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Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 25 June 2026 | Viewed by 3560

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Special Issue Editors

Dr. Mohammad Kassar

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Guest Editor

1. Clinic for General and Interventional Cardiology/Angiology, Heart and Diabetes Center, Bad Oeynhausen, Germany
2. Department of Cardiology, Inselspital Bern, Bern University Hospital, 3012 Bern, Switzerland
Interests: cardiology; echocardiography; valvular heart disease; interventional cardiology; minimally invasive AV-valve interventions
Special Issues, Collections and Topics in MDPI journals

Dr. Muhammed Gerçek

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Guest Editor

Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
Interests: valvular heart disease; interventional cardiology; mitral regurgitation; tricuspid regurgitation

Dr. Felix Rudolph

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Guest Editor Assistant

Special Issue Information

Dear Colleagues,

Valvular heart disease (VHD) is undergoing a transformative era driven by rapid technological innovation and interdisciplinary research. This Special Issue will spotlight the next frontier in VHD by focusing on novel diagnostic imaging techniques, advanced computational modeling, and translational approaches that bridge bench-to-bedside progress. Cutting-edge tools such as artificial intelligence-assisted echocardiography, cardiac MRI with radiomics, and patient-specific 3D-printed valves are redefining how we understand, diagnose, and treat valvular disorders.

In parallel, developments in tissue engineering, bioresorbable scaffolds, and next-generation transcatheter devices are paving the way for more personalized and durable therapies. An emphasis will also be placed on early disease detection using omics technologies and machine learning models, as well as future perspectives in precision medicine for VHD.

We invite original research and comprehensive reviews that explore these exciting innovations and will help shape the future of valvular heart disease management.

Dr. Mohammad Kassar
Dr. Muhammed Gerçek
Guest Editors

Dr. Felix Rudolph
Guest Editor Assistant

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Keywords

prosthetic heart valve
heart valve pathophysiology
structural heart valve interventions
echocardiographic assessment
cardiovascular imaging
valvular heart disease
valvular regurgitation
valvular stenosis
minimally invasive surgery
concomitant valve disease

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Published Papers (4 papers)

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Research

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14 pages, 611 KB

Open AccessArticle

Early Predictors of Surgical Explantation of Transcatheter Aortic Valve Replacement: A Multi-Center International Database Analysis

by George Bcharah, Sant Kumar, Juan M. Farina, Hend Bcharah, Mahmoud Abdelnabi, Jonathan Sayegh, Ramzi Ibrahim, Omneya Kandil, Hussein Abdul Nabi, Ahmad Jabri, Hursh Naik, Pyong D. Yoon, Bryan Barrus and Kristen A. Sell-Dottin

J. Clin. Med. 2026, 15(4), 1527; https://doi.org/10.3390/jcm15041527 - 14 Feb 2026

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Abstract

Background: Indications for TAVR explant have been established, although limited data exist regarding pre-TAVR baseline characteristics that predict eventual explantation. Methods: The TriNetX network, a database comprising medical records from over 105 institutions, was used. Two cohorts were created: those who underwent TAVR without explant and those requiring subsequent TAVR explant and SAVR. Predictors of explantation were analyzed by multivariate models. Results: Among the 63,377 patients undergoing TAVR, 273 (0.4%) required explantation. Patients in the explant group were younger (69.1 ± 11.3 vs. 78.1 ± 8.8 years; p < 0.001), more likely to have a thoracic aortic aneurysm (TAA) (10.6% vs. 4.7%; p < 0.001) and had higher LDL levels (88.2 ± 41.3 vs. 80.7 ± 34.6 mg/dL; p = 0.011). They also had increased post-TAVR rates of acute kidney injury (9.2% vs. 5.2%; p = 0.004) and paravalvular leak (5.9% vs. 0.9%; p < 0.001). Age at TAVR (HR 1.04; CI 1.03–1.06), baseline TAA (HR 1.69; CI 1.09–2.63), history of infective endocarditis (HR 1.92; CI 1.10–3.35), and higher LDL (HR 1.02; 95% CI 1.00–1.03) were independent predictors for explantation. Conclusions: Younger age at TAVR, TAA, history of endocarditis, and elevated baseline LDL were notable predictors of explantation. These findings highlight the necessity of pre-procedural assessment and follow-up in high-risk patients to optimize TAVR durability. Full article

(This article belongs to the Special Issue Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research)

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11 pages, 1271 KB

Open AccessArticle

Effects of Contrast Media on Renal Function Following Computed Tomography Prior to Transcatheter Aortic Valve Implantation

by Edward Itelman, Jenan Awesat, Pablo Codner, Yaron Aviv, Tzlil Grinberg, Merry Abitbol, Gideon Shafir, Keren Skalsky, Alon Shechter, Ran Kornowski and Ashraf Hamdan

