283 results on '"Sondergaard, L"'
Search Results
202. 2020 ESC Guidelines for the management of adult congenital heart disease.
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Baumgartner H, De Backer J, Babu-Narayan SV, Budts W, Chessa M, Diller GP, Lung B, Kluin J, Lang IM, Meijboom F, Moons P, Mulder BJM, Oechslin E, Roos-Hesselink JW, Schwerzmann M, Sondergaard L, and Zeppenfeld K
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- Adult, Humans, Cardiology, Heart Defects, Congenital therapy
- Published
- 2021
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203. Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses.
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Landes U, Sathananthan J, Witberg G, De Backer O, Sondergaard L, Abdel-Wahab M, Holzhey D, Kim WK, Hamm C, Buzzatti N, Montorfano M, Ludwig S, Conradi L, Seiffert M, Guerrero M, El Sabbagh A, Rodés-Cabau J, Guimaraes L, Codner P, Okuno T, Pilgrim T, Fiorina C, Colombo A, Mangieri A, Eltchaninoff H, Nombela-Franco L, Van Wiechen MPH, Van Mieghem NM, Tchétché D, Schoels WH, Kullmer M, Tamburino C, Sinning JM, Al-Kassou B, Perlman GY, Danenberg H, Ielasi A, Fraccaro C, Tarantini G, De Marco F, Redwood SR, Lisko JC, Babaliaros VC, Laine M, Nerla R, Castriota F, Finkelstein A, Loewenstein I, Eitan A, Jaffe R, Ruile P, Neumann FJ, Piazza N, Alosaimi H, Sievert H, Sievert K, Russo M, Andreas M, Bunc M, Latib A, Godfrey R, Hildick-Smith D, Chuang MA, Blanke P, Leipsic J, Wood DA, Nazif TM, Kodali S, Barbanti M, Kornowski R, Leon MB, and Webb JG
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- Acute Kidney Injury epidemiology, Aged, Aged, 80 and over, Aortic Valve Insufficiency epidemiology, Aortic Valve Stenosis mortality, Conversion to Open Surgery statistics & numerical data, Coronary Occlusion epidemiology, Female, Hemorrhage epidemiology, Humans, Male, Pacemaker, Artificial statistics & numerical data, Patient Safety, Propensity Score, Registries, Aortic Valve Stenosis surgery, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Transcatheter Aortic Valve Replacement
- Abstract
Background: Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) are now both used to treat aortic stenosis in patients in whom life expectancy may exceed valve durability. The choice of initial bioprosthesis should therefore consider the relative safety and efficacy of potential subsequent interventions., Objectives: The aim of this study was to compare TAVR in failed transcatheter aortic valves (TAVs) versus surgical aortic valves (SAVs)., Methods: Data were collected on 434 TAV-in-TAV and 624 TAV-in-SAV consecutive procedures performed at centers participating in the Redo-TAVR international registry. Propensity score matching was applied, and 330 matched (165:165) patients were analyzed. Principal endpoints were procedural success, procedural safety, and mortality at 30 days and 1 year., Results: For TAV-in-TAV versus TAV-in-SAV, procedural success was observed in 120 (72.7%) versus 103 (62.4%) patients (p = 0.045), driven by a numerically lower frequency of residual high valve gradient (p = 0.095), ectopic valve deployment (p = 0.081), coronary obstruction (p = 0.091), and conversion to open heart surgery (p = 0.082). Procedural safety was achieved in 116 (70.3%) versus 119 (72.1%) patients (p = 0.715). Mortality at 30 days was 5 (3%) after TAV-in-TAV and 7 (4.4%) after TAV-in-SAV (p = 0.570). At 1 year, mortality was 12 (11.9%) and 10 (10.2%), respectively (p = 0.633). Aortic valve area was larger (1.55 ± 0.5 cm
2 vs. 1.37 ± 0.5 cm2 ; p = 0.040), and the mean residual gradient was lower (12.6 ± 5.2 mm Hg vs. 14.9 ± 5.2 mm Hg; p = 0.011) after TAV-in-TAV. The rate of moderate or greater residual aortic regurgitation was similar, but mild aortic regurgitation was more frequent after TAV-in-TAV (p = 0.003)., Conclusions: In propensity score-matched cohorts of TAV-in-TAV versus TAV-in-SAV patients, TAV-in-TAV was associated with higher procedural success and similar procedural safety or mortality., Competing Interests: Author Disclosures Dr. Webb is a consultant to and has received research funding from Edwards Lifesciences, Abbott Vascular, Boston Scientific, and ViVitro Labs. Dr. Kim has received proctor or speaker fees from Boston Scientific, Abbott, Edwards Lifesciences, and Medtronic. Dr. Barbanti is a consultant for Edwards; and is an Advisory Board member for Biotronik. Dr. Sondergaard has received consultant fees and institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and Symetis. Dr. Redwood is a proctor for and has received lecture fees from Edwards. Dr. Hamm is an Advisory Board member for Medtronic. Dr. Sinning has received speaker honoraria and research grants from Medtronic, Boston Scientific, and Edwards Lifesciences. Dr. Wood is a consultant to and has received research funding from Edwards Lifesciences, Abbott Vascular, and Boston Scientific. Dr. Sathananthan is a consultant to Edwards Lifesciences. Dr. Schofer has received speaker fees and travel compensation from Boston Scientific; and has received travel compensation from Edwards Lifesciences and Abbott/St. Jude Medical. Dr. Leipsic is a consultant to Circle CVI and Edwards Lifesciences; and provides institutional core laboratory services to Edwards Lifesciences, Abbott, Medtronic, and Neovasc. Dr. Andreas is a proctor for Edwards and Abbott; and is an Advisory Board member for Medtronic. Dr. Guerrero has received research grant support from Abbott Vascular and Edwards Lifesciences. Dr. Castriota is a proctor for Medtronic and Boston Scientific. Dr. Kodali has received research grants from Edwards Lifesciences, Medtronic, and Boston Scientific; has received grants and personal fees from Abbott Vascular and JenaValve; has received personal fees from Meril Lifesciences; has received personal fees from and holds equity in Admedus; and holds equity in Supira, Microinterventional Devices, Dura Biotech, and Thubrikar Aortic Valve. Dr. Conradi is a consultant to Edwards Lifesciences, Medtronic, Boston Scientific, Abbott, Neovasc, and JenaValve. Dr. Nazif has received consulting fees or honoraria from Edwards Lifesciences, Medtronic, Boston Scientific, Biotrace, and Baylis Medical; and has received consulting fees from and holds equity in Venus Medtech. Dr. Pilgrim has received research grants from Boston Scientific, Edwards Lifesciences, and Biotronik; and has received speaker fees from Boston Scientific and Biotronik. Dr. Babaliaros is a consultant to Edwards Lifesciences; and holds equity in Transmural Systems. Dr. Van Mieghem has received institutional research grants and consulting fees from Abbott, Boston Scientific, Medtronic, Daiichi-Sankyo, and PulseCath; and has received institutional research grant support from Edwards Lifesciences. Dr. Latib has received institutional research or grant support from Abbott, Boston Scientific, Medtronic, and Edwards Lifesciences; and has received personal consulting honoraria from Abbott, Edwards Lifesciences, and Medtronic. Dr. Hildick-Smith is a proctor and adviser to Boston Scientific, Medtronic, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)- Published
- 2021
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204. Remote education: what's new?
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Sondergaard L, Sawaya FJ, and De Backer O
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- 2020
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205. Transcatheter Treatment of Residual Significant Mitral Regurgitation Following TAVR: A Multicenter Registry.
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Witberg G, Codner P, Landes U, Barbanti M, Valvo R, De Backer O, Ooms JF, Sievert K, El Sabbagh A, Jimenez-Quevedo P, Brennan PF, Sedaghat A, Masiero G, Werner P, Overtchouk P, Watanabe Y, Montorfano M, Bijjam VR, Hein M, Fiorina C, Arzamendi D, Rodriguez-Gabella T, Fernández-Vázquez F, Baz JA, Laperche C, Grasso C, Branca L, Estévez-Loureiro R, Benito-González T, Amat Santos IJ, Ruile P, Mylotte D, Buzzatti N, Piazza N, Andreas M, Tarantini G, Sinning JM, Spence MS, Nombela-Franco L, Guerrero M, Sievert H, Sondergaard L, Van Mieghem NM, Tchetche D, Webb JG, and Kornowski R
- Subjects
- Aged, Aged, 80 and over, Aortic Valve surgery, Aortic Valve Stenosis surgery, Humans, Registries, Severity of Illness Index, Treatment Outcome, Mitral Valve Insufficiency surgery, Transcatheter Aortic Valve Replacement
- Abstract
Objectives: The aim of this study was to describe baseline characteristics, and periprocedural and mid-term outcomes of patients undergoing transcatheter mitral valve interventions post-transcatheter aortic valve replacement (TAVR) and examine their clinical benefit., Background: The optimal management of residual mitral regurgitation (MR) post-TAVR is challenging., Methods: This was an international registry of 23 TAVR centers., Results: In total, 106 of 24,178 patients (0.43%) underwent mitral interventions post-TAVR (100 staged, 6 concomitant), most commonly percutaneous edge-to-edge mitral valve repair (PMVR). The median interval post-TAVR was 164 days. Mean age was 79.5 ± 7.2 years, MR was >moderate in 97.2%, technical success was 99.1%, and 30-day device success rate was 88.7%. There were 18 periprocedural complications (16.9%) including 4 deaths. During a median follow-up of 464 days, the cumulative risk for 3-year mortality was 29.0%. MR grade and New York Heart Association (NYHA) functional class improved dramatically; at 1 year, MR was moderate or less in 90.9% of patients (mild or less in 69.1%), and 85.9% of patients were in NYHA functional class I/II. Staged PMVR was associated with lower mortality versus medical treatment (57.5% vs. 30.8%) in a propensity-matched cohort (n = 156), but this was not statistically significant (hazard ratio: 1.75; p = 0.05)., Conclusions: For patients who continue to have significant MR, remain symptomatic post-TAVR, and are anatomically suitable for transcatheter interventions, these interventions are feasible, safe, and associated with significant improvement in MR grade and NYHA functional class. These results apply mainly to PMVR. A staged PMVR strategy was associated with markedly lower mortality, but this was not statistically significant. (Transcatheter Treatment for Combined Aortic and Mitral Valve Disease. The Aortic+Mitral TRAnsCatheter Valve Registry [AMTRAC]; NCT04031274)., Competing Interests: Author Disclosures Dr. Barbanti has received consultant fees from Edwards Lifesciences. Dr. De Backer has received research grants and consultant fees from Abbott and Boston Scientific. Dr. Sievert has received institutional honoraria, travel expenses, and consulting fees from 4tech Cardio, Abbott, Ablative Solutions, Ancora Heart, Append Medical, Bavaria Medizin Technologie GmbH, Bioventrix, Boston Scientific, Carag, CardiacDimensions, Cardimed, Celonova, Comed B.V., Contego, CVRx, Dinova, Edwards Lifesciences, Endologix, Hemoteq, Hangzhou Nuomao Medtech, Holistick Medical, Lifetech, Maquet Getinge Group, Medtronic, Mokita, Occlutech, Recor, RenalGuard, Terumo, Vascular Dynamics, Vectorious Medtech, Venus, Venock, and Vivasure Medical. Dr. Grasso has been a proctor for Abbott Vascular. Dr. Andreas has been a proctor for Abbott and Edwards Lifesciences; and has received advisory board fees from Medtronic. Dr. Guerrero has received research grant support from Edwards Lifesciences. Dr. Van Mieghem has received research grant support from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, PulseCath BV, and Daiichi-Sankyo; and advisory fees from Abbott, Boston Scientific, Ancora, Medtronic, PulseCath BV, and Daiichi-Sankyo. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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206. Valve thrombosis after transcatheter aortic valve replacement-cause for concern?
