Search

Your search keyword '"A, Vahanian"' showing total 184 results
Start Over Author "A, Vahanian" Publisher oxford university press
184 results on '"A, Vahanian"'

2. Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper

Author

Lancellotti, P, Pibarot, P, Chambers, J, La Canna, G, Pepi, M, Dulgheru, R, Dweck, M, Delgado, V, Garbi, M, Vannan, M, Montaigne, D, Badano, L, Maurovich-Horvat, P, Pontone, G, Vahanian, A, Donal, E, Cosyns, B, Lancellotti P., Pibarot P., Chambers J., La Canna G., Pepi M., Dulgheru R., Dweck M., Delgado V., Garbi M., Vannan M. A., Montaigne D., Badano L., Maurovich-Horvat P., Pontone G., Vahanian A., Donal E., Cosyns B., Lancellotti, P, Pibarot, P, Chambers, J, La Canna, G, Pepi, M, Dulgheru, R, Dweck, M, Delgado, V, Garbi, M, Vannan, M, Montaigne, D, Badano, L, Maurovich-Horvat, P, Pontone, G, Vahanian, A, Donal, E, Cosyns, B, Lancellotti P., Pibarot P., Chambers J., La Canna G., Pepi M., Dulgheru R., Dweck M., Delgado V., Garbi M., Vannan M. A., Montaigne D., Badano L., Maurovich-Horvat P., Pontone G., Vahanian A., Donal E., and Cosyns B.

Abstract

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Imaging is pivotal in the evaluation of native valve regurgitation and echocardiography is the primary imaging modality for this purpose. The imaging assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy and function, and the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation largely relies on the results of imaging. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing native valve regurgitation. The present document aims to present clinical guidance for the multi-modality imaging assessment of native valvular regurgitation.

Published
2022

3. Mitral balloon valvuloplasty

Author

Vahanian, Alec, additional, Himbert, Dominique, additional, Brochet, Eric, additional, Ducrocq, Grégory, additional, and Iung, Bernard, additional

Published
2018
Full Text
View/download PDF

7. The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Author

José Luis Zamorano, Serge Boveda, Marco Metra, Mitja Lainscak, Ewa A. Jankowska, Theresa McDonagh, Jeroen J. Bax, Christian Mueller, Petar M. Seferovic, Andrew J.S. Coats, Thor Edvardsen, Andreas Baumbach, John G.F. Cleland, Claudio Muneretto, Ottavio Alfieri, Thomas Deneke, Mandeep R. Mehra, Jean-François Obadia, Fabien Praz, Lars Lund, Frank Ruschitzka, Dimitrios Farmakis, Alec Vahanian, Gerhard Hindricks, Hein Heidbuchel, Gerasimos Filippatos, Johann Bauersachs, Christoph Leclercq, Jelena Čelutkienė, Wilfried Mullens, Jörg Hausleiter, Nathan Mewton, Ralph Stephan von Bardeleben, Bernard Prendergast, Nikolaos Dagres, Stephan Windecker, Volker Rudolph, Piotr Ponikowski, Stefan D. Anker, Warwick Medical School, University of Warwick [Coventry], German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), Queen Mary University of London (QMUL), Yale University School of Medicine, IRCCS San Raffaele Scientific Institute [Milan, Italie], University Medical Center [Mainz], Hannover Medical School [Hannover] (MHH), Leiden University Medical Center (LUMC), Clinique Pasteur [Toulouse], Vilnius University [Vilnius], University of Glasgow, Universität Leipzig [Leipzig], University of Cyprus [Nicosia], National and Kapodistrian University of Athens (NKUA), University-Hospital Munich-Großhadern [München], University of Wrocław [Poland] (UWr), University of Ljubljana, CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Karolinska University Hospital [Stockholm], King‘s College London, Harvard Medical School [Boston] (HMS), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), University Hospital Basel [Basel], Ziekenhuis Oost-Limburg (ZOL), University of Brescia, Bern University Hospital [Berne] (Inselspital), Ruhr-Universität Bochum [Bochum], Université de Paris (UP), Universidad Carlos III de Madrid [Madrid] (UC3M), Oslo University Hospital [Oslo], Antwerp University Hospital [Edegem] (UZA), University of Belgrade [Belgrade], Guy's and St Thomas' Hospital [London], and Clinical sciences

Subjects
medicine.medical_specialty, Percutaneous, Functional mitral regurgitation, Heart failure, Secondary mitral regurgitation, Transcatheter mitral valve repair, 610 Medicine & health, 030204 cardiovascular system & hematology, law.invention, Special Article, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Mitral valve, medicine, AcademicSubjects/MED00200, 030212 general & internal medicine, Mitral regurgitation, Ejection fraction, business.industry, Guideline, medicine.disease, 3. Good health, medicine.anatomical_structure, Ventricle, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Secondary (or functional) mitral regurgitation (SMR) occurs frequently in chronic heart failure (HF) with reduced left ventricular (LV) ejection fraction, resulting from LV remodelling that prevents coaptation of the valve leaflets. Secondary mitral regurgitation contributes to progression of the symptoms and signs of HF and confers worse prognosis. The management of HF patients with SMR is complex and requires timely referral to a multidisciplinary Heart Team. Optimization of pharmacological and device therapy according to guideline recommendations is crucial. Further management requires careful clinical and imaging assessment, addressing the anatomical and functional features of the mitral valve and left ventricle, overall HF status, and relevant comorbidities. Evidence concerning surgical correction of SMR is sparse and it is doubtful whether this approach improves prognosis. Transcatheter repair has emerged as a promising alternative, but the conflicting results of current randomized trials require careful interpretation. This collaborative position statement, developed by four key associations of the European Society of Cardiology—the Heart Failure Association (HFA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Cardiovascular Imaging (EACVI), and European Heart Rhythm Association (EHRA)—presents an updated practical approach to the evaluation and management of patients with HF and SMR based upon a Heart Team approach., Graphical abstract

Published
2021
Full Text
View/download PDF

8. Acute valve disease and endocarditis

Author

Franck Thuny, Gregory Ducrocq, Bernard Iung, and Alec Vahanian

Subjects
medicine.medical_specialty, business.industry, medicine, Endocarditis, medicine.disease, business, Valve disease, Surgery
Abstract

The management of patients with acute valve disease is now a rare, but challenging, event, as valvular patients are often elderly with severe comorbidities. Furthermore, a proportion of previously operated patients present with acute valve dysfunction. The aim, in this situation, is to establish a rapid diagnosis, based on clinical examination and echocardiography, followed by early intervention. The primary treatment remains surgical valve replacement but more conservative surgical approaches have been developed More recently, percutaneous interventional techniques have been introduced. However, every effort should be made to avoid performing interventions in an acute situation, as it is always at high risk.

Published
2021
Full Text
View/download PDF

11. Mitral balloon valvuloplasty

Author

Vahanian, Alec, primary, Himbert, Dominique, additional, Brochet, Eric, additional, Ducrocq, Grégory, additional, and Iung, Bernard, additional

Published
2010
Full Text
View/download PDF

15. Mitral stenosis

Author

Alec Vahanian

Abstract

Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. Echocardiography is the main method used to assess the severity and consequences of MS, as well as the extent of anatomic lesions. The treatment of MS has been revolutionized since the development of percutaneous mitral balloon commissurotomy (PMC) Intervention should be performed in symptomatic patients with clinically significant MS (moderate to severe) (valve area

Published
2018
Full Text
View/download PDF

16. IMMU-25. RADIO-IMMUNOTHERAPY USING THE IDO PATHWAY INHIBITOR INDOXIMOD FOR CHILDREN WITH NEWLY-DIAGNOSED DIPG

Author

Amy Smith, Dolly Aguilera, Ramses F. Sadek, Theodore S. Johnson, Ian M. Heger, Eugene P. Kennedy, Eric Ring, Nicholas N. Vahanian, Bree R. Eaton, Craig Castellino, Nicholas K. Foreman, Charles J. Link, W. Martin, A. Al-Basheer, David H. Munn, Natia Esiashvili, and Tobey J. MacDonald

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Standard of care, Temozolomide, business.industry, medicine.medical_treatment, Radio immunotherapy, Newly diagnosed, medicine.disease, Chemotherapy regimen, Abstracts, Cancer immunotherapy, Internal medicine, Glioma, Medicine, Neurology (clinical), business, Adverse effect, medicine.drug
Abstract

BACKGROUND: Indoximod is an IDO pathway inhibitor with a differentiated mechanism of action directly targeting immune cells to reverse the immune suppression generated by tumors. An ongoing phase-1b/2a study (NCT02502708) using indoximod in combination with temozolomide and/or re-irradiation for children with relapsed/refractory pediatric brain tumors has established the recommended phase-2 dose (RP2D) of indoximod for this regimen and has shown this approach to be well-tolerated and feasible in these highly complex and fragile patients. Diffuse Intrinsic Pontine Glioma (DIPG) is an FDA-designated orphan disease, with no curative treatment options and dismal prognosis. The primary hypothesis is that addition of indoximod-based immunotherapy to standard-of-care radiation, followed by immuno-chemotherapy with indoximod plus temozolomide will improve objective response rates, 12-month event-free survival, and median overall survival. DESIGN/METHODS: Newly-diagnosed DIPG patients age 3 to 21 years are treated with indoximod (RP2D) in combination with conformal radiation therapy (54 Gy), followed by cyclic immune-chemotherapy using indoximod (RP2D=38.4 mg/kg/day divided BID throughout each cycle) combined with temozolomide (200 mg/m2/day, days 1-5 of each 28-day cycle). Up to 30 patients may be enrolled. RESULTS: The trial is ongoing. At this time, we have enrolled the first 6 newly-diagnosed DIPG patients. At the end of the indoximod plus radiation block, the first two patients had objective tumor response without any significant adverse events to date. Interim outcome and safety data for the first 8 months of accrual will be presented.

