9 results on '"Ruile, Philipp"'
Search Results
2. Investigation of factors determining haemodynamic relevance of leaflet thrombosis after transcatheter aortic valve implantation.
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Soschynski, Martin, Hein, Manuel, Capilli, Fabio, Hagar, Muhammad Taha, Ruile, Philipp, Breitbart, Philipp, Westermann, Dirk, Taron, Jana, Schuppert, Christopher, Schlett, Christopher L, Bamberg, Fabian, and Krauss, Tobias
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THROMBOSIS ,HEART valve prosthesis implantation ,BLOOD vessels ,VENTRICULAR ejection fraction ,MULTIPLE regression analysis ,SURGICAL complications ,ATRIAL fibrillation ,PROSTHETIC heart valves ,ELECTROCARDIOGRAPHY ,HEMODYNAMICS ,COMPUTED tomography ,BODY mass index - Abstract
Aims To determine the conditions under which early hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) becomes haemodynamically relevant. Methods and results The study included 100 patients (age: 81.5 ± 5.5 years; female 63%), thereof 50 patients with HALT. After anonymization and randomization, blinded readers measured maximum thrombus thickness per prosthesis (MT_pr) and movement restriction (MR_pr) on electrocardiogram (ECG)-gated whole heart cycle computed tomography angiography. These measurements were compared with echocardiographic mean pressure gradient (mPG), its increase from baseline (ΔmPG), and Doppler velocity index (DVI). Haemodynamic valve deterioration (HVD) was defined as mPG > 20 mmHg. Age, body mass index, valve type, valve size, left ventricular ejection fraction, and atrial fibrillation were considered as influencing factors. Multiple regression analysis revealed that only valve size (P = 0.001) and MT_pr (P = 0.02) had a significant influence on mPG. In an interaction model, valve size moderated the effect of MT_pr on mPG significantly (P = 0.004). Sub-group analysis stratified by valve sizes showed a strong correlation between MT_pr and echocardiographic parameters for 23 mm valves (mPG: r = 0.57, ΔmPG: r = 0.68, DVI: r = 0.55, each with P < 0.001), but neither for 26 nor 29 mm valves (r < 0.2, P > 0.2 for all correlations). Six of seven prostheses with HVD had a 23 mm valve diameter, while one had 29 mm (P = 0.02). Conclusion Early HALT rarely causes significant mPG increase. Our study shows that valve size is a key factor influencing the haemodynamic impact of HALT. In small valve sizes, mPG is more likely to increase. Our study is the first to offer in vivo evidence supporting previous in vitro findings on this topic. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Pre-Procedural Assessment of the Femoral Access Route for Transcatheter Aortic Valve Implantation: Comparison of a Non-Contrast Time-of-Flight Magnetic Resonance Angiography Protocol with Contrast-Enhanced Dual-Source Computed Tomography Angiography.