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Sibilitz KL, Fukutomi M, and Sondergaard L
- Abstract
Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
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- 2020
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207. Bicuspid Aortic Valve Morphology and Outcomes After Transcatheter Aortic Valve Replacement.
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Yoon SH, Kim WK, Dhoble A, Milhorini Pio S, Babaliaros V, Jilaihawi H, Pilgrim T, De Backer O, Bleiziffer S, Vincent F, Shmidt T, Butter C, Kamioka N, Eschenbach L, Renker M, Asami M, Lazkani M, Fujita B, Birs A, Barbanti M, Pershad A, Landes U, Oldemeyer B, Kitamura M, Oakley L, Ochiai T, Chakravarty T, Nakamura M, Ruile P, Deuschl F, Berman D, Modine T, Ensminger S, Kornowski R, Lange R, McCabe JM, Williams MR, Whisenant B, Delgado V, Windecker S, Van Belle E, Sondergaard L, Chevalier B, Mack M, Bax JJ, Leon MB, and Makkar RR
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- Aged, Aged, 80 and over, Bicuspid Aortic Valve Disease diagnostic imaging, Female, Follow-Up Studies, Humans, Male, Mortality trends, Prospective Studies, Tomography, X-Ray Computed mortality, Tomography, X-Ray Computed trends, Treatment Outcome, Bicuspid Aortic Valve Disease mortality, Bicuspid Aortic Valve Disease surgery, Internationality, Registries, Transcatheter Aortic Valve Replacement mortality, Transcatheter Aortic Valve Replacement trends
- Abstract
Background: Bicuspid aortic stenosis accounts for almost 50% of patients undergoing surgical aortic valve replacement in the younger patients. Expanding the indication of transcatheter aortic valve replacement (TAVR) toward lower-risk and younger populations will lead to increased use of TAVR for patients with bicuspid aortic valve (BAV) stenosis despite the exclusion of bicuspid anatomy in all pivotal clinical trials., Objectives: This study sought to evaluate the association of BAV morphology and outcomes of TAVR with the new-generation devices., Methods: Patients with BAV confirmed by central core laboratory computed tomography (CT) analysis were included from the international multicenter BAV TAVR registry. BAV morphology including the number of raphe, calcification grade in raphe, and leaflet calcium volume were assessed with CT analysis in a masked fashion. Primary outcomes were all-cause mortality at 1 and 2 years, and secondary outcomes included 30-day major endpoints and procedural complications., Results: A total of 1,034 CT-confirmed BAV patients with a mean age of 74.7 years and Society of Thoracic Surgeons score of 3.7% underwent TAVR with contemporary devices (n = 740 with Sapien 3; n = 188 with Evolut R/Pro; n = 106 with others). All-cause 30-day, 1-year, and 2-year mortality was 2.0%, 6.7%, and 12.5%, respectively. Multivariable analysis identified calcified raphe and excess leaflet calcification (defined as more than median calcium volume) as independent predictors of 2-year all-cause mortality. Both calcified raphe plus excess leaflet calcification were found in 269 patients (26.0%), and they had significantly higher 2-year all-cause mortality than those with 1 or none of these morphological features (25.7% vs. 9.5% vs. 5.9%; log-rank p < 0.001). Patients with both morphological features had higher rates of aortic root injury (p < 0.001), moderate-to-severe paravalvular regurgitation (p = 0.002), and 30-day mortality (p = 0.016)., Conclusions: Outcomes of TAVR in bicuspid aortic stenosis depend on valve morphology. Calcified raphe and excess leaflet calcification were associated with increased risk of procedural complications and midterm mortality. (Bicuspid Aortic Valve Stenosis Transcatheter Aortic Valve Replacement Registry; NCT03836521)., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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208. Clinical impact of conduction disturbances in transcatheter aortic valve replacement recipients: a systematic review and meta-analysis.
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Faroux L, Chen S, Muntané-Carol G, Regueiro A, Philippon F, Sondergaard L, Jørgensen TH, Lopez-Aguilera J, Kodali S, Leon M, Nazif T, and Rodés-Cabau J
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- Aortic Valve surgery, Bundle-Branch Block etiology, Bundle-Branch Block therapy, Humans, Risk Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Pacemaker, Artificial, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Aims: The clinical impact of new-onset persistent left bundle branch block (NOP-LBBB) and permanent pacemaker implantation (PPI) on transcatheter aortic valve replacement (TAVR) recipients remains controversial. We aimed to evaluate the impact of (i) periprocedural NOP-LBBB and PPI post-TAVR on 1-year all-cause death, cardiac death, and heart failure hospitalization and (ii) NOP-LBBB on the need for PPI at 1-year follow-up., Methods and Results: We performed a systematic search from PubMed and EMBASE databases for studies reporting raw data on 1-year clinical impact of NOP-LBBB or periprocedural PPI post-TAVR. Data from 30 studies, including 7792 patients (12 studies) and 42 927 patients (21 studies) for the evaluation of the impact of NOP-LBBB and PPI after TAVR were sourced, respectively. NOP-LBBB was associated with an increased risk of all-cause death [risk ratio (RR) 1.32, 95% confidence interval (CI) 1.17-1.49; P < 0.001], cardiac death (RR 1.46, 95% CI 1.20-1.78; P < 0.001), heart failure hospitalization (RR 1.35, 95% CI 1.05-1.72; P = 0.02), and PPI (RR 1.89, 95% CI 1.58-2.27; P < 0.001) at 1-year follow-up. Periprocedural PPI after TAVR was associated with a higher risk of all-cause death (RR 1.17, 95% CI 1.11-1.25; P < 0.001) and heart failure hospitalization (RR 1.18, 95% CI 1.03-1.36; P = 0.02). Permanent pacemaker implantation was not associated with an increased risk of cardiac death (RR 0.84, 95% CI 0.67-1.05; P = 0.13)., Conclusion: NOP-LBBB and PPI after TAVR are associated with an increased risk of all-cause death and heart failure hospitalization at 1-year follow-up. Periprocedural NOP-LBBB also increased the risk of cardiac death and PPI within the year following the procedure. Further studies are urgently warranted to enhance preventive measures and optimize the management of conduction disturbances post-TAVR., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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209. Value of FEops HEARTguide patient-specific computational simulations in the planning of left atrial appendage closure with the Amplatzer Amulet closure device: rationale and design of the PREDICT-LAA study.
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Garot P, Iriart X, Aminian A, Kefer J, Freixa X, Cruz-Gonzalez I, Berti S, Rosseel L, Ibrahim R, Korsholm K, Odenstedt J, Nielsen-Kudsk JE, Saw J, Sondergaard L, and De Backer O
- Subjects
- Atrial Appendage physiopathology, Atrial Fibrillation diagnostic imaging, Atrial Function, Left, Canada, Cardiac Catheterization adverse effects, Europe, Heart Rate, Humans, Multicenter Studies as Topic, Predictive Value of Tests, Prospective Studies, Randomized Controlled Trials as Topic, Treatment Outcome, Atrial Appendage diagnostic imaging, Atrial Fibrillation therapy, Cardiac Catheterization instrumentation, Patient-Specific Modeling, Therapy, Computer-Assisted, Tomography, X-Ray Computed
- Abstract
Background: Optimal preprocedural planning is essential to ensure successful device closure of the left atrial appendage (LAA)., Design: The PREDICT-LAA study is a prospective, international, multicentre, randomised controlled trial (ClinicalTrials.gov NCT04180605). Two hundred patients eligible for LAA closure with an Amplatzer Amulet device (Abbott, USA) will be enrolled in the study. Patients will be allocated to a computational simulation arm (experimental) or standard treatment arm (control) using a 1:1 randomisation. For patients randomised to the computational simulation arm, preprocedural planning will be based on the analysis of cardiac computed tomography (CCT)-based patient-specific computational simulations (FEops HEARTguide, Ghent, Belgium) in order to predict optimal device size and position. For patients in the control arm, preprocedural planning will be based on local practice including CCT analysis. The LAA closure procedure and postprocedural antithrombotic therapy will follow local practice in both arms. The primary endpoint of the study is incomplete LAA closure and device-related thrombus as assessed at 3 months postprocedural CCT. Secondary endpoints encompass procedural efficiency (number of devices used, number of repositioning, procedural time, radiation exposure, contrast dye), procedure-related complications within 7 days postprocedure and a composite of all-cause death and thromboembolic events at 12 months., Conclusion: The objective of the PREDICT-LAA study is to test the hypothesis that a preprocedural planning for LAA closure with the Amplatzer Amulet device based on patient-specific computational simulations can result in a more efficient procedure, optimised procedural outcomes and better clinical outcomes as compared with a standard preprocedural planning., Trial Registration Number: ClinicalTrials.gov Registry (NCT04180605)., Competing Interests: Competing interests: ODB and LS have received institutional research grants from Abbott and FEops NV., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2020
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210. Durability of transcatheter bioprosthetic aortic valves.
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Sondergaard L
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- Aortic Valve surgery, Humans, Aortic Valve Stenosis surgery, Bioprosthesis adverse effects, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement adverse effects
- Published
- 2020
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211. Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction.
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Landes U, Webb JG, De Backer O, Sondergaard L, Abdel-Wahab M, Crusius L, Kim WK, Hamm C, Buzzatti N, Montorfano M, Ludwig S, Schofer N, Voigtlaender L, Guerrero M, El Sabbagh A, Rodés-Cabau J, Guimaraes L, Kornowski R, Codner P, Okuno T, Pilgrim T, Fiorina C, Colombo A, Mangieri A, Eltchaninoff H, Nombela-Franco L, Van Wiechen MPH, Van Mieghem NM, Tchétché D, Schoels WH, Kullmer M, Tamburino C, Sinning JM, Al-Kassou B, Perlman GY, Danenberg H, Ielasi A, Fraccaro C, Tarantini G, De Marco F, Witberg G, Redwood SR, Lisko JC, Babaliaros VC, Laine M, Nerla R, Castriota F, Finkelstein A, Loewenstein I, Eitan A, Jaffe R, Ruile P, Neumann FJ, Piazza N, Alosaimi H, Sievert H, Sievert K, Russo M, Andreas M, Bunc M, Latib A, Govdfrey R, Hildick-Smith D, Sathananthan J, Hensey M, Alkhodair A, Blanke P, Leipsic J, Wood DA, Nazif TM, Kodali S, Leon MB, and Barbanti M
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- Aged, Aortic Valve surgery, Equipment Failure Analysis, Female, Global Health, Humans, Male, Outcome Assessment, Health Care, Registries statistics & numerical data, Survival Analysis, Symptom Assessment statistics & numerical data, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency epidemiology, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis adverse effects, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Postoperative Complications surgery, Reoperation instrumentation, Reoperation methods, Reoperation statistics & numerical data, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement methods
- Abstract
Background: Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail., Objectives: The authors sought to examine outcomes following redo-TAVR., Methods: The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively., Results: Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm
2 and 1.51 ± 0.57 cm2 ; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively., Conclusions: Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern., (Copyright © 2020. Published by Elsevier Inc.)- Published
- 2020
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212. Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios.
