvular mitral regurgitation, demonstrated by multimodality imaging and confirmed during surgical repair. ().
View Article and Find Full Text PDFObjectives: This study sought to evaluate the prognostic value of an increased mean mitral valve pressure gradient (MVG) in patients with primary mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER).
Background: Conflicting data exist regarding impact of increased mean MVG on outcomes after TEER.
Methods: This study included 419 patients with primary MR (mean age 80.
Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System.
JACC Cardiovasc Interv
October 2020
Objectives: The primary objective of this study was to evaluate the effectiveness of the MitraClip G4 in the reduction of mitral regurgitation (MR).
Background: The next-generation MitraClip G4 system was recently introduced for the treatment of MR in the United States.
Methods: The study included consecutive patients undergoing transcatheter mitral edge-to-edge repair for MR with the MitraClip G4.