cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.11505708.v1
title: Outcomes after Tricuspid Valve Replacement for Carcinoid Heart Disease: A Multicenter Study

description: Background This study evaluates clinical and echocardiographic outcomes in patients who underwent tricuspid valve replacement (TVR) for carcinoid heart disease (CaHD) stratified to prosthesis type (biological vs mechanical). Methods All patients undergoing TVR for CaHD between 1991 and 2017 were analyzed retrospectively in four tertiary centers. Cox-proportional hazard models were used to analyze survival data and mixed-models for repeated measurements of echo and laboratory data. Results In total, 49 patients (median age: 59 [51-66], 45% male) underwent biological (n=20, 41%) or mechanical (n=29, 59%) TVR. Three (6%) patients died in-hospital and 3-year actuarial survival was 73.3±8.7% (biological) and 56.1±10.0% (mechanical) (P=0.69). During a median follow-up of 17 months, two patients with a biological prosthesis required reoperation for structural valve deterioration, while one patient with mechanical prostheses had a reoperation due to valve thrombosis. No significant differences in bleeding, thrombosis, thrombo-embolism and heart failure admissions were noted between prosthesis types. Postoperative valve regurgitation increased more in patients with biological prosthesis (p=0.022). Maximum tricuspid inflow gradient was higher in patients with biological prostheses (p=0.02), however course over time was comparable between prosthesis types (p=0.136). Conclusion Tricuspid valve surgery for CaHD can be performed with acceptable hospital mortality risk. This data shows no apparent benefit of biological valves over mechanical prosthesis or vice versa. Valve choice should be made in a multi-disciplinary team taking into account expected lifespan, planned treatment for the carcinoid syndrome and neuroendocrine tumor and patient preferences.
DOI: 10.6084/m9.figshare.12896907
title: Transcatheter Implantation of SAPIEN S3 Valve in a Large Flexible Tricuspid Annuloplasty Ring

description: Transcatheter Implantation of SAPIEN S3 Valve in a Large Flexible Tricuspid Annuloplasty Ring
DOI: 10.6084/m9.figshare.12848445
title: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis

description: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
DOI: 10.6084/m9.figshare.12848445.v2
title: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis

description: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
DOI: 10.6084/m9.figshare.12848448
title: Extreme Right Atrial Disc Expansion of Septal Occluder Post Iatrogenic Atrial Septal Defect Closure

description: Extreme Right Atrial Disc Expansion of Septal Occluder Post Iatrogenic Atrial Septal Defect Closure
DOI: 10.6084/m9.figshare.12896907.v2
title: Transcatheter Implantation of Sapien S3 Valve in a Large Flexible Tricuspid Annuloplasty Ring

description: Transcatheter Implantation of Sapien S3 Valve in a Large Flexible Tricuspid Annuloplasty Ring
DOI: 10.6084/m9.figshare.12848439.v1
title: Echocardiographic Guidance of Transcatheter Mitral Valve Edge-To-Edge Repair

description: Transcatheter edge-to-edge mitral valve repair is an established, minimally invasive treatment option for selected patients with moderate-to-severe or severe mitral regurgitation. Although transcatheter edge-to-edge mitral valve repair offers a significant step forward in the management of mitral regurgitation, the rate of procedural-related complications is not trivial. Optimal peri-procedural imaging using transesophageal echocardiography is thus critical to determine procedural candidacy and ensure safe implantation. In this review of echocardiographic guidance of transcatheter mitral valve edge-to-edge repair, we present a step by step approach of the recommended echocardiographic views for evaluation of transcatheter edge-to-edge mitral valve repair before, during, and post-procedure including the guidance of septal puncture.
DOI: 10.6084/m9.figshare.12848448.v2
title: Extreme Right Atrial Disc Expansion of Septal Occluder Post Iatrogenic Atrial Septal Defect Closure

description: Extreme Right Atrial Disc Expansion of Septal Occluder Post Iatrogenic Atrial Septal Defect Closure
DOI: 10.6084/m9.figshare.12848454.v2
title: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery

description: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery
DOI: 10.6084/m9.figshare.12848439
title: Echocardiographic Guidance of Transcatheter Mitral Valve Edge-To-Edge Repair