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Bax JJ, Delgado V, Hahn RT, Leipsic J, Min JK, Grayburn P, Sondergaard L, Yoon SH, and Windecker S
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- Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis physiopathology, Bioprosthesis, Clinical Decision-Making, Echocardiography, Doppler, Color, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Heart Valve Prosthesis, Hemodynamics, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Patient Selection, Predictive Value of Tests, Prosthesis Design, Risk Factors, Severity of Illness Index, Treatment Outcome, Ventricular Function, Left, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Multimodal Imaging, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with symptomatic severe aortic stenosis. Technological advances and the learning curve have resulted in better procedural results in terms of hemodynamic valve performance and intermediate-term clinical outcomes. The integration of anatomical and functional information provided by multimodality imaging has improved size selection of TAVR prostheses, permitted better patient selection, and provided new insights in the performance of the TAVR prostheses at follow-up. Furthermore, the field of TAVR continues to develop and expand the technique to younger patients with lower risk on the one hand, and more complex clinical scenarios, on the other hand, such as degenerated aortic bioprostheses, bicuspid aortic valves, or pure native aortic regurgitation. The present review article summarizes how multimodality imaging can be integrated in TAVR in clinical (sometimes complex) scenarios that have not been included in the landmark randomized clinical trials., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2020
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213. Direct Current Cardioversion of Atrial Fibrillation in Patients With Left Atrial Appendage Occlusion Devices.
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Sharma SP, Turagam MK, Gopinathannair R, Reddy V, Kar S, Mohanty S, Cheng J, Holmes DR Jr, Sondergaard L, Natale A, and Lakkireddy D
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- Aged, Feasibility Studies, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Atrial Appendage, Atrial Fibrillation complications, Atrial Fibrillation therapy, Electric Countershock, Septal Occluder Device
- Abstract
Background: Direct current cardioversion (DCCV) is a common rhythm control strategy in patients with symptomatic atrial fibrillation or flutter. There is no long-term data regarding the safety of DCCV in patients with endocardial left atrial appendage occlusion (LAAO) devices., Objectives: The purpose of this study was to assess the feasibility and safety of DCCV in patients with an LAAO device., Methods: This multicenter retrospective study included 148 patients with an LAAO device who underwent DCCV for symptomatic atrial fibrillation or atrial flutter., Results: The average age of the included patients was 72 ± 7 years and 59% were men. All patients (100%) had a transesophageal echocardiogram prior to DCCV. Device-related thrombus was seen in 2.7%. They were all successfully treated with oral anticoagulation (OAC) and were able to undergo DCCV after 6 to 8 weeks. DCCV restored sinus rhythm in all patients. None of the patients had DCCV-related thromboembolic complications. A total of 22% of patients were newly started on OAC after DCCV. There was no difference in DCCV-related complications between patients treated with or without OAC post-DCCV. Patients receiving OAC post-DCCV were found to undergo cardioversion at an earlier time after implantation (3.6 months [interquartile range (IQR): 0.7 to 8.6 months] vs. 8.6 months [IQR: 2.5 to 13.3 months]; p = 0.003). Three transient ischemic attacks, unrelated to DCCV, were found during follow-up. During a median follow-up of 12.8 months (IQR: 11.8 to 14.2 months), no device or left atrial thrombosis, device dislodgement, or a new device leak were observed. One patient died during follow-up due to noncardiac cause., Conclusions: DCCV is feasible in high-risk AF patients with an LAAO device without the need for oral anticoagulation if pre-procedural transesophageal echocardiography shows good device position, absence of device-related thrombus, and peridevice leak of ≤5 mm. The preliminary results are encouraging, but further large studies are warranted to establish safety., (Copyright © 2019. Published by Elsevier Inc.)
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- 2019
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214. Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration).
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Kim WK, Schäfer U, Tchetche D, Nef H, Arnold M, Avanzas P, Rudolph T, Scholtz S, Barbanti M, Kempfert J, Mangieri A, Lauten A, Frerker C, Yoon SH, Holzamer A, Praz F, De Backer O, Toggweiler S, Blumenstein J, Purita P, Tarantini G, Thilo C, Wolf A, Husser O, Pellegrini C, Burgdorf C, Antolin RAH, Díaz VAJ, Liebetrau C, Schofer N, Möllmann H, Eggebrecht H, Sondergaard L, Walther T, Pilgrim T, Hilker M, Makkar R, Unbehaun A, Börgermann J, Moris C, Achenbach S, Dörr O, Brochado B, Conradi L, and Hamm CW
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Registries, Retrospective Studies, Risk Factors, Stroke epidemiology, Treatment Outcome, Embolism epidemiology, Embolism etiology, Embolism mortality, Heart Valve Prosthesis adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications mortality, Prosthesis Failure adverse effects, Prosthesis Failure etiology, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Aims: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort., Methods and Results: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective., Conclusion: Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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215. Patient-Specific Computer Simulation of Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Morphology.
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Dowling C, Bavo AM, El Faquir N, Mortier P, de Jaegere P, De Backer O, Sondergaard L, Ruile P, Mylotte D, McConkey H, Rajani R, Laborde JC, and Brecker SJ
- Subjects
- Aged, Aortic Valve diagnostic imaging, Aortic Valve surgery, Bicuspid Aortic Valve Disease, Female, Humans, Male, Retrospective Studies, Aortic Valve abnormalities, Computer Simulation, Diagnostic Imaging, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases surgery, Transcatheter Aortic Valve Replacement methods
- Abstract
Background: A patient-specific computer simulation of transcatheter aortic valve replacement (TAVR) in tricuspid aortic valve has been developed, which can predict paravalvular regurgitation and conduction disturbance. We wished to validate a patient-specific computer simulation of TAVR in bicuspid aortic valve and to determine whether patient-specific transcatheter heart valve (THV) sizing and positioning might improve clinical outcomes., Methods: A retrospective study was performed on TAVR in bicuspid aortic valve patients that had both pre- and postprocedural computed tomography imaging. Preprocedural computed tomography imaging was used to create finite element models of the aortic root. Finite element analysis and computational fluid dynamics was performed. The simulation output was compared with postprocedural computed tomography imaging, cineangiography, echocardiography, and electrocardiograms. For each patient, multiple simulations were performed, to identify an optimal THV size and position for the patient's specific anatomic characteristics., Results: A total of 37 patients were included in the study. The simulations accurately predicted the THV frame deformation (minimum-diameter intraclass correlation coefficient, 0.84; maximum-diameter intraclass correlation coefficient, 0.88; perimeter intraclass correlation coefficient, 0.91; area intraclass correlation coefficient, 0.91), more than mild paravalvular regurgitation (area under the receiver operating characteristic curve, 0.86) and major conduction abnormalities (new left bundle branch block or high-degree atrioventricular block; area under the receiver operating characteristic curve, 0.88). When compared with the implanted THV size and implant depth, optimal patient-specific THV sizing and positioning reduced simulation-predicted paravalvular regurgitation and markers of conduction disturbance., Conclusions: Patient-specific computer simulation of TAVR in bicuspid aortic valve may predict the development of important clinical outcomes, such as paravalvular regurgitation and conduction abnormalities. Patient-specific THV sizing and positioning may improve clinical outcomes of TAVR in bicuspid aortic valve.
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- 2019
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216. Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis and Low Surgical Risk.
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Sondergaard L and Costa G
- Subjects
- Aortic Valve surgery, Humans, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
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- 2019
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217. Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert Panel.
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Rodés-Cabau J, Ellenbogen KA, Krahn AD, Latib A, Mack M, Mittal S, Muntané-Carol G, Nazif TM, Sondergaard L, Urena M, Windecker S, and Philippon F
- Subjects
- Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis epidemiology, Atrioventricular Block diagnosis, Atrioventricular Block epidemiology, Atrioventricular Block therapy, Bundle-Branch Block diagnosis, Bundle-Branch Block epidemiology, Bundle-Branch Block surgery, Cardiac Conduction System Disease diagnosis, Cardiac Conduction System Disease epidemiology, Disease Management, Expert Testimony methods, Humans, Transcatheter Aortic Valve Replacement adverse effects, Treatment Outcome, United States epidemiology, Aortic Valve Stenosis surgery, Cardiac Conduction System Disease therapy, Cardiology standards, Consensus, Expert Testimony standards, Transcatheter Aortic Valve Replacement standards
- Abstract
Despite major improvements in transcatheter aortic valve replacement (TAVR) periprocedural complications in recent years, the occurrence of conduction disturbances has not decreased over time and remains the most frequent complication of the procedure. Additionally, there has been an important lack of consensus on the management of these complications, which has indeed translated into a high degree of uncertainty regarding the most appropriate treatment of a large proportion of such patients along with major differences between centers and studies in pacemaker rates post-TAVR. There is therefore an urgent need for a uniform strategy regarding the management of conduction disturbances after TAVR. The present expert consensus scientific panel document has been formulated by a multidisciplinary group of interventional cardiologists, electrophysiologists, and cardiac surgeons as an initial attempt to provide a guide for the management of conduction disturbances after TAVR based on the best available data and group expertise., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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218. Transcatheter aortic valve implantation in patients with longer life expectancy: what measures are needed?
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Sondergaard L
- Subjects
- Aortic Valve surgery, Humans, Life Expectancy, Registries, Aortic Valve Stenosis surgery, Surgeons, Transcatheter Aortic Valve Replacement
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- 2019
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219. Evaluating the cost-effectiveness of percutaneous closure of a patent foramen ovale versus medical management in patients with a cryptogenic stroke: from the UK payer perspective.
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Hildick-Smith D, Turner M, Shaw L, Nakum M, Hartaigh BÓ, Evans RM, Rhodes JF, Sondergaard L, and Kasner SE
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- Anticoagulants administration & dosage, Anticoagulants economics, Cost-Benefit Analysis, Female, Foramen Ovale, Patent drug therapy, Health Expenditures, Humans, Male, Markov Chains, Middle Aged, Models, Econometric, Secondary Prevention, Stroke economics, United Kingdom, Endovascular Procedures economics, Endovascular Procedures methods, Foramen Ovale, Patent surgery, Stroke prevention & control
- Abstract
Aims: Percutaneous closure of a patent foramen ovale (PFO) is known to lower the risk of recurrent stroke in patients with a cryptogenic stroke. However, the economic implications of transcatheter PFO closure are less well known. From a UK payer perspective, a detailed economic appraisal of PFO closure was performed for prevention of recurrent ischemic stroke in patients with a PFO who had experienced a cryptogenic stroke., Materials and Methods: A Markov cohort model was constructed using a 5-year time-horizon with a patient mean age of 45.2 years, reflecting the characteristics reported in the REDUCE trial. Transition probabilities, clinical inputs, costs, and utility values were ascertained from published and national costing sources. Total costs, incremental costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were calculated, utilizing a discount rate of 3.5%. A range of univariate and probabilistic sensitivity analyses were also performed., Results: When applying a willingness-to-pay (WTP) threshold of £20,000/QALY in accordance with NICE guidelines, PFO closure compared with antiplatelet therapy alone showed a beneficial cost/QALY of £18,584, attained at 4 years. Applying discount rates of 0% and 6% had a negligible effect on the base-case model findings. PFO closure demonstrated a 76.9% probability of being cost-effective at a WTP threshold of £20,000/QALY at a 5-year time-horizon., Limitations: This model focused specifically on UK stroke patients and typically enrolled young (mean age <65 years old) patients. Hence, caution should be taken when comparing data vs non-UK populations, and it remains unclear how older patients might have affected cost-effectiveness findings, as the risk of paradoxical embolism can persist as patients age., Conclusion: Percutaneous closure of a PFO is cost-effective compared with antiplatelet therapy alone, underlining the economic benefits potentially afforded by this treatment in selected patients.
