Azeem Latib

Montefiore Medical Center · Department of Cardiology

Poster presented at: The 3rd Annual Mount Sinai Morningside and Mount Sinai West Internal Medicine Residency Research Week; 2022 May 9-13; Virtual meeting, NY, USA.

Background and Objective: As one of the most prevalent valvular pathologies affecting millions globally, moderate-to-severe tricuspid regurgitation (TR) predisposes to increased mortality. Despite the well-established risk of adverse outcomes, an overwhelming majority of TR patients are managed conservatively due to challenges associated with timel...

Background The right ventricular (RV)–pulmonary arterial (PA) coupling ratio relates the efficiency with which RV stroke work is transferred into the PA. Lower ratios indicate an inadequate RV contractile response to increased afterload. Objectives This study sought to evaluate the prognostic significance of RV-PA coupling in patients with tricusp...

Objectives: The purpose of this study was to characterize the anatomic relationship between the inferior vena cava (IVC) and tricuspid annulus (TA) and its potential impact on the performance of transcatheter TV interventions. Background: Transcatheter tricuspid valve (TV) interventions are emerging as a therapeutic alternative for the treatment...

Over the last 15 years, the management of aortic valve disease has been changed by transcatheter aortic valve replacement, which has become the standard of care across the entire spectrum of surgical risk. As a result of continuous evolution of this technique, several next-generation transcatheter heart valves (THVs) have been developed to minimize...

We systematically categorized the longer-term (≥3 years) structural and functional characteristics of the ABSORB bioresorbable vascular scaffold (BVS) using optical coherence tomography imaging and coronary vasomotor reactivity testing and further compared the functional characteristics of BVS stented versus remote coronary segments. A total of 92...

Background The Index of Microcirculatory Resistance (IMR), measured with a pressure-thermistor tipped coronary guidewire has been established as a gold standard for coronary microvascular assessment. Angiography-based IMR (angio-IMR) is a novel method to derive IMR without intracoronary instrumentation or the need for adenosine. Methods PubMed and...

Aims: To evaluate the impact of systematic predilation with balloon aortic valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI). Methods and results: We performed a systematic meta-analysis investigating patients undergoing TAVI with systematic BAV vs no BAV in RCT or in adjusted studies. Device success was the primary endpoint,...

The tricuspid valve often is referred to as "the forgotten valve" because it frequently is managed conservatively due to poor prognostic outcomes with conventional surgical intervention, in particular, in high-risk patients. Nevertheless, a paradigm shift has occurred in recent years, due to a growing evidence base supporting the independent progno...

Background Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods This multicenter study included a total of 579 patients who had the diagnosis of definite IE at a median of 171 (53-421)...

Aims Transcatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as potential...

Aims Data on Absorb bioresorbable vascular scaffold (BVS) use in patients presenting with ST-segment elevation myocardial infarction (STEMI) are limited. Furthermore, Absorb studies including STEMI patients lacked a prespecified implantation technique to optimize BVS deployment. To assess the 3-year clinical outcomes STEMI patients undergoing prima...

Aims In patients with severe aortic stenosis, trans-prosthetic haemodynamics after transcatheter aortic valve implantation (TAVI) tend to be more favourable than after surgical aortic valve replacement, especially after self-expandable valve (SEV) implantation. The relative performance of TAVI according to leaflet position, that is supra-annular an...

BACKGROUND COAPT trial entry criteria are useful to identify patients with better outcomes after transcatheter edge-to-edge repair (TEER). However, up to half of real-world patients with secondary mitral regurgitation (SMR) undergoing TEER do not meet these highly selective criteria and no study has formally investigated them. The aim of this study...

There have been mixed results regarding the efficacy and safety of various percutaneous coronary intervention bifurcation techniques. An electronic search of Medline, Scopus, and Cochrane databases was performed for randomized controlled trials that compared the outcomes of any bifurcation techniques. We conducted a pairwise meta-analysis comparing...