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Brado, Johannes, Breitbart, Philipp, Hein, Manuel, Pache, Gregor, Schmitt, Ramona, Hein, Jonas, Apweiler, Matthias, Soschynski, Martin, Schlett, Christopher, Bamberg, Fabian, Neumann, Franz-Josef, Westermann, Dirk, Krauss, Tobias, and Ruile, Philipp
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HEART valve prosthesis implantation ,MAGNETIC resonance angiography ,ANGIOGRAPHY ,ILIAC artery ,PEARSON correlation (Statistics) - Abstract
Background: We aimed to evaluate the feasibility of a non-contrast time-of-flight magnetic resonance angiography (TOF-MRA) protocol for the pre-procedural access route assessment of transcatheter aortic valve implantation (TAVI) in comparison with contrast-enhanced cardiac dual-source computed tomography angiography (CTA). Methods and Results: In total, 51 consecutive patients (mean age: 82.69 ± 5.69 years) who had undergone a pre-TAVI cardiac CTA received TOF-MRA for a pre-procedural access route assessment. The MRA image quality was rated as very good (median of 5 [IQR 4–5] on a five-point Likert scale), with only four examinations rated as non-diagnostic. The TOF-MRA systematically underestimated the minimal effective vessel diameter in comparison with CTA (for the effective vessel diameter in mm, the right common iliac artery (CIA)/external iliac artery (EIA)/common femoral artery (CFA) MRA vs. CTA was 8.04 ± 1.46 vs. 8.37 ± 1.54 (p < 0.0001) and the left CIA/EIA/CFA MRA vs. CTA was 8.07 ± 1.32 vs. 8.28 ± 1.34 (p < 0.0001)). The absolute difference between the MRA and CTA was small (for the Bland–Altman analyses in mm, the right CIA/EIA/CFA was −0.36 ± 0.77 and the left CIA/EIA/CFA was −0.25 ± 0.61). The overall correlation between the MRA and CTA measurements was very good (with a Pearson correlation coefficient of 0.87 (p < 0.0001) for the right CIA/EIA/CFA and a Pearson correlation coefficient of 0.9 (p < 0.0001) for the left CIA/EIA/CFA). The feasibility agreement between the MRA and CTA for transfemoral access was good (the right CIA/EIA/CFA agreement was 97.9% and the left CIA/EIA/CFA agreement was 95.7%, Kohen's kappa: 0.477 (p = 0.001)). Conclusions: The TOF-MRA protocol was feasible for the assessment of the access route in an all-comer pre-TAVI population. This protocol might be a reliable technique for patients at an increased risk of contrast-induced nephropathy. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Outcomes in transcatheter aortic valve replacement for bicuspid versus tricuspid aortic valve stenosis
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Yoon, Sung-Han, Bleiziffer, Sabine, De Backer, Ole, Delgado, Victoria, Arai, Takahide, Ziegelmueller, Johannes, Barbanti, Marco, Sharma, Rahul, Perlman, Gidon Y, Khalique, Omar K, Holy, Erik W, Saraf, Smriti, Deuschl, Florian, Fujita, Buntaro, Ruile, Philipp, Neumann, Franz-Josef, Pache, Gregor, Takahashi, Masao, Kaneko, Hidehiro, Schmidt, Tobias, Ohno, Yohei, Schofer, Niklas, Kong, William K F, Tay, Edgar, Sugiyama, Daisuke, Kawamori, Hiroyuki, Maeno, Yoshio, Abramowitz, Yigal, Chakravarty, Tarun, Kuwata, Shingo, et al, University of Zurich, and Yoon, Sung-Han
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congenital, hereditary, and neonatal diseases and abnormalities ,aortic Stenosis ,bicuspid aortic valve ,cardiovascular system ,10209 Clinic for Cardiology ,610 Medicine & health ,cardiovascular diseases ,2705 Cardiology and Cardiovascular Medicine ,transcatheter aortic valve implantation ,10020 Clinic for Cardiac Surgery - Published
- 2017
5. Need for pacemaker implantation in patients with normal QRS duration immediately after transcatheter aortic valve implantation.
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Schoechlin, Simon, Jalil, Fares, Blum, Thomas, Ruile, Philipp, Hein, Manuel, Nührenberg, Thomas G, Arentz, Thomas, and Neumann, Franz-Josef
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Aims: We sought to assess the need for permanent pacemaker implantation (PPI) in patients with QRS <120 ms in electrocardiogram (ECG) after transcatheter aortic valve implantation (TAVI).Methods and Results: We retrospectively analysed 1139 consecutive patients who underwent transfemoral TAVI between 2008 and 2016, receiving different valve types. All patients were surveyed by continuous ECG monitoring for 48 h, 12-lead ECGs starting immediately after procedure, as well as 24-h Holter recording the day before discharge. Indication for PPI was at the discretion of the attending physician. Among 760 patients with QRS <120 ms prior to the TAVI procedure, 400 patients showed QRS <120 ms immediately after procedure, whereas 360 patients had QRS ≥120 ms. In the group with QRS <120 ms, PPI was performed in 34 patients [8.5%; 95% confidence interval (CI) 5.6-11.2%] during the first week. Eight of the PPIs in the group with QRS <120 ms (2%; CI 0.8-3.5%) fulfilled Class I indications for PPI after TAVI, whereas 26 PPIs had different indications [left bundle branch block, sick sinus, low-grade atrioventricular (AV) block]. Complete AV block developed in three patients of the group of QRS <120 ms (0.75%; CI 0.0-1.7%), which in all cases occurred after the 48 h-surveillance period. During 1-year follow-up, 11 PPIs were performed (2.8%; CI 1.2-4.5%), thereof three PPI for Class I indications including one complete AV block.Conclusion: In patients with QRS duration <120 ms immediately after TAVI, the risk for complete AV block was low during the first week after TAVI and 1-year follow-up. [ABSTRACT FROM AUTHOR]- Published
- 2019
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6. Impact of the type of transcatheter heart valve on the incidence of early subclinical leaflet thrombosis.
