Heart Valve Disease: Latest Advances and Prospects

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 5603

Special Issue Editors


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Guest Editor
Cardiac Surgery Unit, Clinical and Experimental Department, University of Florence, 50121 Florence, Italy
Interests: cardiovascular surgery; cardiac surgery; aortic diseases; mitral valve annuloplasty; transcatheter aortic valve implantation

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Guest Editor
Cardiac Surgery F.U., Experimental and Clinical Medicine Department, University of Florence, 50134 Firenze, Italy
Interests: aortic valve disease; electrophysiology/arrhythmia; cardiac; heart failure

Special Issue Information

Dear Colleagues,

Valvular heart disease is a leading cause of cardiovascular morbidity and mortality worldwide, and the resultant disease burden is only projected to increase. In the last few decades, the treatment of valve pathologies has been transformed by advances in medical technology. The development of diagnostic tools and an enhanced clinical understanding of pathophysiology have allowed us to re-examine long-held ideas and think up new possible solutions in this area. A variety of novel, minimally invasive, and transcatheter methods have been developed. In this new Special Issue, we review the latest advances in diagnosis, preoperative planning, and management in the field of heart valve disease and look to future possibilities to discover better treatment solutions.

We look forward to articles and reviews presenting the latest developments in heart valve disease.

Dr. Beatrice Bacchi
Prof. Dr. Massimo Bonacchi
Guest Editors

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Keywords

  • valve repair
  • valve replacement
  • minimally invasive valve surgery
  • robotic valve surgery
  • ross procedure
  • bicuspid aortic valve
  • prosthetic heart valve
  • tissue-engineered heart valve
  • transcatheter valve procedures
  • heart valve pathophysiology
  • heart valve preoperative planning
  • heart valve instrumental diagnosis
  • artificial intelligence for diagnosis
  • heart valve interventions
  • heart valve diseases

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Published Papers (3 papers)

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Research

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16 pages, 1686 KiB  
Article
Clinical Outcomes and Cost Analysis in Patients with Heart Failure Undergoing Transcatheter Edge-to-Edge Repair for Mitral Valve Regurgitation
by Aleksander Dokollari, Serge Sicouri, Roberto Rodriguez, Eric Gnall, Paul Coady, Farah Mahmud, Stephanie Kjelstrom, Georgia Montone, Yoshiyuki Yamashita, Jarrett Harish, Beatrice Bacchi, Rakesh C Arora, Ashish Shah, Nitin Ghorpade, Sandra Abramson, Katie Hawthorne, Scott Goldman, William Gray, Francesco Cabrucci, Massimo Bonacchi and Basel Ramlawiadd Show full author list remove Hide full author list
J. Pers. Med. 2024, 14(9), 978; https://doi.org/10.3390/jpm14090978 - 15 Sep 2024
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Abstract
Objective: To analyze the clinical and cost outcomes of transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) in heart failure (HF) patients. Methods: All 162 HF patients undergoing TEER for MR between January 2019 and March 2023 were included. A propensity-adjusted analysis was [...] Read more.
Objective: To analyze the clinical and cost outcomes of transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) in heart failure (HF) patients. Methods: All 162 HF patients undergoing TEER for MR between January 2019 and March 2023 were included. A propensity-adjusted analysis was used to compare 32 systolic vs. 97 diastolic vs. 33 mixed (systolic + diastolic) HF patients. Systolic, diastolic, and mixed HF patients were defined according to AHA guidelines. The primary outcome was the long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events (MACCEs, all-cause mortality + stroke + myocardial infarction + repeat intervention). Results: The mean age was 76.3 vs. 80.9 vs. 76 years old, and the mean ejection fraction (EF) was 39.5% vs. 59.8% vs. 39.7% in systolic vs. diastolic vs. mixed HF, respectively. Postoperatively, the diastolic vs. systolic HF group had a higher intensive care unit stay (21 vs. 0 h; HR 67.5 (23.7, 111.4)]; lower ventilation time [2 vs. 2.3 h; HR 49.4 (8.6, 90.2)]; lower EF [38% vs. 58.5%; HR 9.9 (3.7, 16.1)]. In addition, the diastolic vs. mixed HF groups had a lower incidence of EF < 50% (11 vs. 27 patients; HR 6.6 (1.6, 27.3) and a lower use of dialysis (one vs. three patients; HR 18.1 (1.1, 287.3), respectively. At a mean 1.6 years follow-up, all-cause death [HR 39.8 (26.2, 60.5)], MACCEs [HR 50.3 (33.7–75.1)], and new pacemaker implantations [HR 17.3 (8.7, 34.6)] were higher in the mixed group. There was no significant total hospital cost difference among the systolic (USD 106,859) vs. diastolic (USD 91,731) vs. mixed (USD 120,522) HF groups (p = 0.08). Conclusions: TEER for MR evidenced the worst postoperative and follow-up clinical outcomes in the mixed HF group compared to diastolic and systolic HF groups. No total hospital cost differences were observed. Full article
(This article belongs to the Special Issue Heart Valve Disease: Latest Advances and Prospects)
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14 pages, 294 KiB  
Article
Inflammatory Response Genes’ Polymorphism Associated with Risk of Rheumatic Heart Disease
by Anna Sinitskaya, Maria Khutornaya, Oksana Hryachkova, Maxim Asanov, Alyona Poddubnyak, Anastasia Ponasenko and Maxim Sinitsky
J. Pers. Med. 2024, 14(7), 753; https://doi.org/10.3390/jpm14070753 - 15 Jul 2024
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Abstract
Rheumatic heart disease (RHD) caused by group A streptococcus infection is one of the most important reasons of cardiovascular morbidity and mortality in low- and middle-income countries. Aberrant host immune response modulated by polymorphisms in inflammatory response genes plays an important role in [...] Read more.
Rheumatic heart disease (RHD) caused by group A streptococcus infection is one of the most important reasons of cardiovascular morbidity and mortality in low- and middle-income countries. Aberrant host immune response modulated by polymorphisms in inflammatory response genes plays an important role in RHD pathogenesis. This study aimed to determine risk-associated polymorphic variants in inflammatory response genes in Caucasian RHD patients. A total of 251 Caucasian RHD patients and 300 healthy donors were recruited for this study, and 27 polymorphic sites in 12 genes (TLR1, TLR2, TLR4, TLR6, IL1B, IL6R, IL6, IL10, IL12RB1, IL12B, TNF and CRP) were analyzed using allele-specific PCR. It was demonstrated that the polymorphic variants rs1800871 and rs1800872 in the IL10 gene, rs 1130864, rs3093077 and rs1205 in the CRP gene, rs375947 in the IL12RB1 gene, rs 5743551 and rs5743611 in the TLR1 gene, and rs3775073 in the TLR6 gene can modify RHD risk in a gender- and age-dependent manner. The obtained results can be used to determine the personalized risk of RHD in healthy donors during medical examination or screening, as well as to develop appropriate early prevention strategies targeting RHD in the risk groups. Full article
(This article belongs to the Special Issue Heart Valve Disease: Latest Advances and Prospects)

