Thrombotic antiphospholipid syndrome (APS) is an autoimmune disorder that is challenging to diagnose and treat correctly. A correct diagnosis requires clinical manifestations (venous, arterial, or placental thrombosis) and laboratory criteria documented on at least 2 occasions at least 12 weeks apart. These patients are generally considered to be at high risk for recurrent thrombosis and require indefinite-duration anticoagulation therapy.

The patient had a long-standing history of nonischemic cardiomyopathy diagnosed at age 53 years

With significant expansion of indications for transcatheter aortic valve replacement (TAVR) to include younger and low risk patients, the choice of transcatheter heart valve (THV) system is of paramount importance to ensure better short- and long-term outcomes.

With expanding evidence for benefit with guideline-directed medical therapy (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF), heart failure with mildly reduced ejection fraction (HFmrEF), heart failure with preserved ejection fraction (HFpEF), and heart failure with improved ejection fraction (HFimpEF), clinicians commonly inquire on how to initiate, sequence, and uptitrate GDMT in patients with HF. In the following paragraphs, I will try to address these concepts in the context of evolving evidence.

In recent years, transcatheter mitral valve edge-to-edge repair (M-TEER) has been established as an evidence-based therapy in patients with mitral regurgitation (MR)–dominant phenotypes of chronic heart failure with reduced ejection fraction (HFrEF) on optimized medical therapy.