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Ruile, Philipp, Minners, Jan, Schoechlin, Simon, Pache, Gregor, Hochholzer, Willibald, Blanke, Philipp, Jander, Nikolaus, Gick, Michael, Schröfel, Holger, and Siepe, Matthias
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CHEMOEMBOLIZATION , *HEART valve physiology , *THROMBOSIS , *COMPUTED tomography , *ANGIOGRAPHY - Abstract
OBJECTIVES: The aim of this study was to investigate whether balloon-expandable and self-expandable transcatheter heart valves (THVs) differ in terms of the incidence of early subclinical leaflet thrombosis (LT). METHODS: Electrocardiographic-gated cardiac dual-source computed tomography angiography was performed at a median of 5 days after transcatheter aortic valve implantation and assessed for evidence of LT. RESULTS: Of the 629 consecutive patients, 538 (86%) received a balloon-expandable THV and 91 (14%) a self-expandable THV. LT was documented in 77 (14%) patients with a balloon-expandable valve and in 16 (18%) with a self-expandable valve (P = 0.42). Similarly, LT was not significantly related to THV size (P = 0.62). Corresponding to a lower rate of atrial fibrillation in the group with LT [25 (27%) vs 222 (41%), P = 0.01], anticoagulation at the time of computed tomography angiography was less frequent in this group [21 (23%) vs 183 (34%), P = 0.03]. Among the other potentially relevant covariables, there was no significant difference in the clinical baseline and the procedural characteristics between patients with and without LT (age 82 ± 6 years vs 82 ± 6 years, P = 0.51; ejection fraction 49 ± 10% vs 50 ± 10%, P = 0.47). In multivariate logistic regression analysis, including potentially relevant covariables, valve type was not significantly associated with LT (P = 0.36). In the univariate and multivariate analyses, only the lack of anticoagulation at the time of computed tomography angiography was predictive of thrombus formation [0.563 (0.335-0.944), P = 0.03; 0.576 (0.343-0.970), P = 0.04]. CONCLUSIONS: In this large retrospective study of 629 patients, the type and the size of THV was not predictive of early LT. [ABSTRACT FROM AUTHOR]
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- 2018
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7. Right ventricular function after aortic valve replacement: a pilot study comparing surgical and transcatheter procedures using 3D echocardiography.
