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J Cardiol Cases 2022 May 8;25(5):292-296. Epub 2021 Dec 8.

Department of Cardiology, NRS Medical College and Hospital, Kolkata, India.

Ruptured sinus of Valsalva aneurysm (RSOV) is an uncommon cause of high output heart failure. RSOV most commonly opens into the right ventricle followed by the right atrium and non-coronary cusp involvement is relatively uncommon. Infective endocarditis (IE) is a rare cause of RSOV. Read More

JACC Cardiovasc Interv 2022 May 13;15(9):935-945. Epub 2022 Apr 13.

Smidt Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. Electronic address:

Objectives: 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. Read More

Eur Heart J Case Rep 2022 Mar 22;6(3):ytac094. Epub 2022 Feb 22.

Department of Cardiology, Royal Brompton & Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, Hill End Rd, Harefield, Uxbridge UB9 6JH, UK.

Background: Aortic-to-right ventricle (ARV) fistula is an uncommon complication of transcatheter aortic valve implantation (TAVI). Even though surgical closure is usually the treatment of choice in such communications, percutaneous treatment options are valuable alternatives for these high-risk surgical patients.

Case Summary: In this article, we present the percutaneous closure of an ARV fistula after TAVI, in a highly symptomatic patient with recurrent episodes of heart failure decompensation with worsening right ventricular function, who failed conservative medical treatment and was deemed inoperable. Read More

BMJ Case Rep 2022 Apr 26;15(4). Epub 2022 Apr 26.

Gastroenterology, Medway Maritime Hospital, Gillingham, Kent, UK.

Portopulmonary hypertension (PoPH) is a poorly understood complication of liver disease which affects about 10% of patients with pulmonary hypertension. This case report outlines the difficulties in diagnosing and managing a patient with advanced disease, and the impact of these delays on the patient.PoPH has a significant risk of mortality with a 2-year survival rate of 67%. Read More

Multimed Man Cardiothorac Surg 2022 04 5;2022. Epub 2022 Apr 5.

Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Various interventional and minimally invasive surgical approaches are currently available for the treatment of mitral valve pathologies. However, only a few of these options are applicable in patients with previously operated on mitral valves. In this case report, we provide detailed insight into the step-by-step guidance of a percutaneous transseptal transcatheter mitral valve-in-valve implant under cerebral protection in a patient with a deteriorated surgically implanted mitral bioprosthesis. Read More

Ann Biomed Eng 2022 Apr 22. Epub 2022 Apr 22.

Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, 16802-4400, USA.

Patients with Fontan circulation have increased risk of heart failure, but are not always candidates for heart transplant, leading to the development of the subpulmonic Penn State Fontan Circulation Assist Device. The aim of this study was to use patient-specific computational fluid dynamics simulations to evaluate anastomosis options for implanting this device. Simulations were performed of the pre-surgical anatomy as well as four surgical options: a T-junction and three Y-grafts. Read More

J Am Coll Cardiol 2022 04;79(16):1549-1561

Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: Limited data exist to characterize novel measures of left atrial (LA) structure and function in older adults without prevalent heart failure (HF).

Objectives: The aim was to assess reference range of LA measures, their associations with N-terminal pro-B-type natriuretic-peptide (NT-proBNP) and the related risk for incident HF or death.

Methods: We analyzed LA structure (LA maximal [LAViMax] and minimal volume indexed by body surface area) and function (LA emptying fraction, LA reservoir, conduit, and contraction strain) in 4,901 participants from the ARIC (Atherosclerosis Risk In Communities) study (mean age 75 ± 5 years, 40% male, and 19% Black) without prevalent HF. Read More

Ann Vasc Surg 2022 Apr 6. Epub 2022 Apr 6.

Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland.

Objectives: An infection-resistant, immediately available conduit for trauma and urgent vascular reconstruction remains a critical need for successful limb salvage. While autologous vein remains the gold standard, vein-limited patients and size mismatch are common issues. The Human Acellular Vessel (HAV) (Humacyte, Durham, NC) is a bioengineered conduit with off-the-shelf availability and resistance to infection, ideal characteristics for patients with challenging revascularization scenarios. Read More

JACC Cardiovasc Interv 2022 04;15(7):698-708

Baylor Scott & White Health, Dallas, Texas, USA.