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- 2019
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220. Bicuspid Aortic Valve Anatomy and Relationship With Devices: The BAVARD Multicenter Registry.
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Tchetche D, de Biase C, van Gils L, Parma R, Ochala A, Lefevre T, Hovasse T, De Backer O, Sondergaard L, Bleiziffer S, Lange R, Kornowski R, Landes U, Norgaard BL, Biasco L, Philippart R, Molina-Martin de Nicolas J, Mylotte D, Lemee C, Dumonteil N, and Van Mieghem NM
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis etiology, Aortic Valve Stenosis physiopathology, Bicuspid Aortic Valve Disease, Europe, Female, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases physiopathology, Humans, Israel, Male, Multidetector Computed Tomography, Prosthesis Design, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Transcatheter Aortic Valve Replacement adverse effects, Treatment Outcome, Aortic Valve abnormalities, Aortic Valve Stenosis surgery, Heart Valve Diseases complications, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Background: Sizing for transcatheter aortic valve implantation in bicuspid aortic valves (BAV) remains controversial., Methods and Results: The aim of the BAVARD (Bicuspid Aortic Valve Anatomy and Relationship With Devices) retrospective registry is to capture the sizing ratios used for transcatheter aortic valve implantation in BAV and analyze the second-generation prostheses geometry postimplantation. About 101 patients with BAV along with available pre- and post-transcatheter aortic valve implantation multidetector computed tomography were compared with 88 tricuspid aortic valves (TAV) patients. Preprocedural multidetector computed tomography diagnosed type 0 and type 1 BAV in, respectively, 12.9% and 86.1 % of BAV. At baseline, the ellipticity index was similar between BAV and TAV patients: 1.2±0.1 versus 1.2±0.1, P=0.09. The mean annular oversizing was, respectively, 1.14±0.04 and 1.04±0.04, P<0.001, in TAV and BAV patients. The mean prosthesis intercommissural distance, ratio was 1.03±0.1. The mean diameter of the prostheses at the annulus matched the mean perimeter-derived diameter of the aortic annulus at baseline with TAV (23.3±2.2 versus 23.6±1.9, P=0.4) and was smaller with BAV (24±2.8 versus 26.8±3.1, P<0.01), confirming 11% underexpansion in BAV. Finally, in situ, prosthesis diameter and ellipticity followed the same pattern, with stable values from the distal edge to 12 mm above, in both groups., Conclusions: Second-generation prostheses similarly reshape the aortic annulus in TAV and BAV. Prostheses keep consistent diameters from distal edge to 12 mm in TAV and BAV. Prosthesis underexpansion is constantly observed in BAV. Annular-based sizing is accurate in BAV with minimal oversizing. The intercommissural distance, 4 mm above the annulus, could be integrated in gray zones., Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03495050.
- Published
- 2019
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221. Endocarditis After Transcatheter Pulmonary Valve Replacement.
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McElhinney DB, Sondergaard L, Armstrong AK, Bergersen L, Padera RF, Balzer DT, Lung TH, Berger F, Zahn EM, Gray RG, Hellenbrand WE, Kreutzer J, Eicken A, Jones TK, and Ewert P
- Subjects
- Adolescent, Adult, Child, Endocarditis, Bacterial diagnostic imaging, Endocarditis, Bacterial epidemiology, Equipment Contamination, Female, Follow-Up Studies, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases epidemiology, Heart Valve Prosthesis Implantation trends, Humans, Male, Middle Aged, Postoperative Complications diagnostic imaging, Postoperative Complications epidemiology, Prospective Studies, Pulmonary Valve diagnostic imaging, Pulmonary Valve microbiology, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Insufficiency epidemiology, Young Adult, Endocarditis, Bacterial etiology, Heart Valve Diseases surgery, Heart Valve Prosthesis Implantation adverse effects, Postoperative Complications etiology, Pulmonary Valve surgery, Pulmonary Valve Insufficiency surgery
- Abstract
Background: Endocarditis has emerged as one of the most concerning adverse outcomes in patients with congenital anomalies involving the right ventricular outflow tract (RVOT) and prosthetic valves., Objectives: The aim of this study was to evaluate rates and potential risk factors for endocarditis after transcatheter pulmonary valve replacement in the prospective Melody valve trials., Methods: All patients in whom a transcatheter pulmonary valve (TPV) was implanted in the RVOT as part of 3 prospective multicenter studies comprised the analytic cohort. The diagnosis of endocarditis and involvement of the TPV were determined by the implanting investigator., Results: A total of 309 patients underwent transcatheter pulmonary valve replacement (TPVR) and were discharged with a valve in place. The median follow-up duration was 5.1 years, and total observation until study exit was 1,660.3 patient-years. Endocarditis was diagnosed in 46 patients (median 3.1 years after TPVR), and a total of 35 patients were reported to have TPV-related endocarditis (34 at the initial diagnosis, 1 with a second episode). The annualized incidence rate of endocarditis was 3.1% per patient-year and of TPV-related endocarditis was 2.4% per patient-year. At 5 years post-TPVR, freedom from a diagnosis of endocarditis was 89% and freedom from TPV-related endocarditis was 92%. By multivariable analysis, age ≤12 years at implant (hazard ratio: 2.3; 95% confidence interval: 1.2 to 4.4; p = 0.011) and immediate post-implant peak gradient ≥15 mm Hg (2.7; 95% confidence interval: 1.4 to 4.9; p = 0.002) were associated with development of endocarditis and with development of TPV-related endocarditis (age ≤12 years: 2.8; 95% confidence interval: 1.3 to 5.7; p = 0.006; gradient ≥15 mm Hg: 2.6; 95% confidence interval: 1.3 to 5.2; p = 0.008)., Conclusions: Endocarditis is an important adverse outcome following TVPR in children and adults with post-operative congenital heart disease involving the RVOT. Ongoing efforts to understand, prevent, and optimize management of this complication are paramount in making the best use of TPV therapy. (Melody Transcatheter Pulmonary Valve [TPV] Study: Post Approval Study of the Original Investigational Device Exemption [IDE] Cohort; NCT00740870; Melody Transcatheter Pulmonary Valve Post-Approval Study; NCT01186692; and Melody Transcatheter Pulmonary Valve [TPV] Post-Market Surveillance Study; NCT00688571)., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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222. State of Transcatheter Aortic Valve Implantation in Spain Versus Europe and Non-European Countries.
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Biagioni C, Tirado-Conte G, Rodés-Cabau J, Ryan N, Cerrato E, Nazif TM, Eltchaninoff H, Sondergaard L, Ribeiro HB, Barbanti M, Nietlispach F, De Jaegere P, Agostoni P, Trillo R, Jiménez-Quevedo P, D'Ascenzo F, Wendler O, Maluenda G, Chen M, Tamburino C, Macaya C, Leon MB, and Nombela-Franco L
- Subjects
- Aged, Aged, 80 and over, Aortic Valve Stenosis diagnosis, Echocardiography, Transesophageal, Europe, Female, Humans, Male, Risk Factors, Spain, United States, Aortic Valve surgery, Aortic Valve Stenosis surgery, Patient Selection, Transcatheter Aortic Valve Replacement statistics & numerical data
- Abstract
Background: Transcatheter aortic valve implantation (TAVI) is now the standard treatment for severe aortic stenosis in high-risk symptomatic patients, and its indications are expanding to lower-risk patients., Objectives: The objective of this study was to analyze the state of TAVI in Spain vs other European and non-European countries., Methods: Using an online questionnaire, we analyzed the routine practice of 250 TAVI centers worldwide. The questionnaire included 59 questions on patient selection, technical aspects of the procedure, and postprocedural management. The centers were divided into Spain (n = 41), rest of Europe (n = 105), and rest of the world (n = 104)., Results: The cumulative number of procedures (74; range, 40-122) and those performed in the last year (16.5; range, 15-29.5) in Spain, were significantly lower than the rest of Europe (P<.01) and the rest of the world (P<.01). The patient risk profile was higher, with an under-use of functional tests compared to the rest of the world. While the use of computed tomography to analyze the aortic annulus was lower in Spain (P<.001), general anesthesia and transesophageal echocardiography were more frequently used in Spain than in the rest of Europe (P<.001 for both). Dual-antiplatelet therapy is the most common post-TAVI antithrombotic therapy in the absence of an indication for anticoagulation, although its duration is longer in Spain (6 months) compared to European centers (3 months)., Conclusions: Routine TAVI practice in Spain differed in some key aspects of preprocedural, intraprocedural, and postprocedural management. Future studies will help to unify strategies and assess their impact on clinical results.
- Published
- 2018
223. Patient-Specific Computer Simulation to Elucidate the Role of Contact Pressure in the Development of New Conduction Abnormalities After Catheter-Based Implantation of a Self-Expanding Aortic Valve.
- Author
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Rocatello G, El Faquir N, De Santis G, Iannaccone F, Bosmans J, De Backer O, Sondergaard L, Segers P, De Beule M, de Jaegere P, and Mortier P
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Cardiac Catheters, Female, Finite Element Analysis, Heart Block diagnosis, Heart Block physiopathology, Humans, Male, Multidetector Computed Tomography, Predictive Value of Tests, Pressure, Prosthesis Design, Risk Assessment, Risk Factors, Treatment Outcome, Aortic Valve surgery, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Heart Block etiology, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Models, Cardiovascular, Patient-Specific Modeling
- Abstract
Background: The extent to which pressure generated by the valve on the aortic root plays a role in the genesis of conduction abnormalities after transcatheter aortic valve replacement (TAVR) is unknown. This study elucidates the role of contact pressure and contact pressure area in the development of conduction abnormalities after TAVR using patient-specific computer simulations., Methods and Results: Finite-element computer simulations were performed to simulate TAVR of 112 patients who had undergone TAVR with the self-expanding CoreValve/Evolut R valve. On the basis of preoperative multi-slice computed tomography, a patient-specific region of the aortic root containing the atrioventricular conduction system was determined by identifying the membranous septum. Contact pressure and contact pressure index (percentage of area subjected to pressure) were quantified and compared in patients with and without new conduction abnormalities. Sixty-two patients (55%) developed a new left bundle branch block or a high-degree atrioventricular block after TAVR. Maximum contact pressure and contact pressure index (median [interquartile range]) were significantly higher in patients with compared with those without new conduction abnormalities (0.51 MPa [0.43-0.70 MPa] and 33% [22%-44%], respectively, versus 0.29 MPa [0.06-0.50 MPa] and 12% [1%-28%]). By multivariable regression analysis, only maximum contact pressure (odds ratio, 1.35; confidence interval, 1.1-1.7; P =0.01) and contact pressure index (odds ratio, 1.52; confidence interval, 1.1-2.1; P =0.01) were identified as independent predictors for conduction abnormalities, but not implantation depth., Conclusions: Patient-specific computer simulations revealed that maximum contact pressure and contact pressure index are both associated with new conduction abnormalities after CoreValve/Evolut R implantation and can predict which patient will have conduction abnormalities., (© 2018 American Heart Association, Inc.)
