Review
Pharmacology & Pharmacy
Harish Sharma, Shazia Afzal, Juergen Leick, Nikos Werner, Sagar N. Doshi, M. Adnan Nadir
Summary: This review aims to provide clinicians with guidance on the optimal antithrombotic strategy post-TAVR, taking into consideration different patient populations and the limitations of existing guidelines.
PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Cardiac & Cardiovascular Systems
Alberto Alperi, Josep Rodes-Cabau, Matheus Simonato, Didier Tchetche, Gaetan Charbonnier, Henrique B. Ribeiro, Azeem Latib, Matteo Montorfano, Marco Barbanti, Sabine Bleiziffer, Bjorn Redfors, Mohamed Abdel-Wahab, Abdelhakim Allali, Giuseppe Bruschi, Massimo Napodano, Marco Agrifoglio, Anna Sonia Petronio, Cristina Giannini, Albert Chan, Ran Kornowski, Nili Schamroth Pravda, Matti Adam, Alessandro Iadanza, Stephane Noble, Andrew Chatfield, Magdalena Erlebach, Joerg Kempfert, Timm Ubben, Harindra Wijeysundera, Moritz Seiffert, Thomas Pilgrim, Won-Keun Kim, Luca Testa, David Hildick-Smith, Roberto Nerla, Claudia Fiorina, Christina Brinkmann, Lars Conzelmann, Didier Champagnac, Francesco Saia, Henrik Nissen, Hafid Amrane, Brian Whisenant, Jasmin Shamekhi, Lars Sondergaard, John G. Webb, Danny Dvir
Summary: In a large series of ViV-TAVR procedures, the incidence of periprocedural PPI was relatively low and decreased with the use of new-generation THV systems. Older age, larger THV size, and previous right bundle branch block were associated with an increased risk of PPI. Although there were no significant differences in 30-day mortality between the PPI and no-PPI groups, PPI patients exhibited a trend toward higher mortality risk at follow-up.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Adil Wani, Daniel R. Harland, Tanvir K. Bajwa, Stacie Kroboth, Khawaja Afzal Ammar, Suhail Q. Allaqaband, Sue Duval, Bijoy K. Khandheria, A. Jamil Tajik, Renuka Jain
Summary: By analyzing patients with different subtypes of severe AS after TAVR, it was found that myocardial mechanics improved post-TAVR and the recovery of GLS was associated with a survival benefit. Patients with low-flow AS showed significant improvement in GLS post-TAVR, but still had impaired function.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, General & Internal
Camille Granger, Paul Guedeney, Jean-Philippe Collet
Summary: Transcatheter aortic valve replacement (TAVR) has expanded to lower-risk patients with aortic stenosis, but the optimal antithrombotic regimen is still a priority. Single antiplatelet therapy (SAPT) has shown lower bleeding rates compared to dual antiplatelet therapy (DAPT) in patients without an indication for anticoagulation. Patients requiring lifelong oral anticoagulation (OAC) are at higher risk of bleeding events with OAC plus antiplatelet therapy, without any advantages on mortality or ischemic outcomes. Guidelines now recommend SAPT and OAC alone for TAVR patients without and with a long-term indication for anticoagulation.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Phillip M. Trusty, Sanchita S. Bhat, Vahid Sadri, Md Tausif Salim, Emelia Funnell, Norihiko Kamioka, Rahul Sharma, Raj Makkar, Vasilis Babaliaros, Ajit P. Yoganathan
Summary: This study is the first patient-specific study that correlates flow stasis with thrombus volume in the neosinus post-transcatheter aortic valve replacement, covering multiple valve types and sizes. The results show a significant positive correlation between flow stasis and thrombus volume. Neosinus-specific factors lead to hemodynamic and thrombotic variability among individual patients. Measurement of neosinus flow stasis may guide strategies to improve outcomes in transcatheter aortic valve replacement.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Matthias Bogyi, Rudiger E. Schernthaner, Christian Loewe, Gloria M. Gager, Al Medina Dizdarevic, Christina Kronberger, Marek Postula, Jacek Legutko, Poonam Velagapudi, Christian Hengstenberg, Jolanta M. Siller-Matula
Summary: This meta-analysis evaluated the clinical relevance of subclinical leaflet thrombosis (SLT) post transcatheter aortic valve replacement. The use of intra-annular valves was associated with a higher risk of SLT, while oral anticoagulation showed a significant risk reduction. Further studies are needed to assess the long-term effects of screening tests and antithrombotic therapy on valve functionality and clinical prognosis.
