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3. Temporal Changes of Patient Characteristics Over 12 Years in a Single-Center Transcatheter Aortic Valve Implantation Cohort

Author

Demal, T. J., additional, Weimann, J., additional, Ojeda, F. M., additional, Bhadra, O. D., additional, Linder, M., additional, Ludwig, S., additional, Grundmann, D., additional, Voigtländer, L., additional, Waldschmidt, L., additional, Schirmer, J., additional, Schofer, N., additional, Blankenberg, S., additional, Reichenspurner, H., additional, Conradi, L., additional, Seiffert, M., additional, and Schäfer, A., additional

Published
2023
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5. Procedural Success in Transaxillary Transcatheter Aortic Valve Implantation According to Type of Transcatheter Heart Valve: Results from the Multicenter TAXI Registry

Author

Schäfer, A., additional, Bhadra, O. D., additional, Conradi, L., additional, Westermann, D., additional, Reichenspurner, H., additional, De Backer, O., additional, Sondergaard, L., additional, Qureshi, W. T., additional, Kakouros, N., additional, Amat-Santos, I., additional, Kaneko, T., additional, Teles, R., additional, Nolasco, T., additional, Abecasis, M., additional, Werner, N., additional, Sacha, J., additional, Trani, C., additional, Mangieri, A., additional, Regueiro, A., additional, Biancari, F., additional, Niemelä, M., additional, Giannini, F., additional, Buono, A., additional, Bruno, F., additional, Savontaus, M., additional, Ielasi, A., additional, Ferraro, P., additional, Biondi-Zoccai, G., additional, Morello, A., additional, and Giordano, A., additional

Published
2023
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6. TAVI Using a Balloon-Expandable Transcatheter Heart Valve in Patients with Aortic Annuli Exceeding Formally Approved Dimensions

Author

Sarwari, H., additional, Bhadra, O. D., additional, Demal, T. J., additional, Grundmann, D., additional, Waldschmidt, L., additional, Sörensen, N., additional, Schirmer, J., additional, Schofer, N., additional, Pecha, S., additional, Blankenberg, S., additional, Reichenspurner, H., additional, Conradi, L., additional, Seiffert, M., additional, and Schäfer, A., additional

Published
2023
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7. LVAD Explantation Using a Double-Patch Technique

Author

Bhadra, O. D., additional, Pausch, J., additional, Aubin, H., additional, Akhyari, P., additional, Lichtenberg, A., additional, Barten, M., additional, Schäfer, A., additional, Alassar, Y., additional, Reichenspurner, H., additional, and Bernhardt, A. M., additional

Published
2023
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10. Surgical Explantation After TAVR Failure: Mid-Term Outcomes From the EXPLANT-TAVR International Registry

Author

Bapat, V. N., Zaid, S., Fukuhara, S., Saha, S., Vitanova, K., Kiefer, P., Squiers, J. J., Voisine, P., Pirelli, L., von Ballmoos, M. W., Chu, M. W. A., Rodes-Cabau, J., Dimaio, J. M., Borger, M. A., Lange, R., Hagl, C., Denti, P., Modine, T., Kaneko, T., Tang, G. H. L., Sengupta, A., Holzhey, D., Noack, T., Harrington, K. B., Mohammadi, S., Brinster, D. R., Atkins, M. D., Algadheeb, M., Bagur, R., Desai, N. D., Bhadra, O. D., Conradi, L., Shults, C., Satler, L. F., Ramlawi, B., Robinson, N. B., Wang, L., Petrossian, G. A., Andreas, M., Werner, P., Garatti, A., Vincent, F., Van Belle, E., Juthier, F., Leroux, L., Doty, J. R., Goldberg, J. B., Ahmad, H. A., Goel, K., Shah, A. S., Geirsson, A., Forrest, J. K., Grubb, K. J., Hirji, S., Shah, P. B., Bruschi, G., Gelpi, G., Belluschi, I., Ouzounian, M., Ruel, M., Al-Atassi, T., Kempfert, J., Unbehaun, A., Van Mieghem, N. M., Hokken, T. W., Ben Ali, W., Ibrahim, R., Demers, P., Pizano, A., Di Eusanio, M., Capestro, F., Estevez-Loureiro, R., Pinon, M. A., Salinger, M. H., Rovin, J., D'Onofrio, A., Tessari, C., Di Virgilio, A., Taramasso, M., Gennari, M., Colli, A., Whisenant, B. K., Nazif, T. M., Kleiman, N. S., Szerlip, M. Y., Waksman, R., George, I., Nguyen, T. C., Maisano, F., Deeb, G. M., Bavaria, J. E., Reardon, M. J., Mack, M. J., Brinkman, W. T., George, T. J., Potluri, S., Ryan, W. H., Schaffer, J. M., Smith, R. L., Szerlip, M., Nazif, T., Rahim, H., Grubb, K., Atkins, M., Goel, S., Kleiman, N., Reardon, M., Doty, J., Whisenant, B., Salinger, M., Satler, L., Schults, C., Fisher, S., Alexis, S. L., Kliger, C. A., Rutkin, B., P. -J., Yu, Petrossian, G., Robinson, N., Deeb, M., Oakley, J., Bavaria, J., Desai, N., Walsh, L., Nguyen, T., Ahmad, H., Goldberg, J., Spielvogel, D., Forrest, J., Chu, M., Cartier, R., Abois, A. -P., Boodhwani, M., Dick, A., Glover, C., Labinaz, M., Lam, B. -K., Delhaye, C., Delsaux, A., Denimal, T., Gaul, A., Koussa, M., Pamart, T., Sonnabend, S., Krane, M., Munsterer, A., Bhadra, O., Merlanti, B., Russo, C. F., Romagnoni, C., and Pinnon, M.

