When a PFO is not really a PFO. 🔍
Closure of a small ASD at the FO with an Occlutech 23/25 mm in a young stroke patient with high RoPE/PASCAL scores. 3D TEE was key for accurate wire crossing in a highly aneurysmal septum 🎯

📍@ Ospedale di Prato Santo Stefano

Implications of small aortic annulus in patients treated with TAVI according to hemodynamic phenotypes of severe aortic stenosis ❣️Last publication of @Doc_Niro 👉link.springer.com/article/10.100… when he was with us @iCorGTrias Small aortic annulus may delay diagnosis and treatment!!

Tissue Characteristics Underlying Endocardial Local Impedance Subtypes in Chronic myocardial Infarction - Heart Rhythm 👉heartrhythmjournal.com/article/S1547-…
Kudos to @AranyoJulia for this fantastic experimental work @iCorGTrias @HRSonline @GTRecerca @ritmo_SEC @EHRAPresident @hgermanstrias

#ACC25 #CircSimPub Two-year follow-up results of TRILUMINATE trial indicate significant reduction in tricuspid regurgitation severity & decreased HF hospitalization rates with tricuspid TEER compared to medical therapy. ahajrnls.org/4c9VokJ #AHAJournals @hahn_rt @tavrkapadia

Free until April 1: Late Clinical Outcomes of BEV in Small Annuli (PARTNER Trials)
authors.elsevier.com/sd/article/S19… See also bit.ly/SmallAnnulusEd…
bit.ly/OPERA_TAVI
bit.ly/Bern_TAVI
bit.ly/SOLVE-TAVI @JACCJournals @ACCinTouch @PPibarot @djc795 @ESC_Journals @escardio

Mortality associated with moderate and severe mitral regurgitation in 608 570 men and women undergoing echocardiography bit.ly/3VSS7zg

Happy Wednesday!

Just published in #EHJCVI

The clinical use of stress #echofirst in chronic coronary syndromes and beyond #CAD: a clinical consensus statement from #EACVI of the @escardio

@ESC_Journals @leylaelifsade @C_VanDeHeyning @Ivan_Echocardio @PalMaurovich @Ph_Bertrand _n_shah @denisamuraru @s_e_petersen @Sarah_Moharem @VDelgadoGarcia

Pleased to share that I am now fully certified in Adult TOE by EACVI!

A sincere thank you to my mentor, @VDelgadoGarcia, and to @EFerrerSistach for their invaluable guidance and support in helping me grow.

Ad maiora!

Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT AS Registry-2: @JACCJournals

🥸 Good morning

😱 Summary

👇👇👇

With the first woman President, Dr Victoria Delgado, a new mandate in the #EACVI journey is just starting.

I feel honored to have the opportunity to work, learn and get inspired by the fantastic personalities of @VDelgadoGarcia and EACVI Past President @s_e_petersen in the next a great leader, superb mentor, cardiologist and researcher. Victoria’s journey has been marked by relentless hard work and passion for #cvimaging, commitment to excellence and to uplift others.

She has incredible metrics for her age (h index >100, citations > 110 k), reflecting worldwide academic impact and exceptional productivity.

I am convinced that the #EACVI is in excellent hands under her leadership

@EACVIPresident

Congratulations!! Well deserved! @JGrapsa

New Tutorials on 3D echocardiography for valvular heart disease 👉 escelearning.escardio.org/training/1852
💗28 chapters with all you need to know on 3D echo and valvular heart disease
💗9 CME credits when you complete them
You can't miss it!
@denisamuraru @NAjmoneMarsan @EACVIPresident

Two new MUST READS from @JACCJournals on Echo assessment and Outcomes of Aortic Regurgitation. bit.ly/AR_Echo-CMR and bit.ly/AR-LVDysfx. @WilliamZoghbi @pattypellikka @ottoecho @ACCinTouch @escardio

Must-read review on cardiogenic shock just published in The Lancet:
-> cardiogenic shock is a complex syndrome defined by systemic hypoperfusion and inadequate cardiac output arising from a wide array of underlying causes
->few therapeutic interventions have shown survival benefisupport early revascularisation of the culprit vessel in infarct-related cardiogenic shock and temporary circulatory support in selected patients
-> numerous questions remain unanswered, including pharmacotherapy, mechanical circulatory support devices, secondary organ dysfunction, and supportive care
thelancet.com/journals/lance… @TheLancet

It has been an absolute pleasure to have @Doc_Niro with us as fellow of the Cardiovascular imaging department of the @IcorCat at @hgermanstrias
Kind, hard worker and enthusiastic
His achievements, the best reward for us! Good luck in your new endeavor!

#TCT2024 in case you missed it! EARLY TAVR meets primary endpoint driven by Unplanned CV Hospitalization. Also prevents ⬇️ QoL! bit.ly/EARLY_TAVR @NEJM @TCTMD

New multicenter registry data in #JACCImaging including > 3700 patients with isolated moderate-to-severe degenerative MR (DMR) on the prognostic impact of pulmonary hypertension (PHTN) measured by Doppler echocardiography.
jacc.org/doi/epdf/10.10…

Key messages:
- SPAP response to theerogeneous: 25% had classic severe PHTN (SPAP ≥ 50 mm Hg), and 30% had moderate PHTN (ie, 35-49 mm Hg).
- excess mortality emerges for SPAP levels much below classical thresholds, with moderate PHTN (35-49 mm Hg) independently associated with excess mortality under medical management, which is eliminated after surgical correction of DMR.
- severe PHTN (SPAP ≥ 50 mm Hg) is associated with more severe excess mortality, which is attenuated but not suppressed after surgical correction of DMR.
- SPAP by Doppler is not just a surrogate for DMR severity, but is incremental to the Doppler EROA, RVol, and clinical characteristics in predicting outcome -> it is pivotal to obtain SPAP during #echofirst throughout the spectrum of DMR severity.

In conclusion, consider moderate PHTN (35-49 mm Hg) in the decision-making for early surgical repair in patients with severe DMR to restore their life expectancy.

Discussing atrial secondary TR with the electrophysiologists during our meeting "ATRIAL FIBRILLATION. CHANGING THE PARADIGM: FROM THE TREATMENT OF ARRHYTHMIA TO THAT OF THE ARRHYTHMIC PATIENT" was great. This condition is not even cited in the latest ESC GL about AF.

#echofirst cheat sheet
How to approach MR?
B4 the exam:
-hemodynamic status
- GMDT in SMR?
- AF?
- Symptoms?
- Need for stress test (after exam)

Step by step approach inside a structured and comprehensive minimum dataset followed by pathology based data set

The complete of putting together different information from the echo exam like putting together pieces of a puzzle 🧩

The Guideline Directed Triangle of the Truth:
GDTT
👊how much
👊why
👊structural integrity

1how much?
🫵Volumetric parameters from minimum data set as LVOT SV, total LV SV with its plausibility check by looking at RVOT SV & tot. RV SV
🫵Increased E wave inflow velocity > 1,2 m/s & DVI
🫵Vena contracta
🫵PISA EROA in case it has been suitable to use

2why?
🔑Leaflet position
🔑Jet direction
🔑3D confirming

3 structural integrity
📏LVEDS
🛢️LAVI
LVEF, GLS
“sPAP”

FREE FOR 50 DAYS!!! SOTA EVOQUE TTVR Screening and Intraprocedural Guidance
bit.ly/3XTWifw @JACCJournals @ACCinTouch @escardio @ESC_Journals @EuroInterventio @GilbertTangMD @j_hausleiter