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Advances in Heart Valve Disease
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Advances in Heart Valve Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 July 2024 | Viewed by 5134

Special Issue Editor

Dr. Won-Keun Kim

E-Mail Website
Guest Editor
Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
Interests: coronary artery disease; cardiac imaging; heart failure; cardiology; echocardiography; heart; myocardial infarction; cardiac function; cardiac surgery; interventional cardiology

Special Issue Information

Dear Colleagues,  

With an ageing population, valvular heart disease (VHD) is a growing global burden. Transcatheter treatment options have emerged in the past two decades and have brought about a paradigm shift in the treatment of VHD, in particular for aortic valve disease. We have inaugurated a Special Issue that focuses on recent advances in the field of transcatheter aortic valve implantation and how those advances translate into contemporary clinical practice. To this end, we would like to invite state-of-the-art reviews, editorials, and original research in this area for inclusion in this Special Issue.

We look forward to your submissions!

Dr. Won-Keun Kim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • durability
  • prosthesis-patient mismatch
  • paravalvular leakage
  • coronary access
  • lifetime management
  • cerebral protection
  • conduction disturbance
  • commissural alignment
  • valve-in-valve

Published Papers (5 papers)

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Research

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11 pages, 1027 KiB  
Article
Infective Endocarditis in Belgium: Prospective Data in Adults from the ESC EORP European Endocarditis Registry
by Bram Roosens, Bernard Cosyns, Patrizio Lancellotti, Cécile Laroche, Christine Selton-Suty, Agnès Pasquet, Johan De Sutter, Philippe Unger, Bernard Paelinck, Paul Vermeersch, Andreea Motoc, Xavier Galloo, Bernard Iung, Gilbert Habib and on behalf of the EURO-ENDO Investigators Group
J. Clin. Med. 2024, 13(5), 1371; https://doi.org/10.3390/jcm13051371 - 28 Feb 2024
Viewed by 620
Abstract
(1) Background: infective endocarditis (IE) is a significant health concern associated with important morbidity and mortality. Only limited, often monocentric, retrospective data on IE in Belgium are available. This prospective study sought to assess the clinical characteristics and outcomes of Belgian IE patients [...] Read more.
(1) Background: infective endocarditis (IE) is a significant health concern associated with important morbidity and mortality. Only limited, often monocentric, retrospective data on IE in Belgium are available. This prospective study sought to assess the clinical characteristics and outcomes of Belgian IE patients in the ESC EORP European endocarditis (EURO-ENDO) registry; (2) Methods: 132 IE patients were identified based on the ESC 2015 criteria and included in six tertiary hospitals in Belgium; (3) Results: The average Belgian IE patient was male and 62.8 ± 14.9 years old. The native valve was most affected (56.8%), but prosthetic/repaired valves (34.1%) and intracardiac device-related (5.3%) IE are increasing. The most frequently identified microorganisms were S. aureus (37.2%), enterococci (15.5%), and S. viridans (15.5%). The most frequent complications were acute renal failure (36.2%) and embolic events (23.6%). Cardiac surgery was effectively performed when indicated in 71.7% of the cases. In-hospital mortality occurred in 15.7% of patients. Predictors of mortality in the multivariate analysis were S. aureus (HR = 2.99 [1.07–8.33], p = 0.036) and unperformed cardiac surgery when indicated (HR = 19.54 [1.91–200.17], p = 0.012). (4) Conclusion: This prospective EURO-ENDO ancillary analysis provides valuable contemporary insights into the profile, treatment, and clinical outcomes of IE patients in Belgium. Full article
(This article belongs to the Special Issue Advances in Heart Valve Disease)
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14 pages, 3303 KiB  
Article
Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients
by Caglayan Demirel, Christoph Fritz Rothenbühler, Markus Huber, Michelle Schweizer, Inga Todorski, David Alexander Gloor, Stephan Windecker, Jonas Lanz, Stefan Stortecky, Thomas Pilgrim and Gabor Erdoes
J. Clin. Med. 2024, 13(5), 1322; https://doi.org/10.3390/jcm13051322 - 26 Feb 2024
Viewed by 482
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a treatment option for severe aortic valve stenosis. Pre-TAVR assessments, extending beyond anatomy, include evaluating frailty. Potential frailty parameters in pre-TAVR computed tomography (CT) scans are not fully explored but could contribute to a comprehensive frailty [...] Read more.
Background: Transcatheter aortic valve replacement (TAVR) is a treatment option for severe aortic valve stenosis. Pre-TAVR assessments, extending beyond anatomy, include evaluating frailty. Potential frailty parameters in pre-TAVR computed tomography (CT) scans are not fully explored but could contribute to a comprehensive frailty assessment. The primary objective was to investigate the impact of total muscle area (TMA) and visceral adipose tissue (VAT) as frailty parameters on 5-year all-cause mortality in patients undergoing TAVR. Methods: Between 01/2017 and 12/2018, consecutive TAVR patients undergoing CT scans enabling TMA and VAT measurements were included. Results: A total of 500 patients qualified for combined TMA and VAT analysis. Age was not associated with a higher risk of 5-year mortality (HR 1.02, 95% CI: 0.998–1.049; p = 0.069). Body surface area normalized TMA (nTMA) was significantly associated with 5-year, all-cause mortality (HR 0.927, 95% CI: 0.927–0.997; p = 0.033), while VAT had no effect (HR 1.002, 95% CI: 0.99–1.015; p = 0.7). The effect of nTMA on 5-year, all-cause mortality was gender dependent: the protective effect of higher nTMA was found in male patients (pinteraction: sex × nTMA = 0.007). Conclusions: Normalized total muscle area derived from a routine CT scan before transcatheter aortic valve replacement complements frailty assessment in patients undergoing TAVR. Full article