Objectives: The aim of this study was to report the outcomes of valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) at 5 years.

Background: TAVR for degenerated surgical bioprostheses in patients at high risk for reoperative surgery is an important treatment option that may delay or obviate the need for surgical intervention; however, long-term outcomes of this procedure are unknown.

Methods: The PARTNER (Placement of Aortic Transcatheter Valves) 2 ViV and continued access registries prospectively enrolled patients with failed surgical bioprostheses at high risk for reoperation. Read More

ESC Heart Fail 2022 Jun 30;9(3):1507-1523. Epub 2022 Mar 30.

Cardiology, Cardio-thoracic Department, Civil Hospitals and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Heart failure (HF) is a major cause of mortality, hospitalizations, and reduced quality of life and a major burden for the healthcare system. The number of patients that progress to an advanced stage of HF is growing. Only a limited proportion of these patients can undergo heart transplantation or mechanical circulatory support. Read More

Neth Heart J 2022 Mar 29. Epub 2022 Mar 29.

Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.

Despite the high prevalence and adverse clinical outcomes of severe tricuspid regurgitation (TR), conventional treatment options, surgical or pharmacological, are limited. Surgery is associated with a high peri-operative risk and medical treatment has not clearly resulted in clinical improvements. Therefore, there is a high unmet need to reduce morbidity and mortality in patients with severe TR. Read More

J Invasive Cardiol 2022 May 25;34(5):E369-E373. Epub 2022 Mar 25.

Providence Valve Center, 9427 SW Barnes Road, West Pavilion, 5th Floor, Suite 593, Portland, OR 97225 USA.

Background: There are limited invasive treatment options for patients with end-stage heart failure and left ventricular assist device (LVAD) who develop severe aortic valve regurgitation (AR). One option for such patients is transcatheter aortic valve replacement (TAVR). There are limited data on outcomes of patients with LVAD who receive TAVR for severe AR. Read More

J Cardiothorac Vasc Anesth 2022 Feb 23. Epub 2022 Feb 23.

Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Outcomes Research Consortium, Cleveland, OH.

Millions of American adults suffer from right heart failure (RHF), a condition associated with high rates of hospitalization, organ failure, and death. There is a multitude of etiologies and mechanisms that lead to RHF, often in a feedforward spiral of decline. The management of advanced cases of RHF can be particularly difficult. Read More

Cells 2022 03 18;11(6). Epub 2022 Mar 18.

Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E Broad St., P.O. Box 980011, Richmond, VA 23219, USA.

Cancer cachexia is a multifactorial, paraneoplastic syndrome that impacts roughly half of all cancer patients. It can negatively impact patient quality of life and prognosis by causing physical impairment, reducing chemotherapy tolerance, and precluding them as surgical candidates. While there is substantial research on cancer-induced skeletal muscle cachexia, there are comparatively fewer studies and therapies regarding cardiac cachexia in the setting of malignancy. Read More

JACC Cardiovasc Interv 2022 04 16;15(7):753-766. Epub 2022 Mar 16.

Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA; DeMatteis Cardiovascular Institute, St. Francis Hospital, Roslyn, New York, USA. Electronic address:

Objectives: This study sought to determine correlates and consequences of contrast-associated acute kidney injury (CA-AKI) on clinical outcomes in patients with or without pre-existing chronic kidney disease (CKD).

Background: The incidence and impact of CA-AKI on clinical outcomes during contemporary percutaneous coronary intervention (PCI) are not fully defined.