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Keyl, Cornelius, Schneider, Jens, Beyersdorf, Friedhelm, Ruile, Philipp, Siepe, Matthias, Pioch, Katja, Schneider, Rebecca, and Jander, Nikolaus
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RIGHT ventricular hypertrophy ,AORTIC valve surgery ,THREE-dimensional echocardiography ,AORTIC stenosis ,ARTIFICIAL implants - Abstract
OBJECTIVES: Previous studies have found that standard echocardiographic measures of right ventricular (RV) function were impaired after surgical replacement of the aortic valve (SAVR), but not after transcatheter aortic valve implantation (TAVI). We used 3D echocardiography to gain further insight into the changes of RV performance in patient undergoing SAVR or TAVI. METHODS: We conducted a prospective non-randomized study with two parallel groups and performed echocardiographic evaluation in 20 patients with aortic stenosis undergoing SAVR (age 77 ± 4 years), and in 20 patients undergoing TAVI via the transfemoral approach (age 83 ± 6 years) 1 week before and between the fifth and seventh day after the procedure. RESULTS: Tricuspid annular plane systolic excursion was postoperatively markedly reduced in patients undergoing SAVR (13 ± 2 vs 26 ± 4 mm, post- vs preoperative, P < 0.001), but not in patients undergoing TAVI (24 ± 7 vs 24 ± 5 mm, P = 0.90). Fractional shortening of the RV midcavity transverse diameter, however, increased after SAVR (50 ± 8 vs 31 ± 11%, P < 0.001) in contrast to TAVI (33 ± 10 vs 34 ± 9%, P = 0.85). The RV ejection fraction, assessed by 3D echocardiography, remained unchanged in both patient groups (SAVR, 55 ± 6 vs 55 ± 7%, P = 0.52; TAVI, 56 ± 8 vs 54 ± 7%, P = 0.28). CONCLUSIONS: RV longitudinal contraction decreased after SAVR, whereas RV transverse contraction increased. Both parameters did not change after TAVI. RV ejection fraction and RV stroke volume remained constant irrespective of the technique of aortic valve replacement, thus indicating that global systolic RV function is not compromised after SAVR. [ABSTRACT FROM AUTHOR]
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- 2016
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8. Prosthesis Position after TAVI with Balloon-Expandable SAPIEN 3 in Bicuspid Aortic Valves.
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Breitbart, Philipp, Minners, Jan, Czerny, Martin, Hein, Manuel, Neumann, Franz-Josef, and Ruile, Philipp
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MITRAL valve ,AORTIC valve ,HEART valve prosthesis implantation ,COMPUTED tomography ,PROSTHETICS - Abstract
Background: Prior data suggest a correlation between the position of transcatheter heart valves (THV) and the occurrence of complications after transcatheter aortic valve implantation (TAVI) in patients with tricuspid aortic valves (TAV). However, data including a detailed analysis of prosthesis positioning in bicuspid aortic valves (BAV) are limited. Therefore, the purpose of this study was to investigate THV position after TAVI in BAV. Methods: We evaluated the THV position in 50 BAV and 50 TAV patients (all received the balloon-expandable Sapien 3 prosthesis) using fusion imaging of pre- and post-procedural computed tomography angiography. According to the manufacturers' recommendations, a low implantation position was defined as >30% of the prosthesis below the annulus. Results: THV position was appropriate in the majority of the patients within both groups (90.0% for BAV vs. 96.0% for TAV, p = 0.240). In BAV, we observed a more pronounced THV waist (7.4 ± 4.5% vs. 5.8 ± 3.0%, p = 0.043) and a lower average THV expansion (91.9 ± 12.2% vs. 95.5 ± 2.7% of nominal expansion, p = 0.044). Conclusions: Accurate positioning in relation to the aortic annulus of the TAVI Sapien 3 prosthesis is possible in patients with BAV with results comparable to TAV. However, there is a more pronounced prosthesis waist and a lower average THV expansion in BAV. [ABSTRACT FROM AUTHOR]