Subjects
TAVR explantation, TAVR failure, surgical aortic valve replacement, transcatheter aortic valve replacement
Published
2021

12. Transcatheter Aortic Valve Implantation after Previous Mitral Valve Repair or Replacement: Technical Considerations and Clinical Outcomes

Author

Sarwari, H., additional, Bhadra, O., additional, Ludwig, S., additional, Schirmer, J., additional, Schofer, N., additional, Pecha, S., additional, Seiffert, M., additional, Blankenberg, S., additional, Reichenspurner, H., additional, Conradi, L., additional, Westermann, D., additional, and Schäfer, A., additional

Published
2022
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15. Diagnostic value and prognostic impact of various invasively derived hemodynamic parameters in patients with severe aortic stenosis undergoing TAVI

Author

Grundmann, D, primary, Linder, M, additional, Gossling, A, additional, Voigtlaender, L, additional, Ludwig, S, additional, Waldschmidt, L, additional, Demal, T, additional, Bhadra, O, additional, Seiffert, M, additional, Schaefer, A, additional, Reichenspurner, H, additional, Blankenberg, S, additional, Westermann, D, additional, Conradi, L, additional, and Schofer, N, additional

Published
2021
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18. Transcatheter Aortic Valve-in-Valve Implantation versus Redo Surgery: A Contemporary Comparative Analysis

Author

Demal, T. J., additional, Gordon, C., additional, Bhadra, O. D., additional, Linder, M., additional, Ludwig, S., additional, Voigtländer, L., additional, Waldschmidt, L., additional, Schirmer, J., additional, Schofer, N., additional, Seiffert, M., additional, Blankenberg, S., additional, Reichenspurner, H., additional, Westermann, D., additional, and Conradi, L., additional

Published
2021
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21. Comparison of Two Contemporary Balloon-Expandable Transcatheter Heart Valves: Sapien 3 versus Sapien 3 Ultra

Author

Bhadra, O. D., additional, Demal, T. J., additional, Schneeberger, Y., additional, Ludwig, S., additional, Waldschmidt, L., additional, Grundmann, D., additional, Voigtlaender, L., additional, Linder, M., additional, Schofer, N., additional, Blankenberg, S., additional, Reichenspurner, H., additional, Seiffert, M., additional, Conradi, L., additional, Westermann, D., additional, and Schaefer, A., additional

Published
2021
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24. Prevalence and prognostic impact of left ventricular outflow tract calcification in patients with severe aortic stenosis undergoing transfemoral TAVI using second-generation devices

Author

Waldschmidt, L, primary, Gossling, A, additional, Ludwig, S, additional, Linder, M, additional, Voigtlaender, L, additional, Schaefer, A, additional, Bhadra, O, additional, Schirmer, J, additional, Reichenspurner, H, additional, Blankenberg, S, additional, Westermann, D, additional, Seiffert, M, additional, Conradi, L, additional, and Schofer, N, additional

Published
2020
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29. Preliminary Experience of Extracorporeal Cytokine Hemoadsorption During Lvad Implantation in Cardiogenic Shock Patients.

Author

Pausch, J., Bhadra, O., Barten, M., Schulte-Uentrop, L., Reichenspurner, H., and Bernhardt, A.

