Publications by authors named "Tamburino C"
Background: The self-expanding, supra-annular Evolut valve is an established platform for Transcatheter Aortic Valve Implantation (TAVI). Evolut PRO introduced an outer sealing wrap to mitigate paravalvular leakage. We evaluated the 3-year clinical outcomes and valve performance of the Evolut PRO in standard clinical practice for severe aortic stenosis (AS) patients at intermediate or higher risk for surgery.
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- Tethering is a common issue in mitral valve problems, often seen in patients with serious regurgitation, but its true effects on treatment outcomes are not well understood.
- A study involving over 2,200 patients found that while those with tethering had higher initial rates of cardiac death and rehospitalization, after adjusting for other factors, tethering did not significantly impact long-term outcomes.
- Consequently, the study suggests that having tethering should not prevent suitable patients from undergoing transcatheter edge-to-edge repair (TEER) for mitral valve issues.
Background: Head-to-head comparisons of second and third generations of transcatheter heart valves (THVs) are mostly limited to 2-arm studies and to mid-term follow-up. The aim of this study was to simultaneously compare clinical outcomes of transcatheter aortic valve replacement (TAVR) with 4 different THVs at 5 years.
Methods: Patients undergoing transfemoral TAVR with 4 second-generation THV platforms and enrolled in the multicentre prospective OBSERVANT II study from December 2016 to September 2018 were compared according to the THV received.
Background: Prosthesis-patient mismatch after transcatheter aortic valve replacement (TAVR) can be measured echocardiographically (measured prosthesis-patient mismatch [PPMm]) or predicted (predicted prosthesis-patient mismatch [PPMp]) using published effective orifice area (EOA) reference values. However, the clinical implications of PPM post-TAVR remain unclear.
Objectives: This study aimed to elucidate the prevalence of PPMm and PPMp post-TAVR and their impact on mortality in a large international cohort.
Background: New conduction disturbances are frequent after transcatheter aortic valve implantation (TAVI). Refining our ability to predict high-grade atrioventricular block (AVB) occurring later than 24 hours after the procedure would be useful in order to select patients eligible for early discharge.
Aims: This study was designed to identify predictors of high-grade AVB occurring between 24 hours and 30 days after TAVI and to develop and validate a predictive risk score.
Article Synopsis
- The study compared long-term outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with low EuroSCORE II for aortic stenosis.
- At 10 years, survival rates were significantly higher for SAVR at 37% compared to 18.2% for TAVR, with differences becoming noticeable after 3 years.
- The incidence of repeat aortic valve procedures was low for both methods, but TAVR had a slightly lower rate at 1.1% compared to 2.6% for SAVR, although this difference was not statistically significant.
Background: Endocarditis is an infectious disease, with an incidence of ∼15 cases per 100 000 people, affecting the tricuspid valve in 10% of cases. Infective endocarditis with negative blood cultures (BCNIE) accounts for more than 20% of cases of infective endocarditis. Perivalvular extension of the infection represents the most detrimental complications of BCNIE.
View Article and Find Full Text PDFBackground: Patients undergoing transcatheter aortic valve implantation (TAVI) for bicuspid aortic stenosis (AS) frequently present with ascending aortic (AAo) dilatation which is left untreated. The objective of this study was to study the natural progression and underlying mechanisms of AAo dilatation after TAVI for bicuspid AS.
Methods: Patients with a native bicuspid AS and a baseline AAo maximum diameter > 40 mm treated by TAVI and in whom post-TAVI computed tomography (CT) scans beyond 1 year were available were included.
Left atrial appendage closure (LAAC) is a crucial intervention for stroke prevention in patients with non-valvular atrial fibrillation who are unsuitable for long-term anticoagulation. Amulet and Watchman are the most implanted devices worldwide for performing LAAC, and the aim of this review is to provide a comprehensive comparison focusing on their efficacy, safety, and short- and long-term outcomes. The Watchman device, the first to gain FDA approval, has been extensively studied and demonstrates significant reductions in stroke and systemic embolism rates.
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- - The study aims to compare immediate versus staged percutaneous coronary intervention (PCI) strategies for patients with aneurysmatic right coronary artery (ARCA) during acute coronary syndrome (ACS), analyzing outcomes from 85 patients.
- - Results show that both PCI strategies had similar rates of procedural success and long-term outcomes, but the staged approach led to a higher incidence of bleeding and longer hospital stays.
- - The findings suggest that while both methods are viable, immediate PCI might be preferable due to lower complications and shorter hospital duration.
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 study investigates the effects of red blood cell (RBC) transfusion on short-term mortality in patients undergoing transapical transcatheter aortic valve implantation (TA-TAVI), where bleeding is common.
