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Medicina
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Transcatheter Therapies for Valvular Heart Disease
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Transcatheter Therapies for Valvular Heart Disease

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1886

Special Issue Editors

Dr. Massimo Baudo

E-Mail Website
Guest Editor
Lankenau Institute for Medical Research, Wynnewood, PA, USA
Interests: cardiothoracic surgery; minimally invasive surgery; aortic valve; mitral valve
Dr. Basel Ramlawi

E-Mail Website
Guest Editor
Lankenau Medical Center, 100 E Lancaster Avenue, Wynnewood, PA 19096, USA
Interests: cardiothoracic surgery; heart and vascular; valve repair
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Transcatheter valvular interventions have transformed the treatment of valvular heart disease. These procedures are particularly attractive due to their minimally invasive nature, fewer complications during and after the procedure, quicker recovery times, and reduced hospital stay.

Nowadays, every heart valve—from the aortic to the pulmonary—has a possible transcatheter option. This broad range of transcatheter solutions allows for tailored treatments for various types of valvular heart disease, enhancing patient outcomes and expanding the options available to clinicians.

The main aim of this Special Issue of Medicina is to showcase the cutting-edge evidence of such rapidly evolving technology. This Special Issue is open to studies on transcatheter interventions on any of the heart’s valves that provide new insight into this field. Papers focused on clinical outcomes, new interventional approaches, and systematic reviews with or without meta-analysis are strongly encouraged.

Dr. Massimo Baudo
Dr. Basel Ramlawi
Guest Editors

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • aortic valve transcatheter interventions
  • mitral valve transcatheter interventions
  • tricuspid valve transcatheter interventions
  • pulmonary valve transcatheter interventions
  • transcatheter aortic valve intervention/replacement
  • mitral transcatheter edge-to-edge repair
  • transcatheter mitral valve replacement
  • percutaneous annuloplasty
  • tricuspid transcatheter edge-to-edge repair
  • transcatheter pulmonary valve replacement

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Published Papers (3 papers)

