IntroductionThe aim of our study was to determine the self-reported incidence and prevalence of running-related injuries among participants of the 18th Ljubljana Marathon, and to identify risk factors for their occurrence.MethodsA customized questionnaire was distributed over registration. Independent samples of t-test and chi-square test were used to calculate the differences in risk factors occurrence in the injured and non-injured group. Factors which appeared significantly more frequently in the injured group were included further into multiple logistic regression analysis.ResultsThe reported lifetime running injury (absence >2 weeks) incidence was: 46% none, 47% rarely, 4% occasionally, and 2% often. Most commonly injured body regions were: knee (30%), ankle and Achilles’ tendon (24%), foot (15%), and calf (12%). Male gender, running history of 1-3 years, and history of previous injuries were risk factors for life-time running injury. In the season preceding the event, 65% of participants had not experienced any running injuries, 19% of them reported minor problems (max 2 weeks absenteeism), but 10% and 7% suffered from moderate (absence 3-4 weeks) or major (more than 4 weeks pause) injuries. BMI was identified as the solely risk factor.ConclusionsThis self-reported study revealed a 53% lifetime prevalence of running-related injuries, with the predominate involvement of knee, ankle and Achilles’ tendon. One out of three recreational runners experienced at least one minor running injury per season. It seems that male gender, short running experience, previous injury, and BMI do increase the probability for running-related injuries.

Background: Computed tomography (CT) is the recommended imaging technique for defining the anatomical suitability for current transcatheter technologies and planning tricuspid valve (TV) intervention. The aim of the Tricuspid Regurgitation IMAging (TRIMA) study was to assess the geometrical characteristics of the TV complex using novel CT parameters. Methods: This prospective, single-center study enrolled 22 consecutive patients with severe tricuspid regurgitation, who underwent a cardiac CT study dedicated to the right chambers. The following variables were obtained: annulus area and perimeter, septal-lateral and antero-posterior diameters, tenting height, and anatomical regurgitant orifice area. Moreover, the following novel annular parameters were assessed: distance between commissures, distance between TV centroid and commissures, and angles between centroid and commissures. Results: A significant phasic variability during the cardiac cycle existed for all variables except for eccentricity, angles, and distance between the postero-septal and antero-posterior commissure and distance between the centroid and antero-posterior commissure. There was a significant relationship between the TV annulus area and novel annular parameters, except for annular angles. Additionally, novel annular variables were found to predict the annulus area. Conclusions: These novel additional variables may provide an initial platform from which the complexity of the TV annular morphology can continue to be better understood for further improving transcatheter therapies.

Background: The natural history of tricuspid valve regurgitation (TR) is characterized by poor prognosis and high in-hospital mortality when treated with isolated surgery. We report the preliminary echocardiographic and procedural results of a prospective cohort of symptomatic patients with high to prohibitive surgical risk and at least severe TR who underwent transcatheter edge-to-edge repair through the TriClipTM system. Methods: From June 2020 to March 2022, 27 consecutive patients were screened, and 13 underwent transcatheter TriClipTM repair. In-hospital, 30-day and six-month clinical and echocardiographic outcomes were collected. Results: Nine patients had severe, three massive and one baseline torrential TR. Sustained TR reduction of ≥1 grade was achieved in all patients, of which 90% reached a moderate TR or less. On transthoracic echocardiographic examination, there were significant reductions in vena contracta width (p < 0.001), effective regurgitant orifice area (p < 0.001) and regurgitant volume (p < 0.001) between baseline and hospital discharge. We also observed a significant reduction in tricuspid annulus diameter (p < 0.001), right ventricular basal diameter (p = 0.001) and right atrial area (p = 0.026). Conclusion: Treatment with the edge-to-edge TriClip device is safe and effective. The resulting echocardiographic improvements indicate tricuspid valve leaflet approximation does not just significantly reduce the grade of TR but also affects adjacent structures and improves right ventricular afterload adaptation.

Acute coronary artery occlusion is a relatively rare procedural adverse event in valve-in-valve transcatheter aortic valve implantation.Here we present a case of a 26-mm Sapien 3 prosthetic valve implantation in a degenerated 23-mm Freedom Solo bioprosthetic surgical valve with subsequent left and right coronary occlusion. Left coronary artery occlusion was managed immediately with the use of an upfront coronary artery protection technique and drug-eluting stent placement. Right coronary artery occlusion presented with rightsided heart failure and cardiac arrest that required resuscitation and additional hemodynamic support. As the artery could not be engaged with a catheter, a combination of intravenous antithrombotic and anticoagulant therapy was used as a successful bailout step to restore adequate coronary flow.

Background: Transcatheter aortic valve implantation (TAVI) is a widely used treatment of severe aortic stenosis. Implantation of a self-expanding valve into a dense calcified aortic annulus can be challenging and may result in device malposition and malfunction. Aim: The aim of our case report is to present a novel technique of transcatheter aortic valve dislocation treatment. Case presentation: An 86-year-old woman with severely calcified aortic valve underwent TAVI using a 27-mm self-expanding Portico valve (Abbott Vasc, USA). In the last phase of implantation, the valve dislocated deep into the left ventricular outflow tract resulting in significant paravalvular regurgitation and patient instability. Repositioning of the valve with a single snare was ineffective because of severe aortic ring calcifications. A novel "double snare" technique was applied and the valve was successfully repositioned upward with an excellent anatomic and haemodynamic result. Conclusion: "Double snare" technique can be an effective strategy for repositioning of deeply implanted self-expanding transcatheter aortic valves. It represents an efficient bailout strategy in case of single snare approach failure, especially in cases of severe aortic ring calcifications.