- Out of 11,265 TAVI participants, 548 had TA-TAVI, with 209 receiving RBC transfusions, and the study found a significant association between transfusion and increased 30-day mortality.
- The research concluded that RBC transfusion independently predicts higher short-term mortality in TA-TAVI patients, regardless of other factors like major bleeding and kidney injury.
Article Synopsis
- Researchers studied how heart failure (HF) affects death rates in patients getting a special heart valve repair called M-TEER, focusing on a condition called secondary mitral regurgitation (SMR).
- They found that patients with advanced HF (serious heart problems) had a higher chance of dying in the next two years, but those who got much better SMR results had lower death risks.
- The results showed that improving SMR is important for all patients, whether their heart failure is advanced or not, as it can help them live longer.
Article Synopsis
- * Data from the GIOTTO registry was analyzed, focusing on 657 DMR patients divided based on their EuroSCORE risk level; results indicated higher all-cause mortality associated with a EuroSCORE of 4% or more, as well as specific health factors like low left ventricular ejection fraction.
- * The findings revealed that over half of the patients with DMR had a low EuroSCORE, and successful M
: To date, data regarding the characteristics and management of obstructive, stable coronary artery disease (CAD) encountered in patients undergoing transcatheter aortic valve implantation (TAVI) are sparse. The aim of the study was to analyze granular details, treatment, and outcomes of patients undergoing TAVI with obstructive, stable CAD from real-world practice. : REVASC-TAVI (Management of myocardial REVASCularization in patients undergoing Transcatheter Aortic Valve Implantation with coronary artery disease) is an investigator-initiated, multicenter registry, which collected data from patients undergoing TAVI with obstructive stable CAD found during the pre-TAVI work-up.
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- 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.
Paravalvular regurgitation remains a frequent finding after transcatheter aortic valve replacement and is associated with unfavorable outcomes if more-than-mild grade. In this case, a patient underwent a third transcatheter aortic valve replacement procedure for worsening symptoms due to severe paravalvular regurgitation. The case underlines the role of preprocedural planning in achieving treatment success.
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- 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.
Article Synopsis
- Percutaneous coronary intervention (PCI) for bifurcation lesions remains challenging, prompting a multicenter study to evaluate the Bioss Lim C device, designed specifically for such cases.
- The study involving 207 patients assessed both acute and long-term outcomes, focusing on complications like side branch occlusion and major adverse events (MACE) following implantation.
- Results showed that 13% of patients experienced complications shortly after the procedure, and after about 24 months, 11.1% faced major adverse events, including 4.8% deaths, indicating the need for careful management during and after treatment.
Article Synopsis
- Dialysis is a serious but rare complication following transcatheter aortic valve replacement, and researchers analyzed the TRITAVI registry to develop a clinical score for assessing this risk.
- They identified various preprocedural factors (like male sex, diabetes, and anemia) and procedural features (like contrast volume and need for transfusion) that contribute to the risk, resulting in two scoring systems (TRITAVIpre and TRITAVIpost) which demonstrated strong predictive power.
- The study confirmed that the need for dialysis significantly increases mortality rates, emphasizing the importance of the developed scores in predicting dialysis risk before the procedure.
Article Synopsis
- This study compares the outcomes of two self-expanding transcatheter heart valve systems (ACURATE and EVOLUT) in patients undergoing valve-in-valve (ViV) procedures for degenerated surgical prostheses.
- A total of 835 patients across 20 centers were analyzed, with key outcomes including technical success, device success, and 30-day mortality rates evaluated between the two groups.
- Results showed that while overall procedural outcomes were similar, specific diameter measurements influenced device success differently between the two valve systems.
Article Synopsis
- The study assesses the effectiveness of self-expanding (SE) Evolut PRO/PRO+ versus balloon-expandable (BE) SAPIEN ULTRA valves in patients with small aortic annuli, using data from the OPERA-TAVI registry.
- It finds that the 1-year primary effectiveness outcomes are similar for both valve types, but the SE group shows better results for 30-day device-related outcomes.
- The SE valves have higher rates of disabling strokes and paravalvular leaks, while the BE valves exhibit more issues with prosthesis-patient mismatch and elevated residual mean gradients.
Background: Coronary re-engagement after transcatheter aortic valve replacement (TAVR) using self-expanding transcatheter heart valves (THVs) systematically implanted using commissural alignment (CA) techniques has been poorly investigated.
Objectives: The aim of this study was to evaluate unsuccessful coronary cannulation, and its predictors, after TAVR using self-expanding devices implanted using CA techniques.
Methods: RE-ACCESS 2 (Reobtain Coronary Ostia Cannulation Beyond Transcatheter Aortic Valve Stent 2) was an investigator-driven, single-center, prospective study that enrolled consecutive TAVR patients receiving Evolut and ACURATE THVs implanted using CA techniques.