Published
2018

17. Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)

Author

Roos-Hesselink, Jolien, Baris, Lucia, Johnson, Mark, De Backer, Julie, Otto, Catherine, Marelli, Ariane, Jondeau, Guillaume, Budts, Werner, Grewal, Jasmine, Sliwa, Karen, Parsonage, William, Maggioni, Aldo P., van Hagen, Iris, Vahanian, Alec, Tavazzi, Luigi, Elkayam, Uri, Boersma, Eric, Hall, Roger, Roos-Hesselink, Jolien, Baris, Lucia, Johnson, Mark, De Backer, Julie, Otto, Catherine, Marelli, Ariane, Jondeau, Guillaume, Budts, Werner, Grewal, Jasmine, Sliwa, Karen, Parsonage, William, Maggioni, Aldo P., van Hagen, Iris, Vahanian, Alec, Tavazzi, Luigi, Elkayam, Uri, Boersma, Eric, and Hall, Roger

Abstract

Aims Reducing maternal mortality is a World Health Organization (WHO) global health goal. Although maternal deaths due to haemorrhage and infection are declining, those related to heart disease are increasing and are now the most important cause in western countries. The aim is to define contemporary diagnosis-specific outcomes in pregnant women with heart disease. Methods From 2007 to 2018, pregnant women with heart disease were prospectively enrolled in the Registry Of Pregnancy and results And Cardiac disease (ROPAC). Primary outcome was maternal mortality or heart failure, secondary outcomes were other cardiac, obstetric, and foetal complications. We enrolled 5739 pregnancies; the mean age was 29.5. Prevalent diagnoses were congenital (57%) and valvular heart disease (29%). Mortality (overall 0.6%) was highest in the pulmonary arterial hypertension (PAH) group (9%). Heart failure occurred in 11%, arrhythmias in 2%. Delivery was by Caesarean section in 44%. Obstetric and foetal complications occurred in 17% and 21%, respectively. The number of high-risk pregnancies (mWHO Class IV) increased from 0.7% in 2007–2010 to 10.9% in 2015–2018. Determinants for maternal complications were pre-pregnancy heart failure or New York Heart Association >II, systemic ejection fraction <40%, mWHO Class 4, and anticoagulants use. After an increase from 2007 to 2009, complication rates fell from 13.2% in 2010 to 9.3% in 2017. Conclusion Rates of maternal mortality or heart failure were high in women with heart disease. However, from 2010, these rates declined despite the inclusion of more high-risk pregnancies. Highest complication rates occurred in women with PAH.

Published
2019

18. Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)

Author

Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH, Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck Brentano C, Hobbs R, Kearney P, McDonagh T, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas PE, Widimsky P, Agladze V, Aliot E, Balabanski T, Blomstrom Lundqvist C, Capucci A, Crijns H, Dahlöf B, Folliguet T, Glikson M, Goethals M, Gulba DC, Ho SY, Klautz RJ, Kose S, McMurray J, PERRONE FILARDI, PASQUALE, Raatikainen P, Salvador MJ, Schalij MJ, Shpektor A, Sousa J, Stepinska J, Uuetoa H, Zamorano JL, Zupan I, European Heart Rhythm Association, European Association for Cardio Thoracic Surgery, ESC Committee for Practice Guidelines, Document Reviewers, Camm, Aj, Kirchhof, P, Lip, Gy, Schotten, U, Savelieva, I, Ernst, S, Van Gelder, Ic, Al Attar, N, Hindricks, G, Prendergast, B, Heidbuchel, H, Alfieri, O, Angelini, A, Atar, D, Colonna, P, De Caterina, R, De Sutter, J, Goette, A, Gorenek, B, Heldal, M, Hohloser, Sh, Kolh, P, Le Heuzey, Jy, Ponikowski, P, Rutten, Fh, Vahanian, A, Auricchio, A, Bax, J, Ceconi, C, Dean, V, Filippatos, G, Funck Brentano, C, Hobbs, R, Kearney, P, Mcdonagh, T, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Vardas, Pe, Widimsky, P, Agladze, V, Aliot, E, Balabanski, T, Blomstrom Lundqvist, C, Capucci, A, Crijns, H, Dahlöf, B, Folliguet, T, Glikson, M, Goethals, M, Gulba, Dc, Ho, Sy, Klautz, Rj, Kose, S, Mcmurray, J, PERRONE FILARDI, Pasquale, Raatikainen, P, Salvador, Mj, Schalij, Mj, Shpektor, A, Sousa, J, Stepinska, J, Uuetoa, H, Zamorano, Jl, Zupan, I, European Heart Rhythm, Association, European Association for Cardio Thoracic, Surgery, ESC Committee for Practice, Guideline, Document, Reviewers, Alfieri, Ottavio, Ponikowski, P., Fysiologie, Cardiologie, RS: CARIM School for Cardiovascular Diseases, Camm, A. J, Lip, G, Van Gelder, I. C, Hohloser, S. H, and Le Heuzey, J. Y.

Subjects
Lung Diseases, Male, Rate control, Heart Valve Diseases, Management of atrial fibrillation, Angiotensin-Converting Enzyme Inhibitors, Comorbidity, Upstream therapy, Hyperthyroidism, law.invention, Cardiac Resynchronization Therapy, Electrocardiography, Ventricular Dysfunction, Left, Postoperative Complications, Atrial fibrillation European Society of Cardiology Guidelines Anticoagulation Rate control Rhythm control Upstream therapy Pulmonary vein isolation Left atrial ablation randomized controlled-trial congestive-heart-failure parkinson-white-syndrome cardiac resynchronization therapy angiotensin-converting enzyme polyunsaturated fatty-acids antiarrhythmic-drug therapy long-term survival radiofrequency catheter ablation placebo-controlled trial, Randomized controlled trial, Heart Rate, Pregnancy, Recurrence, law, Prevalence, Secondary Prevention, Medicine, Angioplasty, Balloon, Coronary, Precision Medicine, Mineralocorticoid Receptor Antagonists, Middle Aged, Congestive-Heart-Failure, Left atrial ablation, Primary Prevention, Stroke, Catheter Ablation, Cardiology, Female, Rhythm control, Cardiology and Cardiovascular Medicine, Risk assessment, Anti-Arrhythmia Agents, Sports, Radiofrequency Catheter Ablation, Adult, medicine.medical_specialty, Point-of-Care Systems, Angiotensin-Converting Enzyme, Antiarrhythmic-Drug Therapy, Placebo-Controlled Trial, Electric Countershock, MEDLINE, Hemorrhage, Guidelines, Parkinson-White-Syndrome, Risk Assessment, Pulmonary vein isolation, European Society of Cardiology, Anticoagulation, Fibrinolytic Agents, Thromboembolism, Internal medicine, Diabetes Mellitus, Humans, Polyunsaturated Fatty-Acids, International Normalized Ratio, Acute Coronary Syndrome, Randomized Controlled-Trial, Long-Term Survival, Aged, Heart Failure, Intraoperative Care, business.industry, Conflict of interest, Anticoagulants, Evidence-based medicine, Cardiomyopathy, Hypertrophic, Precision medicine, Atrial fibrillation, Athletes, CHA2DS2–VASc score, Quality of Life, Wolff-Parkinson-White Syndrome, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Platelet Aggregation Inhibitors
Abstract

Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A large number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC Web Site (http://www.escardio.org/guidelines-surveys/esc-guidelines/about/Pages/rules-writing.aspx). In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to pre-defined scales, as outlined in Tables 1 and 2 . View this table: Table 1 Classes of recommendations View this table: Table 2 Levels of evidence The experts of the writing panels have provided disclosure statements of all relationships they may have that might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified to the ESC. The Task Force report received its entire financial support from …

Published
2010

19. The future of transcatheter mitral valve interventions: competitive or complementary role of repair vs. replacement?

Author

Georg Lutter, Ottavio Alfieri, Lars Søndergaard, Karl-Heinz Kuck, Martyn Thomas, Francesco Maisano, Nicolo Piazza, Ted Feldman, Maurice Buchbinder, Howard C. Herrmann, Martin B. Leon, Alec Vahanian, Stephan Windecker, Maurizio Taramasso, John G. Webb, Joachim Schofer, Shmuel Banai, Gregg W. Stone, Mark Reisman, Carlos E. Ruiz, Olaf Franzen, Volkmar Falk, Georg Nickenig, Michael Mack, Antonio Colombo, Saibal Kar, University of Zurich, Maisano, Francesco, Maisano, F, Alfieri, Ottavio, Banai, S, Buchbinder, M, Colombo, A, Falk, V, Feldman, T, Franzen, O, Herrmann, H, Kar, S, Kuck, Kh, Lutter, G, Mack, M, Nickenig, G, Piazza, N, Reisman, M, Ruiz, Ce, Schofer, J, Sondergaard, L, Stone, Gw, Taramasso, M, Thomas, M, Vahanian, A, Webb, J, Windecker, S, and Leon, Mb

Subjects
Cardiac Catheterization, medicine.medical_specialty, Mitral Valve Annuloplasty, Psychological intervention, 610 Medicine & health, Ventricular Function, Left, 2705 Cardiology and Cardiovascular Medicine, Mitral valve annuloplasty, Mitral valve, medicine, Humans, Intensive care medicine, Bioprosthesis, Heart Valve Prosthesis Implantation, Prosthetic valve, business.industry, MitraClip, Anticoagulants, Mitral Valve Insufficiency, Equipment Design, Surgical procedures, 10020 Clinic for Cardiac Surgery, Surgery, medicine.anatomical_structure, Echocardiography, Fluoroscopy, Heart Valve Prosthesis, Mitral Valve, Cardiology and Cardiovascular Medicine, business, Forecasting
Abstract

Transcatheter mitral interventions has been developed to address an unmet clinical need and may be an alternative therapeutic option to surgery with the intent to provide symptomatic and prognostic benefit. Beyond MitraClip therapy, alternative repair technologies are being developed to expand the transcatheter intervention armamentarium. Recently, the feasibility of transcatheter mitral valve implantation in native non-calcified valves has been reported in very high-risk patients. Acknowledging the lack of scientific evidence to date, it is difficult to predict what the ultimate future role of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development.