Tricuspid valve regurgitation is both globally prevalent and undertreated. Historically, surgical intervention for isolated tricuspid regurgitation (TR) was avoided despite the prevalence of TR, largely due to poor surgical outcomes and an incomplete understanding of how it independently affects mortality. Over the past two decades, TR has been sho...

Chronic heart failure is one of the most debilitating chronic conditions affecting millions of people and adding a significant financial burden to health care systems worldwide. Despite the significant therapeutic advances achieved over the last decade, morbidity and mortality remain high. Multiple catheter-based interventional therapies targeting...

Background Transcatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as pote...

A correction to this paper has been published: https://doi.org/10.1007/s00392-021-01824-z

Objectives The aim of this study was to compare the feasibility, safety, and clinical outcomes of transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BAV) versus tricuspid aortic valve (TAV) stenosis. Background At present, limited observational data exist supporting TAVR in the context of bicuspid anatomy. Methods Primary end...

Background Staphylococcus aureus (S aureus) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on S aureus IE after transcatheter aortic valve replacement (TAVR). Methods Data was obtained from the Infectious Endocarditis after TAVR International Registr...

Background: Both balloon-expandable (BE) and self-expandable (SE) valves for transcatheter aortic valve implantation (TAVI) are broadly used in clinical practice. However, adequately powered randomized controlled trials comparing these two valve designs are lacking. Methods: The CENTER-study included 12,381 patients undergoing transfemoral TAVI....

Objectives To compare clinical outcomes in high bleeding risk (HBR) patients with and without complex percutaneous coronary intervention (PCI) treated with Resolute Onyx zotarolimus-eluting stents (ZES) after 1-month dual antiplatelet therapy (DAPT). Background PCI with 1-month DAPT has been demonstrated to be safe in HBR patients treated with Res...

There are an increasing number of transcatheter tricuspid valve interventions being performed worldwide using commercially available and investigational devices. These devices can be classified by their intended mechanism of correction of tricuspid valve disease and imaging in the pre-procedural and periprocedural period is essential for procedural...

Background Based on a recent randomized control trial (RCT), prasugrel is recommended in preference to ticagrelor for patients with non-ST-segment elevation ACS (NSTE-ACS), however, limited data exists. Objectives We aimed to investigate the effect of P2Y12 inhibitors on ischemic and bleeding events in NSTE-ACS patients. Methods Clinical trials e...

Objectives: The PREVAIL study evaluated the safety and effectiveness of a paclitaxel-coated percutaneous transluminal coronary angioplasty balloon catheter for the treatment of coronary de novo and in-stent restenosis (ISR) lesions in patients with symptomatic ischemic heart disease. Methods: PREVAIL was a prospective, multicenter, single-arm st...

Despite the current evidence supporting clinical benefits of fractional flow reserve (FFR), its uptake in the cardiac catheterization laboratory has been slow due to procedural cost and increased time with the need for maximum hyperemia. Recently, novel physiological indices derived from coronary angiography and intracoronary imaging have emerged t...

Objectives This systematic review and meta-analysis compares direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients with atrial fibrillation and bioprosthetic valve replacement or repair (BVR). Background The optimal anticoagulation therapy for patients with atrial fibrillation and a history of bioprosthetic valve repla...

Durability of transcatheter heart valve (THV) is critical as the indication of transcatheter aortic valve implantation (TAVI) expands to patients with longer life-expectancy. We aimed to compare the durability of different THV systems (balloon-expandable [BE] and self-expandable [SE]) and surgical aortic valve replacement (SAVR) prosthesis. PUBMED...

With aging society, one of the more challenging obstacles in percutaneous coronary interventions are calcified coronary lesions. Calcified lesions may impede stent delivery, limit balloon and stent expansion, cause uneven drug distribution, and hinder wire advancement. Even in the setting of acceptable procedural success, vessel calcification is in...