description: Transcatheter edge-to-edge mitral valve repair is an established, minimally invasive treatment option for selected patients with moderate-to-severe or severe mitral regurgitation. Although transcatheter edge-to-edge mitral valve repair offers a significant step forward in the management of mitral regurgitation, the rate of procedural-related complications is not trivial. Optimal peri-procedural imaging using transesophageal echocardiography is thus critical to determine procedural candidacy and ensure safe implantation. In this review of echocardiographic guidance of transcatheter mitral valve edge-to-edge repair, we present a step by step approach of the recommended echocardiographic views for evaluation of transcatheter edge-to-edge mitral valve repair before, during, and post-procedure including the guidance of septal puncture.
DOI: 10.6084/m9.figshare.12848445.v1
title: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis

description: Novel Technique for Treatment of Severe Left Pulmonary Artery Stenosis Using a GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis
DOI: 10.6084/m9.figshare.12848448.v1
title: Extreme Right Atrial Disc Expansion of Septal Occluder post Iatrogenic Atrial Septal Defect Closure

description: Extreme Right Atrial Disc Expansion of Septal Occluder post Iatrogenic Atrial Septal Defect Closure
DOI: 10.6084/m9.figshare.12848454
title: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery

description: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery
DOI: 10.6084/m9.figshare.12848454.v1
title: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery

description: Transcatheter Aortic Valve Replacement with a Retro-Annular Circumflex Artery
DOI: 10.6084/m9.figshare.8246393.v2
title: Added Value of Practicing Cardiac Interventions Under Fluoroscopy Using Patient-Specific 3D Printed Cardiac Models

description: <b>Background:</b> 3D printing technology has been used to practice cardiac structural interventions in a benchtop setting. We hypothesized that practice on such models under fluoroscopy using standard access and deployment techniques would be feasible and create more realistic simulations. <b>Methods:</b> Computed Tomography Angiography data was segmented with commercial software and models exported for 3D printing. The resulting models were fixed to a catheterization table and the planned procedures attempted under fluoroscopy. Operator success and failures were noted and compared with actual case outcomes. <b>Results:</b> Three cases investigating left atrial appendage ligation and paravalvular leak closure were successfully simulated, with associated outcomes in the actual cases paralleling the simulated experiences. <b>Conclusion:</b> Patient-specific 3D printed cardiac models are easily visualized under fluoroscopy, with an anatomic fidelity sufficient to permit simulation and practice of structural interventions. Further work is needed to prove the value of this technology for improving patient outcomes and optimizing the training of future operators.
DOI: 10.6084/m9.figshare.8299886
title: Simultaneous Aortic Paravalvular Leak Repair and Transcatheter Valve-in-Valve Therapy for Actively Dehiscing Bioprosthetic AVR Causing Multi-System Organ Failure

description: Simultaneous Aortic Paravalvular Leak Repair and Transcatheter Valve-in-Valve Therapy for Actively Dehiscing Bioprosthetic AVR Causing Multi-System Organ Failure
DOI: 10.6084/m9.figshare.8864195.v1
title: Transcatheter Heart Valve Thrombosis-Induced Myocardial Infarction: A Rare Manifestation of Transcatheter Aortic Valve Thrombosis

description: Transcatheter Heart Valve Thrombosis-Induced Myocardial Infarction: A Rare Manifestation of Transcatheter Aortic Valve Thrombosis
DOI: 10.6084/m9.figshare.8246393
title: Added Value of Practicing Cardiac Interventions Under Fluoroscopy Using Patient-Specific 3D Printed Cardiac Models

description: <b>Background:</b> 3D printing technology has been used to practice cardiac structural interventions in a benchtop setting. We hypothesized that practice on such models under fluoroscopy using standard access and deployment techniques would be feasible and create more realistic simulations. <b>Methods:</b> Computed Tomography Angiography data was segmented with commercial software and models exported for 3D printing. The resulting models were fixed to a catheterization table and the planned procedures attempted under fluoroscopy. Operator success and failures were noted and compared with actual case outcomes. <b>Results:</b> Three cases investigating left atrial appendage ligation and paravalvular leak closure were successfully simulated, with associated outcomes in the actual cases paralleling the simulated experiences. <b>Conclusion:</b> Patient-specific 3D printed cardiac models are easily visualized under fluoroscopy, with an anatomic fidelity sufficient to permit simulation and practice of structural interventions. Further work is needed to prove the value of this technology for improving patient outcomes and optimizing the training of future operators.
DOI: 10.6084/m9.figshare.8299886.v1
title: Simultaneous Aortic Paravalvular Leak Repair and Transcatheter Valve-in-Valve Therapy for Actively Dehiscing Bioprosthetic AVR Causing Multi-System Organ Failure