JACC-CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Cardiac & Cardiovascular Systems
Hashrul N. Rashid, Michael Michail, Jaineel Ramnarain, Arthur Nasis, Stephen J. Nicholls, James D. Cameron, Robert P. Gooley
Summary: This study found that HALT is an independent predictor of haemodynamic valve deterioration (HVD), and specific depth and area thresholds were identified to predict HVD. CT following TAVR can determine patients at risk of HVD.
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
(2022)
Article
Cardiac & Cardiovascular Systems
Miho Fukui, Vinayak N. Bapat, Santiago Garcia, Marshall W. Dworak, Go Hashimoto, Hirotomo Sato, Mario Gossl, Maurice Enriquez-Sarano, John R. Lesser, Joao L. Cavalcante, Paul Sorajja
Summary: This study found that frame deformation, asymmetric leaflet, and smaller neosinus volume are associated with the occurrence of HALT in patients undergoing TAVR. The presence of HALT is associated with an increased risk of mortality within 1 year.
Review
Cardiac & Cardiovascular Systems
Thomas J. Cahill, Ajay J. Kirtane, Martin Leon, Susheel K. Kodali
Summary: OAC has been shown effective at preventing subclinical leaflet thrombosis, but overall it does not provide clinical benefits and may be harmful to some patients due to bleeding risk.
Article
Cardiac & Cardiovascular Systems
Marco Moscarelli, Rosa Prestera, Vincenzo Pernice, Sabrina Milo, Francesco Violante, Federico Cuffari, Claudia Di Pasquale, Angelo Ferlisi, Giuseppe Speziale, Gianni D. Angelini, Khalil Fattouch
Summary: This meta-analysis examined the incidence of subclinical leaflets valve thrombosis (SLT) after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR), the association with anticoagulation therapy, and the risk for neurological events. The study found that SLT was more common after TAVR compared to SAVR, and oral anticoagulation therapy reduced the incidence of SLT. However, SLT was not associated with an increased risk for neurological events.
AMERICAN JOURNAL OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Hashrul N. Rashid, Ronak Rajani, Jonathon Leipsic, Pal Maurovitch-Horvat, Tiffany Patterson, Simon Redwood, Jack Lee, Harriet Hurrell, Stephen J. Nicholls, Arthur Nasis, Sujith Seneviratne, James D. Cameron, Bernard Prendergast, Robert P. Gooley
Summary: Subclinical leaflet thrombosis (LT) can occur after surgical and transcatheter aortic valve replacement, and computed tomography (CT) has become a reliable imaging modality for diagnosing this condition. However, the experience in utilizing CT imaging for subclinical LT is limited but growing. This review emphasizes a systematic approach to acquiring and analyzing CT imaging for subclinical LT, highlighting the clinical consequences of subclinical LT and the implications for anti-thrombotic treatment after diagnosis.
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
(2023)
Article
Mechanics
Jihun Kang, Hyun Jung Koo, Dong Hyun Yang, Hojin Ha
Summary: This study investigates the mechanism of thrombus formation after transcatheter aortic valve implantation (TAVI) and suggests that patients with long native leaflets in their aortic sinus are at a higher risk of thrombosis and may require additional treatment.
Review
Cardiac & Cardiovascular Systems
Ofir Koren, Vivek Patel, Tarun Chakravarty, Hasan Jilaihawi, Aakriti Gupta, Shirin Sadri, Raj R. Makkar
Summary: Transcatheter aortic valve intervention (TAVR) has emerged as an alternative to surgical aortic valve replacement for severe aortic stenosis. Leaflet thrombosis, which refers to blood clot formation on bioprosthetic valve leaflets, can affect valve function and patient outcomes. This study provides an overview of the mechanisms, prevention strategies, and treatment options for leaflet thrombosis in TAVR.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Mi Hee Jang, Jung-Min Ahn, Do-Yoon Kang, Kyung Won Kim, Hyun Jung Koo, Dong Hyun Yang, Seung Chai Jung, Byungjun Kim, Yiu Tung Anthony Wong, Cheung Chi Simon Lam, Wei-Hsian Yin, Jeng Wei, Yung-Tsai Lee, Hsien-Li Kao, Mao-Shin Lin, Tsung-Yu Ko, Won-Jang Kim, Se Hun Kang, Euihong Ko, Seung-Ah Lee, Dae-Hee Kim, Hoyun Kim, Yeonwoo Choi, Jinho Lee, Seung-Jung Park, Duk-Woo Park
Summary: In patients who underwent successful transcatheter aortic valve replacement (TAVR), the presence of subclinical leaflet thrombosis did not significantly affect valve hemodynamic status and was not a predictor of structural valve deterioration. Further long-term follow-up is needed to evaluate its impact on valve durability.