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- 2018
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224. Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).
- Author
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Capodanno D, Petronio AS, Prendergast B, Eltchaninoff H, Vahanian A, Modine T, Lancellotti P, Sondergaard L, Ludman PF, Tamburino C, Piazza N, Hancock J, Mehilli J, Byrne RA, Baumbach A, Kappetein AP, Windecker S, Bax J, and Haude M
- Subjects
- Europe, Humans, Prosthesis Failure, Aortic Valve surgery, Aortic Valve Stenosis surgery, Bioprosthesis adverse effects, Cardiology, Consensus, Societies, Medical, Thoracic Surgery
- Published
- 2017
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225. Leaflet Thrombosis after TAVI.
- Author
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Sondergaard L, Sigitas C, Chopra M, Bieliauskas G, and De Backer O
- Published
- 2017
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226. Natural history of subclinical leaflet thrombosis affecting motion in bioprosthetic aortic valves.
- Author
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Sondergaard L, De Backer O, Kofoed KF, Jilaihawi H, Fuchs A, Chakravarty T, Kashif M, Kazuno Y, Kawamori H, Maeno Y, Bieliauskas G, Guo H, Stone GW, and Makkar R
- Subjects
- Aged, Aortic Valve Insufficiency etiology, Aortic Valve Stenosis physiopathology, Echocardiography, Female, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular physiopathology, Humans, Male, Middle Aged, Movement physiology, Postoperative Complications etiology, Prosthesis Failure, Registries, Transcatheter Aortic Valve Replacement, Aortic Valve physiopathology, Aortic Valve Stenosis surgery, Bioprosthesis, Heart Valve Prosthesis, Thrombosis etiology
- Abstract
Aims: Four-dimensional volume-rendered computed tomography (4DCT) has demonstrated instances of hypo-attenuating leaflet thickening (HALT) with or without hypo-attenuation affecting motion (HAM) after transcatheter and surgical aortic valve implantation (TAVI, SAVR). The temporal pattern of evolution of these phenomena is uncertain., Methods and Results: The SAVORY registry enrolled patients treated by TAVI (n = 75) or SAVR (n = 30) with two 4DCT scans fully interpretable for HALT and HAM as well as unchanged anti-thrombotic medication between the scans. Logistic regression analysis was performed to examine the evolution of HALT and HAM while accounting for demographic and baseline variables, timing of both CT scans, valve type and antithrombotic therapy. The analysis population consisted of 84 patients, in whom first and second CT scans were performed at 140 ± 152 days and 298 ± 141 days after valve implantation, respectively. Hypo-attenuating leaflet thickening was noted in 32 patients (38.1%), with HAM in 17 (20.2%). Both findings were dynamic, showing progression in 13 (15.5%) and regression and 9 (10.7%) patients. Compared with antiplatelet therapy, progression was less likely among patients on oral anticoagulation with vitamin-K antagonists or non-VKA oral anticoagulants (odds ratio: 0.014, P = 0.036). Maintenance on chronic oral anticoagulation was not a significant predictor of regression. These findings were similar for both transcatheter and surgical bioprosthetic aortic valves. No patients developed symptoms of valve dysfunction and leaflet thickening was not clearly associated with any clinical events., Conclusions: Subclinical leaflet thrombosis is a common finding after TAVI and SAVR, and may progress from normal leaflet over HALT to the more severe HAM. The phenomenon can develop and regress at variable intervals after valve implantation. Anticoagulants may have a protective effect against the development of HALT, but HALT can also regress without anticoagulation therapy., Registered at Clinicaltrials.gov: NCT02426307., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2017
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227. Sequential transcatheter aortic valve implantation due to valve dislodgement - a Portico valve implanted over a CoreValve bioprosthesis.
- Author
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Campante Teles R, Costa C, Almeida M, Brito J, Sondergaard L, Neves JP, Abecasis J, and M Gabriel H
- Subjects
- Aged, 80 and over, Female, Humans, Prosthesis Design, Aortic Valve Stenosis surgery, Bioprosthesis, Heart Valve Prosthesis, Postoperative Complications surgery, Prosthesis Failure, Transcatheter Aortic Valve Replacement methods
- Abstract
Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve
® , which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved. After several months, she required another intervention, performed with a St. Jude Portico® repositionable self-expanding transcatheter aortic valve. There was a good clinical response that was maintained at one-year follow-up. The use of a self-expanding transcatheter bioprosthesis with repositioning features is a solution in cases of valve dislocation to avoid suboptimal positioning of a second implant, especially when the two valves have to be positioned overlapping or partially overlapping each other., (Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)- Published
- 2017
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228. Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves.
- Author
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Sondergaard L
- Subjects
- Bioprosthesis, Heart Valve Prosthesis, Humans, Aortic Valve, Thrombosis
- Published
- 2017
- Full Text
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229. Time to Explore Transcatheter Aortic Valve Replacement in Younger, Low-Risk Patients.
- Author
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Sondergaard L
- Subjects
- Age Factors, Aortic Valve physiopathology, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Heart Valve Prosthesis, Hemodynamics, Humans, Patient Selection, Recovery of Function, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement mortality
- Abstract
During the last decade transcatheter aortic valve replacement (TAVR) has been established as a treatment for patients with severe aortic stenosis, who are at particularly high surgical risk. As compared with surgical aortic valve replacement (SAVR), TAVR has been associated with lower early risk of mortality, atrial fibrillation, acute kidney injury, and bleeding. Furthermore, device and periprocedural improvements have addressed most of the initial limitations for TAVR, including the Achilles' heel, paravalvular leakage. Supported by this as well as preliminary data among lower-risk patients, TAVR is currently being evaluated in prospective randomized trials against SAVR in younger low-risk patients. Although durability of the TAVR device may be of concern in younger patients given their longer life expectancy, intermediate-term controlled data does not reveal any difference between TAVR and SAVR devices., (Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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230. Transcatheter Aortic Valve Replacement Using the Portico System: 10 Things to Remember.
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Tzikas A, Amrane H, Bedogni F, Brambilla N, Kefer J, Manoharan G, Makkar R, Möllman H, Rodés-Cabau J, Schäfer U, Settergren M, Spargias K, van Boven A, Walther T, Worthley SG, and Sondergaard L
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Prosthesis Design, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Cardiac Catheterization methods, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement methods
- Abstract
The Portico system (St. Jude Medical, Minneapolis, MN, USA) consists of a self-expanding valve prosthesis and a delivery system designed for transcatheter aortic valve replacement (TAVR). We describe this system, its 10-steps implantation procedure, and provide tips and tricks based on our personal experience with this system., (© 2016, Wiley Periodicals, Inc.)
- Published
- 2016
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231. Will PARTNER change my practice? Placement of Aortic Transcatheter Valves (PARTNER) 2 Cohort A trial - transcatheter or surgical aortic-valve replacement in intermediate-risk patients.
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Natarajan D, Makkar R, MacCarthy P, Eltchaninoff H, Sondergaard L, and Prendergast B
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- Humans, Randomized Controlled Trials as Topic, Transcatheter Aortic Valve Replacement trends, Transcatheter Aortic Valve Replacement statistics & numerical data
- Published
- 2016
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232. Left atrial appendage occlusion with the AMPLATZER Amulet device: an expert consensus step-by-step approach.
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Tzikas A, Gafoor S, Meerkin D, Freixa X, Cruz-Gonzalez I, Lewalter T, Saw J, Berti S, Nielsen-Kudsk JE, Ibrahim R, Lakkireddy D, Paul V, Arzamendi D, Nietlispach F, Worthley SG, Hildick-Smith D, Thambo JB, Tondo C, Aminian A, Kalarus Z, Schmidt B, Sondergaard L, Kefer J, Meier B, Park JW, Sievert H, and Omran H
- Subjects
- Atrial Appendage physiopathology, Consensus, Echocardiography, Transesophageal, Fluoroscopy methods, Humans, Punctures, Treatment Outcome, Atrial Appendage surgery, Atrial Fibrillation surgery, Cardiac Catheterization instrumentation, Equipment Design, Septal Occluder Device
- Abstract
Aims: This document aims to describe a standardised methodology for performing left atrial appendage occlusion (LAAO) using the AMPLATZER Amulet device, and to provide useful tips and tricks for operators with different levels of experience., Methods and Results: Physicians who are experts in LAAO and had personal clinical experience with the AMPLATZER Amulet device were asked to contribute in the preparation of this consensus document. Twenty-seven physicians (20 interventional cardiologists and 7 electrophysiologists) from 14 different countries reviewed the manuscript. A step-by-step approach, simulating a real case, was followed. Starting with patient selection and planning, related cardiac imaging is discussed, followed by vascular access - transseptal puncture optimisation. Then, angiographic calibration/sizing and the required fluoroscopy views are explained and a device sizing strategy is proposed. Device preparation and de-airing is briefly described, followed by sheath exchange, device deployment steps, evaluation of device stability and decision for final release. The way to recapture and change a device is then shown, together with some additional tips on how to deal with challenging anatomies like "chicken wing" left atrial appendage. Finally, for operators who are switching from AMPLATZER Cardiac Plug to Amulet, the main differences between the two devices with respect to implantation technique are presented., Conclusions: In conclusion, this document reflects a consensus approach by expert implanters on the steps of LAAO technique and best practices for implantation of the AMPLATZER Amulet device, along with some practical tips to minimise the complication rate.
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- 2016
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233. Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQ mitral valve bioprosthesis: first procedure description and 30-day follow-up.
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Ussia GP, Quadri A, Cammalleri V, De Vico P, Muscoli S, Marchei M, Ruvolo G, Sondergaard L, and Romeo F
- Subjects
- Aged, Follow-Up Studies, Humans, Male, Mitral Valve Insufficiency diagnosis, Prosthesis Design, Prosthesis Failure, Treatment Outcome, Bioprosthesis, Cardiac Catheterization instrumentation, Heart Valve Prosthesis adverse effects, Heart Valve Prosthesis Implantation methods, Mitral Valve surgery, Mitral Valve Insufficiency surgery
- Abstract
Aims: Transcatheter mitral valve implantation for mitral valve regurgitation is in the very early phase of development because of challenging anatomy and device dimensions. We describe the procedure of a transfemoral-transseptal implantation of the second-generation CardiAQ mitral valve bioprosthesis and 30-day follow-up., Methods and Results: The procedure was performed percutaneously, without any left extracorporeal circulatory support. The patient had severe mitral regurgitation with severely depressed ventricular function and other comorbidities. The patient was deemed extreme high risk for conventional cardiac surgery by a multidisciplinary team. The main procedural steps were the creation of an arteriovenous loop with an exchange nitinol wire, and the use of a customised "steerable snare system" to facilitate the catheter delivery system into the mitral annulus. Transoesophageal echocardiography and fluoroscopy were utilised for device positioning and deployment. The mitral valve prosthesis was implanted with mild mitral regurgitation. The postoperative course was uneventful and at 30-day follow-up the patient is in NYHA Class I, with good function of the mitral valve bioprosthesis., Conclusions: This procedure shows that percutaneous transfemoral transcatheter mitral valve implantation is feasible, safe and successful. Further experience is needed to render this procedure clinically available.