description: Simultaneous Aortic Paravalvular Leak Repair and Transcatheter Valve-in-Valve Therapy for Actively Dehiscing Bioprosthetic AVR Causing Multi-System Organ Failure
DOI: 10.6084/m9.figshare.8279438
title: Discordant Grading of Aortic Stenosis Severity: New Insights from an <i>In Vitro</i> Study

description: <b>Background</b><b>:</b> Low gradient (mean gradient, &lt; 40 mmHg) aortic stenosis (AS) may occur in conjunction with a small valve effective orifice area (EOA) &lt; 1 cm<sup>2</sup>. This discordant grading in AS severity raises challenges from both a diagnostic and therapeutic standpoint. We sought to identify echocardiographic markers of severe AS in normal and low flow conditions <i>in vitro</i>. <b>Methods</b><b>:</b> In an <i>in vitro</i> mock circulatory system, we tested 6 degrees of AS severity (3 severe and 3 nonsevere), and 3 levels of stroke volume (30, 50, 70 ml), heart rate (60, 80, 100 bpm), and mean arterial pressure (100, 120, 140 mmHg). MG and EOA were measured by Doppler-echocardiography. <b>Results</b><b>:</b> In normal flow conditions, a MG of 40 mmHg corresponded to an EOA of 0.85 cm<sup>2</sup>, and an EOA of 1.0 cm<sup>2</sup> to a MG of 28 mmHg. The presence of EOA &lt; 0.85 cm<sup>2</sup> and MG between 24 and 40 mmHg in the low-flow condition yielded a 100% specificity for severe AS. In normal flow conditions, these thresholds were respectively &lt; 0.9 cm<sup>2</sup> and &gt; 36 mmHg. <b>Conclusion</b><b>:</b> Low gradient AS may occur in severe AS in both low and normal flow conditions. The presence of a valve EOA &lt; 0.85 cm<sup>2</sup> with an MG ≥ 25 mmHg may be used as a criteria to confirm severe AS in presence of low flow. In patients with normal-flow, a MG ≥ 37 mmHg is generally suggestive of severe AS. <b>Abbreviations</b>: AS: aortic stenosis; EOA: effective orifice area; HR: heart rate; LFLG: low-flow low-gradient; LVEF: left ventricular ejection fraction; MAP: mean arterial pressure; MG: mean gradient; NFLG: normal-flow low-gradient; SV: stroke volume
DOI: 10.6084/m9.figshare.8246393.v1
title: Added Value of Practicing Cardiac Interventions Under Fluoroscopy Using Patient-Specific 3D Printed Cardiac Models

description: Added Value of Practicing Cardiac Interventions Under Fluoroscopy Using Patient-Specific 3D Printed Cardiac Models
DOI: 10.6084/m9.figshare.8279438.v2
title: Discordant Grading of Aortic Stenosis Severity: New Insights from an <i>In Vitro</i> Study

description: <b>Background</b><b>:</b> Low gradient (mean gradient, &lt; 40 mmHg) aortic stenosis (AS) may occur in conjunction with a small valve effective orifice area (EOA) &lt; 1 cm<sup>2</sup>. This discordant grading in AS severity raises challenges from both a diagnostic and therapeutic standpoint. We sought to identify echocardiographic markers of severe AS in normal and low flow conditions <i>in vitro</i>. <b>Methods</b><b>:</b> In an <i>in vitro</i> mock circulatory system, we tested 6 degrees of AS severity (3 severe and 3 nonsevere), and 3 levels of stroke volume (30, 50, 70 ml), heart rate (60, 80, 100 bpm), and mean arterial pressure (100, 120, 140 mmHg). MG and EOA were measured by Doppler-echocardiography. <b>Results</b><b>:</b> In normal flow conditions, a MG of 40 mmHg corresponded to an EOA of 0.85 cm<sup>2</sup>, and an EOA of 1.0 cm<sup>2</sup> to a MG of 28 mmHg. The presence of EOA &lt; 0.85 cm<sup>2</sup> and MG between 24 and 40 mmHg in the low-flow condition yielded a 100% specificity for severe AS. In normal flow conditions, these thresholds were respectively &lt; 0.9 cm<sup>2</sup> and &gt; 36 mmHg. <b>Conclusion</b><b>:</b> Low gradient AS may occur in severe AS in both low and normal flow conditions. The presence of a valve EOA &lt; 0.85 cm<sup>2</sup> with an MG ≥ 25 mmHg may be used as a criteria to confirm severe AS in presence of low flow. In patients with normal-flow, a MG ≥ 37 mmHg is generally suggestive of severe AS. <b>Abbreviations</b>: AS: aortic stenosis; EOA: effective orifice area; HR: heart rate; LFLG: low-flow low-gradient; LVEF: left ventricular ejection fraction; MAP: mean arterial pressure; MG: mean gradient; NFLG: normal-flow low-gradient; SV: stroke volume
DOI: 10.6084/m9.figshare.8864195
title: Transcatheter Heart Valve Thrombosis-Induced Myocardial Infarction: A Rare Manifestation of Transcatheter Aortic Valve Thrombosis