Methods: The ADAPT-DES (Assessment of Dual AntiPlatelet Therapy With Drug Eluting Stents) study was a prospective, multicenter registry of 8,582 patients treated with ≥1 drug-eluting stent(s). Read More

J Am Coll Cardiol 2022 03;79(11):1092-1107

Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

As the prevalence of advanced heart failure continues to rise, treatment strategies for select patients include heart transplantation or durable left ventricular assist device (LVAD) support, both of which improve quality of life and extend survival. Recently, the HeartMate 3 has been incorporated into clinical practice, the United Network for Organ Sharing donor heart allocation system was revised, and the management of LVAD-related complications has evolved. Contemporary LVAD recipients have greater preoperative illness severity, but survival is higher and adverse event rates are lower compared with prior eras. Read More

JACC Cardiovasc Interv 2022 03;15(5):481-491

St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Objectives: The aim of this study was to report the midterm outcomes at 1 year in the expanded first-in-human experience with the transfemoral EVOQUE system (Edwards Lifesciences) for tricuspid regurgitation (TR).

Background: Untreated TR is associated with excess mortality and morbidity. The first-in-human experience with the EVOQUE tricuspid valve replacement system reported favorable 30-day outcomes with no mortality in a compassionate use population. Read More

Expert Rev Cardiovasc Ther 2022 Mar 20;20(3):169-183. Epub 2022 Mar 20.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.

Introduction: Atrial fibrillation and heart failure frequently co-exist and the combination is associated with a worse prognosis than either condition alone. A number of pharmacological agents and invasive procedures have been shown to benefit this complex patient group.

Objective: In this review, we compare different therapeutic approaches to atrial fibrillation and heart failure, including pharmacotherapy, left atrial catheter ablation and pace-and-ablate. Read More

Front Med (Lausanne) 2022 18;9:803388. Epub 2022 Feb 18.

Sleep Medicine Center, Charité-Universitätsmedizin, Berlin, Germany.

Sleep apnea is traditionally classified as obstructive sleep apnea (OSA), which occurs when the upper airway collapses due to the relaxation of oropharyngeal musculature, and central sleep apnea occurs when the brainstem cannot stimulate breathing. Most sleep apnea in patients with heart failure (HF) results from coexisting OSA and central sleep apnea (CSA), or complex sleep apnea syndrome. OSA and CSA are common in HF and can be involved in its progression by exposure to the heart to intermittent hypoxia, increased preload and afterload, activating sympathetic, and decreased vascular endothelial function. Read More

Kyobu Geka 2022 Jan;75(1):4-9

Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Tokyo Women's Medical University has a long history with leading development in the field of cardiovascular surgery in Japan, including ventricular assist device (VAD) and heart transplantation (HT). Our institute has performed implantable VAD implantation in 73 patients with refractory heart failure as a bridge to transplantation. The long-term survival rate of that showed 94%, 85%, and 61% in 1, 3, and 5 years, respectively. Read More

Eur J Heart Fail 2022 Apr 27;24(4):603-619. Epub 2022 Mar 27.

University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Novel pharmacologic treatment options reduce mortality and morbidity in a cost-effective manner in patients with heart failure (HF). Undisputedly, the effective implementation of these agents is an essential element of good clinical practice, which is endorsed by the European Society of Cardiology (ESC) guidelines on acute and chronic HF. Yet, physicians struggle to implement these therapies as they have to balance the true and/or perceived risks versus their substantial benefits in clinical practice. Read More

Rev Cardiovasc Med 2022 Feb;23(2):76

Cardio Center, IRCCS Humanitas Research Hospital, 20089 Rozzano-Milan, Italy.

Tricuspid regurgitation (TR) has a considerable prevalence in the overall population, that further increases in selected categories of patients. Three morphologic types of TR prevail, namely primary, secondary and atrial TR, mostly, but not always, occurring in different subsets of patients. Recent evidences demonstrate a negative impact of TR on outcomes, irrespective of etiology and even when less than severe in grading. Read More

JACC Cardiovasc Interv 2022 02;15(4):411-422

Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy.

Objectives: This study evaluated the incidence, management, and outcome of patients who experienced MitraClip (Abbott Vascular) failure secondary to loss of leaflet insertion (LLI), single leaflet detachment (SLD), or embolization.

Background: Transcatheter edge-to-edge repair with MitraClip is an established therapy for the treatment of mitral regurgitation (MR), but no data exist regarding the prevalence and outcome according to the mode of clip failure.

