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4. Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints

Author

Hahn, R, Lawlor, M, Davidson, C, Badhwar, V, Sannino, A, Spitzer, E, Lurz, P, Lindman, B, Topilsky, Y, Baron, S, Chadderdon, S, Khalique, O, Tang, G, Taramasso, M, Grayburn, P, Badano, L, Leipsic, J, Lindenfeld, J, Windecker, S, Vemulapalli, S, Redfors, B, Alu, M, Cohen, D, Rodes-Cabau, J, Ailawadi, G, Mack, M, Ben-Yehuda, O, Leon, M, Hausleiter, J, Arnold, S, Bapat, V, Berry, N, Blanke, P, Burkhoff, D, Coylewright, M, Duggal, N, Galper, B, George, I, Guerrero, M, Hamid, N, Jagadeesan, V, Kodali, S, Krucoff, M, Lang, R, Madhavan, M, Mclaughin, V, Mehran, R, Philippon, F, Sethi, S, Simonato, M, Smith, R, Sodhi, N, Spertus, J, Stocker, T, Stone, G, Hahn R. T., Lawlor M. K., Davidson C. J., Badhwar V., Sannino A., Spitzer E., Lurz P., Lindman B. R., Topilsky Y., Baron S. J., Chadderdon S., Khalique O. K., Tang G. H. L., Taramasso M., Grayburn P. A., Badano L., Leipsic J., Lindenfeld J., Windecker S., Vemulapalli S., Redfors B., Alu M. C., Cohen D. J., Rodes-Cabau J., Ailawadi G., Mack M., Ben-Yehuda O., Leon M. B., Hausleiter J., Arnold S., Bapat V., Berry N., Blanke P., Burkhoff D., Coylewright M., Duggal N., Galper B., George I., Guerrero M., Hamid N., Jagadeesan V., Kodali S., Krucoff M., Lang R., Madhavan M., McLaughin V., Mehran R., Philippon F., Sethi S. S., Simonato M., Smith R., Sodhi N., Spertus J., Stocker T. J., Stone G., Hahn, R, Lawlor, M, Davidson, C, Badhwar, V, Sannino, A, Spitzer, E, Lurz, P, Lindman, B, Topilsky, Y, Baron, S, Chadderdon, S, Khalique, O, Tang, G, Taramasso, M, Grayburn, P, Badano, L, Leipsic, J, Lindenfeld, J, Windecker, S, Vemulapalli, S, Redfors, B, Alu, M, Cohen, D, Rodes-Cabau, J, Ailawadi, G, Mack, M, Ben-Yehuda, O, Leon, M, Hausleiter, J, Arnold, S, Bapat, V, Berry, N, Blanke, P, Burkhoff, D, Coylewright, M, Duggal, N, Galper, B, George, I, Guerrero, M, Hamid, N, Jagadeesan, V, Kodali, S, Krucoff, M, Lang, R, Madhavan, M, Mclaughin, V, Mehran, R, Philippon, F, Sethi, S, Simonato, M, Smith, R, Sodhi, N, Spertus, J, Stocker, T, Stone, G, Hahn R. T., Lawlor M. K., Davidson C. J., Badhwar V., Sannino A., Spitzer E., Lurz P., Lindman B. R., Topilsky Y., Baron S. J., Chadderdon S., Khalique O. K., Tang G. H. L., Taramasso M., Grayburn P. A., Badano L., Leipsic J., Lindenfeld J., Windecker S., Vemulapalli S., Redfors B., Alu M. C., Cohen D. J., Rodes-Cabau J., Ailawadi G., Mack M., Ben-Yehuda O., Leon M. B., Hausleiter J., Arnold S., Bapat V., Berry N., Blanke P., Burkhoff D., Coylewright M., Duggal N., Galper B., George I., Guerrero M., Hamid N., Jagadeesan V., Kodali S., Krucoff M., Lang R., Madhavan M., McLaughin V., Mehran R., Philippon F., Sethi S. S., Simonato M., Smith R., Sodhi N., Spertus J., Stocker T. J., and Stone G.