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- 2021
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9. Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis
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Jeroen J. Bax, Yigal Abramowitz, Hidehiro Kaneko, Fabian Nietlispach, Niklas Schofer, Thomas Modine, Omar K. Khalique, Tarun Chakravarty, Masao Takahashi, S. Chiu Wong, Ulrich Schaefer, Thierry Lefèvre, Erik W. Holy, Brian Whisenant, Seung-Jung Park, Smriti Saraf, Florian Deuschl, Emmanuel Teiger, Gidon Y. Perlman, Ole De Backer, Yohei Ohno, Christian Butter, Marco Barbanti, Rahul Sharma, Mohamed Abdel-Wahab, Franz-Josef Neumann, Philipp Blanke, Gerald Yong, Antonio Colombo, Hiroyuki Kawamori, Bernard Chevalier, Mamoo Nakamura, Hyo-Soo Kim, Johannes Ziegelmueller, William K.F. Kong, Susheel Kodali, Michael S. Lee, Shingo Kuwata, Sung Han Yoon, Buntaro Fujita, Luca Testa, Edgar Tay, Stephan Ensminger, Daisuke Sugiyama, Corrado Tamburino, Jonathon Leipsic, Hsien-Li Kao, Yoshio Maeno, John G. Webb, Victoria Delgado, David Hildick-Smith, Lars Søndergaard, Takahide Arai, Raj Makkar, Tobias Schmidt, Danny Dvir, Francesco Bedgoni, Azeem Latib, Philipp Ruile, Sabine Bleiziffer, Martin B. Leon, Gregor Pache, Yoon, Sung han, Bleiziffer, Sabine, De Backer, Ole, Delgado, Victoria, Arai, Takahide, Ziegelmueller, Johanne, Barbanti, Marco, Sharma, Rahul, Perlman, Gidon Y., Khalique, Omar K., Holy, Erik W., Saraf, Smriti, Deuschl, Florian, Fujita, Buntaro, Ruile, Philipp, Neumann, Franz josef, Pache, Gregor, Takahashi, Masao, Kaneko, Hidehiro, Schmidt, Tobia, Ohno, Yohei, Schofer, Nikla, Kong, William K. F., Tay, Edgar, Sugiyama, Daisuke, Kawamori, Hiroyuki, Maeno, Yoshio, Abramowitz, Yigal, Chakravarty, Tarun, Nakamura, Mamoo, Kuwata, Shingo, Yong, Gerald, Kao, Hsien li, Lee, Michael, Kim, Hyo soo, Modine, Thoma, Wong, S. Chiu, Bedgoni, Francesco, Testa, Luca, Teiger, Emmanuel, Butter, Christian, Ensminger, Stephan M., Schaefer, Ulrich, Dvir, Danny, Blanke, Philipp, Leipsic, Jonathon, Nietlispach, Fabian, Abdel wahab, Mohamed, Chevalier, Bernard, Tamburino, Corrado, Hildick smith, David, Whisenant, Brian K., Park, Seung jung, Colombo, Antonio, Latib, Azeem, Kodali, Susheel K., Bax, Jeroen J., Sã¸ndergaard, Lar, Webb, John G., Lefãvre, Thierry, Leon, Martin B., and Makkar, Raj
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Aortic valve ,Male ,medicine.medical_treatment ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Global Health ,aortic stenosis ,bicuspid aortic valve ,transcatheter aortic valve implantation ,Aged ,Aortic Valve ,Aortic Valve Stenosis ,Female ,Humans ,Retrospective Studies ,Survival Rate ,Transcatheter Aortic Valve Replacement ,Treatment Outcome ,Tricuspid Valve ,Heart Valve Prosthesis ,Cardiology and Cardiovascular Medicine ,0302 clinical medicine ,Bicuspid aortic valve ,Bicuspid Aortic Valve Disease ,Valve replacement ,Retrospective Studie ,Heart Valve Diseases/surgery ,030212 general & internal medicine ,Survival Rate/trends ,Tricuspid valve ,Heart Valve Disease ,medicine.anatomical_structure ,Aortic valve stenosis ,Cardiology ,cardiovascular system ,Human ,Transcatheter Aortic Valve Replacement/methods ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Aortic Valve Stenosis/mortality ,Tricuspid Valve/abnormalities ,03 medical and health sciences ,Internal medicine ,medicine ,cardiovascular diseases ,Survival rate ,business.industry ,Aortic Valve/abnormalities ,Retrospective cohort study ,aortic stenosi ,medicine.disease ,Aortic Valve Stenosi ,Stenosis ,Heart Valve Prosthesi ,business - Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS).OBJECTIVES: This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry.METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria.RESULTS: Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28).CONCLUSIONS: Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices.
- Published
- 2017
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