description: Transcatheter Heart Valve Thrombosis-Induced Myocardial Infarction: A Rare Manifestation of Transcatheter Aortic Valve Thrombosis
DOI: 10.6084/m9.figshare.8798504
title: Myocardial Injury Post Transcatheter Aortic Valve Implantation Comparing Mechanically Expanded Versus Self-Expandable Versus Balloon-Expandable Valves

description: <b>Background:</b> Myocardial injury (MI) is common with transcatheter aortic valve implantation (TAVI) and may predict poor outcome. We aim: 1) to evaluate the difference in change of high-sensitivity-Troponin-T (hsTnT) within 24h after transfemoral-TAVI between mechanically-expanded (MEV), self-expanding (SEV) and balloon-expandable-valves (BEV); 2) to determine predictors for MI post-TAVI; and 3) to assess whether MI is associated with 30-day mortality. <b>Methods:</b> This multicenter retrospective observational study included 1208 consecutively treated transfemoral-TAVI patients from three European centers. All patients treated with a MEV, SEV or BEV with available hsTnT measurements at baseline and within 24 h post-TAVI were included. Significant MI was defined as an elevation of hsTnT ≥ 15x the upper-reference-limit. <b>Results:</b> Overall, the median hsTnT rise was 741 ng/L and was lower with MEV (MEV 335 vs. SEV 901 vs. BEV 649 ng/L, <i>p</i> &lt; 0.001). MI occurred in 925 patients (77%) and was less frequent with MEV (MEV 67%, SEV 79% and BEV 76%, <i>p</i> = 0.007). Occurrence of MI was similar after implantation of first vs. second- generation SEV (79 vs. 80%, <i>p</i> = 0.72) and BEV (77 vs. 76%, <i>p</i> = 0.90). There was no association between frequency of annulus manipulation and MI. On multivariable analysis (OR (95% CI) non-MEV (1.63 (1.06–2.49)), mean aortic gradient (1.02 (1.01–1.03)), left ventricular ejection fraction (1.03 (1.01–1.04)), and previous myocardial infarction (1.62 (1.04–2.56)) were positively associated with MI. There was no association between MI and 30-day mortality. <b>Conclusion:</b> Transcatheter valve design determines peri-procedural MI and is less frequent with MEV. MI is not associated with 30-day mortality.
DOI: 10.6084/m9.figshare.8279438.v1
title: Discordant Grading Of Aortic Stenosis Severity: New Insights from an In Vitro Study

description: BACKGROUND: Low gradient (mean gradient, MG &lt; 40 mmHg) aortic stenosis (AS) may occur in conjunction with a small valve effective orifice area (EOA) &lt; 1 cm<sup>2</sup>. This discordant grading in AS severity raises challenges from both a diagnostic and therapeutic standpoint. We sought to identify echocardiographic markers of severe AS in normal and low flow conditions <i>in vitro</i>. METHODS: In an <i>in vitro</i> mock circulatory system, we tested 6 degrees of AS severity (3 severe and 3 non-severe), and 3 levels of stroke volume (30, 50, 70 ml), heart rate (60, 80, 100 bpm), and mean arterial pressure (100, 120, 140 mmHg). MG and EOA were measured by Doppler-echocardiography. RESULTS: In normal flow conditions, a MG of 40 mmHg corresponded to an EOA of 0.85 cm<sup>2</sup>, and an EOA of 1 cm<sup>2</sup> to a MG of 28 mmHg. The presence of EOA &lt; 0.85 cm<sup>2</sup> and MG between 24 and 40 mmHg in the low-flow condition yielded a 100% specificity for severe AS. In normal flow conditions, these thresholds were respectively &lt; 0.9 cm<sup>2</sup> and &gt; 36 mmHg. CONCLUSION: Low gradient AS may occur in severe AS in both low and normal flow conditions. The presence of a valve EOA &lt; 0.85 cm<sup>2</sup> with a mean gradient ≥ 25 mmHg may be used as a criteria to confirm the presence of severe AS in presence of low flow. In patients with normal-flow, a MG ≥ 37 mmHg is generally suggestive of severe AS.
DOI: 10.6084/m9.figshare.8798504.v2
title: Myocardial Injury Post Transcatheter Aortic Valve Implantation Comparing Mechanically Expanded Versus Self-Expandable Versus Balloon-Expandable Valves