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Research

13 pages, 568 KiB  
Article
Impact of Institutional Monthly Volume of Transcatheter Edge-to-Edge Repair Procedures for Significant Mitral Regurgitation: Evidence from the GIOTTO-VAT Study
by Nicola Corcione, Paolo Ferraro, Filippo Finizio, Michele Cimmino, Michele Albanese, Alberto Morello, Giuseppe Biondi-Zoccai, Paolo Denti, Antonio Popolo Rubbio, Francesco Bedogni, Antonio L. Bartorelli, Annalisa Mongiardo, Salvatore Giordano, Francesco De Felice, Marianna Adamo, Matteo Montorfano, Francesco Maisano, Giuseppe Tarantini, Francesco Giannini, Federico Ronco, Emmanuel Villa, Maurizio Ferrario, Luigi Fiocca, Fausto Castriota, Angelo Squeri, Martino Pepe, Corrado Tamburino and Arturo Giordanoadd Show full author list remove Hide full author list
Medicina 2025, 61(5), 904; https://doi.org/10.3390/medicina61050904 - 16 May 2025
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Abstract
Background and Objectives: Mitral valve transcatheter edge-to-edge repair (TEER) is a widely adopted therapeutic approach for managing significant mitral regurgitation (MR) in high-risk surgical candidates. While procedural safety and efficacy have been demonstrated, the impact of institutional expertise on outcomes remains unclear. [...] Read more.
Background and Objectives: Mitral valve transcatheter edge-to-edge repair (TEER) is a widely adopted therapeutic approach for managing significant mitral regurgitation (MR) in high-risk surgical candidates. While procedural safety and efficacy have been demonstrated, the impact of institutional expertise on outcomes remains unclear. We aimed at evaluating whether the institutional monthly volume of TEER influences short- and long-term clinical results. Materials and Methods: This analysis from the multicenter, prospective GIOTTO trial study evaluated the impact of institutional monthly volume on outcomes of TEER to remedy significant mitral regurgitation. Centers were stratified into tertiles based on monthly volumes (≤2.0 cases/month, 2.1–3.5 cases/month, >3.5 cases/month), and key clinical, echocardiographic, and procedural outcomes were analyzed. Statistical analysis was based on standard bivariate tests as well as unadjusted and multivariable adjusted Cox models. Results: A total of 2213 patients were included, stratified into tertiles based on institutional procedural volume: 645 (29.1%) patients in the first tertile, 947 (42.8%) patients in the second tertile, and 621 (28.1%) patients in the third tertile. Several baseline differences were found, with some features disfavoring less busy centers (e.g., functional class and surgical risk, both p < 0.05), and others suggesting a worse risk profile in those treated in busier institutions (e.g., frailty and history of prior mitral valve intervention, both p < 0.05). Procedural success rates were higher in busier centers (p < 0.001), and hospital stay was also shorter there (p < 0.001). Long-term follow-up (median 14 months) suggested worse outcomes in patients treated in less busy centers at unadjusted analysis (e.g., p = 0.018 for death, p = 0.015 for cardiac death, p = 0.014 for death or hospitalization for heart failure, p < 0.001 for cardiac death or hospitalization for heart failure), even if these associations proved no longer significant after multivariable adjustment, except for cardiac death or hospitalization for heart failure, which appeared significantly less common in the busiest centers (p < 0.05). Similar trends were observed when focusing on tertiles of overall center volume and when comparing for each center the first 50 cases with the following ones. Conclusions: High institutional monthly volume of TEER mitral valve repair appears to correlate with an improved procedural success rate and shorter hospitalizations. Similarly favorable results were found for long-term rates of cardiac death or hospitalization for heart failure. These findings inform on the importance of operator experience and center expertise in achieving state-of-the-art results with TEER, while confirming the usefulness of the proctoring approach when naïve centers begin a TEER program. Full article
(This article belongs to the Special Issue Transcatheter Therapies for Valvular Heart Disease)
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14 pages, 1804 KiB  
Article
Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation
by Massimo Baudo, Serge Sicouri, Francesco Cabrucci, Yoshiyuki Yamashita, Dimitrios E. Magouliotis, Sarah M. Carnila, Sandra V. Abramson, Katie M. Hawthorne, Harish Jarrett, Roberto Rodriguez, Scott M. Goldman, Paul M. Coady, Eric M. Gnall, William A. Gray, Sandro Gelsomino and Basel Ramlawi
Medicina 2025, 61(4), 686; https://doi.org/10.3390/medicina61040686 - 9 Apr 2025
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Abstract
Background and Objectives: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess the evolution of moderate MR following TAVI. [...] Read more.
Background and Objectives: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess the evolution of moderate MR following TAVI. Materials and Methods: Between 2018 and 2023, 1476 patients underwent TAVI. We excluded those with previous aortic or mitral valve interventions, endocarditis, concomitant percutaneous coronary intervention, or emergent procedures. Patients with severe aortic or tricuspid regurgitation or significant mitral stenosis were excluded. Ultimately, only patients with moderate MR were included, resulting in a final population of 154 patients. Results: Mean age was 81.4 ± 7.8 years, 48.1% (74/154) were female, and 48.1% (74/154) were functional MR. There was one surgical conversion due to annular rupture. Thirty-day mortality was 1.9% (3/154). Postoperative echocardiography showed 38 (24.7%) patients with none/trace MR, 91 (59.1%) with mild MR, 22 (14.3%) with moderate MR, and 3 (1.9%) with severe MR. Finally, according to the echocardiographic follow-up [median follow-up 1.0 (IQR: 0.1–1.2) years], 20.1% (31/154) had no/trace MR, 39.6% (61/154) had mild MR, 35.7% (55/154) had moderate MR, and 4.5% (7/154) had severe MR. Overall, 67 (43.5%) patients had any MR grade progression, 62 (40.3%) had stable disease, and 25 (16.2%) had any MR grade reduction at the last follow-up from the operation. No difference in MR evolution was seen between functional and primary MR. Conclusions: Concomitant moderate MR during TAVI has a variable evolution over time. A more detailed characterization of patients with preoperative moderate MR undergoing TAVI is necessary to identify those with a disease progression risk. Full article
(This article belongs to the Special Issue Transcatheter Therapies for Valvular Heart Disease)
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11 pages, 560 KiB  
Article
Predictive Factors of Cardiac Function Recovery and Mortality in Patients with Reduced Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation
by Murat Can Güney, Hakan Süygün, Melike Polat, Hüseyin Ayhan, Telat Keleş, Zeynep Şeyma Turinay Ertop, Betül Banu Karasu and Engin Bozkurt
Medicina 2025, 61(2), 266; https://doi.org/10.3390/medicina61020266 - 4 Feb 2025
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Abstract
Background and Objectives: Patients with reduced left ventricular ejection fraction (LVEF) are reported to have unfavorable outcomes following transcatheter aortic valve implantation (TAVI). This study aims to evaluate outcomes and identify predictive factors for LVEF recovery following TAVI in patients with reduced [...] Read more.
Background and Objectives: Patients with reduced left ventricular ejection fraction (LVEF) are reported to have unfavorable outcomes following transcatheter aortic valve implantation (TAVI). This study aims to evaluate outcomes and identify predictive factors for LVEF recovery following TAVI in patients with reduced LVEF. Materials and Methods: This retrospective study analyzed 114 patients with symptomatic severe aortic stenosis (AS) with LVEF < 40% who underwent TAVI between 2011 and 2023 at two centers. Echocardiographic parameters, including LVEF, ventricular dimensions, and relative wall thickness (RWT), were assessed at baseline and during follow-up. The outcomes and predictors of substantial LVEF improvement and mortality were analyzed using univariate and multivariate logistic regression methods. Results: Anemia (OR = 4.345, 95% CI: 1.208–15.626, p = 0.024), RWT (OR = 1.224, 95% CI: 1.064–1.407, p = 0.005), and early post-procedural changes in left ventricular end-systolic dimension (LVESD) (OR = 1.297, 95% CI: 1.037–1.622, p = 0.023) and left ventricular end-diastolic dimension (LVEDD) (OR = 1.346, 95% CI: 1.034–1.753, p = 0.027) at one-month follow-up were identified as significant factors associated with LVEF recovery at one year. Regarding factors related to mortality, higher baseline AVMG levels were associated with a lower probability of death after one year (OR = 0.926, 95% CI: 0.875–0.979, p = 0.007). Conversely, a more limited increase in LVEF from baseline to the final follow-up was linked to poor prognosis and higher mortality at one year (95% CI: 1.045–1.594, p = 0.018). Conclusions: This study demonstrated that TAVI in patients with AS and reduced LVEF can be performed with high procedural success, low mortality, and significant improvement in cardiac function during follow-up. Additionally, anemia, baseline RWT, and early post-procedural changes in LVESD and LVEDD were identified as factors associated with LVEF recovery. Baseline AVMG and changes in LVEF at the final follow-up were found to be significant predictors of total mortality. Full article
(This article belongs to the Special Issue Transcatheter Therapies for Valvular Heart Disease)
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