Published
2015
Full Text
View/download PDF

20. Adjudicating paravalvular leaks of transcatheter aortic valves: a critical appraisal

Author

Mohammad Abdelghani, Patrick W. Serruys, Carl Schultz, Osama Ibrahim Ibrahim Soliman, Alec Vahanian, and Cardiology

Subjects
Aortic valve, medicine.medical_specialty, Transcatheter aortic, Aortic Valve Insufficiency, 030204 cardiovascular system & hematology, Doppler echocardiography, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Routine clinical practice, 030212 general & internal medicine, Intensive care medicine, medicine.diagnostic_test, business.industry, Aortic Valve Stenosis, medicine.disease, Clinical trial, Critical appraisal, medicine.anatomical_structure, Aortic valve stenosis, Paravalvular leakage, Aortic Valve, Heart Valve Prosthesis, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Paravalvular leakage (PVL) is an important complication of transcatheter aortic valve implantation (TAVI). It contributed to the erosion of the clinical benefits of TAVI and confidence of its adoption as a default therapy in low surgical-risk patients. Newer TAVI technologies are provided with effective paravalvular sealing as well as retrieval/reposition mechanisms that are believed to considerably lower the risk of PVL. Meanwhile, developments in timely detection and accurate quantitation of PVL remain lagging behind those technological advances. The Valve Academic Research Consortium-standardized criteria of PVL assessment are based on echocardiography and are, according to experts' opinion, not adequately validated. Peri-procedural diagnosis, based on angiographic, haemodynamic, and/or echocardiographic methods, is so far without standardization of acquisition or interpretation. The aim of this report is to review the strengths and limitations of the current technologies used for PVL adjudication. Understanding this strengths/limitations ratio is important to define an appropriate scheme for detection and quantitation of PVLs both in clinical trials and in routine clinical practice.

Published
2016
Full Text
View/download PDF

21. IMCT-21UPDATES ON PHASE 1B/2 COMBINATION STUDY OF THE IDO PATHWAY IHIBITOR INDOXIMOD WITH TEMOZOLOMIDE FOR ADULT PATIENTS WITH TEMOZOLOMIDE-REFRACTORY PRIMARY MALIGNANT BRAIN TUMORS

Author

Nicholas N. Vahanian, Frank Mott, Eugene P. Kennedy, Olivier Rixe, Yousef Zakharia, Ramses F. Sadek, David H. Munn, Rimas V. Lukas, Charles J. Link, and Howard Colman

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Temozolomide, Bevacizumab, business.industry, medicine.medical_treatment, Brain tumor, medicine.disease, Radiosurgery, Refractory, In vivo, Internal medicine, Immunology, medicine, Neurology (clinical), Dosing, business, Abstracts from the 20th Annual Scientific Meeting of the Society for Neuro-Oncology, CD8, medicine.drug
Abstract

BACKGROUND: Indoleamine 2, 3-dioxygenase (IDO) is a key immune-modulatory enzyme within the IDO Pathway that inhibits CD8+ T cells and enhances the suppressor activity of Tregs. IDO is expressed in 50 to 90% of glioblastoma (GBM), and this high expression correlates with poor prognosis. IDO pathway inhibitors such as indoximod can improve anti-tumor T cell response slowing the tumor growth in vivo. We have demonstrated a synergistic effect of indoximod when combined with temozolomide (TMZ) and radiation in a syngeneic orthotopic brain tumor model. The purpose of this study is to determine the safety and preliminary efficacy of indoximod in combination with TMZ in recurrent refractory malignant brain tumors. METHODS: After progression on TMZ, patients are treated with indoximod (1200 mg BID orally) combined with a standard fixed dose of TMZ (150mg/m2x5 days). In the phase 2 expansion, patients are enrolled into 3 cohorts: 2a: indoximod with TMZ, 2b: indoximod with TMZ and bevacizumab (after progression on bevacizumab), 2c: indoximod with TMZ in conjunction with stereotactic radiosurgery in selected patients. Indoximod is administered for 28 days of each treatment cycle. RESULTS: 30 patients of a planned 105 are enrolled of which 12 patients completed the phase 1b cohort with no DLTs. The ready for phase 2 dose was 1200mg BID. 4 patients in phase 1b remain on study, the longest for 15 months. Best responses to date in the phase 1b component include one patient demonstrating an ongoing PR at 15 months per RANO criteria and SD in 4 patients lasting between 4 and 11 months. No severe AEs or change in TMZ dosing due to indoximod addition were documented. CONCLUSIONS: The phase 1b part has been successfully concluded with encouraging preliminary observations. Enrollment into the phase 2 portion is ongoing. Updates will be presented at the meeting. NCT02052648.

Published
2015

22. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: Aortic and pulmonary regurgitation (native valve disease)

Author

Lancellotti, P, Tribouilloy, C, Hagendorff, A, Moura, L, Popescu, B, Agricola, E, Monin, J, Pierard, L, Badano, L, Zamorano, J, Sicari, R, Vahanian, A, Roelandt, J, Lancellotti P., Tribouilloy C., Hagendorff A., Moura L., Popescu B. A., Agricola E., Monin J. -L., Pierard L. A., Badano L., Zamorano J. L., Sicari R., Vahanian A., Roelandt J. R. T. C., Lancellotti, P, Tribouilloy, C, Hagendorff, A, Moura, L, Popescu, B, Agricola, E, Monin, J, Pierard, L, Badano, L, Zamorano, J, Sicari, R, Vahanian, A, Roelandt, J, Lancellotti P., Tribouilloy C., Hagendorff A., Moura L., Popescu B. A., Agricola E., Monin J. -L., Pierard L. A., Badano L., Zamorano J. L., Sicari R., Vahanian A., and Roelandt J. R. T. C.

Abstract

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Echocardiography has become the primary non-invasive imaging method for the evaluation of valvular regurgitation. The echocardiographic assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy, and function as well as the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation thus largely integrates the results of echocardiography. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing regurgitation. © The Author 2010.

Published
2010

23. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Author

Steg, Pg, James, Sk, Atar, D, Badano, Lp, Lundqvist, Cb, Borger, Ma, Di Mario, C, Dickstein, K, Ducrocq, G, Fernandez Aviles, F, Gershlick, Ah, Giannuzzi, P, Halvorsen, S, Huber, K, Juni, P, Kastrati, A, Knuuti, J, Lenzen, Mj, Mahaffey, Kw, Valgimigli, M, Van't Hof, A, Widimsky, P, Zahger, D, ESC Committee for Practice Guidelines, Bax, Jj, Baumgartner, H, Ceconi, Claudio, Dean, V, Deaton, C, Fagard, R, Funck Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Torbicki, A, Vahanian, A, Windecker, S, Document, Reviewers, Astin, F, Aström Olsson, K, Budaj, A, Clemmensen, P, Collet, Jp, Fox, Ka, Fuat, A, Gustiene, O, Hamm, Cw, Kala, P, Lancellotti, P, Maggioni, Ap, Merkely, B, Neumann, Fj, Piepoli, Mf, Van de Werf, F, Verheugt, F, Wallentin, L., Steg, P, James, S, Atar, D, Badano, L, Lundqvist, C, Borger, M, Di Mario, C, Dickstein, K, Ducrocq, G, Fernandez-Aviles, F, Gershlick, A, Giannuzzi, P, Halvorsen, S, Huber, K, Juni, P, Kastrati, A, Knuuti, J, Lenzen, M, Mahaffey, K, Valgimigli, M, Van'T Hof, A, Widimsky, P, Zahger, D, Bax, J, Baumgartner, H, Ceconi, C, Dean, V, Deaton, C, Fagard, R, Funck-Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, B, Reiner, Z, Sechtem, U, Sirnes, P, Tendera, M, Torbicki, A, Vahanian, A, Windecker, S, Astin, F, Astrom-Olsson, K, Budaj, A, Clemmensen, P, Collet, J, Fox, K, Fuat, A, Gustiene, O, Hamm, C, Kala, P, Lancellotti, P, Maggioni, A, Merkely, B, Neumann, F, Piepoli, M, Van De Werf, F, Verheugt, F, and Wallentin, L

Subjects
Emergency Medical Services, Biomedical Research, General Practice, Myocardial Infarction, Guideline, Anxiety, ST-segment elevation, Electrocardiography, Myocardial infarction, Coronary Artery Bypass, 610 Medicine & health, Fibrinolytic Agent, Cardiovascular diseases [NCEBP 14], Secondary prevention, General Medicine, Reperfusion therapy, Antifibrinolytic Agents, Exercise Therapy, Hospitalization, cardiovascular system, Cardiology, Acute coronary syndromes Ischaemic heart disease, Cardiomyopathies, Cardiology and Cardiovascular Medicine, Ticagrelor, Human, medicine.drug, Acute coronary syndrome, medicine.medical_specialty, Cardiotonic Agents, Pain, Myocardial Reperfusion, Acute myocardial infarction, Guidelines, Antifibrinolytic Agent, Risk Assessment, Time-to-Treatment, Percutaneous Coronary Intervention, Fibrinolytic Agents, Internal medicine, medicine, Humans, Cardiotonic Agent, Hemodynamic, cardiovascular diseases, Emergency Treatment, Cardiomyopathie, Heart Failure, Cardiac Imaging Technique, Management of acute coronary syndrome, Emergency Medical Service, business.industry, Coronary Artery Bypa, Platelet Aggregation Inhibitor, Hemodynamics, Arrhythmias, Cardiac, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, Long-Term Care, Primary percutaneous coronary intervention Antithrombotic therapy, Cardiac Imaging Techniques, Dyspnea, Hyperglycemia, Door-to-balloon, Myocardial infarction complications, Myocardial infarction diagnosis, business, Risk Reduction Behavior, Platelet Aggregation Inhibitors, Out-of-Hospital Cardiac Arrest, Forecasting
Abstract

