Evidence map›Paper›PMID 40767990›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2025

High residual gradients after transcatheter aortic valve implantation in raphe-type bicuspid aortic valve stenosis: insights from the AD-HOC registry.

Francesco Tartaglia, Mauro Gitto, Won-Keun Kim, Pier Pasquale Leone, Tommaso Fabris, Chiara De Biase, Giuliano Costa, Nicholas Montarello, Andrea Scotti, Michele Bellamoli and 47 more

Abstract readMulticenter Study
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Timely hospital discharge in TAVI patients: towards a patient-centered care pathway.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

57 authors.

Francesco TartagliaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Mauro GittoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Won-Keun KimKerckhoff Heart Center, Bad Nauheim, Germany.
Pier Pasquale LeoneMontefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Tommaso FabrisDepartment of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padua, Italy.
Chiara De BiaseClinique Pasteur, Toulouse, France.
Giuliano CostaU.O.C. Cardiologia, Centro Alte Specialitá E Trapianti, P.O. G. Rodolico, A.O.U. Policlinico-V. Emanuele, Universitá Di Catania, Catania, Italy.
Nicholas MontarelloDepartment of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Andrea ScottiMontefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Michele BellamoliCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Mesfer AlfadhelDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Ofir KorenDepartment of Cardiology Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Simone FezziDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Barbara BelliniInterventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Mauro MassussiInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Giulia CostaCardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Chiara FraccaroClinique Pasteur, Toulouse, France.
Alessandro MazzapicchiCardiology Unit, Cardiac Thoracic and Vascular Department, Istituto Di Ricovero E Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Enrico GiacominCardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy.
Francesco BurzottaDepartment of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Andrea ZitoDepartment of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Riccardo GorlaDepartment of Cardiology, Istituto Di Ricovero E Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy.
Marco AngelillisCardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Karsten HugDepartment of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany.
Carlo BriguoriInterventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy.
Luca BettariCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Antonio MessinaCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Michele GalassoCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Damiano RegazzoliDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Greta CattaneoCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Mauro BoiagoDepartment of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padua, Italy.
Gianmaria CalamitaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Giulia LaterraUniversità Degli Studi Di Enna "Kore", Enna, Italy.
Matthias RenkerKerckhoff Heart Center, Bad Nauheim, Germany.
Mario Garcia GomezCentro de Investigación Biomédica en Red, Division of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Alfonso IelasiDivision of Cardiology, Istituto Di Ricovero E Cura a Carattere Scientifico Hospital Galeazzi-Sant'Ambrogio, Milan, Italy.
Uri LandesCardiology Department, Edith Wolfson Medical Center, Holon, Israel.
Tobias RheudeDepartment of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany.
Francesco BedogniDepartment of Cardiology, Istituto Di Ricovero E Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy.
Ignacio Amat SantosCentro de Investigación Biomédica en Red, Division of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Francesco SaiaCardiology Unit, Cardiac Thoracic and Vascular Department, Istituto Di Ricovero E Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Lin BaiDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Mao ChenDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Marianna AdamoInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Marco De CarloCardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Matteo MontorfanoInterventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Raj R MakkarDepartment of Cardiology Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Darren MylotteDepartment of Cardiology, University Hospitals Galway, Galway, Ireland.
Daniel J BlackmanDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Marco BarbantiUniversità Degli Studi Di Enna "Kore", Enna, Italy.
Didier TchetcheClinique Pasteur, Toulouse, France.
Giuseppe TarantiniDepartment of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padua, Italy.
Azeem LatibMontefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Diego MaffeoCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Ole De BackerDepartment of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Andrea BuonoCardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Antonio MangieriDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy. antonio.mangieri@gmail.com.ORCID http://orcid.org/0000-0002-3239-4046

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBicuspid aortic valve (BAV) stenosis poses several challenges when transcatheter aortic valve implantation (TAVI) is performed, including the risk of high residual gradients (HRG).

objectiveTo identify incidence, predictors and outcomes of HRG after TAVI in Sievers type 1 BAV stenosis.

methodsConsecutive patients with Sievers type 1 BAV stenosis undergoing TAVI at 24 international centers from 2016 to 2023 were enrolled. HRG were defined as a mean transvalvular gradient ≥ 20 mmHg at 30 days, according to Valve Academic Research Consortium-3 (VARC-3) criteria. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all-cause death, neurologic events or hospitalization for heart failure, assessed at 3 years after TAVI. Secondary endpoints included the single components of the primary outcome. Endpoints were assessed according to the presence of HRG, before and after covariate adjustment for clinically relevant confounders.

resultsA total of 972 patients were enrolled. HRG post-TAVI were found in 35 patients (3.6%). Patients with HRG had a higher preprocedural aortic valve gradient (57.0 [interquartile range: 49.0-69.0] mmHg vs 48.0 [40.0-58.0] mmHg, p < 0.001) and received smaller transcatheter heart valve (THV) (26.0 [23.0-29.0] mm vs 29.0 [26.0-29.0] mm, p < 0.001) when compared to patients with normal residual gradients (NRG). The only independent predictor of HRG was a bioprosthesis size ≤ 23 mm. At 3 years, MACE occurred in 35.0% of HRG patients and 22.3% of NRG patients (adjusted hazard ratio [HR]: 2.41, 95% confidence interval [CI]: 1.15-5.04; p = 0.019). HRG patients had a higher risk of neurologic events as compared to NRG patients (13.3% versus 4.5%, adjusted HR: 4.50, 95% CI: 1.52-13.30, p = 0.007).

conclusionsAfter TAVI in Sievers type 1 BAV stenosis, HRG occurred in around 4% of cases and were associated with an increased risk of MACE and neurologic events.

Indexed as

Aortic ValveAortic Valve StenosisBicuspid Aortic Valve DiseasePostoperative ComplicationsRegistriesTranscatheter Aortic Valve ReplacementAgedAged, 80 and overFemaleFollow-Up StudiesHumansIncidenceMaleRisk FactorsTreatment OutcomeBicuspidGradientsTranscatheter aortic valve intervention

Identifiers

PMID40767990

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.