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Structural Heart Disease   

Questions discussed in this category

What is the optimal anti-platelet/anticoagulant strategy and duration following a left atrial appendage occlusion with a watchmen device and is a CTA good enough to assess if the device is well seated and without any peri device leaks?
1 Answer available
How do you decide between using a self-expanding supraannular valve and a balloon-expandable valve for TAVR in patients with severe aortic stenosis and a small aortic annulus?
Hermann, et al., SMART Trial, PMID 38587261
1 Answer available
What are your top 5 reasons to choose between a TAVI valve Edwards SAPIEN 3 (Edwards Lifesciences) vs an Evolut FX (Medtronic) and what favors one over the other?
1 Answer available
What are your top takeaways from ACC 2024?
3 Answers available
How do you determine the feasibility of doing a valve-in-valve for patients requiring AVR with index surgical aortic valve replacement?
1 Answer available
How do you decide the right time for MitraClip intervention in patients with symptomatic heart failure and severe mitral regurgitation who are on maximally tolerated GDMT?
1 Answer available
When would you consider performing direct implantation versus prior dilatation with balloon aortic valvuloplasty during TAVR?
3 Answers available
Following cardiac MRI, what imaging modality would you consider to further evaluate mild aortic regurgitation (regurgitant fraction on cardiac MRI of 26%) and mild to moderate mitral regurgitation secondary to mild bi-leaflet mitral valve prolapse (RF 30%) with low-normal LVEF and incomplete RBBB? 
1 Answer available
Which class(es) of antihypertensives do you recommend for first-line therapy for hypertension in severe aortic stenosis?
1 Answer available
When would be the appropriate time to refer an asymptomatic young adult with unicuspid AV s/p valvuloplasty during adolescence for AVR following exercise stress TTE findings demonstrating increase in aortic valve mean gradient from 40mmHg to 70mmHg (achieving 15 METS)?
2 Answers available
Are there any indications to close a PFO during pregnancy if a woman had a cryptogenic stroke in her first trimester?
1 Answer available
What are your top takeaways from AHA 2023?
4 Answers available
What is a reasonable surveillance strategy and length of time to maintain patients with thrombosed bioprosthetic valves on systemic anticoagulation?
1 Answer available
Should we routinely include geriatric functional assessments to determine candidacy for TAVR?
(ie., assessing gait speed, cognition, physical function, fall history, orthostatic vital signs, etc.)
1 Answer available
When should cardiac MRI be obtained alongside standard echocardiography for outpatient monitoring of the progression of chronic aortic regurgitation?
How often should cardiac MRI be ordered in this context? 
1 Answer available
How do you approach mitral valve endocarditis associated with a large vegetation size and severe mitral regurgitation, but without any heart failure, hemodynamic instability or valve destruction?
While the current guidelines favor early surgery (within 48 hrs of diagnosis) for this population based on the results of the EASE trial (link attache...
3 Answers available
When would you consider percutaneous mechanical aspiration of vegetation in right-sided endocarditis?
1 Answer available
What would be the utility of calcium scoring for the evaluation of low-flow low-gradient aortic stenosis, and what cut-off values typically fall within the severe range?
1 Answer available
What structural features preclude a transcatheter edge-to-edge repair in a patient with severe symptomatic tricuspid regurgitation?
1 Answer available
When would you consider discharging post-TAVR patients on outpatient mobile cardiac telemetry with baseline right bundle branch block without further signs of conduction abnormalities 24-48 hours after the procedure, given risk of developing later-onset conduction abnormalities?
And if so, what is a reasonable length of time for outpatient cardiac monitoring?
2 Answers available
Which clinical and echocardiographic parameters (i.e. LVEF, AVA) do you use when determining patient candidacy for LV device-assisted percutaneous balloon aortic valvuloplasty in patients with cardiogenic shock and severe AS?
1 Answer available
What would be a reasonable means of mechanical circulatory support as a bridge to AVR for patients with severe aortic regurgitation complicated by cardiogenic shock?
1 Answer available
Should vasodilatory therapies be considered first-line in the management of hypertension in patients with severe aortic regurgitation?
2 Answers available
What is a reasonable approach to monitoring mechanical valve function if systemic anticoagulation needs to be held in the setting of an acute intracranial hemorrhage?
1 Answer available
Is there a preferred heart rate range for patients with moderate to severe paravalvular leak post-TAVR?
1 Answer available
Among asymptomatic patients with chronic, severe primary MR, can serial global longitudinal strain measurements assist with determining timing for repeat surveillance TEEs and/or facilitate timing for MVR?
1 Answer available
When should we integrate CT calcium scoring into routine outpatient practice to arbitrate severity of aortic stenosis?
1 Answer available