Methods: Between January 2009 and December 2020, we retrospectively screened 4,294 procedures of MitraClip performed in 19 centers. Read More

Circ Cardiovasc Imaging 2022 03 17;15(3):e000075. Epub 2022 Feb 17.

All patients surviving an acute aortic dissection require continued lifelong surveillance of their diseased aorta. Late complications, driven predominantly by chronic false lumen degeneration and aneurysm formation, often require surgical, endovascular, or hybrid interventions to treat or prevent aortic rupture. Imaging plays a central role in the medical decision-making of patients with chronic aortic dissection. Read More

Heart Lung Circ 2022 Feb 11. Epub 2022 Feb 11.

Department of Cardiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA. Electronic address:

Background: Specific aetiologies of cardiomyopathy can significantly impact treatment options as well as appropriateness and prioritisation for advanced heart failure therapies such as ventricular assist device (VAD) or orthotopic heart transplantation (OHT). We reviewed the tissue diagnoses of patients who underwent advanced therapies for heart failure (HF) to identify diagnostic discrepancies.

Methods: This study presents a retrospective cohort of the aetiology of cardiomyopathy in 118 patients receiving either durable VAD or OHT. Read More

J Clin Med 2022 Jan 31;11(3). Epub 2022 Jan 31.

Cardiac Surgery, Cardiovascular Department, University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.

Mechanical circulatory support and heart transplantation are established surgical options for treatment of advanced heart failure. Since the prevalence of advanced heart failure is progressively increasing, there is a clear need to treat more patients with mechanical circulatory support and to increase the number of heart transplantations. This narrative review summarizes recent progress in surgical treatment options of advanced heart failure and proposes an algorithm for treatment of the advanced heart failure patient at >65 years of age. Read More

Pol Arch Intern Med 2022 03 11;132(3). Epub 2022 Feb 11.

Department of Internal Medicine and Geriatric Cardiology, Center of Postgraduate Medical Education, Warsaw, Poland

Obesity is a chronic disease associated with increased metabolic and cardiovascular risk, excessive morbidity and mortality worldwide. The authors of the present consensus, clinicians representing medical specialties related to the treatment of obesity and its complications, reviewed a number of European and American guidelines, published mostly in 2019-2021, and summarized the principles of obesity management to provide a practical guidance considering the impact that increased adiposity poses to health. From a clinical perspective, the primary goal of obesity treatment is to prevent or slow down the progression of diseases associated with obesity, reduce metabolic and cardiovascular risk, and improve the quality of life by achieving adequate and stable weight reduction. Read More

ESC Heart Fail 2022 04 8;9(2):866-873. Epub 2022 Feb 8.

Department of Internal Medicine III, Division of Cardiology, University Hospital of Heidelberg, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.

Aims: Several new percutaneous tricuspid repair systems have recently been introduced as new treatment options for severe tricuspid regurgitation (TR). Clinical improvement following percutaneous tricuspid valve leaflet repair has been demonstrated by recent studies. A possible impact on exercise capacity has not yet been reported. Read More

JACC Cardiovasc Interv 2022 02 31;15(4):e39-e40. Epub 2022 Jan 31.

Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany; Dresden Cardiovascular Research Institute and Core Laboratories GmbH, Dresden, Germany.

J Am Coll Cardiol 2022 02;79(4):390-414

HCM Program, New York University Langone Health, New York, New York, USA.

Hypertrophic cardiomyopathy (HCM), a relatively common, globally distributed, and often inherited primary cardiac disease, has now transformed into a contemporary highly treatable condition with effective options that alter natural history along specific personalized adverse pathways at all ages. HCM patients with disease-related complications benefit from: matured risk stratification in which major markers reliably select patients for prophylactic defibrillators and prevention of arrhythmic sudden death; low risk to high benefit surgical myectomy (with percutaneous alcohol ablation a selective alternative) that reverses progressive heart failure caused by outflow obstruction; anticoagulation prophylaxis that prevents atrial fibrillation-related embolic stroke and ablation techniques that decrease the frequency of paroxysmal episodes; and occasionally, heart transplant for end-stage nonobstructive patients. Those innovations have substantially improved outcomes by significantly reducing morbidity and HCM-related mortality to 0. Read More