Article
Engineering, Biomedical
Dong Qiu, Ali N. Azadani
Summary: This study investigates the impact of regional stent under-expansion on leaflet kinematics, leaflet structural characteristics, and the likelihood of leaflet thrombosis following transcatheter aortic valve replacement (TAVR). The results show that regional TAV frame under-expansion impairs leaflet motion and increases mechanical stress, which can lead to blood stasis and tissue degeneration. Post-procedural balloon dilatation of TAVs could be beneficial in reducing leaflet distortion and normalizing leaflet stress distribution.
INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING
(2022)
Article
Biophysics
Nathan D. Camarillo, Rafael Jimenez-Silva, Frances T. Sheehan
Summary: This article discusses the statistical dependence between multiple measurements from the same participant and provides recommendations for using these measurements when they are not independent.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
J. Huet, A. -S. Boureau, A. Sarcher, C. Cornu, A. Nordez
Summary: Standard compression in freehand 3D ultrasound induces a bias in volume calculations, but minimal compression and gel pad methods have similar results. With a trained examiner and precautions, the bias can be minimized and become acceptable in clinical applications.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
C. Lariviere, A. H. Eskandari, H. Mecheri, F. Ghezelbash, D. Gagnon, A. Shirazi-Adl
Summary: Recent developments in musculoskeletal modeling have focused on model customization. Personalization of the spine profile may affect estimates of spinal loading and stability. This study investigates the biomechanical consequences of changes in the spinal profile and finds that personalizing the spine profile has medium to large effects on trunk muscle forces and negligible to small effects on spinal loading and stability.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
Luke T. Mattar, Arash B. Mahboobin, Adam J. Popchak, William J. Anderst, Volker Musahl, James J. Irrgang, Richard E. Debski
Summary: Exercise therapy fails in about 25.0% of cases for individuals with rotator cuff tears, and one reason for this failure may be the inability to strengthen and balance the muscle forces that keep the humeral head in the correct position. This study developed computational musculoskeletal models to compare the net muscle force before and after exercise therapy between successfully and unsuccessfully treated patients. The study found that unsuccessfully treated patients had less inferiorly oriented net muscle forces, which may increase the risk of impingement.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
Natsuki Sado, Takeshi Edagawa, Toshihide Fujimori, Shogo Hashimoto, Yoshikazu Okamoto, Takahito Nakajima
Summary: The existing methods for predicting hip and lumbosacral joint centres in Japanese adults are biased and differ between sexes. We propose new regression equations that consider soft-tissue thickness, sex differences, and a height-directional measure, and validate them using leave-one-out cross-validation.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
Peimin Yu, Xuanzhen Cen, Qichang Mei, Alan Wang, Yaodong Gu, Justin Fernandez
Summary: This study aimed to explore the intra-foot biomechanical differences among individuals with chronic ankle instability (CAI), copers, and healthy individuals during dynamic tasks. The study found that copers and CAI individuals had smaller dorsiflexion angles and copers presented a more eversion position compared to healthy participants. Copers also had greater dorsiflexion angles in the metatarsophalangeal joint and more inversion moments in the subtalar joint during certain tasks. These findings can help in designing interventions to restore ankle joint functions in CAI individuals.
JOURNAL OF BIOMECHANICS
(2024)
Article
Biophysics
Jon Skovgaard Jensen, Anders Holsgaard-Larsen, Anders Stengaard Sorensen, Per Aagaard, Jens Bojsen-Moller
Summary: This study investigates the biomechanical effects of robot-assisted body weight unloading (BWU) on gait patterns in healthy young adults. The results show that dynamic robot-assisted BWU enables reduced kinetic requirements without distorting biomechanically normal gait patterns during overground walking.
JOURNAL OF BIOMECHANICS
(2024)