J. Clin. Med. 2025, 14(24), 8754; https://doi.org/10.3390/jcm14248754 - 10 Dec 2025

Cited by 1 | Viewed by 1018

Abstract

Background: Preprocedural contrast-enhanced computed tomography (CT) is essential for planning Transcatheter Aortic Valve Implantation (TAVI), but concerns remain regarding contrast-induced (CI) acute kidney injury, especially in patients with chronic kidney disease. This study aimed to evaluate the incidence of CI-acute kidney injury following contrast-enhanced CT performed before TAVI. Methods: CI-acute kidney injury was defined according to the Kidney Disease—Improving Global Outcomes (KDIGO) guidelines. Nonionic, low-osmolality iodinated contrast material was used for all CT studies. The primary outcome was the incidence of CI-acute kidney injury post-CT. Secondary outcomes included the need for renal replacement therapy and the 30-day post-CT mortality rate. Results: Our study included 359 patients. The median age was 81, and 44% were males. Chronic kidney disease was present in 59.3% of patients, and the overall incidence of CI-acute kidney injury occurred in 24 patients (7%), without a significant difference between patients with and without baseline chronic kidney disease (4.8% vs. 8%, respectively; p = 0.331). Three consecutive creatinine tests within a median of 5.8 days showed that acute kidney injury occurred in only six patients (1.7%). No patients required new dialysis initiation within 30 days. Multivariable analysis did not identify baseline chronic kidney disease or IV contrast volume as independent predictors of CI-acute kidney injury. Conclusions: CI-acute kidney injury following pre-TAVI CT is low, even among patients with chronic kidney disease. Most cases were transient and did not require dialysis. Routine avoidance of CT due to chronic kidney disease may not be warranted. Full article

(This article belongs to the Special Issue Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research)

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17 pages, 1243 KB

Open AccessArticle

Characterization of Patients Unsuited for Transcatheter Mitral Valve Interventions

by Carolina Göttsche Esperança Clara, Hannah Eustergerling, Johanna Isabella Pepping, Vanessa Trenkpohl, Kai Peter Friedrichs, Maria Ivannikova, Tanja Katharina Rudolph, Johanna Bormann, Johannes Kirchner, Max Potratz, Volker Rudolph, Mohammad Kassar, Muhammed Gerçek and Felix Rudolph

J. Clin. Med. 2025, 14(20), 7275; https://doi.org/10.3390/jcm14207275 - 15 Oct 2025

Viewed by 796

Abstract

Background/Objectives: The objective of this study was to characterize echocardiographic characteristics comparing patients accepted or deemed unsuitable for transcatheter mitral valve interventions. Methods: We performed a retrospective analysis of 293 patients with severe mitral regurgitation evaluated for mitral transcatheter edge-to-edge repair (M-TEER) or transcatheter mitral valve replacement (TMVR), if patients were primarily identified as unsuitable candidates for M-TEER, at our institution between 2018 and 2023. All patients underwent transthoracic and transesophageal echocardiography, and mitral valve quantification (MVQ) analysis was performed. Feasibility was determined by an interdisciplinary Heart Team based on quantitative data and semi-quantitative echocardiographic parameters, including mean pressure gradient, regurgitation volumes, and morphological aspects alongside clinical assessment. Patient characteristics were evaluated using clinical records and echocardiographic data. Results: We screened 195 patients for M-TEER, 168 of which were accepted for the procedure. M-TEER-rejected patients presented with higher regurgitation volumes and higher transmitral pressure gradients than those accepted to undergo M-TEER. We then screened 104 patients for TMVR, and 27 were approved for the procedure. Patients rejected for TMVR presented with lower tenting volume, area, and height and had smaller ventricular diameters. Further, mitral valve area appears to be an important parameter in determining MR treatment strategy. Conclusions: The majority of MR patients screened for transcatheter intervention were suitable for M-TEER. However, elevated MPG and more pronounced billowing were the main factors associated with M-TEER exclusion. Conversely, the only morphological parameter associated with TMVR refusal was small left ventricular size. Importantly, the multimorbidity of patients and level of critical illness did not prohibit TMVR. Full article

(This article belongs to the Special Issue Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research)

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Review

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15 pages, 4192 KB

Open AccessReview

Transcatheter Tricuspid Valve Annuloplasty with the Cardioband System: A Step-by-Step Guide

by Maria Laura Novembre, Lluis Asmarats, Chi Hion Pedro Li, Marcel Santaló-Corcoy, Xavier Millán and Dabit Arzamendi

J. Clin. Med. 2025, 14(21), 7772; https://doi.org/10.3390/jcm14217772 - 1 Nov 2025

Viewed by 861

Abstract

Direct transcatheter tricuspid valve annuloplasty represents a significant advancement in the treatment of severe symptomatic tricuspid regurgitation. Previous studies have shown the efficacy of transcatheter annuloplasty with significant reductions in tricuspid regurgitation and improvements in functional status. The aim of this review is to provide a comprehensive step-by-step guide to the procedure, focusing on appropriate patient selection, main procedural steps and identification and management of possible complications to enhance our understanding of the procedure and maximize procedural success. Full article

(This article belongs to the Special Issue Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research)

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Innovations and Future Directions in Valvular Heart Disease: Imaging, Technology, and Translational Research

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