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- 2016
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234. Effect of advanced chronic kidney disease in clinical and echocardiographic outcomes of patients treated with MitraClip system.
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Estévez-Loureiro R, Settergren M, Pighi M, Winter R, D'Allara G, Jacobsen P, Sondergaard L, Cheung G, Ghione M, Ihlemann N, Moat NE, Price S, Rosenberg TS, Di Mario C, and Franzen O
- Subjects
- Aged, Aged, 80 and over, Echocardiography mortality, Female, Follow-Up Studies, Heart Valve Prosthesis Implantation mortality, Humans, Male, Middle Aged, Mitral Valve Insufficiency mortality, Registries, Renal Insufficiency, Chronic mortality, Survival Rate trends, Treatment Outcome, Heart Valve Prosthesis Implantation instrumentation, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Renal Insufficiency, Chronic diagnostic imaging, Renal Insufficiency, Chronic surgery, Surgical Instruments
- Abstract
Background: Data regarding the influence of different levels of renal dysfunction on clinical and echocardiographic results of MitraClip therapy are scarce. We aimed to evaluate the impact of baseline advance renal failure in the outcomes of a cohort of patients treated with MitraClip., Methods and Results: We analyzed data from a multicenter registry of 173 patients treated with MitraClip between 2009 and 2012. Patients were classified as advanced chronic kidney disease (CKD, creatinine clearance [CrCl] <30 ml/min, group 1, n=20), moderate CKD (CrCl 30-60 ml/min, group 2, n=78) and normal renal function (CrCl >60 ml/min, group 3, n=75). Twenty patients (11.5%) presented advanced CKD. Procedural success was equal in the 3 groups (95.0% group 1, 100% in group 2 and 96.0% in group 3, p=0.180). Post-procedural MR and NYHA class at 1 month (MR ≥ 3+5.0% vs. 0% vs. 4.0% p=0.190 and NYHA>II 40.0% vs. 21.0% vs. 18.3%, p=0.101) and 6 months (MR ≥ 3+0% vs. 13.0% vs. 2.7%, p=0.330; and NYHA class>II 54.5% vs. 26.9% vs. 25.6%, p=0.298) did not differ between groups. However, patients in group 1 experienced higher frequency of the composite end-point of mortality or readmission at 16.2 ± 11.1 months of follow-up (HR 4.8, CI 95% 1.1-21.3)., Conclusion: Advanced CKD is linked to an excess of cardiac adverse events. This should be judiciously taken into account when selecting patients for MitraClip., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
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235. The CardiAQ transcatheter mitral valve implantation system.
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Sondergaard L, Ussia GP, Dumonteil N, and Quadri A
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- Animals, Cardiac Catheterization adverse effects, Cardiac Catheterization methods, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation methods, Hemodynamics, Humans, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency physiopathology, Patient Selection, Prosthesis Design, Risk Factors, Treatment Outcome, Bioprosthesis, Cardiac Catheterization instrumentation, Cardiac Catheters, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Mitral Valve physiopathology, Mitral Valve Insufficiency therapy
- Published
- 2015
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236. Effect of gender on results of percutaneous edge-to-edge mitral valve repair with MitraClip system.
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Estévez-Loureiro R, Settergren M, Winter R, Jacobsen P, Dall'Ara G, Sondergaard L, Cheung G, Pighi M, Ghione M, Ihlemann N, Moat NE, Price S, Streit Rosenberg T, Di Mario C, and Franzen O
- Subjects
- Aged, Denmark epidemiology, Female, Follow-Up Studies, Humans, Incidence, Kaplan-Meier Estimate, Male, Mitral Valve Insufficiency mortality, Prosthesis Design, Retrospective Studies, Sex Factors, Survival Rate trends, Sweden epidemiology, Treatment Outcome, United Kingdom epidemiology, Heart Valve Prosthesis, Mitral Valve Insufficiency surgery, Postoperative Complications epidemiology
- Abstract
Knowledge regarding gender-specific results of percutaneous edge-to-edge mitral valve repair is scarce. The aim of this study was to investigate gender differences in outcomes in a cohort of patients treated with MitraClip implantation. A multicenter registry of 173 patients treated with MitraClip prostheses from 2009 to 2012 at 3 experienced centers was performed. One hundred nine patients (63%) were men. Men were younger (mean age 73 ± 10 vs 79 ± 9 years, p = 0.001) and had a higher prevalence of previous coronary bypass graft surgery (34% vs 13%, p = 0.002), previous myocardial infarction (46% vs 20%, p = 0.001), and diabetes mellitus (26% vs 11%, p = 0.020). There were no differences regarding New York Heart Association (NYHA) functional class before the intervention (NYHA class III or IV in 95% of men vs 97% of women, p = 0.472) or the cause of mitral regurgitation (MR) (functional in 58% of men vs 48% of women, p = 0.233). Men exhibited significantly larger ventricles (mean indexed left ventricular end-systolic diameter 2.4 ± 0.8 vs 2.0 ± 1.6 cm/m(2), p = 0.002, and mean indexed left ventricular end-diastolic volume 92.7 ± 46.1 vs 59.9 ± 24.6 ml/m(2), p <0.001). At 1 month, there were no differences between groups in the reduction of MR or NYHA functional class (MR grade ≤2+ in 98.2% of men vs 96.8% of women, p = 0.586, and NYHA class ≤II in 78.3% of men vs 77% of women, p = 0.851). At 6 months, results were maintained (MR grade ≤2+ in 89.5% of men vs 96.8% of women, p = 0.414, and NYHA class ≤II in 73.1% of men vs 74.2% of women, p = 0.912). After a mean follow-up period of 16.1 ± 11.1 months, no difference was found between groups in the incidence of death or admission for heart failure (log-rank p = 0.798). In conclusion, MitraClip implantation seems to be an equally safe and effective treatment of MR in men and women., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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237. Echocardiographic and clinical outcomes of central versus noncentral percutaneous edge-to-edge repair of degenerative mitral regurgitation.
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Estévez-Loureiro R, Franzen O, Winter R, Sondergaard L, Jacobsen P, Cheung G, Moat N, Ihlemann N, Ghione M, Price S, Duncan A, Streit Rosenberg T, Barker S, Di Mario C, and Settergren M
- Subjects
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Mitral Valve Insufficiency mortality, Retrospective Studies, Treatment Outcome, Catheterization, Central Venous methods, Echocardiography, Transesophageal methods, Heart Valve Prosthesis Implantation methods, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery
- Abstract
Objectives: This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR., Background: It is unknown whether the use of MitraClip therapy in noncentral dMR is as safe and effective as in central dMR., Methods: We analyzed a multicenter registry of 173 patients treated with the MitraClip and compared results of central and noncentral dMR., Results: Seventy-nine patients (age 79.2 ± 8.0 years, 58.2% men) had dMR. Forty-nine patients (62%) had central dMR, with the remainder classified as noncentral dMR (n = 30, 38%). Patients with noncentral dMR had a wider pre-procedural vena contracta (8.5 ± 2.0 mm vs. 6.9 ± 2.2 mm, p = 0.039) and higher systolic pulmonary pressure (57.9 ± 18.0 vs. 47.3 ± 13.0 mm Hg, p = 0.019). Procedural success was the same in both groups (95.5% central vs. 96.7% noncentral, p = 0.866). Post-procedural MR and New York Heart Association (NYHA) functional class at 1 month (MR ≤2, 96.0% vs. 96.6%, p = 0.866, and NYHA functional class ≤II, 81.6% vs. 90.0%, p = 0.335) and 6 months (95.2% central vs. 91.7% noncentral, p = 0.679; and NYHA functional class >II, 21.1% vs. 0%, p = 0.128) did not differ between groups. There were also no differences in serious post-procedural adverse events: partial clip detachment (central n = 1 [2.0%] vs. noncentral n = 1 [3.3%], p = 1.000), death (5.4% central vs. 13.0% noncentral, p = 0.298), or heart failure admission (10.8% central vs. 8.7% noncentral, p = 0.791)., Conclusions: In experienced centers, MitraClip treatment can be performed safely and effectively in both central and noncentral dMR., (Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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238. Percutaneous pulmonary valve replacement after different duration of free pulmonary regurgitation in a porcine model: effects on the right ventricle.
- Author
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Ersboell M, Vejlstrup N, Nilsson JC, Kjaergaard J, Norman W, Lange T, Taylor A, Bonhoeffer P, and Sondergaard L
- Subjects
- Animals, Pulmonary Valve pathology, Pulmonary Valve physiology, Pulmonary Valve surgery, Pulmonary Valve Insufficiency physiopathology, Swine, Treatment Outcome, Cardiac Catheterization methods, Disease Models, Animal, Heart Valve Prosthesis Implantation methods, Pulmonary Valve Insufficiency surgery, Ventricular Function, Right physiology
- Abstract
Background: Free pulmonary regurgitation (PR) after surgical correction of Tetralogy of Fallot (ToF) with transannular patching can lead to irreversible right ventricular (RV) failure. However, the optimal timing of valve replacement is still debated., Methods and Results: Thirty six pigs were included in the study. Twenty one pigs had a bare metal stent placed in the pulmonary annulus inducing free PR and 9 animals served as control. Six animals died prematurely due to procedural complications. The 21 animals were divided into 3 groups with differential duration of PR (1, 2, 3 months, respectively) after which PPVR was performed. After 1 month with competent valve the animals were euthanized. Cardiac magnetic resonance (CMR) and right heart catheterization were performed serially. Free PR led to severe dilation of the RV in all three groups compared to matched controls (p<0.001). Final RV volume after one month with competent pulmonary valve was modeled. Increase in RV volume from baseline to valve replacement (ΔRV) was the only predictor of RV recovery (p<0.001) and increases in ΔRV beyond 120 mL/m2 were predictive of very low probability of recovery. A total of 5 animals did not recover., Conclusions: Recovery of right ventricular function after free PR by treatment with PPVR was successful in the majority of animals. Increases in RV volume during PR were the only predictor of non-recovery after PPVR and duration of PR did not in itself predict treatment success., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2013
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239. Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent.