Abstract

Interest in the pathophysiology, etiology, management, and outcomes of patients with tricuspid regurgitation (TR) has grown in the wake of multiple natural history studies showing progressively worse outcomes associated with increasing TR severity, even after adjusting for multiple comorbidities. Historically, isolated tricuspid valve surgery has been associated with high in-hospital mortality rates, leading to the development of transcatheter treatment options. The aim of this first Tricuspid Valve Academic Research Consortium document is to standardize definitions of disease etiology and severity, as well as endpoints for trials that aim to address the gaps in our knowledge related to identification and management of patients with TR. Standardizing endpoints for trials should provide consistency and enable meaningful comparisons between clinical trials. A second Tricuspid Valve Academic Research Consortium document will focus on further defining trial endpoints and will discuss trial design options.

Published
2023

6. Intermodality Comparison Of Myocardial Extracellular Volume Fraction Assessment In Patients Undergoing TAVR Or TMVR Evaluation

Author

Lesser, A., primary, Koike, H., additional, Schmidt, S., additional, Cheng, V., additional, Fukui, M., additional, Okada, A., additional, Wang, C., additional, Phichaphop, A., additional, Bapat, V., additional, Sorajja, P., additional, Enriquez-Sarano, M., additional, Lesser, J., additional, and Cavalcante, J., additional

Published
2023
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9. Impact Of Comprehensive Computed Tomography Assessment With Extracellular Volume And Longitudinal Strain Analysis On Transcatheter Aortic Valve Replacement Outcomes

Author

Koike, H., primary, Schmidt, S., additional, Cheng, V., additional, Fukui, M., additional, Okada, A., additional, Wang, C., additional, Phichaphop, A., additional, Bapat, V., additional, Sorajja, P., additional, Enriquez-Sarano, M., additional, Lesser, J., additional, and Cavalcante, J., additional

Published
2023
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34. Pledgeted versus nonpledgeted sutures in aortic valve replacement

Author

Velders, B.J.J., Vriesendorp, M.D., Sabik, J.F., Dagenais, F., Labrousse, L., Bapat, V., Aldea, G.S., Anyanwu, A.C., Cai, Y.P., Klautz, R.J.M., and Cardiothoracic Surgery

Subjects
Pulmonary and Respiratory Medicine, pledgets, paravalvular leak, suturing technique, endocarditis, Surgery, thromboembolism, surgical aortic valve replacement
Abstract

Objective: The objective of this study was to compare short-and midterm clinical and echocardiographic outcomes according to the use of pledgeted sutures during aortic valve replacement. Methods: Patients with aortic stenosis or regurgitation requiring aortic valve replacement were enrolled in a prospective cohort study to evaluate the safety of a new stented bioprosthesis. Outcomes were analyzed according to the use of pledgets (pledgeted group) or no pledgets (nonpledgeted group). The primary outcome was a composite of thromboembolism, endocarditis, and major paravalvular leak at 5 years of follow-up. Secondary outcomes included multiple clinical end-points and hemodynamic outcomes. Propensity score matching was performed to adjust for prognostic factors, and subanalyses with small valve sizes (< 23 mm) and suturing techniques were performed. Results: The pledgeted group comprised 640 patients (59%), and the nonpledgeted group 442 (41%), with baseline discrepancies in demographic characteristics, comorbidities, and stenosis severity. There were no differences between groups in any outcome. After propensity score matching, the primary outcome occurred in 41 (11.7%) patients in the pledgeted and 36 (9.8%) in the nonpledgeted group (P = .51). The effective orifice area was smaller in the pledgeted group (P = .045), whereas no difference was observed for the mean or peak pressure gradient. Separate subanalyses with small valve sizes and suturing techniques did not show relevant differences. Conclusions: In this large propensity score-matched cohort, comprehensive clinical outcomes were comparable between patients who underwent aortic valve replacement with pledgeted and nonpledgeted sutures up to 5 years of follow-up, but pledgets might lead to a slightly smaller effective orifice area in the long run.

Published
2022

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