Subjects
*CARDIOGENIC shock, *ARTIFICIAL blood circulation, *HEART assist devices, *RIGHT ventricular dysfunction, *SURGICAL complications, *CYTOKINES
Abstract

Systemic inflammation due to cardiogenic shock is associated with vasoplegia leading to organ-hypoperfusion, right heart failure and poor clinical outcome. Extracorporeal cytokine hemoadsorption emerged to attenuate excessive levels of inflammatory cytokines, potentially improving patient outcome. Nevertheless, its prognostic impact during high-risk LVAD implantation remains unknown. 40 consecutive patients with advanced heart failure underwent continuous-flow LVAD implantation at our institution between 2018 and 2020. Out of 25 high-risk patients in cardiogenic shock (INTERMACS profile 1 and 2), 9 patients (CytoSorb-group) underwent LVAD implantation with, 16 patients (Control-group) without simultaneous cytokine hemoadsorption during cardiopulmonary bypass. Besides preoperative patient characteristics, postoperative lactate clearance, vasopressor administration and mean arterial pressure, perioperative complication and 30-day mortality rates, were retrospectively analyzed. Apart from an increased rate of re-operations within the CytoSorb-group baseline characteristics including the severity of left and right ventricular dysfunction and consecutive signs of end-organ failure were similar in both groups. Of note, all included patients, were categorized as INTERMACS profile ≤2 prior to LVAD implantation. Preoperative short-term mechanical circulatory support bridging was comparable (66.7% vs. 75%; p=0.66) prior to LVAD implantation. Procedural characteristics including intraoperative volume management and postoperative vasopressor administration were similar in both groups. There was no difference regarding postoperative lactate clearance, although postoperative mean arterial pressure was significantly higher in the Control-group (71.3mmHg vs. 57.4mmHg; p<0.01). Furthermore, the 30-day mortality rate was significantly higher in the CytoSorb-group (33.3 vs. 0.0%; p=0.01). Extracorporeal cytokine hemoadsorption during high-risk LVAD implantation was not associated with a decrease of postoperative vasopressor support, improved hemodynamics, nor an accelerated lactate clearance. [ABSTRACT FROM AUTHOR]

Published
2023
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30. Percutaneous transaxillary access for endovascular aortic procedures in the multicenter international PAXA registry

Author

Oliver D. Bhadra, Massimo Lenti, Alvaro Moreno, Maria Lucia Locca, Inga U. Builyte, Luca Bertoglio, Jürgen Verbist, Roberto Chiesa, Alessandro Beneduce, Marco Ancona, Lenard Conradi, Jury Schewel, Jose M. Ligero, Wouter van den Eynde, Francisco Montiel, Hemindermeet Singh, Sonia Ronchey, Gianbattista Parlani, Nuno Dias, Javier Rio, Andrea Melloni, Matteo Montorfano, Amir Kaki, Tobias Schmidt, Gioele Simonte, Max Meertens, Dominic P.J. Howard, Björn Sonesson, Bertoglio, L., Conradi, L., Howard, D. P. J., Kaki, A., Van den Eynde, W., Rio, J., Montorfano, M., Dias, N. V., Ronchey, S., Parlani, G., Chiesa, R., Schewel, J., Ancona, M., Beneduce, A., Bhadra, O. D., Builyte, I. U., Lenti, M., Ligero, J. M., Locca, M. L., Melloni, A., Meertens, M., Montiel, F., Moreno, A., Schmidt, T., Simonte, G., Singh, H., Sonesson, B., and Verbist, J.

Subjects
Aortic valve, Vascular access closure device, Male, medicine.medical_specialty, Percutaneous, Time Factors, medicine.medical_treatment, Aortic Diseases, Heart Valve Diseases, Aorta, Thoracic, Punctures, TAVI, Thoracic aorta aneurysm, Ventricular assist device, Risk Assessment, Blood Vessel Prosthesis Implantation, Postoperative Complications, Axillary artery, Risk Factors, medicine.artery, Catheterization, Peripheral, medicine, Humans, Vascular closure device, Registries, Stroke, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Endovascular Procedures, Odds ratio, medicine.disease, United States, Surgery, Europe, medicine.anatomical_structure, Treatment Outcome, Hemostasis, Aortic Valve, Axillary Artery, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract

Background The aim of the study was to demonstrate the safety and effectiveness of a suture-mediated vascular closure device to perform hemostasis after an axillary artery access during endovascular procedures on the aortic valve, the aorta and its side branches. Methods A physician-initiated, international, multicenter, retrospective registry was designed to evaluate the success rate (VARC-2 reporting standards) of percutaneous transaxillary access closure with a suture-mediated closure device. Secondary end points were minor access vascular complications, transient peripheral nerve injury, stroke, and influence on periprocedural outcomes of puncture technique. Results Three hundred thirty-one patients (median age, 76 years; 69.2% males) in 11 centers received a percutaneous transaxillary access during endovascular cardiac (n = 166) or vascular (n = 165) procedures. The closure success rate was 84.6%, with 5 open conversions (1.5%), 45 adjunctive endovascular procedures (13.6%), and 1 nerve injury (0.3%). Secondary closure success was obtained in 325 patients (98%) after 7 bare stenting, 37 covered stenting, and 1 thrombin injection. Introducer sheaths 16F or larger (odds ratio, 3.70; 95% confidence interval, 1.22-11.42) and balloon-assisted hemostasis (odds ratio, 4.45; 95% confidence interval, 1.27-15.68) were associated with closure failure. A threshold of five percutaneous axillary accesses was associated with decreased rates of open conversion, but not with increased primary closure success. Primary closure success was 90.3% in the 175 patients with sheaths smaller than 16F, performed after the first 5 procedures in each center. Temporary nerve injury and stroke were observed in 2% and 4% of patients, respectively. Conclusions Percutaneous transaxillary aortic procedures, in selected patients, can be performed with low rates of open conversion. The need for additional endovascular bailout procedures is not negligible when introducers sheaths 16F or larger are required.