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Demkow M, Biernacka EK, Spiewak M, Kowalski M, Siudalska H, Wolski P, Sondergaard L, Miśko J, Hoffman P, and Rużyłło W
- Subjects
- Adult, Echocardiography, Female, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Humans, Magnetic Resonance Imaging, Male, Poland, Prosthesis Design, Pulmonary Valve Insufficiency diagnosis, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Insufficiency physiopathology, Radiography, Thoracic, Stroke Volume, Time Factors, Treatment Outcome, Ventricular Function, Left, Ventricular Function, Right, Ventricular Outflow Obstruction diagnosis, Ventricular Outflow Obstruction etiology, Ventricular Outflow Obstruction physiopathology, Young Adult, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Cardiac Surgical Procedures adverse effects, Heart Defects, Congenital therapy, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods, Metals, Pulmonary Valve physiopathology, Pulmonary Valve Insufficiency therapy, Stents, Ventricular Outflow Obstruction therapy
- Abstract
Objectives: To evaluate the effectiveness and safety of percutaneous pulmonary valve implantation (PPVI) with routine prestenting with a bare metal stent (BMS)., Background: PPVI is a relatively new method of treating patients with repaired congenital heart disease (CHD). Results of PPVI performed with routine prestenting have never been reported., Methods: Consecutive patients who underwent PPVI for homograft dysfunction with prestenting with BMS were studied. The schedule of follow-up assessment comprised clinical evaluation, cardiovascular magnetic resonance, transthoracic echocardiography, and chest X-ray to screen for device integrity., Results: PPVI was performed with no serious complications in all patients (n=10, mean age 26.8±4.0 years, 60% males). In nine patients with significant pulmonary stenosis, peak right ventricular outflow tract (RVOT) gradient was reduced from a mean of 80.6±22.7 to 38.8±10.4 mm Hg on the day following implantation (P=0.001). At 1-month and 6-month follow-ups, mean RVOT gradient was 34.0±9.8 and 32.0±12.2 mm Hg, respectively. In patients with significant pulmonary regurgitation, mean pulmonary regurgitation fraction decreased from 19%±6% to 2%±1% (P=0.0008). Relief of RVOT obstruction and restoration of pulmonary valve competence were associated with significant decrease in right ventricular (RV) end-diastolic and end-systolic volumes (125.5±48.6 to 109.2±42.9 mL/m2 ; P=0.002 and 68.4±41.5 vs. 50.9±40.6 mL/m2; P=0.001) as well as improvement in RV ejection fraction (48.8%±13.1% to 57.6%±14.4%; P=0.003) and New York Heart Association class (P=0.003). All patients completed 6-month follow-up. No stent fractures were observed., Conclusions: PPVI with routine prestenting with BMS is a safe and effective method of treatment in patients with repaired CHD., (Copyright © 2010 Wiley-Liss, Inc.)
- Published
- 2011
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240. [POL-PAVTI--Polish report on transcatheter pulmonary artery valve implantation of Melody-Medtronic prosthesis in the first 14 patients in Poland].
- Author
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Ruzyłło W, Demkow M, Włodarska EK, Kowalski M, Spiewak M, Siudalska H, Wolski P, Miśko J, Hoffman P, Kusa J, Szkutnik M, Białkowski J, Fiszer R, Urbańska E, and Sondergaard L
- Subjects
- Adolescent, Adult, Blood Vessel Prosthesis Implantation methods, Cardiac Surgical Procedures methods, Echocardiography, Transesophageal, Follow-Up Studies, Heart Defects, Congenital diagnostic imaging, Humans, Male, Poland, Pulmonary Artery abnormalities, Treatment Outcome, Ventricular Outflow Obstruction surgery, Young Adult, Heart Defects, Congenital surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods, Pulmonary Artery surgery, Pulmonary Valve surgery
- Abstract
Aim: To assess the early results of the pulmonary artery valve transcatheter implantation (PAVTI) in pts included into POL-PAVTI registry. Detailed medical and economic analyses were performed., Methods: Pulmonary artery valve implantation was performed in 14 pts (9 men), aged 16-31 (mean 24.6 +/- 4.8) years, with pulmonary homograft dysfunction after total repair of tetralogy of Fallot (4 pts), pulmonary atresia (2 pts), pulmonary stenosis (1 pt), common arterial trunk type I (1 pt), Ross procedure (3 pts) and TGA - Rastelli operation (3 pts). Eleven pts underwent in the past 2-5 surgical or/and catheter interventions. Indication for PAVTI was based on clinical evaluation and echocardiographic studies. Assessment of morphological and functional features of the right ventricle (RV) and homograft with the use of cardiac magnetic resonance (CMR) was performed in 10 cases. Pulmonary stenosis (max. pulmonary gradient 32-119, mean 72 +/- 28 mmHg) was observed in 13 pts and/or significant pulmonary regurgitation in 10 pts. The procedure was performed in general anesthesia. The deployment of a valved stent in the pulmonary valve position was preceded by a metal stent implantation. Results were evaluated by echocardiography two days after the procedure and one month later. Four patients were evaluated 6 months after procedure., Results: Time of the procedure varied 60-190 (mean 127 +/- 35) min, time of fluoroscopy ranged 12-31 (mean 21 +/- 11) min. PAVTI was successfully performed in all pts without serious complications. Patients were discharged from the hospital 48-293 (mean 120 +/- 71) h after procedure. Significant reduction of pulmonary gradient after the procedure assessed by echocardiography was observed on the second day (20-60, mean 38 +/- 12 mmHg, p < 0.0001) and one month (19-52, mean 34 +/- 9 mmHg, p < 0.0001). Mild pulmonary regurgitation was observed in 2 pts. In 5 pts evaluated 6 months after procedure haemodynamic parameters were unchanged; no late complications were observed. Average cost of the procedure including a price of the valve (82 000 PLN) was 98 000 PLN., Conclusions: Pulmonary artery valve transvascular implantation is an effective and safe method of non-surgical treatment for patients with homograft dysfunction. Cost-effectiveness is approvable.
- Published
- 2009
241. Screening of adults with congenital cardiac disease lost for follow-up.
- Author
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Iversen K, Vejlstrup NG, Sondergaard L, and Nielsen OW
- Subjects
- Adult, Biomarkers blood, Denmark epidemiology, Disease Progression, Female, Follow-Up Studies, Heart Defects, Congenital blood, Heart Defects, Congenital epidemiology, Humans, Male, Middle Aged, Prevalence, Prognosis, Retrospective Studies, Severity of Illness Index, Time Factors, Auscultation methods, Echocardiography methods, Heart Defects, Congenital diagnosis, Mass Screening methods, Natriuretic Peptide, Brain blood, Patient Compliance
- Abstract
Objective: A problem facing doctors treating adults with congenitally malformed hearts is that a significant number of these patients are lost for follow-up. The purpose of our study is to describe the medical history and clinical findings in a group of such adults that was lost for follow-up. DESIGN, SETTINGS AND PATIENTS: The Danish press ran a front-page story about adults with congenitally malformed hearts who were lost for follow-up. These patients were strongly advised to contact a center for congenital cardiac disease, and we examined all responding patients within four-weeks., Interventions: We carried out a structured interview, a clinical examination, echocardiography, and measured levels of N-terminal pro brain natriuretic peptide., Results: The number of responders was 147. Based on the diagnosis and the findings, further follow-up was scheduled for 52 (35.4%), either because of significant residual lesions, found in 32, or the risk of late complications, judged to be present in 20. Symptoms were present in 36.5% of patients scheduled for follow-up. The presence of a heart murmur was highly predictive of the need for further follow-up but the sensitivity was too low to recommend the use of auscultation as a screening test., Conclusion: A large proportion of adults with congenitally malformed hearts who are lost for follow-up require regular assessment according to a modern standard. Symptoms, signs, and measurement of natriuretic peptide cannot replace full cardiological assessment. It is a challenge for centres treating adults with congenital heart disease to find the lost group of patient with significant cardiac malformations.
- Published
- 2007
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242. Neurohumoral prediction of left-ventricular morphologic response to beta-blockade with metoprolol in chronic left-ventricular systolic heart failure.
- Author
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Groenning BA, Nilsson JC, Hildebrandt PR, Kjaer A, Fritz-Hansen T, Larsson HB, and Sondergaard L
- Subjects
- Adult, Aged, Aged, 80 and over, Biological Factors blood, Biomarkers blood, Blood Pressure drug effects, Blood Pressure physiology, Chronic Disease, Diastole drug effects, Double-Blind Method, Female, Heart Rate drug effects, Heart Rate physiology, Heart Ventricles drug effects, Heart Ventricles pathology, Hormones blood, Humans, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, ROC Curve, Renin blood, Sensitivity and Specificity, Stroke Volume drug effects, Stroke Volume physiology, Systole drug effects, Treatment Outcome, Adrenergic beta-Antagonists therapeutic use, Heart Failure blood, Heart Failure drug therapy, Metoprolol therapeutic use, Neurotransmitter Agents blood, Ventricular Dysfunction, Left blood, Ventricular Dysfunction, Left drug therapy, Ventricular Remodeling drug effects
- Abstract
Background: In order to tailor therapy in heart failure, a solution might be to develop sensitive and reliable markers that can predict response in individual patients or monitor effectiveness of therapy., Aims: To evaluate neurohumoral factors as markers for left-ventricular (LV) antiremodelling from metoprolol treatment in patients with chronic LV systolic heart failure., Methods: Forty-one subjects randomised to placebo or metoprolol were studied with magnetic resonance imaging and blood samples to measure LV dimensions and ejection fraction, epinephrine, norepinephrine, plasma renin activity, aldosterone, atrial (ANP) and brain natriuretic peptides, arginine-vasopressin and endothelin-1 at baseline, 5 weeks and 6 months after randomisation., Results: Baseline ANP was identified as sole independent marker for changes in LV end-diastolic (deltaLVEDVI: r=-0.70, P=0.002), and end-systolic (deltaLVESVI: r=-0.53, P=0.03) volumes during metoprolol treatment. Change in ANP during the study was an independent marker for deltaLVEDVI: r=0.66, P=0.004, and deltaLVESVI: r=0.69, P=0.002 in the entire metoprolol group, but at the individual patient level, results were less clear., Conclusion: The pre-treatment plasma level of ANP may be a predictor of LV antiremodelling from treatment with metoprolol in patients with chronic heart failure. However, the potential for individual neurohumoral monitoring of the effects on LV dimensions during beta-blockade appears limited., (Copyright 2002 European Society of Cardiology)
- Published
- 2002
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243. A functional and structural basis for TCR cross-reactivity in multiple sclerosis.
- Author
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Lang HL, Jacobsen H, Ikemizu S, Andersson C, Harlos K, Madsen L, Hjorth P, Sondergaard L, Svejgaard A, Wucherpfennig K, Stuart DI, Bell JI, Jones EY, and Fugger L
- Subjects
- Animals, B-Lymphocytes cytology, B-Lymphocytes immunology, Cell Line, Cross Reactions, Crystallography, X-Ray, HLA-DR Antigens chemistry, HLA-DRB1 Chains, HLA-DRB5 Chains, Humans, Mice, Mice, Transgenic, Models, Molecular, Myelin Basic Protein chemistry, Protein Structure, Tertiary, Receptors, Antigen, T-Cell, alpha-beta genetics, HLA-DR Antigens immunology, Herpesvirus 4, Human immunology, Multiple Sclerosis immunology, Myelin Basic Protein immunology, Receptors, Antigen, T-Cell, alpha-beta immunology
- Abstract
The multiple sclerosis (MS)-associated HLA major histocompatibility complex (MHC) class II alleles DRB1*1501, DRB5*0101 and DQB1*0602 are in strong linkage disequilibrium, making it difficult to determine which is the principal MS risk gene. Here we show that together the DRB1 and DRB5 loci may influence susceptibility to MS. We demonstrate that a T cell receptor (TCR) from an MS patient recognized both a DRB1*1501-restricted myelin basic protein (MBP) and DRB5*0101-restricted Epstein-Barr virus (EBV) peptide. Crystal structure determination of the DRB5*0101-EBV peptide complex revealed a marked degree of structural equivalence to the DRB1*1501-MBP peptide complex at the surface presented for TCR recognition. This provides structural evidence for molecular mimicry involving HLA molecules. The structural details suggest an explanation for the preponderance of MHC class II associations in HLA-associated diseases.
- Published
- 2002
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244. Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations.