Papers discussed in this category

JACC Cardiovasc Interv, 2017 Jul 19
Clinical Impact of Baseline Right Bundle Branch Block in Patients Undergoing Transcatheter Aortic Valve Replacement.
Struct Heart, 2022 Mar 17
Risk Stratification and Management of Advanced Conduction Disturbances Following TAVI in Patients With Pre-Existing RBBB.
J Am Coll Cardiol, 2019 Aug 27
Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert Panel.
JACC. Cardiovascular interventions, 2014-07
Futility, benefit, and transcatheter aortic valve replacement.
Struct Heart, 2022 Oct 31
Left Atrial-Veno-Arterial Extracorporeal Membrane Oxygenation: Step-By-Step Procedure and Case Example.
Neth Heart J, 2020 Feb
Global longitudinal strain to predict left ventricular dysfunction in asymptomatic patients with severe mitral valve regurgitation: literature review.
Presse Med, 2011 Oct 05
[Benfluorex and valvular heart disease].
Journal of cardiovascular imaging, 2018 Jun 22
Antihypertensive Treatment in Severe Aortic Stenosis.
Circulation, 2020 Dec 17
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
N Engl J Med, 2012 Jun 28
Early surgery versus conventional treatment for infective endocarditis.
The Journal of thoracic and cardiovascular surgery, 2017-12
Contracts with people who inject drugs following valve surgery: Unrealistic and misguided expectations.
Tex Heart Inst J, 2022 Nov 1
Use of AngioVac Vacuum Aspiration for Refractory Endocarditis in a Postoperative Mustard Patient.
Catheter Cardiovasc Interv, 2022 Jul 26
Treatment of cardiac device-related infective endocarditis utilizing the new T20 curve catheter and flow saver with the Inari mechanical aspiration system.
Multimed Man Cardiothorac Surg, 2020 Sep 25
Percutaneous aspiration of vegetation from tricuspid valve infective endocarditis.
JACC Case Rep, 2022 May 04
Case Series of Percutaneous Mechanical Aspiration of Mitral Valve Endocarditis.
Circulation, 2015 Sep 15
Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.
J Am Coll Cardiol, 2021 Feb 02
Feasibility Study of the Transcatheter Valve Repair System for Severe Tricuspid Regurgitation.
Circulation, 2023 Nov 13
Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study.
Circulation, 2023 Nov 11
Arrhythmic Risk In Biventricular Pacing Compared with Left Bundle Branch Area Pacing: Results From The International LBBAP Collaborative Study (I-CLAS).
Circulation. Cardiovascular quality and outcomes, 2023 Nov 06
Off-Label Dosing of Direct Oral Anticoagulants Among Inpatients with Atrial Fibrillation in the United States.
American heart journal, 2017 Apr 24
Rationale and design of the Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation (ARTESiA) trial.
The New England journal of medicine, 2023 Nov 11
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.
American heart journal, 2023 Mar 25
Screening for peripartum cardiomyopathies using artificial intelligence in Nigeria (SPEC-AI Nigeria): Clinical trial rationale and design.
JAMA, 2023 Nov 11
Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial.
American heart journal, 2020 Oct 13
Rationale and design of ApoA-I Event Reducing in Ischemic Syndromes II (AEGIS-II): A phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of CSL112 in subjects after acute myocardial infarction.
The New England journal of medicine, 2024 Apr 07
Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock.
Circulation, 2016-12-13
Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I).
American heart journal, 2022 May 17
Empagliflozin in patients post myocardial infarction rationale and design of the EMPACT-MI trial.
The New England journal of medicine, 2024 Apr 06
Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes.
The New England journal of medicine, 2024 Apr 07
Self-Expanding or Balloon-Expandable TAVR in Patients with a Small Aortic Annulus.

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