ACE : angiotensin-converting enzyme ACS : acute coronary syndrome ADP : adenosine diphosphate AF : atrial fibrillation AMI : acute myocardial infarction AV : atrioventricular AIDA-4 : Abciximab Intracoronary vs. intravenously Drug Application APACHE II : Acute Physiology Aand Chronic

Published
2012
Full Text
View/download PDF

24. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

Author

Authors, Task Force Members, Vahanian, Alec, Alfieri, Ottavio, Andreotti, Felicita, Antunes, Manuel J, Barón-Esquivias, Gonzalo, Baumgartner, Helmut, Borger, Michael Andrew, Carrel, Thierry P, De Bonis, Michele, Evangelista, Arturo, Falk, Volkmar, Lung, Bernard, Lancellotti, Patrizio, Pierard, Luc, Price, Susanna, Schäfers, Hans-Joachim, Schuler, Gerhard, Stepinska, Janina, Swedberg, Karl, Takkenberg, Johanna, Von Oppell, Ulrich Otto, Windecker, Stephan, Zamorano, Jose Luis, Zembala, Marian, ESC Committee for Practice Guidelines, CPG, Bax, Jeroen J, Ceconi, Claudio, Dean, Veronica, Deaton, Christi, Fagard, Robert, Funck-Brentano, Christian, Hasdai, David, Hoes, Arno, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, McDonagh, Theresa, Moulin, Cyril, Popescu, Bogdan A, Reiner, Zeljko, Sechtem, Udo, Sirnes, Per Anton, Tendera, Michal, Torbicki, Adam, Document, Reviewers, Von Segesser, Ludwig, Badano, Luigi P, Bunc, Matjaz, Claeys, Marc J, Drinkovic, Niksa, Filippatos, Gerasimos, Habib, Gilbert, Kappetein, A Pieter, Kassab, Roland, Lip, Gregory Y H, Moat, Neil, Nickenig, Georg, Otto, Catherine M, Pepper, John, Piazza, Nicolo, Pieper, Petronella G, Rosenhek, Raphael, Shuka, Naltin, Schwammenthal, Ehud, Schwitter, Juerg, Mas, Pilar Tornos, Trindade, Pedro T, Walther, Thomas, Authors/Task Force, Member, Vahanian, A, Alfieri, Ottavio, Andreotti, F, Antunes, Mj, Baron Esquivias, G, Baumgartner, H, Borger, Ma, Carrel, Tp, DE BONIS, Michele, Evangelista, A, Falk, V, Iung, B, Lancellotti, P, Pierard, L, Price, S, Schafers, Hj, Schuler, G, Stepinska, J, Swedberg, K, Takkenberg, J, Von Oppell, Uo, Windecker, S, Zamorano, Jl, Zembala, M, ESC Committee for Practice, Guideline, Bax, Jj, Ceconi, C, Dean, V, Deaton, C, Fagard, R, Funck Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Torbicki, A, Document, Reviewer, Von Segesser, L, Badano, Lp, Bunc, M, Claeys, Mj, Drinkovic, N, Filippatos, G, Habib, G, Kappetein, Ap, Kassab, R, Lip, Gy, Moat, N, Nickenig, G, Otto, Cm, Pepper, J, Piazza, N, Pieper, Pg, Rosenhek, R, Shuka, N, Schwammenthal, E, Schwitter, J, Mas, Pt, Trindade, Pt, and Walther, T.

Subjects
610 Medicine & health
Published
2012
Full Text
View/download PDF

25. Acute valve disease and endocarditis

Author

Gregory Ducrocq, Franck Thuny, Bernard Iung, and Alec Vahanian

Abstract

The management of patients with acute valve disease is now a rare, but challenging, event, as valvular patients are often elderly with severe comorbidities. Furthermore, a proportion of previously operated patients present with acute valve dysfunction. The aim, in this situation, is to establish a rapid diagnosis, based on clinical examination and echocardiography, followed by early intervention. The primary treatment remains surgical valve replacement. However, a more conservative surgical approach is under development, and, more recently, percutaneous interventional techniques have been introduced. In the future, every effort should be made to avoid performing interventions in an acute situation, as it is always at high risk.

Published
2015
Full Text
View/download PDF

26. Open issues in transcatheter aortic valve implantation. Part 2: procedural issues and outcomes after transcatheter aortic valve implantation

Author

Helmut Baumgartner, Alec Vahanian, Raimund Erbel, Vinayak Bapat, Jonathon Leipsic, Christian W. Hamm, Martin B. Leon, Philippe Pibarot, John G. Webb, Jeroen J. Bax, Nicolo Piazza, Martyn Thomas, Stephan Windecker, Jean-Philippe Collet, Josep Rodés-Cabau, José Luis Zamorano, Patrick W. Serruys, Arie Pieter Kappetein, William C. Roberts, Philip MacCarthy, Victoria Delgado, Cardiothoracic Surgery, and Cardiology

Subjects
Pacemaker, Artificial, medicine.medical_specialty, Future studies, Complications, Transcatheter aortic, Aortic Valve Insufficiency, Medizin, Aortic regurgitation, 610 Medicine & health, Regurgitation (circulation), Transcatheter Aortic Valve Replacement, Postoperative Complications, Fibrinolytic Agents, Internal medicine, Humans, Medicine, Prosthesis Durability, Registries, Bioprosthesis, Transcatheter aortic valve implantation, Conduction abnormalities, business.industry, Access site, Patient Selection, Arrhythmias, Cardiac, Aortic Valve Stenosis, Prognosis, medicine.disease, Prosthesis Failure, Stroke, Cardiac Imaging Techniques, Treatment Outcome, Aortic valve stenosis, Cardiology, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business, Fibrinolytic agent, Forecasting
Abstract

This article provides an overview on procedure-related issues and uncertainties in outcomes after transcatheter aortic valve implantation (TAVI). The different access sites and how to select them in an individual patient are discussed. Also, the occurrence and potential predictors of aortic regurgitation (AR) after TAVI are addressed. The different methods to quantify AR are reviewed, and it appears that accurate and reproducible quantification is suboptimal. Complications such as prosthesis-patient mismatch and conduction abnormalities (and need for permanent pacemaker) are discussed, as well as cerebrovascular events, which emphasize the development of optimal anti-coagulative strategies. Finally, recent registries have shown the adoption of TAVI in the real world, but longer follow-up studies are needed to evaluate the outcome (but also prosthesis durability). Additionally, future studies are briefly discussed, which will address the use of TAVI in pure AR and lower-risk patients.

Published
2014
Full Text
View/download PDF

27. Safety and preliminary efficacy of one month glycoprotein IIb/IIIa inhibition with lefradafiban in patients with acute coronary syndromes without ST-elevation

Author

A.P.J. Klootwijk, K.M. Akkerhuis, T. Baardman, K.L. Neuhaus, G. Nehmiz, J. Hoffmann, J.W. Deckers, Robert G. Wilcox, U. Roth, A Vahanian, M. L. Simoons, J-L. Boland, and Cardiology

Subjects
Male, Risk, medicine.medical_specialty, Pyrrolidines, Fibrinogen receptor, Myocardial Infarction, Hemorrhage, Platelet Glycoprotein GPIIb-IIIa Complex, Angina, Double-Blind Method, Internal medicine, medicine, Humans, Prodrugs, Myocardial infarction, Angina, Unstable, Aged, biology, Aspirin, business.industry, Unstable angina, Heparin, ST elevation, Biphenyl Compounds, Anticoagulants, Leukopenia, Middle Aged, medicine.disease, Troponin, Survival Analysis, Surgery, Cardiology, biology.protein, Female, Cardiology and Cardiovascular Medicine, business, Glycoprotein IIb/IIIa, TIMI, Platelet Aggregation Inhibitors
Abstract

Aims Oral glycoprotein IIb/IIIa inhibitors might enhance the early benefit of an intravenous agent and prevent subsequent cardiac events in patients with acute coronary syndromes. We assessed the safety and preliminary efficacy of 1 month treatment with three dose levels of the oral GP IIb/IIIa blocker lefradafiban in patients with unstable angina or myocardial infarction without persistent ST elevation. Methods The Fibrinogen Receptor Occupancy STudy (FROST) was designed as a dose-escalation trial with 20, 30 and 45mg lefradafiban t.i.d. or placebo. Five hundred and thirty-one patients were randomized in a 3:1 ratio to lefradafiban or placebo in a double-blind manner. Efficacy was assessed by the incidence of death, myocardial infarction, coronary revascularization and recurrent angina. Safety was evaluated by the occurrence of bleeding classified according to the TIMI criteria and by measuring clinical laboratory parameters. Results There was a trend towards a reduction in cardiac events with lefradafiban 30mg when compared with placebo and lefradafiban 20mg. The benefit was particularly apparent in patients with a positive (≥0·1ng.ml−1) troponin I test at baseline and less so in those with a negative test result. In patients receiving lefradafiban, the cardiac event rate decreased with increasing minimal levels of fibrinogen receptor occupancy. There was a dose-dependent increase in the incidence of bleeding: the composite of major or minor bleeding occurred in 1% of placebo patients, 5% of patients receiving lefradafiban 20mg and in 7% of patients receiving 30mg, with an excessive risk (15%) in the 45mg group which resulted in early discontinuation of this dose level. Gingival and arterial or venous puncture site bleedings were most common and accounted for more than 60% of all haemorrhagic events. There was an increased incidence of neutropenia (neutrophils