- Author
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Groenning BA, Nilsson JC, Sondergaard L, Pedersen F, Trawinski J, Baumann M, Larsson HB, and Hildebrandt PR
- Subjects
- Aged, Biomarkers blood, Case-Control Studies, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, ROC Curve, Heart Failure blood, Heart Failure diagnosis, Magnetic Resonance Imaging, Nerve Tissue Proteins blood, Peptide Fragments blood
- Abstract
Background: Brain- and N-terminal pro brain natriuretic peptide (NT-proBNP) have been identified as promising markers for heart failure. However, previous studies have revealed that they may hold insufficient diagnostic power for implementation into clinical practice because of a significant overlap in the range of plasma levels between healthy subjects and subjects with heart failure. We hypothesized that imprecision of the reference method (ie, the echocardiographic evaluation of left ventricular [LV] function) may have affected results from those earlier studies. We therefore wanted to investigate the diagnostic potential of NT-proBNP with magnetic resonance imaging as the reference method for the cardiac measurements., Methods: Forty-eight patients with stable symptomatic heart failure in New York Heart Association functional classifications II to IV were examined once with blood samples and magnetic resonance imaging along with 20 age-matched and gender-matched healthy control subjects., Results: NT-proBNP was associated with LV end-diastolic (r = 0.69; P <.0001) and end-systolic (r = 0.73; P <.0001) volume indices, LV mass index (r = 0.69; P <.0001), and LV ejection fraction (r = -0.75; P <.0001). Receiver operating characteristic curves were calculated for the ability of NT-proBNP to detect LV end-diastolic volume index (>105 mL. m(-2)[cut-off]; sensitivity/specificity, 82%/87%), LV end-systolic volume index (>35 mL. m(-2); sensitivity/specificity, 86%/86%), LV mass index (>152 g. m(-2); sensitivity/specificity, 85%/86%), and LV ejection fraction (<58%; sensitivity/specificity, 84%/85%) deviating more than 2 standard deviations from control values., Conclusion: NT-proBNP is a powerful marker for LV dimensions and systolic function in patients with heart failure and discriminates well between healthy subjects and subjects with impaired LV systolic function or increased LV dimensions.
- Published
- 2002
- Full Text
- View/download PDF
245. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide.
- Author
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Nilsson JC, Groenning BA, Nielsen G, Fritz-Hansen T, Trawinski J, Hildebrandt PR, Jensen GB, Larsson HB, and Sondergaard L
- Subjects
- Biomarkers blood, Dilatation, Female, Follow-Up Studies, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Myocardial Infarction blood, Myocardial Infarction pathology, Natriuretic Peptide, Brain, Stroke Volume, Myocardial Infarction physiopathology, Nerve Tissue Proteins blood, Peptide Fragments blood, Ventricular Remodeling physiology
- Abstract
Background: Left ventricular (LV) remodeling after myocardial infarction (MI) has received much attention because of its severe impact on morbidity and mortality rates. However, the incidence and extent of LV remodeling in a modern infarct population who were offered antiremodeling treatment in compliance with daily clinical practice is unknown. The purpose of this study was to clarify this issue and to evaluate the predictive value of N-terminal pro brain natriuretic peptide (NT-proBNP)., Methods: Forty-two patients with a first transmural MI were examined after 1 week, 1 month, 3 months, 6 months, and 1 year with blood samples and magnetic resonance imaging., Results: In 12 patients (29%), LV end-diastolic volume index (LVEDVI) and LV end-systolic volume index (LVESVI) increased by 24% and 22% (P <.0001; P =.01). In 12 patients (29%), LVEDVI and LVESVI decreased by 19% and 23% (P <.0001; P =.0005), whereas the remaining 18 patients (43%) had stable conditions regarding these LV measures. LV ejection fraction at baseline was significantly reduced in all patient categories but was unchanged over time. Elevated NT-proBNP level at baseline was identified as an independent predictor of increase in LVEDVI during follow-up examination (P =.007). A baseline level of NT-proBNP >115 pmol/L identified patients who later had LV dilatation develop with a sensitivity and specificity of 89% and 68% (area under curve = 0.77)., Conclusion: In this 1-year follow-up study of patients with a first transmural MI, approximately 30% had significant increments develop in LVEDVI and LVESVI, and LV ejection fraction remained unchanged. Patients in whom LV dilatation developed could be identified early after the MI with elevated plasma levels of NT-proBNP.
- Published
- 2002
- Full Text
- View/download PDF
246. Molecular identification of the insect adipokinetic hormone receptors.
- Author
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Staubli F, Jorgensen TJ, Cazzamali G, Williamson M, Lenz C, Sondergaard L, Roepstorff P, and Grimmelikhuijzen CJ
- Subjects
- Amino Acid Sequence, Animals, CHO Cells, Chromatography, High Pressure Liquid, Circular Dichroism, Cloning, Molecular, Cricetinae, Drosophila Proteins chemistry, Drosophila Proteins genetics, Drosophila Proteins isolation & purification, Drosophila Proteins metabolism, Drosophila melanogaster chemistry, Drosophila melanogaster genetics, Insect Hormones isolation & purification, Insect Proteins chemistry, Insect Proteins genetics, Insect Proteins isolation & purification, Insect Proteins metabolism, Ligands, Luminescent Measurements, Molecular Sequence Data, Oligopeptides isolation & purification, Pyrrolidonecarboxylic Acid analogs & derivatives, Receptors, Cell Surface chemistry, Receptors, LHRH chemistry, Sequence Alignment, Spectrometry, Mass, Electrospray Ionization, Bombyx genetics, Drosophila melanogaster metabolism, Insect Hormones metabolism, Oligopeptides metabolism, Receptors, Cell Surface genetics, Receptors, Cell Surface metabolism
- Abstract
The insect adipokinetic hormones (AKHs) are a large family of peptide hormones that are involved in the mobilization of sugar and lipids from the insect fat body during energy-requiring activities such as flight and locomotion, but that also contribute to hemolymph sugar homeostasis. Here, we have identified the first insect AKH receptors, namely those from the fruitfly Drosophila melanogaster and the silkworm Bombyx mori. These results represent a breakthrough for insect molecular endocrinology, because it will lead to the cloning of all AKH receptors from all model insects used in AKH research, and, therefore, to a better understanding of AKH heterogeneity and actions. Interestingly, the insect AKH receptors are structurally and evolutionarily related to the gonadotropin-releasing hormone receptors from vertebrates.
- Published
- 2002
- Full Text
- View/download PDF
247. Antiremodeling effects on the left ventricle during beta-blockade with metoprolol in the treatment of chronic heart failure.
- Author
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Groenning BA, Nilsson JC, Sondergaard L, Fritz-Hansen T, Larsson HB, and Hildebrandt PR
- Subjects
- Adrenergic beta-Antagonists therapeutic use, Adult, Aged, Aged, 80 and over, Double-Blind Method, Female, Hemodynamics drug effects, Humans, Magnetic Resonance Imaging, Male, Metoprolol therapeutic use, Middle Aged, Prospective Studies, Adrenergic beta-Antagonists pharmacology, Heart Failure drug therapy, Metoprolol pharmacology, Ventricular Function, Left drug effects, Ventricular Remodeling drug effects
- Abstract
Objectives: The purpose of the study was to investigate the effects of beta1-blockade on left ventricular (LV) size and function for patients with chronic heart failure., Background: Large-scale trials have shown that a marked decrease in mortality can be obtained by treatment of chronic heart failure with beta-adrenergic blocking agents. Possible mechanisms behind this effect remain yet to be fully elucidated, and previous studies have presented insignificant results regarding suspected LV antiremodeling effects., Methods: In this randomized, placebo-controlled and double-blind substudy to the Metoprolol CR/XL Randomized Intervention Trial in Heart Failure (MERIT-HF), 41 patients were examined with magnetic resonance imaging three times in a six-month period, assessing LV dimensions and function., Results: Decreases in both LV end-diastolic volume index (150 ml/m2 at baseline to 126 ml/m2 after six months, p = 0.007) and LV end-systolic volume index (107 ml/m2 to 81 ml/m2, p = 0.001) were found, whereas LV ejection fraction increased in the metoprolol CR/XL group (29% to 37%, p = 0.005). No significant changes were seen in the placebo group regarding these variables. Left ventricular stroke volume index remained unchanged, whereas LV mass index decreased in both groups (175 g/m2 to 160 g/m2 in the placebo group [p = 0.005] and 179 g/m2 to 164 g/m2 in the metoprolol CR/XL group [p = 0.011)., Conclusions: This study is the first randomized study to demonstrate that the beta1-blocker metoprolol CR/XL has antiremodeling effects on the LV in patients with chronic heart failure and consequently provides an explanation for the highly significant decrease in mortality from worsening heart failure found in the MERIT-HF trial.
- Published
- 2000
- Full Text
- View/download PDF
248. Role of proteins and lipids in non-linear Arrhenius plots of Drosophila mitochondrial succinate-cytochrome c reductase studied by rebinding experiments.
- Author
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Sondergaard L
- Subjects
- Animals, Drosophila melanogaster, Phospholipids metabolism, Protein Binding, Thermodynamics, Membrane Lipids metabolism, Membrane Proteins metabolism, Mitochondria enzymology, Oxidoreductases metabolism, Succinate Cytochrome c Oxidoreductase metabolism
- Abstract
Abrupt changes in the Arrhenius activation energy of membrane-bound enzymes have often been correlated with changes in the physical state of membrane phospholipids. Similar changes in activation energy have also been found in soluble enzymes. The possibility exists, therefore, that in some of the membrane-bound enzymes the changes might reflect intrinsic changes of the proteins independent of changes in the membrane phospholipids. This hypothesis was investigated using Drosophila mitochondria isolated from wild type and the mutant Ocd ts-1. In this mutant it has been shown that succinate-cytochrome c reductase exhibits a change in Arrhenius activation energy at 18 degrees C which is not found in the wild type (Sondergaard, L., Nielsen, N.C. and Smillie, R.M. (1975) FEBS lett. 50, 126-129). A quantitative thin-layer chromatographic analysis of mitochondrial phospholipids showed sphingomyelin to be more abundant in the wild type than in the mutant (5.2% and 4.3% of the total phospholipids, respectively). Since it was shown that the succinate-cytochrome c reductase had a lipid requirement for full activity, reciprocal rebinding experiments were done. These experiments showed that the reconstituted membranes exhibited the change in activation energy at 18 degrees C only when the protein moiety came from mutant mitochondria, that is, the change was independent of the source of the phospholipids used.
- Published
- 1979
- Full Text
- View/download PDF
249. A temperature-sensitive behavioural mutant of Drosophila melanogaster: Out-cold.
- Author
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Sondergaard L
- Subjects
- Animals, Chromosome Mapping, Female, Genotype, Heterozygote, Male, Sex Chromosomes, Temperature, Drosophila melanogaster, Mutation
- Published
- 1975
250. The effect of the Out-cold-ts mutation on temperature induced changes in the Arrhenius activation energy of succinate-cytochrome c reductase activity in Drosophila.
- Author
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Sondergaard L, Nielsen NC, and Smillie RM
- Subjects
- Animals, Calorimetry, Enzyme Activation, Genotype, Homozygote, Kinetics, Succinates, Temperature, Thermodynamics, Cytochrome Reductases metabolism, Drosophila melanogaster enzymology, Mitochondria enzymology, Mutation
- Published
- 1975
- Full Text
- View/download PDF
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