description: <b>Background:</b> Myocardial injury (MI) is common with transcatheter aortic valve implantation (TAVI) and may predict poor outcome. We aim: 1) to evaluate the difference in change of high-sensitivity-Troponin-T (hsTnT) within 24h after transfemoral-TAVI between mechanically-expanded (MEV), self-expanding (SEV) and balloon-expandable-valves (BEV); 2) to determine predictors for MI post-TAVI; and 3) to assess whether MI is associated with 30-day mortality. <b>Methods:</b> This multicenter retrospective observational study included 1208 consecutively treated transfemoral-TAVI patients from three European centers. All patients treated with a MEV, SEV or BEV with available hsTnT measurements at baseline and within 24 h post-TAVI were included. Significant MI was defined as an elevation of hsTnT ≥ 15x the upper-reference-limit. <b>Results:</b> Overall, the median hsTnT rise was 741 ng/L and was lower with MEV (MEV 335 vs. SEV 901 vs. BEV 649 ng/L, <i>p</i> &lt; 0.001). MI occurred in 925 patients (77%) and was less frequent with MEV (MEV 67%, SEV 79% and BEV 76%, <i>p</i> = 0.007). Occurrence of MI was similar after implantation of first vs. second- generation SEV (79 vs. 80%, <i>p</i> = 0.72) and BEV (77 vs. 76%, <i>p</i> = 0.90). There was no association between frequency of annulus manipulation and MI. On multivariable analysis (OR (95% CI) non-MEV (1.63 (1.06–2.49)), mean aortic gradient (1.02 (1.01–1.03)), left ventricular ejection fraction (1.03 (1.01–1.04)), and previous myocardial infarction (1.62 (1.04–2.56)) were positively associated with MI. There was no association between MI and 30-day mortality. <b>Conclusion:</b> Transcatheter valve design determines peri-procedural MI and is less frequent with MEV. MI is not associated with 30-day mortality.
DOI: 10.6084/m9.figshare.8940308
title: Imaging for Percutaneous Left Atrial Appendage Closure: A Contemporary Review

description: Embolic stroke is the most significant complication of atrial fibrillation (AF). Oral anticoagulation (OAC) agents have an established role to prevent stroke in patients with AF. However, in patients who have near-fatal bleeding events during treatment with OAC, alternative, non-pharmacological methods of stroke prevention are needed. The left atrial appendage (LAA) is the most common source of thrombi in AF and recently, mechanical, percutaneous occlusion of the LAA has emerged as an effective strategy for stroke prophylaxis in patients deemed high risk for OAC-related bleeding. Although percutaneous LAA occlusion offers a significant step forward in AF stroke risk prevention, the procedural risks are not trivial and include device leakage, embolization, cardiac perforation, tamponade, and death. To minimize these risks and improve LAA occlusion outcomes, optimal peri-procedural imaging is critical to ensure accurate sizing and safe implantation. In this review of LAA occlusion, we present the current, clinically used percutaneous devices and provide a focused review of the latest imaging approaches used for evaluation of the LAA before, during, and after occlusion.
DOI: 10.6084/m9.figshare.8940308.v2
title: Imaging for Percutaneous Left Atrial Appendage Closure: A Contemporary Review

description: Embolic stroke is the most significant complication of atrial fibrillation (AF). Oral anticoagulation (OAC) agents have an established role to prevent stroke in patients with AF. However, in patients who have near-fatal bleeding events during treatment with OAC, alternative, non-pharmacological methods of stroke prevention are needed. The left atrial appendage (LAA) is the most common source of thrombi in AF and recently, mechanical, percutaneous occlusion of the LAA has emerged as an effective strategy for stroke prophylaxis in patients deemed high risk for OAC-related bleeding. Although percutaneous LAA occlusion offers a significant step forward in AF stroke risk prevention, the procedural risks are not trivial and include device leakage, embolization, cardiac perforation, tamponade, and death. To minimize these risks and improve LAA occlusion outcomes, optimal peri-procedural imaging is critical to ensure accurate sizing and safe implantation. In this review of LAA occlusion, we present the current, clinically used percutaneous devices and provide a focused review of the latest imaging approaches used for evaluation of the LAA before, during, and after occlusion.