Published
2000

28. Open issues in transcatheter aortic valve implantation. Part 1 : patient selection and treatment strategy for transcatheter aortic valve implantation

Author

Bax, Jeroen J., Rodés-Cabau, Josep, Delgado, Victoria, Pibarot, Philippe, Bapat, Vinayak, Baumgartner, Helmut, Collet, Jean P., Erbel, Raimund, Hamm, Christian W., Kappetein, A. P., Leipsic, Jonathon, Leon, Martin B., MacCarthy, Philip, Piazza, Nicolo, Roberts, William C. (William Clifford), Serruys, P. W., Thomas, Martyn, Vahanian, Alec, Webb, John G. (John Graydon), Zamorano, José L. (José Luis), Windecker, Stephan, Bax, Jeroen J., Rodés-Cabau, Josep, Delgado, Victoria, Pibarot, Philippe, Bapat, Vinayak, Baumgartner, Helmut, Collet, Jean P., Erbel, Raimund, Hamm, Christian W., Kappetein, A. P., Leipsic, Jonathon, Leon, Martin B., MacCarthy, Philip, Piazza, Nicolo, Roberts, William C. (William Clifford), Serruys, P. W., Thomas, Martyn, Vahanian, Alec, Webb, John G. (John Graydon), Zamorano, José L. (José Luis), and Windecker, Stephan

Abstract

An exponential increase in the use of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis has been witnessed over the recent years. The current article reviews different areas of uncertainty related to patient selection. The use and limitations of risk scores are addressed, followed by an extensive discussion on the value of three-dimensional imaging for prosthesis sizing and the assessment of complex valve anatomy such as degenerated bicuspid valves. The uncertainty about valvular stenosis severity in patients with a mismatch between the transvalvular gradient and the aortic valve area, and how integrated use of echocardiography and computed tomographic imaging may help, is also addressed. Finally, patients referred for TAVI may have concomitant mitral regurgitation and/or coronary artery disease and the management of these patients is discussed.

Published
2016

29. Atrial fibrillation management: A prospective survey in ESC Member Countries - The Euro Heart Survey on atrial fibrillation

Author

Nieuwlaat R., Capucci A., Camm A. J., Olsson S. B., Andresen D., Davies D. W., Cobbe S., Breithardt G., Le Heuzey J. -Y., Prins M. H., Levy S., Crijns H. J. G. M., Aliot E., Santini M., Vardas P., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Mareev V., Vasiljevic Z., Riecansky I., Kenda M. F., Alonso A., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Ryden L., Tavazzi L., Vahanian A., Wijns W., Grigoryan S. V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L. A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B. B., Petrov V. A., Alexandrova M. M., Goudev A. R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru J., Taborsky M., Cappelen H., Sharaf Y. A., Ibrahim B. S. S., Tammam K., Saad A., Elghawaby H., Sherif H. Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F. F., Rubio J., Malpartida F., Corona M., Sanchez L. T., Herrera J. M. L., Quesada A., Munoz Garcia A. J., Gonzalez C. S., Juango M. S. A., Berjon-Reyero J., Alegret J. M., Fernandez J. M. C., Rosillo C. C., Romero A. F., Lara M. G., Lopez Sendon J. L., De Diego J. J. G., Martin L. S., Irurita M., Guttierez N. H., Rubio J. R. S., Antorrena I., Paves A. B., Salvador A., Orriach M. D., Garcia A. A., Epelde F., Martinez V. B., Sanchez A. B., Galvez C. P., Rivero R. F., Madrid A. H., Baron-Esquivias G., Peinado R., Guindal J. A. G., Vera T. R., Fernandez E. L., Gayan R., Garcia J., Bodegas A., Lopez J. T., Florez J. M., Cabezas C. L., De Castroviejo E. V. R., Bellido J. M., Ruiz M. E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J. C., Lecocq G., Poulain C., Cleland J. G. F. C., Shelton R., Lip G. Y. H., Choudhury A., Abuladze G., Jashi I., Cokkinos D. V., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Domproglou Tsoutsanis, Stefanadis Ch., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N. A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G. -P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G. M., Fioranelli M., Naccarella F., Maranga S. S., Lepera G., Bresciani B., Seragnoli E., Forti M. C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S. M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A. A., Scholte Op Reimer W., De Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., Van Hoogenhuyze D. C. A., Veerhoek M. J., Kamps M., Haan D., Van Rijn N., Bootsma A., Baur L., Van Den Dool A., Fransen H., Eurlings L., Meeder J., De Boer M. J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A. -M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., De Sousa J. M. F. R., Ferreira R., Freitas A., Morais J. C. A., Pires R., Veloso Gomes M. J., Gago P., Candeias R. A. C., Nunes L., Miranda Sa J. V., Ventura M., De Oliveira M., Alves L. B., Bostaca I., Olariu C. T., Dan G. A., Dan A., Podoleanu C., Frigy A., Georgescu G. I. M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D. L., Rancea R., Shubik Y. V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M. I., Makienko N. V., Potpara T., Knezevic S., Randjelovic M., Nieuwlaat R., Capucci A., Camm A.J., Olsson S.B., Andresen D., Davies D.W., Cobbe S., Breithardt G., Le Heuzey J.-Y., Prins M.H., Levy S., Crijns H.J.G.M., Aliot E., Santini M., Vardas P., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J.-J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Mareev V., Vasiljevic Z., Riecansky I., Kenda M.F., Alonso A., Lopez-Sendon J.L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Ryden L., Tavazzi L., Vahanian A., Wijns W., Grigoryan S.V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L.A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B.B., Petrov V.A., Alexandrova M.M., Goudev A.R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru J., Taborsky M., Cappelen H., Sharaf Y.A., Ibrahim B.S.S., Tammam K., Saad A., Elghawaby H., Sherif H.Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F.F., Rubio J., Malpartida F., Corona M., Sanchez L.T., Herrera J.M.L., Quesada A., Munoz Garcia A.J., Gonzalez C.S., Juango M.S.A., Berjon-Reyero J., Alegret J.M., Fernandez J.M.C., Rosillo C.C., Romero A.F., Lara M.G., Lopez Sendon J.L., De Diego J.J.G., Martin L.S., Irurita M., Guttierez N.H., Rubio J.R.S., Antorrena I., Paves A.B., Salvador A., Orriach M.D., Garcia A.A., Epelde F., Martinez V.B., Sanchez A.B., Galvez C.P., Rivero R.F., Madrid A.H., Baron-Esquivias G., Peinado R., Guindal J.A.G., Vera T.R., Fernandez E.L., Gayan R., Garcia J., Bodegas A., Lopez J.T., Florez J.M., Cabezas C.L., De Castroviejo E.V.R., Bellido J.M., Ruiz M.E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J.C., Lecocq G., Poulain C., Cleland J.G.F.C., Shelton R., Lip G.Y.H., Choudhury A., Abuladze G., Jashi I., Cokkinos D.V., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Domproglou, Tsoutsani, Stefanadis Ch., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N.A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G.-P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G.M., Fioranelli M., Naccarella F., Maranga S.S., Lepera G., Bresciani B., Seragnoli E., Forti M.C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S.M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A.A., Scholte Op Reimer W., De Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., Van Hoogenhuyze D.C.A., Veerhoek M.J., Kamps M., Haan D., Van Rijn N., Bootsma A., Baur L., Van Den Dool A., Fransen H., Eurlings L., Meeder J., De Boer M.J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A.-M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., De Sousa J.M.F.R., Ferreira R., Freitas A., Morais J.C.A., Pires R., Veloso Gomes M.J., Gago P., Candeias R.A.C., Nunes L., Miranda Sa J.V., Ventura M., De Oliveira M., Alves L.B., Bostaca I., Olariu C.T., Dan G.A., Dan A., Podoleanu C., Frigy A., Georgescu G.I.M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D.L., Rancea R., Shubik Y.V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M.I., Makienko N.V., Potpara T., Knezevic S., and Randjelovic M.

Subjects
Adult, Heart Failure, Male, Rate control, Risk Factor, Cardiology, Coronary Artery Disease, Guideline, Middle Aged, Atrial fibrillation, Europe, Stroke, Anticoagulation, Prospective Studie, Anti-Arrhythmia Agent, Echocardiography, Hypertension, Practice Guidelines as Topic, Rhythm control, Female, Societies, Medical, Aged, Human
Abstract

Aims To describe atrial fibrillation (AF) management in member countries of the European Society of Cardiology (ESC) and to verify cardiology practices against guidelines. Methods and results Among 182 hospitals in 35 countries, 5333 ambulant and hospitalized AF patients were enrolled, in 2003 and 2004. AF was primary or secondary diagnosis, and was confirmed on ECG in the preceding 12 months. Clinical type of AF was reported to be first detected in 978, paroxysmal in 1517, persistent in 1167, and permanent in 1547 patients. Concomitant diseases were present in 90% of all patients, causing risk factors for stroke to be also highly prevalent (86%). As many as 69% of patients were symptomatic at the time of the survey; among asymptomatic patients, 54% were previously experienced symptoms. Oral anticoagulation was prescribed in 67 and 49% of eligible and ineligible patients, respectively. A rhythm control strategy was applied in 67% of currently symptomatic patients and in 44% of patients who never experienced symptoms. Conclusion This survey provides a unique snapshot of current AF management in ESC member countries. Discordance between guidelines and practice was found regarding several issues on stroke prevention and antiarrhythmic therapy.