Review

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11 pages, 440 KiB  
Review
Short and Long-Term Outcomes of Transcatheter Aortic Valve Implantation in the Small Aortic Annulus: A Systematic Literature Review
by Francesco Cabrucci, Massimo Baudo, Yoshiyuki Yamashita, Aleksander Dokollari, Serge Sicouri and Basel Ramlawi
J. Pers. Med. 2024, 14(9), 937; https://doi.org/10.3390/jpm14090937 - 2 Sep 2024
Cited by 3 | Viewed by 1621
Abstract
Transcatheter aortic valve implantation has revolutionized the treatment of aortic stenosis. The small aortic annulus is one of the most challenging aspects of aortic stenosis treatment and since the beginning, TAVI has shown promising results in this subgroup of patients. This systematic literature [...] Read more.
Transcatheter aortic valve implantation has revolutionized the treatment of aortic stenosis. The small aortic annulus is one of the most challenging aspects of aortic stenosis treatment and since the beginning, TAVI has shown promising results in this subgroup of patients. This systematic literature review aims to investigate the short and long-term outcomes of TAVI in the small aortic annulus. The literature was meticulously screened for this topic until April 2024 using the PRISMA guidelines. Technical aspects, characteristics of this subgroup of patients, hemodynamic performances, and outcomes are discussed. The importance of device selection has shown up, with insight into the differences between self-expandable and the balloon-expandable valves. Two special populations were also taken into account: outcomes of TAVI in the small aortic annulus with bicuspid aortic valve and extra-small aortic annulus. The last 10 years have been paramount in technological advancements, bringing TAVI to broader use in this population. While several important trials underscored the usefulness of TAVI in the small aortic annulus population, the clinical practice still lacks consensus on the ideal device, and the outcomes are debated. The pivotal role of TAVI in this context needs to be addressed with a patient-tailored approach to optimize patient care. Full article
(This article belongs to the Special Issue Heart Valve Disease: Latest Advances and Prospects)
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