(This article belongs to the Special Issue Advances in Heart Valve Disease)
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12 pages, 1165 KiB  
Article
Predictive Factors of Cardiac Mortality Following TEER in Patients with Secondary Mitral Regurgitation
by Teruhiko Imamura, Shuhei Tanaka, Ryuichi Ushijima, Nobuyuki Fukuda, Hiroshi Ueno, Koichiro Kinugawa, Shunsuke Kubo, Masanori Yamamoto, Mike Saji, Masahiko Asami, Yusuke Enta, Masaki Nakashima, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Yoshifumi Nakajima, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida and on behalf of the OCEAN-Mitral Investigatorsadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(3), 851; https://doi.org/10.3390/jcm13030851 - 01 Feb 2024
Viewed by 652
Abstract
Background: Transcatheter edge-to-edge mitral valve repair (TEER) has emerged as a viable approach to addressing substantial secondary mitral regurgitation. In the contemporary landscape where ultimate heart failure-specific therapies, such as cardiac replacement modalities, are available, prognosticating a high-risk cohort susceptible to early cardiac [...] Read more.
Background: Transcatheter edge-to-edge mitral valve repair (TEER) has emerged as a viable approach to addressing substantial secondary mitral regurgitation. In the contemporary landscape where ultimate heart failure-specific therapies, such as cardiac replacement modalities, are available, prognosticating a high-risk cohort susceptible to early cardiac mortality post-TEER is pivotal for formulating an effective therapeutic regimen. Methods: Our study encompassed individuals with secondary mitral regurgitation and chronic heart failure enlisted in the multi-center (Optimized CathEter vAlvular iNtervention (OCEAN)-Mitral registry. We conducted an assessment of baseline variables associated with cardiac death within one year following TEER. Results: Amongst the 1517 patients (median age: 78 years, 899 males), 101 experienced cardiac mortality during the 1-year observation period after undergoing TEER. Notably, a history of heart failure-related admissions within the preceding year, utilization of intravenous inotropes, and elevated plasma B-type natriuretic peptide levels emerged as independent prognosticators for the primary outcome (p < 0.05 for all). Subsequently, we devised a novel risk-scoring system encompassing these variables, which significantly stratified the cumulative incidence of the 1-year primary outcome (16%, 8%, and 4%, p < 0.001). Conclusions: Our study culminated in the development of a new risk-scoring system aimed at predicting 1-year cardiac mortality post-TEER. Full article
(This article belongs to the Special Issue Advances in Heart Valve Disease)
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11 pages, 2125 KiB  
Article
Procedural Outcomes of a Self-Expanding Transcatheter Heart Valve in Patients with Porcelain Aorta
by Clemens Eckel, Johannes Blumenstein, Christina Grothusen, Vedat Tiyerili, Albrecht Elsässer, Guido Dohmen, Anna Zeckzer, Luise Gaede, Yeong-Hoon Choi, Efstratios I. Charitos, Christian W. Hamm, Won-Keun Kim, Helge Möllmann and Matthias Renker
J. Clin. Med. 2023, 12(3), 945; https://doi.org/10.3390/jcm12030945 - 26 Jan 2023
Viewed by 1512
Abstract
Background: Severe calcification of the ascending aorta increases the peri-operative risk for neurological complications in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) seems to be an optimal treatment option in these patients. However, the impact of the extent of aortic [...] Read more.
Background: Severe calcification of the ascending aorta increases the peri-operative risk for neurological complications in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) seems to be an optimal treatment option in these patients. However, the impact of the extent of aortic calcification on procedural and neurological outcomes during TAVI is unclear. Methods: Data from 3010 patients with severe native aortic valve stenosis treated with ACURATE neo/neo2 from May 2012 to July 2022 were evaluated and matched by 2-to-1 nearest-neighbor matching to identify one patient with porcelain aorta (PA) (n = 492) compared with two patients without PA (n = 984). PA was additionally subdivided into circumferential (classic PA) (n = 89; 3.0%) and non-circumferential (partial PA) (n = 403; 13.4%) calcification. We compared outcomes according to VARC-3 criteria among patients with and without PA and identified predictors for occurrence of stroke in the overall population. Results: Technical success (88.5% vs. 87.4%, p = 0.589) and device success at 30 days (82.3% vs. 81.5%, p = 0.755) after transcatheter ACURATE neo/neo2 implantation according to VARC-3 definition was high and did not differ between non-calcified aortas or PA. The rate of in-hospital complications according to VARC-3-definitions was low in both groups. Rates of all stroke (3.2% (n = 31) vs. 2.6% (n = 13), p = 0.705) or transitory ischemic attacks (1.1% vs. 1.2%, p = 1.000) did not differ significantly. Thirty-day all-cause mortality did not differ (3.0% vs. 3.2%, RR 1.1; p = 0.775). Overall device migration/embolization (OR 5.0 [2.10;11.87]), severe bleeding (OR 1.79 [1.11;2.89]), and major structural cardiac complications (OR 3.37 [1.32;8.57]) were identified as independent predictors for in-hospital stroke in a multivariate analysis after implantation of ACURATE neo/neo2. Conclusion: A porcelain aorta does not increase the risk of neurological complications after transfemoral ACURATE neo/neo2 implantation. Based on these findings, transfemoral ACURATE neo/neo2 implantation is safe in these particularly vulnerable patients. Full article
(This article belongs to the Special Issue Advances in Heart Valve Disease)
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Review