Published
2005

30. European Guidelines on Cardiovascular Diseases prevention in clinical practice (version 2012)

Author

Perk, Joep, De Backer, Guy, Gohlke, Helmut, Graham, Ian, Reiner, Zeljko, Verschuren, Monique, Albus, Christian, Benlian, Pascale, Boysen, Gudrun, Cifkova, Renata, Deaton, Christi, Ebrahim, Shah, Fisher, Miles, Germano, Giuseppe, Hobbs, Richard, Hoes, Arno W., Karadeniz, Sehnaz, Mezzani, Alessandro, Prescott, Eva, Rydén, Lars E., Scherer, Martin, Syvänne, Mikko, op Reimer, Wilma Scholte, Vrints, Christiaan, Wood, David, Zamorano, José Luis, Zannad, Faiez, Cooney, Marie Therese, Bax, Jeroen J., Baumgartner, Helmut, Ceconi, Claudio, Dean, Veronica, Fagard, Robert, Funck-Brentano, Christian, Hasdai, David, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, McDonagh, Theresa, Moulin, Cyril, Popescu, Bogdan A., Sechtem, Udo, Sirnes, Per Anton, Tendera, Michal, Torbicki, Adam, Vahanian, Alec, Windecker, Stephan, Aboyans, Victor, Ezquerra, Eduardo Alegria, Baigent, Colin, Brotons, Carlos, Burell, Gunilla, Ceriello, Antonio, De Sutter, Johan, Deckers, Jaap, Del Prato, Stefano, Diener, Hans-Christoph, Fitzsimons, Donna, Fras, Zlatko, Hambrecht, Rainer, Jankowski, Piotr, Keil, Ulrich, Kirby, Mike, Larsen, Mogens Lytken, Mancia, Giuseppe, Manolis, Athanasios J., McMurray, John J. V., Pajak, Andrzej, Parkhomenko, Alexander, Rallidis, Loukianos, Rigo, Fausto, Rocha, Evangelista, Ruilope, Luis Miguel, van der Velde, Enno, Vanuzzo, Diego, Viigimaa, Margus, Volpe, Massimo, Wiklund, Olov, and Wolpert, Christian

Published
2012

31. Valvular heart disease

Author

Bernard Iung, Alec Vahanian, and Gregory Ducroq

Subjects
medicine.medical_specialty, business.industry, Internal medicine, valvular heart disease, Cardiology, Medicine, business, medicine.disease
Abstract

Valvular heart disease (VHD), although not as common as coronarydisease or hypertension, is an important, and challenging, clinicalentity. The prevalence of VHD is still high, increasing with age, affecting 13.2% of people over the age of 75. There have beenimportant changes in the distribution of the aetiologies of VHDin Western countries over the last 50 years and the degenerativeaetiology is now the most frequent. Increased age is associated witha higher frequency of comorbidity, rendering decision-making forintervention more complex. The presence of VHD is of interest in patients with heart failure(HF) because the treatment of the causative VHD may cureHF, which stresses the importance of its detection and appropriatetreatment. However, decision-making for surgery may be difficult in patients with VHD and HF because of higher operativemortality and concerns over late results, which may be worsenedby progression of the underlying disease. The present chapter will concentrate on adult patients eitherwith acquired VHD or with a valve prosthesis, focusing specificallyon the patient with HF.

Published
2011
Full Text
View/download PDF

32. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases

Author

Tendera, Michal, Aboyans, Victor, Bartelink, Marie-Louise, Baumgartner, Iris, Clement, Denis, Collet, Jean-Philippe, Cremonesi, Alberto, De Carlo, Marco, Erbel, Raimund, Fowkes, F. Gerry R., Heras, Magda, Kownator, Serge, Minar, Erich, Ostergren, Jan, Poldermans, Don, Riambau, Vincent, Roffi, Marco, Rother, Joachim, Sievert, Horst, van Sambeek, Marc, Zeller, Thomas, Bax, Jeroen J., Auricchio, Angelo, Baumgartner, Helmut, Ceconi, Claudio, Dean, Veronica, Deaton, Christi, Fagard, Robert, Funck-Brentano, Christian, Hasdai, David, Hoes, Arno W., Knuuti, Juhani, McDonagh, Theresa, Moulin, Cyril, Popescu, Bogdan A., Reiner, Zeljko, Sechtem, Udo, Sirnes, Per Anton, Vahanian, Alec, Windecker, Stephan, Kolh, Philippe, Torbicki, Adam, Agewall, Stefan, Blinc, Ales, Bulvas, Miroslav, Cosentino, Francesco, De Backer, Tine, Gottsater, Anders, Gulba, Dietrich, Guzik, Tomasz J., Jonsson, Bjorn, Kesmarky, Gabor, Kitsiou, Anastasia, Kuczmik, Waclaw, Larsen, Mogens Lytken, Madaric, Juraj, Mas, Jean-Louis, McMurray, John J. V., Micari, Antonio, Mosseri, Moris, Muller, Christian, Naylor, Ross, Norrving, Bo, Oto, Oztekin, Pasierski, Tomasz, Plouin, Pierre-Francois, Ribichini, Flavio, Ricco, Jean-Baptiste, Ruilope, Luis, Schmid, Jean-Paul, Schwehr, Udo, Sol, Berna G. M., Sprynger, Muriel, Tiefenbacher, Christiane, Tsioufis, Costas, and Van Damme, Hendrik

Subjects
Adult, Diagnostic Imaging, Male, Upper extremity artery disease, Multisite artery disease, Risk Assessment, Peripheral Arterial Disease, Renal artery disease, Risk Factors, 80 and over, Humans, Mesenteric artery disease, Vertebral artery disease, Medical History Taking, Physical Examination, Aged, Carotid artery disease, Peripheral artery disease, Endovascular Procedures, Cardiovascular Agents, Middle Aged, Lower extremity artery disease, Prognosis, Exercise Therapy, Reperfusion, Female, Aged, 80 and over, Vascular Surgical Procedures
Published
2011

33. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium

Author

Eugenia Nikolsky, Pascal Vranckx, Alec Vahanian, Arie Pieter Kappetein, Marie-Angèle Morel, Johanna J.M. Takkenberg, John L. Petersen, Jeffrey J. Popma, Stephan Windecker, John G. Webb, Martin B. Leon, Craig Miller, Roxana Mehran, Eugene H. Blackstone, Donald E. Cutlip, Nicolo Piazza, Patrick W. Serruys, Mitchell W. Krucoff, Michael J. Mack, Gerrit-Anne van Es, Cardiology, and Cardiothoracic Surgery

Subjects
Aortic valve, medicine.medical_specialty, Cardiac Catheterization, Endpoint Determination, MEDLINE, Myocardial Infarction, Hemorrhage, SDG 3 - Good Health and Well-being, Clinical Research, Cause of Death, Clinical endpoint, Medicine, Humans, Vascular Diseases, Intensive care medicine, Heart Valve Prosthesis Implantation, Transcatheter aortic valve implantation, business.industry, Surrogate endpoint, Graft Occlusion, Vascular, Aortic Valve Stenosis, Acute Kidney Injury, medicine.disease, Valvular Medicine, Surgery, Prosthesis Failure, Clinical trial, Stroke, Stenosis, Clinical research, medicine.anatomical_structure, Treatment Outcome, Aortic valve stenosis, Aortic Valve, Heart Valve Prosthesis, Cardiology and Cardiovascular Medicine, business
Abstract

Objectives To propose standardized consensus definitions for important clinical endpoints in transcatheter aortic valve implantation (TAVI), investigations in an effort to improve the quality of clinical research and to enable meaningful comparisons between clinical trials. To make these consensus definitions accessible to all stakeholders in TAVI clinical research through a peer reviewed publication, on behalf of the public health. Background Transcatheter aortic valve implantation may provide a worthwhile less invasive treatment in many patients with severe aortic stenosis and since its introduction to the medical community in 2002, there has been an explosive growth in procedures. The integration of TAVI into daily clinical practice should be guided by academic activities, which requires a harmonized and structured process for data collection, interpretation, and reporting during well-conducted clinical trials. Methods and Results The Valve Academic Research Consortium established an independent collaboration between Academic Research organizations and specialty societies (cardiology and cardiac surgery) in the USA and Europe. Two meetings, in San Francisco, California (September 2009) and in Amsterdam, the Netherlands (December 2009), including key physician experts, and representatives from the U. S. Food and Drug Administration (FDA) and device manufacturers, were focused on creating consistent endpoint definitions and consensus recommendations for implementation in TAVI clinical research programs. Important considerations in developing endpoint definitions included: 1) respect for the historical legacy of surgical valve guidelines; 2) identification of pathophysiological mechanisms associated with clinical events; 3) emphasis on clinical relevance. Consensus criteria were developed for the following endpoints: mortality, myocardial infarction, stroke, bleeding, acute kidney injury, vascular complications, and prosthetic valve performance. Composite endpoints for TAVI safety and effectiveness were also recommended. Conclusions Although consensus criteria will invariably include certain arbitrary features, an organized multidisciplinary process to develop specific definitions for TAVI clinical research should provide consistency across studies that can facilitate the evaluation of this new important catheter-based therapy. The broadly based consensus endpoint definitions described in this document may be useful for regulatory and clinical trial purposes. (J Am Coll Cardiol 2011;57:253-69) (C) 2011 by the American College of Cardiology Foundation

