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Medical Sciences
Special Issues
Traditional Surgery and Minimally Invasive Approaches to Valvular Heart Disease
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Traditional Surgery and Minimally Invasive Approaches to Valvular Heart Disease

A special issue of Medical Sciences (ISSN 2076-3271).

Deadline for manuscript submissions: 28 June 2026 | Viewed by 2212

Special Issue Editor

Dr. Paolo Nardi

E-Mail Website
Guest Editor
Cardiac Surgery Division, Tor Vergata University Hospital, Tor Vergata University of Rome, 00133 Rome, Italy
Interests: regenerative therapy for myocardial infarction; coronary artery bypass grafting; myocardial protection; ascending aortic aneurysms: genetic role and aortic wall stress; ascending aorta surgery; adult cardiac surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is a great honor for me to participate as Guest Editor for the Special Issue of the prestigious journal Medical Sciences. The Special Issue aims to analyze the results of traditional aortic valve replacement surgery and to address the issues related to the new micro-invasive aortic valve replacement techniques, i.e., TAVR, as well as mini-invasive (thoracotomy access, rapid deployment or sutureless valve implantation), in order to offer each patient all the valid options for the best possible treatment of aortic valve disease. At the same time, the Special Issue aims to focus also on the technical aspects and the results of mitral valve repair surgery with both minimally invasive and traditional approaches, as well as the treatment of tricuspid diseases.

Dr. Paolo Nardi
Guest Editor

Manuscript Submission Information

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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. Medical Sciences is an international peer-reviewed open access quarterly 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 1600 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 surgery
  • Aortic valve replacement surgery
  • trans-catheter aortic valve replacement
  • minimally invasive approaches to heart valve replacement
  • rapid deployment aortic valve prostheses

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Published Papers (2 papers)

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Research

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18 pages, 2664 KB  
Article
Incidence of Post-Procedural Conduction Disturbances and Rates of Permanent Pacemaker Implantation in Older and Newer Generations of Transcatheter Aortic Heart Valves
by Mostafa Salem, Philipp Laing, Insa Kühling-thees, Wiebke Kasper, Jakob Voran, Hatim Seoudy, Rafael Rangel, Johanne Frank, Derk Frank and Mohammed Saad
Med. Sci. 2025, 13(4), 296; https://doi.org/10.3390/medsci13040296 - 30 Nov 2025
Viewed by 177
Abstract
Objective: This analysis compares new (G2) versus old (G1) generations of transcatheter heart valves (THVs) in transcatheter aortic valve replacement (TAVR) procedures, focusing on key outcomes: post-procedural conduction disturbance (CD) and permanent pacemaker implantation (PPMI). We aim to determine whether G2 valves reduce [...] Read more.
Objective: This analysis compares new (G2) versus old (G1) generations of transcatheter heart valves (THVs) in transcatheter aortic valve replacement (TAVR) procedures, focusing on key outcomes: post-procedural conduction disturbance (CD) and permanent pacemaker implantation (PPMI). We aim to determine whether G2 valves reduce these specific complications and thereby improve patient outcomes compared with G1. Methods: From February 2015 to September 2022, 1468 patients underwent TAVR at the university clinic in Kiel. After applying exclusion criteria, a final cohort of 1182 patients were analysed. Among these, 782 patients underwent TAVR with G1, whereas 400 underwent TAVR with G2. The primary study endpoints were the occurrence of new CD and PPMI within 30 days post-procedure. The secondary endpoints included diverse post-TAVR events as defined by the safety criteria of Valve Academic Research Consortium 3 (VARC III). A statistical analysis compared outcomes between the G1 and G2 groups. Results: Out of 1182 patients, 12.1% required PPMI within 30 days. Rates showed no statistical difference between G2 and G1 for PPMI (10.3% vs. 13.0%, IPTW-weighted p = 0.31) or CD (15.3% vs. 21.48%, IPTW-weighted p = 0.08). Among G2, the Sapien 3 Ultra valve had the lowest PPMI rate (4.8%). Overall, G2 and G1 had similar post-procedural and 30-day mortality rates. Conclusion: G2 valves may reduce post-procedure CD, but the difference is not statistically significant. Differences between specific valve types—such as the Sapien 3 Ultra’s lower rates—are notable, but overall, PPMI and safety profiles remain similar between G1 and G2. Patient and procedural factors still play a significant role. Careful valve and patient selection is essential, and ongoing research will guide further improvements. Full article
(This article belongs to the Special Issue Traditional Surgery and Minimally Invasive Approaches to Valvular Heart Disease)
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Review

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16 pages, 2824 KB  
Review
Mitral Valve Prolapse and Sudden Cardiac Death—A Puzzle with Missing Pieces: Review of the Literature and Case Report
by Diana Roxana Opris, Marius Mihai Harpa, David-Emanuel Anitei, Paul Calburean and Roxana Rudzik
Med. Sci. 2025, 13(3), 185; https://doi.org/10.3390/medsci13030185 - 10 Sep 2025
Cited by 1 | Viewed by 1703
Abstract
Background: Mitral valve prolapse is a common valvular heart disorder, usually associated with a benign prognosis in the absence of significant mitral regurgitation. However, a subset of patients is at increased risk for complex ventricular arrhythmias and sudden cardiac death. Identifying these high-risk [...] Read more.
Background: Mitral valve prolapse is a common valvular heart disorder, usually associated with a benign prognosis in the absence of significant mitral regurgitation. However, a subset of patients is at increased risk for complex ventricular arrhythmias and sudden cardiac death. Identifying these high-risk individuals remains a major clinical challenge. Case Summary: We present the case of a 71-year-old female patient with recurrent syncopal episodes, a strong family history of sudden cardiac death, and complex ventricular ectopy. Multimodality imaging revealed bileaflet mitral valve prolapse, severe mitral regurgitation, mitral annular disjunction, and the Pickelhaube sign, with no evidence of myocardial fibrosis on cardiac magnetic resonance imaging. The patient underwent minimally invasive mitral valve repair and received an implantable cardioverter-defibrillator for primary prevention of sudden cardiac death. Follow-up revealed significant reverse cardiac remodeling, marked reduction in arrhythmic burden, and restoration of mitral valve function. Family screening identified mitral annular disjunction in both of her daughters, who were asymptomatic and without arrhythmias. Discussion: Mitral annular disjunction has emerged as a potentially arrhythmogenic substrate, especially in patients with familial clustering, raising the possibility of a genetic predisposition. Risk stratification remains difficult, as no individual clinical, electrocardiographic, or imaging marker has demonstrated consistent predictive value. Surgical correction of mitral valve prolapse with associated mitral annular disjunction may lead to a reduction in arrhythmic risk and promote favorable structural remodeling. Conclusions: This case-based review emphasizes the importance of advanced imaging techniques in the identification and management of high-risk mitral valve prolapse phenotypes. Early surgical intervention and close arrhythmic surveillance may improve outcomes, although further research is necessary to define risk assessment tools and explore the genetic background of arrhythmogenic mitral valve disease. Full article
(This article belongs to the Special Issue Traditional Surgery and Minimally Invasive Approaches to Valvular Heart Disease)
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