To evaluate the prognostic significance of the preprocedural albumin - bilirubin (ALBI) score on short- and long-term outcomes after transcatheter aortic valve implantation (TAVI). We retrospectively analyzed 737 consecutive patients who underwent TAVI. Patients were stratified into tertiles according to ALBI score. Baseline clinical, echocardiographic, laboratory features were compared across tertiles. The primary endpoint was long-term all-cause mortality; secondary endpoints included in-hospital mortality and major complications. Kaplan-Meier analysis assessed survival, and Cox-regression models evaluated predictors of long-term mortality after adjustment for conventional risk factors. Higher ALBI tertiles were associated with a greater comorbidity burden, worse ventricular function, and elevated biomarkers of inflammation and cardiac stress. In-hospital mortality increased across tertiles (5.3%, 7.3%, 11.8%). Long-term mortality also rose progressively (7.3%, 9.8%, 11.8%), with 60-month survival rates of approximately 90% (T1), 88% (T2), and 73% (T3). ALBI score independently predicted long-term mortality (HR 1.86, 95% CI 1.23-2.82), along with chronic kidney disease and lower TAPSE. Restricted cubic spline analysis demonstrated a near-linear association between ALBI and mortality risk. Preprocedural ALBI score is independently associated with both short and long-term mortality after TAVI and may reflect systemic vulnerability not captured by conventional risk models. Incorporating ALBI into preprocedural assessment could enhance risk stratification.

Nutritional status plays a critical role in patients with advanced heart failure (HF) undergoing left ventricular assist device (LVAD) implantation. However, the comparative prognostic value of different nutritional and inflammatory indices in this population remains unclear. The present study aimed to evaluate the prognostic value of the NAPLES score and compare its performance with other established nutritional and inflammatory indices in patients undergoing LVAD implantation. We retrospectively analyzed consecutive patients who underwent LVAD implantation at a tertiary center. Nutritional indices, including the Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score and NAPLES score, were calculated using preoperative laboratory data. The primary outcome was all-cause mortality. Competing risk analyses were performed using Fine-Gray models, accounting for heart transplantation as a competing event. Multivariable models were adjusted for clinically relevant covariates. A total of 190 patients were included. During follow-up, all-cause mortality occurred more frequently in patients with higher NAPLES scores. In univariate analysis, several nutritional indices were associated with mortality; however, in multivariable analysis, the NAPLES score remained the most robust predictor. Patients in the high NAPLES group had a significantly increased risk of mortality compared to those in the low-risk group. When analyzed as a continuous variable, higher NAPLES scores were independently associated with increased mortality risk. In contrast, the predictive value of CONUT and HALP scores was attenuated after adjustment. Among commonly used nutritional and inflammatory indices, the NAPLES score demonstrated the strongest and most consistent association with all-cause mortality in patients undergoing LVAD implantation. Incorporating the NAPLES score into routine preoperative assessment may improve risk stratification in this high-risk population.

Background: Mycotic aneurysms are rare complications of infective endocarditis, occurring in ∼2% of cases and often associated with high morbidity and mortality. Femoral, carotid, and iliac arteries are most commonly affected. When this complication arises, it further complicates the management and treatment of infective endocarditis, which is already a challenging condition to treat. Case summary: We report a 34-year-old male with a history of mechanical mitral valve replacement who presented with fever, fatigue, and loss of appetite. Due to a high clinical suspicion of infective endocarditis, empirical antibiotics were initiated accordingly. Blood cultures yielded Pseudomonas aeruginosa, and transoesophageal echocardiography revealed vegetation on the mitral prosthetic valve, confirming infective endocarditis. During hospitalization, the patient developed acute leg pain and a drop in haemoglobin levels. Computed tomography angiography revealed a large mycotic aneurysm of the right profunda femoris artery. Due to haemodynamic instability and suspected impending rupture, endovascular treatment was performed using a graft stent. Complete aneurysm exclusion was achieved without complications. The patient completed 8 weeks of intravenous antibiotics. Follow-up imaging confirmed resolution of vegetation, and no abscess or graft infection was observed in the femoral region. He was discharged in stable condition. Discussion: Mycotic aneurysms require urgent and aggressive management due to the risk of rupture. While surgical repair remains the standard of care, endovascular approaches such as graft stent placement offer a viable alternative in haemodynamically unstable patients or those with high surgical risk. This case highlights the importance of timely diagnosis, appropriate antibiotic therapy, and individualized interventional planning to achieve favourable outcomes.