Published
2011
Full Text
View/download PDF

34. The future of transcatheter mitral valve interventions: competitive or complementary role of repair vs. replacement?

Author

Maisano, Francesco, Alfieri, Ottavio, Banai, Shmuel, Buchbinder, Maurice, Colombo, Antonio, Falk, Volkmar, Feldman, Ted, Franzen, Olaf, Herrmann, Howard, Kar, Saibal, Kuck, Karl-Heinz, Lutter, Georg, Mack, Michael, Nickenig, Georg, Piazza, Nicolo, Reisman, Mark, Ruiz, Carlos E, Schofer, Joachim, Søndergaard, Lars, Stone, Gregg W, Taramasso, Maurizio, Thomas, Martyn, Vahanian, Alec, Webb, John, Windecker, Stephan, Leon, Martin B, Maisano, Francesco, Alfieri, Ottavio, Banai, Shmuel, Buchbinder, Maurice, Colombo, Antonio, Falk, Volkmar, Feldman, Ted, Franzen, Olaf, Herrmann, Howard, Kar, Saibal, Kuck, Karl-Heinz, Lutter, Georg, Mack, Michael, Nickenig, Georg, Piazza, Nicolo, Reisman, Mark, Ruiz, Carlos E, Schofer, Joachim, Søndergaard, Lars, Stone, Gregg W, Taramasso, Maurizio, Thomas, Martyn, Vahanian, Alec, Webb, John, Windecker, Stephan, and Leon, Martin B

Abstract

Transcatheter mitral interventions has been developed to address an unmet clinical need and may be an alternative therapeutic option to surgery with the intent to provide symptomatic and prognostic benefit. Beyond MitraClip therapy, alternative repair technologies are being developed to expand the transcatheter intervention armamentarium. Recently, the feasibility of transcatheter mitral valve implantation in native non-calcified valves has been reported in very high-risk patients. Acknowledging the lack of scientific evidence to date, it is difficult to predict what the ultimate future role of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development.

Published
2015

35. Comparison of vascular closure devices for access site closure after transfemoral aortic valve implantation

Author

Barbash, I, Barbanti, M, Webb, J, Molina Martin De Nicolas, J, Abramowitz, Y, Latib, A, Nguyen, C, Deuschl, F, Segev, A, Sideris, K, Buccheri, S, Simonato, M, DELLA ROSA, F, Tamburino, C, Jilaihawi, H, Miyazaki, T, Himbert, D, Schofer, N, Guetta, V, Bleiziffer, S, Tchetche, D, Immè, S, Makkar, R, Vahanian, A, Treede, H, Lange, R, Colombo, A, Dvir, D, Dvir, D., DELLA ROSA, FRANCESCO, Barbash, I, Barbanti, M, Webb, J, Molina Martin De Nicolas, J, Abramowitz, Y, Latib, A, Nguyen, C, Deuschl, F, Segev, A, Sideris, K, Buccheri, S, Simonato, M, DELLA ROSA, F, Tamburino, C, Jilaihawi, H, Miyazaki, T, Himbert, D, Schofer, N, Guetta, V, Bleiziffer, S, Tchetche, D, Immè, S, Makkar, R, Vahanian, A, Treede, H, Lange, R, Colombo, A, Dvir, D, Dvir, D., and DELLA ROSA, FRANCESCO

Abstract

Background The majority of transcatheter aortic valve implantation (TAVI) procedures are currently performed by percutaneous transfemoral approach. The potential contribution of the type of vascular closure device to the incidence of vascular complications is not clear. Aim To compare the efficacy of a Prostar XL-vs. Perclose ProGlide-based vascular closure strategy. Methods The ClOsure device iN TRansfemoral aOrtic vaLve implantation (CONTROL) multi-center study included 3138 consecutive percutaneous transfemoral TAVI patients, categorized according to vascular closure strategy: Prostar XL-(Prostar group) vs. Perclose ProGlide-based vascular closure strategy (ProGlide group). Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Results Propensity matching identified 944 well-matched patients (472 patient pairs). Composite primary end point of major vascular complications or in-hospital mortality occurred more frequently in Prostar group when compared with ProGlide group (9.5 vs. 5.1%, P = 0.016), and was driven by higher rates of major vascular complication (7.4 vs. 1.9%, P < 0.001) in the Prostar group. However, in-hospital mortality was similar between groups (4.9 vs. 3.5%, P = 0.2). Femoral artery stenosis occurred less frequently in the Prostar group (3.4 vs. 0.5%, P = 0.004), but overall, Prostar use was associated with higher rates of major bleeding (16.7 vs. 3.2%, P < 0.001), acute kidney injury (17.6 vs. 4.4%, P < 0.001) and with longer hospital stay (median 6 vs. 5 days, P = 0.007). Conclusions Prostar XL-based vascular closure in transfemoral TAVI procedures is associated with higher major vascular complication rates when compared with ProGlide; however, in-hospital mortality is similar with both devices.

Published
2015

36. Mitral balloon valvuloplasty

Author

Dominique Himbert, Eric Brochet, Gregory Ducrocq, Alec Vahanian, and Bernard Iung

Subjects
medicine.medical_specialty, business.industry, medicine, Balloon valvuloplasty, business, Surgery
Abstract

Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. The treatment of MS has been revolutionized since the development of balloon mitral valvuloplasty (BMV). Until the first publication by Inoue in 1984, surgery was the only treatment for patients with mitral stenosis. Since then, the technique has evolved considerably. A large number of patients with varied conditions have now been treated worldwide, enabling us to assess the efficacy and risk of the technique, and long-term results make us better able to select the most appropriate candidates for treatment using this method.

Published
2010
Full Text
View/download PDF

38. Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

Author

European Association, for Percutaneous Cardiovascular Interventions, Wijns, William, Kolh, Philippe, Danchin, Nicolas, Di Mario, Carlo, Falk, Volkmar, Folliguet, Thierry, Garg, Scot, Huber, Kurt, James, Stefan, Knuuti, Juhani, Lopez-Sendon, Jose, Marco, Jean, Menicanti, Lorenzo, Ostojic, Miodrag, Piepoli, Massimo F, Pirlet, Charles, Pomar, Jose L, Reifart, Nicolaus, Ribichini, Flavio L, Schalij, Martin J, Sergeant, Paul, Serruys, Patrick W, Silber, Sigmund, Sousa Uva, Miguel, Taggart, David, ESC Committee, for Practice Guidelines, Vahanian, Alec, Auricchio, Angelo, Bax, Jeroen, Ceconi, Claudio, Dean, Veronica, Filippatos, Gerasimos, Funck-Brentano, Christian, Hobbs, Richard, Kearney, Peter, McDonagh, Theresa, Popescu, Bogdan A, Reiner, Zeljko, Sechtem, Udo, Sirnes, Per Anton, Tendera, Michal, Vardas Panos, E, Widimsky, Petr, EACTS Clinical Guidelines, Committee, Alfieri, Ottavio, Dunning, Joel, Elia, Stefano, Kappetein, Pieter, Lockowandt, Ulf, Sarris, George, Vouhe, Pascal, von Segesser, Ludwig, Agewall, Stefan, Aladashvili, Alexander, Alexopoulos, Dimitrios, Antunes, Manuel J, Atalar, Enver, Brutel de la Riviere, Aart, Doganov, Alexander, Eha, Jaan, Fajadet, Jean, Ferreira, Rafael, Garot, Jerome, Halcox, Julian, Hasin, Yonathan, Janssens, Stefan, Kervinen, Kari, Laufer, Gunther, Legrand, Victor, Nashef Samer, A M, Neumann, Franz-Josef, Niemela, Kari, Nihoyannopoulos, Petros, Noc, Marko, Piek, Jan J, Pirk, Jan, Rozenman, Yoseph, Sabate, Manel, Starc, Radovan, Thielmann, Matthias, Wheatley, David J, Windecker, Stephan, and Zembala, Marian

Subjects
myocardial, revascularization, medicine.medical_specialty, business.industry, Judgement, Medizin, MEDLINE, Conflict of interest, EuroSCORE, Evidence-based medicine, medicine.disease, Coronary artery bypass surgery, Cardiothoracic surgery, Internal medicine, medicine, Cardiology, Medical emergency, Cardiology and Cardiovascular Medicine, Risk assessment, business
Abstract

Guidelines and Expert Consensus Documents summarize and evaluate all available evidence with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome and the risk–benefit ratio of diagnostic or therapeutic means. Guidelines are no substitutes for textbooks and their legal implications have been discussed previously. Guidelines and recommendations should help physicians to make decisions in their daily practice. However, the ultimate judgement regarding the care of an individual patient must be made by his/her responsible physician(s). The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC website (http://www.escardio.org/knowledge/guidelines/rules). Members of this Task Force were selected by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) to represent all physicians involved with the medical and surgical care of patients with coronary artery disease (CAD). A critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk–benefit ratio. Estimates of expected health outcomes for society are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in Tables 1 and 2 . View this table: Table 1 Classes of recommendations View this table: Table 2 Levels of evidence The members of the Task Force have provided disclosure statements of all relationships that might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at European Heart House, headquarters of the ESC. Any changes in conflict of interest that arose during the writing period were notified to the ESC. The Task Force report received its entire financial support from the ESC and EACTS, without any involvement of the pharmaceutical, device, or surgical industry. ESC …

Published
2010
Full Text
View/download PDF

41. Open issues in transcatheter aortic valve implantation. Part 1 : patient selection and treatment strategy for transcatheter aortic valve implantation

Author

Bax, Jeroen J., Delgado, Victoria, Bapat, Vinayak, Baumgartner, Helmut, Collet, Jean P., Erbel, Raimund, Hamm, Christian W., Kappetein, A. P., Leipsic, Jonathon, Leon, Martin B., MacCarthy, Philip, Piazza, Nicolo, Pibarot, Philippe, Roberts, William C. (William Clifford), Rodés-Cabau, Josep, Serruys, P. W., Thomas, Martyn, Vahanian, Alec, Webb, John G. (John Graydon), Zamorano, José L. (José Luis), Windecker, Stephan, Bax, Jeroen J., Delgado, Victoria, Bapat, Vinayak, Baumgartner, Helmut, Collet, Jean P., Erbel, Raimund, Hamm, Christian W., Kappetein, A. P., Leipsic, Jonathon, Leon, Martin B., MacCarthy, Philip, Piazza, Nicolo, Pibarot, Philippe, Roberts, William C. (William Clifford), Rodés-Cabau, Josep, Serruys, P. W., Thomas, Martyn, Vahanian, Alec, Webb, John G. (John Graydon), Zamorano, José L. (José Luis), and Windecker, Stephan

Abstract

An exponential increase in the use of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis has been witnessed over the recent years. The current article reviews different areas of uncertainty related to patient selection. The use and limitations of risk scores are addressed, followed by an extensive discussion on the value of three-dimensional imaging for prosthesis sizing and the assessment of complex valve anatomy such as degenerated bicuspid valves. The uncertainty about valvular stenosis severity in patients with a mismatch between the transvalvular gradient and the aortic valve area, and how integrated use of echocardiography and computed tomographic imaging may help, is also addressed. Finally, patients referred for TAVI may have concomitant mitral regurgitation and/or coronary artery disease and the management of these patients is discussed.

