Percutaneous treatment of aortic root rupture after transcatheter aortic valve replacement procedure Annular rupture is a feared complication of transcatheter aortic valve replacement (TAVR), mainly after the use of balloon-expanding prosthesis. The treatment depends on the type of annular rupture and its clinical presentation. Therapeutic approaches reported in literature include conventional surgical procedure, isolated pericardial drainage, and conservative strategy. A discussion in a multidisciplinary setting is needed, to improve outcomes after TAVR. We report the case of a sovra-annular rupture after self-expanding TAVR, with a fistula between the aortic root and the right ventricle inflow tract, treated with urgent transradial embolization by vascular plug. This is the first ever reported successful case of transcatheter percutaneous intervention for annular rupture secondary to TAVR. Correspondence to Antonio Pignatelli, MD, Department of Cardiovascular Disease, Mater Dei Hospital, 70100 Bari, via S. Hahnemann 10, Italy Tel: +39 805076727; fax: +39 805076722; e-mail: apignatelli@hotmail.it Received 4 February, 2018 Revised 4 April, 2019 Accepted 11 September, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.jcardiovascularmedicine.com). © 2019 Italian Federation of Cardiology. All rights reserved.

Transfemoral transcatheter aortic valve replacement in the presence of a mitral prosthesis Purpose In the current case series, we present our experience with the self-expanding CoreValve or Evolut R (Medtronic Inc.) in patients with severe symptomatic aortic valve stenosis and concomitant mitral valve prosthesis. Methods Twelve patients with previous mitral valve prosthesis underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and/or aortic valve regurgitation. All patients underwent evaluation with an echocardiogram, computed tomography and coronary angiogram. After the index intervention and before discharge all patients underwent transthoracic echocardiography. All outcomes were defined according to the Valve Academic Research Consortium-2 criteria. Results Eleven patients underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and one patient for severe aortic valve regurgitation. There was immediate improvement of patients’ hemodynamic status; no cases of procedural death, stroke, myocardial infarction, or urgent cardiac surgery occurred. There was no 30-day mortality and all patients improved, with 91.6% in functional New York Heart Association class I–II. Conclusion The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results. Correspondence to Konstantinos Toutouzas, MD, First Department of Cardiology, Medical School of Athens University, Hippokration Hospital, 26 Karaoli and Dimitriou Str., Holargos, 15562 Athens, Greece Tel: +30 210 6510860; fax: +30 210 7250153; e-mail: ktoutouz@gmail.com Received 28 October, 2018 Revised 22 June, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Hypertrophic cardiomyopathy, long QT interval and coronary perforator disease in the Noonan syndrome The current article deals with original electrocardiographic and echocardiographic findings from a young adult patient with Noonan syndrome. Massive hypertrophic cardiomyopathy, long QT interval and abnormal intramural coronary blood flow velocity were simultaneously demonstrated. Correspondence to Cesare de Gregorio, MD, Dipartimento di Medicina Clinica e Sperimentale, Resp. Outpatient Heart Failure and Cardiomyopathy Lab, AOU Policlinico ‘G. Martino’, Via Consolare Valeria, 98125 Messina, Italy Tel: +39 090 221 3531; fax: +39 090 221 3531; e-mail: cdegregorio@unime.it Received 24 January, 2019 Revised 5 July, 2019 Accepted 10 September, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Hypertrophic cardiomyopathy and membranous subaortic stenosis: a rare, but possible association A 69-year-old male was admitted to our hospital with exertional angina and dyspnea. Transthoracic echocardiography showed asymmetric left ventricular (LV) hypertrophy and an elevated subaortic pressure gradient, in absence of dynamic LV outflow tract obstruction. Transesophageal echocardiography and cardiac computed tomography scan revealed the presence of a subvalvular membrane causing a fixed subaortic obstruction. Cardiac magnetic resonance showed typical findings of hypertrophic cardiomyopathy. A final diagnosis of subaortic stenosis associated with hypertrophic cardiomyopathy was made. This case highlights the key role of multimodality imaging in morphological assessment, risk stratification and differential diagnosis of these complex cases of cardiomyopathy, as it may help in identifying concealed concomitant causes of LV outflow tract obstruction. Correspondence to Angelica B. Delogu, MD, Department of Woman and Child Health and Public Health, Catholic University of the Sacred Heart, Largo Francesco Vito, 1, 00168 Rome, Italy Tel: +39 0630154187; e-mail: angelicabibiana.delogu@policlinicogemelli.it Received 22 March, 2019 Revised 21 May, 2019 Accepted 11 September, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Life-saving transcatheter aortic valve implantation for acute severe aortic regurgitation due to rheumatoid arthritis and complicated by cardiogenic shock No abstract available

A case of recurrent acute myocardial infarction Atherosclerotic disease in nonculprit vessels of patients with ST-segment elevation myocardial infarction (STEMI) is a common finding. Our case showed a paradigmatic situation in which the coexistence of multiple coronary lesions in different vessels led to recurrent plaque thrombosis and consequently to two STEMI in a short time frame. In particular, we pointed out the need for established parameters that can support interventional cardiologists’ decisions in the always challenging choice between single or staged procedures in patients with STEMI and multivessel disease. Correspondence to Luca Monzo, MD, PhD, Department of Cardiovascular, Respiratory, Nephrological and Geriatric Sciences, ‘Sapienza’ University, Viale del Policlinico 155, 00161 Rome, Italy Tel: +39 64453891; fax: +39 64463014; e-mail: luca.monzo@uniroma1.it Received 12 May, 2019 Revised 6 September, 2019 Accepted 11 September, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Failing mitral homograft in the tricuspid position treated with a percutaneous approach Patients with degenerated mitral homograft in tricuspid position, albeit rare, can nowadays come to our attention. Here we report on a case that shows that the transcatheter approach can be successfully adopted, leading to an evident improvement in the clinical condition, especially in symptomatic patients who cannot undergo surgical intervention. Correspondence to Dr Alessia Faccini, MD, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, Piazza Edmondo Malan, 1, 20097 San Donato Milanese (MI), Italy Tel: +39 02 52774328; fax: +39 02 52774439; e-mail: alessiafaccini@hotmail.com Received 10 June, 2019 Revised 3 September, 2019 Accepted 10 September, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Transcatheter aortic valve implantation and patients excluded from clinical trials: previous mitral valve replacement No abstract available

A novel, transfemoral prosthesis designed to treat aortic valve regurgitation: technical aspects and procedural guide No abstract available

Transcatheter aortic valve replacement versus surgery in low-risk patients: a meta-analysis of randomized studies No abstract available