1. Kaiser Y, van der Toorn JE, Singh SS, Zheng KH, Kavousi M, Sijbrands EJG, et al. Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification. Eur Heart J 2022;43:3960–3967. https://doi.org/10.1093/eurheartj/ehac377 In the population-based Rotterdam Study, Lp(a) is robustly associated with baseline and new-onset aortic valve calcium (AVC) but not2 with AVC progression, suggesting that Lp(a)-lowering interventions may be most effective in pre-calcific stages of aortic valve disease.
2. Diederichsen ACP, Lindholt JS, Möller S, Øvrehus KA, Auscher S, Lambrechtsen J, et al. Vitamin K2 and D in patients with aortic valve calcification: a randomized double- blinded clinical trial. Circulation 2022;145:1387–1397. https://doi.org/10.1161/CIRCULATIONAHA. 121.057008 In elderly men with an aortic valve calcium (AVC) score >300 AU, 2 years Menaquinone-7 (also known as vitamin K2, a cofactor for the carboxylation of proteins involved in the inhibition of arterial calcification) plus vitamin D supplementation did not influence AVC progression.
3. Banovic M, Putnik S, Penicka M, Doros G, Deja MA, Kockova R, et al. Aortic valve replacement versus conservative treatment in asymptomatic severe aortic stenosis: the AVATAR trial. Circulation 2022;145:648– 658. https://doi.org/10.1161/CIRCULATIONAHA.121.057639. In asymptomatic patients with severe aortic stenosis, early surgery reduced a primary composite of all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure compared with conservative treatment. This randomized trial provides preliminary support for early surgery once aortic stenosis becomes severe, regardless of symptoms.
4. UK TAVI Trial Investigators, Toff WD, Hildick-Smith D, Kovac J, Mullen MJ, Wendler O, et al. Effect of transcatheter aortic valve implantation vs surgical aortic valve replacement on all-cause mortality in patients with aortic stenosis: a randomized clinical trial. JAMA 2022;327:1875–1887. https://doi.org/10.1001/jama.2022.5776 Among patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk, TAVI was noninferior to surgery with respect to allcause mortality at 1 year.
5. Kapadia SR, Makkar R, Leon M, Abdel- Wahab M, Waggoner T, Massberg S, et al. Cerebral embolic protection during transcatheter aortic-valve replacement. New Engl J Med 2022;387:1253–1263. https://doi.org/10.1056/NEJMoa2204961 Among patients with aortic stenosis undergoing transfemoral TAVI, the use of cerebral embolic protection (CEP) did not have a significant effect on the incidence of periprocedural stroke, but on the basis of the 95% confidence interval around this outcome, the results may not rule out a benefit of CEP during TAVI.
6. Benfari G, Sorajja P, Pedrazzini G, Taramasso M, Gavazzoni M, Biasco L, et al. Association of transcatheter edge-to-edge repair with improved survival in older patients with severe, symptomatic degenerative mitral regurgitation. Eur Heart J 2022; 43:16261635. https://doi.org/10.1093/eurheartj/ehab910 Amongst older patients with severe symptomatic degenerative mitral regurgitation DMR at high surgical risk, mitral TEER was associated with higher survival vs. unoperated patients. Successful control of mitral regurgitation was key to survival improvement with mitral TEER, which should be actively considered in patients deemed inoperable.
7. Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, et al. TRISCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery. Eur Heart J 2022;43:654–662. https://doi.org/10.1093/eurheartj/ehab679 We propose TRI-SCORE as a dedicated risk score model based on eight easy to ascertain parameters to inform patients and physicians regarding the risk of solated tricuspid valve surgery and guide the clinical decision-making process of patients with severe tricuspid regirgitation, especially as transcatheter therapies are emerging (www.tri-score.com).
8. Gammie JS, Chu MWA, Falk V, Overbey JR, Moskowitz AJ, Gillinov M, et al. Concomitant tricuspid repair in patients with degenerative mitral regurgitation. N Engl J Med 2022; 386:327–339. https://doi.org/10.1056/NEJMoa2115961 Among patients undergoing mitral-valve surgery, those who also received tricuspid annuloplasty had a lower incidence of a primary-end-point event than those who underwent mitral-valve surgery alone at 2 years, a reduction that was driven by less frequent progression to severe tricuspid regurgitation. Tricuspid repair resulted in more frequent permanent pacemaker implantation. Whether reduced progression of tricuspid regurgitation results in long-term clinical benefit can be determined only with longer follow-up.
9. Özkan M, Gündüz S, Güner A, Kalçık M, Gürsoy MO, Uygur B, et al. Thrombolysis or surgery in patients with obstructive mechanical valve thrombosis: the multicenter HATTUSHA study. J Am Coll Cardiol 2022; 79:977–989. https://doi.org/10.1016/j.jacc.2021.12.027 Low-dose and slow/ultraslow infusion of t-PA were associated with low complications and mortality and high success rates and should be considered as a viable treatment in patients with obstructive prosthetic valve thrombosis.
10. Connolly SJ, Karthikeyan G, Ntsekhe M, Haileamlak A, El Sayed A, El Ghamrawy A, et al. Rivaroxaban in rheumatic heart disease-associated atrial fibrillation. N Engl J Med 2022; 387:978–988. https://doi.org/10.1056/NEJMoa2209051 Among patients with rheumatic heart disease–associated atrial fibrillation, vitamin K antagonist therapy led to a lower rate of a composite of cardiovascular events or death than rivaroxaban therapy, without a higher rate of bleeding.
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