Published
2014

43. Sex-related differences in severe native valvular heart disease: the ESC-EORP Valvular Heart Disease II survey.

Author

Mascherbauer J, Kammerlander A, Nitsche C, Bax J, Delgado V, Evangelista A, Laroche C, Maggioni AP, Magne J, Vahanian A, and Iung B

Subjects
Humans, Female, Male, Aged, Middle Aged, Sex Factors, Europe epidemiology, Heart Valve Diseases epidemiology, Heart Valve Diseases complications
Abstract

Background and Aims: To assess sex differences in disease characteristics and treatment of patients with severe native valvular heart disease (VHD) included in the VHD II EURObservational Research Programme., Methods: A total of 5219 patients were enrolled in 208 European and North African centres and followed for 6 months [41.2% aortic stenosis (AS), 5.3% aortic regurgitation (AR), 4.5% mitral stenosis (MS), 21.3% mitral regurgitation (MR), 2.7% isolated right-sided VHD, 24.9% multiple left-sided VHD]. Indications for intervention were considered concordant if corresponding to class I recommendations specified in the 2012 ESC or 2014 AHA/ACC VHD guidelines., Results: Overall, women were older, more symptomatic, and presented with a higher EuroSCORE II. Bicuspid aortic valve and AR were more prevalent among men while mitral disease, concomitant tricuspid regurgitation (TR), and AS above age 65 were more prevalent among women. On multivariable regression analysis, concordance with recommended treatment was significantly poorer in women with MS and primary MR (both P < .001). Age, patient refusal, and decline of symptoms after conservative treatment were reported significantly more often as reasons to withhold the intervention in females. Concomitant tricuspid intervention was performed at a similar rate in both sexes although prevalence of significant TR was significantly higher in women. In-hospital and 6-month survival did not differ between sexes., Conclusions: (i) Valvular heart disease subtype varied between sexes; (ii) concordance with recommended intervention for MS and primary MR was significantly lower for women; and (iii) survival of men and women was similar at 6 months., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2024
Full Text
View/download PDF

44. Unmet needs in valvular heart disease.

Author

Messika-Zeitoun D, Baumgartner H, Burwash IG, Vahanian A, Bax J, Pibarot P, Chan V, Leon M, Enriquez-Sarano M, Mesana T, and Iung B

Subjects
Humans, Heart Valve Diseases diagnosis, Heart Valve Diseases epidemiology, Heart Valve Diseases therapy
Abstract

Valvular heart disease (VHD) is the next epidemic in the cardiovascular field, affecting millions of people worldwide and having a major impact on health care systems. With aging of the population, the incidence and prevalence of VHD will continue to increase. However, VHD has not received the attention it deserves from both the public and policymakers. Despite important advances in the pathophysiology, natural history, management, and treatment of VHD including the development of transcatheter therapies, VHD remains underdiagnosed, identified late, and often undertreated with inequality in access to care and treatment options, and there is no medication that can prevent disease progression. The present review article discusses these gaps in the management of VHD and potential actions to undertake to improve the outcome of patients with VHD., Competing Interests: Conflict of interest D.M.-Z. has received research grant from Edwards Lifesciences. H.B. received honoraria and travel support from Edwards Lifesciences and Actelion. M.E.-S. received consulting fees from Edwards LLC, Highlife, Artivon, and ChemImage. I.G.B. declares that there is no conflict of interest. A.V. declares that there is no conflict of interest. J.B. has received speaker fees from Edwards Lifesciences and Abbott. P.P. has received funding from Edwards Lifesciences, Medtronic, and Pi-Cardia, for echocardiography core laboratory analyses and research studies in the field of transcatheter valve therapies, for which he received no personal compensation. P.P. has received lecture fees from Edwards Lifesciences and Medtronic. V.C. declares that there is no conflict of interest. M.L. received clinical institutional research grants from Abbott, Boston Scientific, Edwards, and Medtronic. T.M. declares that there is no conflict of interest. B.I. declares that there is no conflict of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2023
Full Text
View/download PDF

45. EURObservational Research Programme: a bibliometric assessment of its scientific output.

Author

Rossello X, Massó-van Roessel A, Chioncel O, Tavazzi L, Ferrari R, Vahanian A, Gale CP, Popescu BA, and Maggioni AP

Subjects
Humans, Registries, Bibliometrics, Cardiology
Abstract

Aims: Given the lack of reliable observational data, a network of volunteer centres, and standardized methodological procedures, the European Society of Cardiology EURObservational Research Programme (EORP) was set up to provide a better understanding of real-world cardiovascular care and outcomes. We aimed to evaluate the scientific impact of EORP using a bibliometric approach., Methods and Results: We collected data for each individual publication and for each individual journal with at least one EORP publication. Bibliometric indicators evaluating research performance were categorized into those evaluating EORP publications (publication-based indicators) and those assessing the journals where those papers were published (journal-based indicators). During the first ∼11 years since its inception, we found that EORP produced 189 publications, with most published in journals in the first quartile (60.9%) or the second quartile (33.5%) of the Web of Science Journal Citation Report. The total number of citations to EORP publications was 9630 (average citation per publication of 51, h-index of 54, and 29 EORP publications with ≥100 citations). Of EORP publications, 20 had an Altmetric Attention Score >50 and 9 had a score >100. A total of 52 EORP papers have been cited 65 times in ESC Clinical Practice Guidelines between 2013 and 2021., Conclusion: EORP registries have contributed to impactful scientific knowledge. The high-quality metrics highlight the relevance of the EORP international cardiovascular registries to the academic community. Efforts are needed to support this, and other programmes aimed at delivering real-world evidence from independent patient data of cardiovascular care and outcomes across multiple geographies., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2022
Full Text
View/download PDF

46. Characteristics, management, and outcomes of patients with multiple native valvular heart disease: a substudy of the EURObservational Research Programme Valvular Heart Disease II Survey.

Author

Tribouilloy C, Bohbot Y, Kubala M, Ruschitzka F, Popescu B, Wendler O, Laroche C, Bartha E, Ince H, Simkova I, Vahanian A, and Iung B

Subjects
Female, Hospitalization, Humans, Heart Failure complications, Heart Failure epidemiology, Heart Failure therapy, Heart Valve Diseases surgery
Abstract

Aims: To assess the characteristics, management, and survival of patients with multiple native valvular heart disease (VHD)., Methods and Results: Among the 5087 patients with ≥1 severe left-sided native VHD included in the EURObservational VHD II Survey (maximum 3-month recruitment period per centre between January and August 2017 with a 6-month follow-up), 3571 had a single left-sided VHD (Group A, 70.2%), 363 had one severe left-sided VHD with moderate VHD of the other ipsilateral valve (Group B, 7.1%), and 1153 patients (22.7%) had ≥2 severe native VHDs (left-sided and/or tricuspid regurgitation, Group C). Patients with multiple VHD (Groups B and C) were more often women, had greater congestive heart failure (CHF) and comorbidity, higher left atrial volumes and pulmonary pressures, and lower ejection fraction than Group A patients (all P ≤ 0.01). During the index hospitalization, 36.7% of Group A (n = 1312), 26.7% of Group B (n = 97), and 32.7% of Group C (n = 377) underwent valvular intervention (P < 0.001). Six-month survival was better for Group A than for Group B or C (both P < 0.001), even after adjustment for age, sex, body mass index, and Charlson index [hazard ratio (HR) 95% confidence interval (CI) 1.62 (1.10-2.38) vs. Group B and HR 95% CI 1.72 (1.32-2.25) vs. Group C]. Groups B and C had more CHF at 6 months than Group A (both P < 0.001). Factors associated with mortality in Group C were age, CHF, and comorbidity (all P < 0.010)., Conclusion: Multiple VHD is common, encountered in nearly 30% of patients with left-sided native VHD, and associated with greater cardiac damage and leads to higher mortality and more heart failure at 6 months than single VHD, yet with lower rates of surgery., (© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2022
Full Text
View/download PDF

49. Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper.

Author

Lancellotti P, Pibarot P, Chambers J, La Canna G, Pepi M, Dulgheru R, Dweck M, Delgado V, Garbi M, Vannan MA, Montaigne D, Badano L, Maurovich-Horvat P, Pontone G, Vahanian A, Donal E, and Cosyns B

Subjects
Echocardiography, Humans, Multimodal Imaging, Heart Valve Diseases diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency diagnostic imaging
Abstract

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Imaging is pivotal in the evaluation of native valve regurgitation and echocardiography is the primary imaging modality for this purpose. The imaging assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy and function, and the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation largely relies on the results of imaging. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing native valve regurgitation. The present document aims to present clinical guidance for the multi-modality imaging assessment of native valvular regurgitation., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissions@oup.com.)

Published
2022
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results