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11 pages, 269 KiB  
Review
Invasive Functional Assessment of Coronary Artery Disease in Patients with Severe Aortic Stenosis in the TAVI Era
by Maren Weferling and Won-Keun Kim
J. Clin. Med. 2023, 12(16), 5414; https://doi.org/10.3390/jcm12165414 - 21 Aug 2023
Cited by 1 | Viewed by 1286
Abstract
Coronary artery disease (CAD) is a common finding in patients suffering from aortic valve stenosis (AS), with a prevalence of over 50% in patients 70 years of age or older. Transcatheter aortic valve intervention (TAVI) is the standard treatment option for patients with [...] Read more.
Coronary artery disease (CAD) is a common finding in patients suffering from aortic valve stenosis (AS), with a prevalence of over 50% in patients 70 years of age or older. Transcatheter aortic valve intervention (TAVI) is the standard treatment option for patients with severe AS and at least 75 years of age. Current guidelines recommend percutaneous coronary intervention (PCI) in patients planned for TAVI with stenoses of >70% in the proximal segments of non-left main coronary arteries and in >50% of left main stenoses. While the guidelines on myocardial revascularization clearly recommend functional assessment of coronary artery stenoses of less than 90% in the absence of non-invasive ischemia testing, a statement regarding invasive functional testing in AS patients with concomitant CAD is lacking in the recently published guideline on the management of valvular heart disease. This review aims to provide an overview of the hemodynamic background in AS patients, discusses and summarizes the current evidence of invasive functional testing in patients with severe AS, and gives a future perspective on the ongoing trials on that topic. Full article
(This article belongs to the Special Issue Advances in Heart Valve Disease)
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