Background: Randomized clinical trials have shown no overall advantage of renal artery revascularization over optimal medical therapy in unselected populations with renal artery stenosis. However, these findings may not be generalizable to all patient subgroups. Carefully selected individuals with high-risk features may still derive substantial clinical benefit from revascularization. Case summary: A 29-year-old woman presented with severe resistant hypertension despite treatment with four antihypertensive agents and strict adherence to lifestyle modifications. Laboratory investigations revealed newly developed renal dysfunction with a significant reduction in estimated glomerular filtration rate compared with prior normal values. Renal Doppler ultrasonography demonstrated chronic total occlusion of the right renal artery, which was subsequently confirmed by computed tomography angiography and invasive renal angiography. Despite complete arterial occlusion, renal size was preserved, and collateral perfusion via the suprarenal artery was evident. Technetium-99 m dimercaptosuccinic acid scintigraphy confirmed viable renal parenchyma, indicating potential reversibility of ischaemic injury. Given persistent uncontrolled blood pressure, progressive deterioration of renal function, and preserved renal viability, percutaneous renal artery revascularization was undertaken. The occluded segment was successfully revascularizated by stent implantation, resulting in complete restoration of arterial patency. Blood pressure normalized promptly after the procedure, allowing significant down-titration of antihypertensive therapy. Renal function improved markedly within 2 weeks and remained stable during long-term follow-up. Discussion: Chronic total renal artery occlusion does not invariably reflect irreversible renal damage. In selected patients with preserved renal anatomy, collateral circulation, and viable parenchyma, endovascular revascularization may lead to sustained improvements in blood pressure control and renal function.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Risk stratification is essential in pulmonary arterial hypertension (PAH), yet the prognostic utility of the albumin‐bilirubin (ALBI) score as a marker of hepatic dysfunction remains underexplored. In this single‐center study, we evaluated the clinical, neurohumoral, echocardiographic and hemodynamic correlates and prognostic value of the ALBI score, and to assess whether this score offers an incremental benefit over the Registry to EValuate Early And Long‐term pulmonary arterial hypertension disease management (REVEAL) 2.0 risk score in patients with PAH. This study evaluated the prognostic value of the ALBI score and its incremental benefit in a cohort of 380 PAH patients (mean age 47.6 ± 18.3 years, 74.3% female). Patients were stratified into low (<= −2.60) and high (> −2.60) ALBI groups. High ALBI scores were significantly associated with worse functional class, reduced exercise capacity, elevated Nt‐proBNP, right ventricular systolic dysfunction, and vena cava plethora (all p  < 0.001). Hemodynamically, elevated ALBI correlated with increased right atrial pressure (RAP) ( p  = 0.005), reduced cardiac index ( p  = 0.002), and a narrowed trans‐systemic pressure gradient ( p  = 0.001). Multivariable Cox regression demonstrated that ALBI was an independent predictor of mortality [Adjusted HR: 1.80 (95% CI: 1.30–2.49), p  < 0.001], outperforming MELD variants and the FIB‐4 index. Integrating ALBI into REVEAL 2.0 yielded higher risk discrimination (C‐index: 0.756) than adding direct echocardiographic indices of right ventricular function or coupling (C‐indices: 0.748–0.749). In sensitivity analyses adjusting for TAPSE/PASP, invasive cardiac index, mean RAP, and background therapy, ALBI maintained its independent prognostic value [Adjusted HR: 1.44 (95% CI: 1.01–2.05), p  = 0.044], with the full model achieving a C‐index of 0.801. Within the REVEAL 2.0 intermediate‐risk subgroup, a high ALBI score identified patients with a three‐fold higher mortality risk [HR: 3.04 (95% CI: 1.25–7.38), p  = 0.014], improving discriminative performance by 26.3%. The ALBI score independently predicts mortality beyond standard pulmonary hemodynamics and echocardiographic right ventricular parameters. Incorporating ALBI into REVEAL 2.0 enhances survival prediction and aids risk refinement in intermediate‐risk PAH.