Background Balancing the effects of dual antiplatelet therapy (DAPT) in the era of potent P2Y12 inhibitors has become a cornerstone of acute coronary syndrome (ACS) management. Recent randomized controlled trials (RCTs) have investigated DAPT de-escalation to decrease the risk of bleeding outcomes. Objectives The aim of this study was to compare t...

Background Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV t...

Objectives The aim of this study was to define predictors of prosthesis-patient mismatch (PPM) and its impact on mortality after transcatheter aortic valve replacement (TAVR) with self-expandable valves (SEVs) in patients with small annuli. Background TAVR seems to reduce the risk for PPM compared with surgical aortic valve replacement, especially...

Mitral regurgitation is the most common valvular lesion in the developed world, with increasing prevalence, morbidity, and mortality. The experience with surgical mitral valve repair or replacement is very well-validated. However, more than 45% of these patients get denied surgery due to an elevated risk profile and advanced disease of the left ven...

Background The use of the HeartMate 3 (HM3) left ventricular assist device (LVAD) is expanding. Despite being associated with lower rates of adverse events and increased survival, outflow graft obstruction (OGO) has been reported in patients with HM3. The incidence and best management of this serious complication remain unclear. Methods We describ...

Background: Bioprosthetic valve fracture (BVF) is a technique to reduce gradients in valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) procedures. Outcome of VIV-TAVI with BVF has not been compared with VIV-TAVI without BVF. Aims: To evaluate the outcome of VIV-TAVI with BVF compared to VIV-TAVI without BVF. Methods: In total,...

Objectives To evaluate outcome and its predictors of bioprosthetic valve fracture (BVF) in patients undergoing valve‐in‐valve transcatheter aortic valve replacement (VIV‐TAVR). Background BVF is feasible and reduces transvalvular gradients in VIV‐TAVR‐procedures, but follow‐up‐data and information on factors influencing the outcome are missing. M...

Over the past decade, several transcatheter devices have been developed to address the treatment of severe mitral regurgitation (MR) in patients at high surgical risk, mainly aimed at repairing the native mitral valve (MV). MV repair devices have recently been shown to have high efficacy and safety. However, to replicate promising trial results, sp...

Objectives: To evaluate the use and outcomes of percutaneous mechanical circulatory support (pMCS) utilized during transcatheter aortic valve implantation (TAVI) from high-volume centers. Methods and results: Our international multicenter registry including 13 high-volume TAVI centers with 87 patients (76.5 ± 11.8 years, 63.2% men) who underwent...

Background: Tricuspid regurgitation (TR) has a poor prognosis and limited treatment options and is frequently accompanied by right ventricular (RV) dysfunction. Transcatheter tricuspid valve interventions (TTVI) to reduce TR have been shown to be safe and feasible with encouraging early results. Patient selection for TTVI remains challenging, with...

Objectives To define the incidence of high residual gradient (HRG) after transcatheter aortic valve replacement (TAVR) in BAVs and their impact on short term outcome and 1-year mortality. Background Transcatheter heart valves (THVs) offer good performance in tricuspid aortic valves with low rate of HRG. However, data regarding their performance in...

Background Stroke is one of the most common and potentially disabling complications of infective endocarditis (IE). However, scarce data exist about stroke complicating IE after transcatheter aortic valve replacement (TAVR). Objectives The purpose of this study was to determine the incidence, risk factors, clinical characteristics, management, and...

Background Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs). Objectives The goal of this study was to determine the incidence, factor...

Objectives The study reports 2-year outcomes from the multicenter, prospective, single-arm CLASP study with functional mitral regurgitation (FMR) and degenerative MR (DMR) analysis. Background Transcatheter repair is a favorable option to treat MR. Long-term prognostic impact of the PASCAL transcatheter valve repair system in patients with clinica...

Mitral regurgitation (MR) is a common disease affecting >4 million patients either in the United States or the European Union. Cardioband is the first fully percutaneous direct annuloplasty ring designed for the treatment of MR in patients not suitable or at high risk for open‐heart surgery. In this chapter, the authors describe the rationale behin...

Oral presentation at: 2021 SGIM annual meeting; 2021 April 20; Virtual meeting, USA.

