Significant progress has been made in both valves and delivery systems (DSs) for transcatheter aortic valve replacement (TAVR) procedures. We aimed to present one-year real-life data regarding TAVR procedures using Portico transcatheter heart valves (THVs) with new-generation, low-profile FlexNav DSs. This retrospective, single-center study enrolled 169 consecutive patients (mean age: 75.8 years, 68% females) with severe aortic stenosis undergoing TAVR with Portico THVs and FlexNav DSs between 2020 and 2021. We evaluated safety and efficacy outcomes, following the VARC-3 consensus, periprocedurally and at 30 days and 1 year. Procedural success was observed in 95.9% of cases, and no procedural mortality occurred. At 30 days, the rates of all-cause mortality, cardiovascular mortality, and neurological events were 4.7%, 3.6%, and 3.0%, respectively. Additionally, major vascular complications, acute kidney injury, and bleeding were recorded at rates of 11.2%, 14.8%, and 7.7%, respectively. The 1-year data showed all-cause mortality, cardiovascular mortality, and neurological event rates of 10.7%, 8.3%, and 7.7%, respectively. The moderate paravalvular leak and permanent pacemaker rates at 1 year were 2.6% and 12.2%, respectively. This real-life data provided evidence of positive outcomes and high technical success with Portico THVs and FlexNav DSs. Furthermore, we found low rates of mortality and neurological events, with satisfactory hemodynamic and functional results.

In many large center randomized controlled studies, it has been shown that percutaneous closure is more effective in patients with Atrial Septal Defect (ASD) who have cryptogenic stroke, when percutaneous closure is compared with medical treatment [1-6]. However, thrombus formation in percutaneous closure devices is one of the known and rare late complications [7]. In this context, we present a case of recurrent stroke attack after late thrombus development in the ASD closure device in a patient receiving dual antithrombotic therapy in our clinic

Background and Objectives: Inflammation and nutritional status are closely associated with prognosis in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). This study compared the prognostic performance of the conventional Naples score and CRP-modified Naples score for predicting in-hospital mortality. Materials and Methods: This retrospective, single-center study included 921 patients with NSTE-ACS undergoing percutaneous coronary intervention. Multivariable logistic regression, ROC analysis, reclassification indices, restricted cubic spline analysis, and decision curve analysis were performed. Results: In-hospital mortality occurred in 79 patients (8.6%). Patients who died had higher Naples score and modified Naples score values than survivors. In multivariable models adjusted for baseline clinical variables and GRACE score, both the modified Naples score and conventional Naples score remained independently associated with in-hospital mortality. The modified Naples score showed an adjusted-OR of 3.85 (95% CI: 2.71–5.48; p < 0.001), whereas the conventional Naples score showed an adjusted-OR of 4.52 (95% CI: 3.05–6.70; p < 0.001). The addition of the modified Naples score improved model performance, with a C-index of 0.819, NRI of 0.741, and IDI of 0.127. Similarly, the conventional Naples score model showed a C-index of 0.827, NRI of 0.843, and IDI of 0.125. In ROC analysis, the AUC was 0.701 for the modified Naples score and 0.683 for the conventional Naples score, without a statistically significant difference between them (ΔAUC = 0.017; p = 0.300). Decision curve analysis showed positive net clinical benefit for both scores, with no consistent superiority of either score. Conclusions: Both Naples-based scores were independently associated with in-hospital mortality and provided comparable prognostic performance in patients with NSTE-ACS undergoing PCI.