The use of transcatheter aortic valve implantation (TAVI) continues to grow worldwide, with over 100 000 procedures performed between 2002 and 2013. Along with the significant clinical benefit demonstrated from transfemoral (TF) TAVI compared to surgical aortic valve replacement (SAVR) in high‐to‐moderate risk patients, recent clinical trials showe...

Introduction Tricuspid regurgitation is a prevalent and undertreated cardiac pathology impacting millions across the globe. While historically surgical interventions for isolated tricuspid regurgitation were largely avoided due to data citing poor surgical outcomes, advances in transcatheter techniques and imaging modalities have reframed the appro...

Background Recurrence of mitral regurgitation (MR) after surgical mitral valve repair (SMVR) varies and may require reoperation. Redo mitral valve surgery can be technically challenging and is associated with increased risk of mortality and morbidity. We aimed to assess the feasibility and safety of MitraClip as a treatment strategy after failed SM...

Objectives The aim of this study was to evaluate the impact of edge‐to‐edge PMVR on short and mid‐term clinical outcomes in patients with CS and severe MR. Background Severe mitral regurgitation (MR) in the setting of cardiogenic shock (CS) is associated with three times higher risk of 1‐year mortality. In refractory CS, edge‐to‐edge percutaneous...

Background Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. Methods Obser...

Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis across a broad spectrum of patient risk profiles. Pre-procedural planning using multislice computed tomography (MSCT) is a fundamental component to ensure acute and long-term procedural success. MSCT can establish the procedural feasibility, the typ...

Aims : The aim of this study is to analyse the prognostic implications of right ventricular (RV) dysfunction as detected by strain analysis in patients with severe tricuspid regurgitation (TR). The evaluation of RV systolic function in presence of severe TR is of paramount importance for operative risk stratification; however, it remains challengi...

Objectives: To determine the occurrence of vascular complications (VCs) following transfemoral transcatheter aortic valve replacement (TAVR) with new-generation devices according to the use of a crossover technique (COT). Background: The use of a COT (with/without balloon) has been associated with a reduction of VCs in TAVR patients. However, sc...

Background Scarce data exist on patients with right ventricular dysfunction (RVD) or pulmonary hypertension (PH) undergoing transcatheter tricuspid valve intervention. This study aimed to determine the early and midterm outcomes and the factors associated with mortality in this group of patients. Methods This subanalysis of the multicenter TriValv...

Severe tricuspid regurgitation is relatively common, especially in the elderly, and portends poor survival. Neither medical therapy nor conventional surgery is efficacious for most patients. In contrast, transcatheter tricuspid valve interventions are showing promise to improve quality of life and mortality. Although there is more clinical experien...

Background Scarce data exist on patients with previous left valve surgery (PLVS) undergoing transcatheter tricuspid valve intervention (TTVI). Objectives This study sought to investigate the procedural and early outcomes in patients with PLVS undergoing TTVI. Methods This was a sub-analysis of the multicenter TriValve registry including 462 patie...

Historically considered the ‘forgotten valve’, there has been increasing attention on the percutaneous transcatheter treatment of tricuspid regurgitation (TR). Prevalence of TR is high in the elderly population and prior studies have shown worse outcomes in patients with severe TR. Advances in transcatheter-based therapies have shed a new light in...

This chapter presents important guiding strategies for optimal Bioresorbable Vascular Scaffold (BVS) implantation. Intracoronary nitroglycerin injection is highly recommended in order to avoid BVS undersizing due to chronic distal arterial spasm. The routine use of a high‐pressure non‐compliant post‐dilatation balloon is strongly recommended. Use o...

Objectives We aimed to evaluate the effect of transcatheter aortic valve implantation (TAVI) approaches on mortality and identify effect modifiers and predictors for mortality. Background Alternative access routes to transfemoral (TF) TAVI include the surgical intra‐thoracic direct‐aortic (DA) and transapical (TA) approach. TA TAVI has been associ...