Published
2021

31. Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Implantation in Patients with Severe Iliofemoral Calcifications: Expanding Transfemoral Indications.

Author

Linder M, Grundmann D, Kellner C, Demal T, Waldschmidt L, Bhadra O, Ludwig S, Voigtländer L, von der Heide I, Nebel N, Hannen L, Schirmer J, Reichenspurner H, Blankenberg S, Conradi L, Schofer N, Schäfer A, and Seiffert M

Abstract

(1) Background: Transfemoral transcatheter aortic valve implantation (TAVI) has become the standard treatment for most patients with severe symptomatic aortic stenosis. Intravascular lithotripsy may facilitate transfemoral TAVI (IVL-TAVI) even in patients with severely calcified iliofemoral disease. We assessed technical aspects and clinical outcomes of this novel approach compared to alternative transaxillary access (TAX-TAVI). (2) Methods: IVL-TAVI was performed for severe iliofemoral calcifications precluding standard transfemoral access in 30 patients from 2019 to 2022 at a single academic heart center. IVL was performed as part of the TAVI procedure in all cases. Results were compared to a control group of 44 TAX-TAVI procedures performed for the same indication from 2016 to 2021. The safety outcome was a composite of all-cause death, stroke, access-related bleeding ≥ type 2 within 24 h and major vascular access site complications at 30 days. The efficacy outcome was defined as a technical success according to VARC-3. (3) Results: Median age was 78.2 [74.3, 82.6] years, 45.9% were female and mean STS-PROM was 3.6% [2.3, 6.0]. Iliofemoral calcifications were more severe in the IVL-TAVI vs. TAX-TAVI groups (lesion length: 63.0 mm [48.6, 80.3] vs. 48.5 mm [33.1, 68.8]; p = 0.043, severe calcification at target lesion: 90.0% vs. 68.2%; p = 0.047, and median arc calcification 360.0° [297.5, 360.0] vs. 360.0° [180.0, 360.0]; p = 0.033). Technical success was achieved in 93.3% vs. 81.8% ( p = 0.187) in IVL- and TAX-TAVI and the safety outcome occurred in 10.0% vs. 31.8% in IVL- and TAX-TAVI ( p = 0.047), respectively. (4) Conclusions: IVL-assisted transfemoral TAVI was feasible and safe with favorable outcomes compared to TAX-TAVI. IVL may further expand the number of patients eligible for transfemoral TAVI and may help overcome limitations of an alternative access.

Published
2024
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32. Impact of left ventricular outflow tract calcification in patients undergoing transfemoral transcatheter aortic valve implantation.

Author

Waldschmidt L, Goßling A, Ludwig S, Linder M, Voigtländer L, Grundmann D, Bhadra O, Demal T, Schirmer J, Reichenspurner H, Blankenberg S, Westermann D, Seiffert M, Conradi L, and Schofer N

Subjects
Aortic Valve diagnostic imaging, Aortic Valve surgery, Calcinosis complications, Humans, Multidetector Computed Tomography, Retrospective Studies, Treatment Outcome, Aortic Valve Stenosis, Heart Valve Prosthesis adverse effects, Transcatheter Aortic Valve Replacement
Abstract

Background: Left ventricular outflow tract (LVOT) calcification is known to be associated with adverse outcomes after transcatheter aortic valve implantation (TAVI) in patients receiving first-generation transcatheter heart valves (THV)., Aims: The aim of the present study was to assess the prevalence of LVOT calcification as well as its impact on outcomes in a contemporary TAVI patient cohort., Methods: This retrospective single-centre analysis includes 1,207 patients who underwent transfemoral TAVI between 2012 and 2018 and in whom adequate contrast-enhanced multislice computed tomgraphy (MSCT) imaging for quantification of LVOT calcification was available., Results: Significant LVOT calcification, defined as >10 mm 3 , was present in 37.4% (n=451) of the patient cohort. After applying propensity score matching there was no difference between patients without (w/o; n=358) and with (w; n=358) significant LVOT calcification with respect to baseline clinical characteristics. At 30 days, the composite of all-cause mortality and non-disabling/disabling stroke occurred more often in patients w LVOT calcification compared to those w/o (4.6 vs 10.1%, p=0.008). Moreover, the composite VARC-3 endpoint of device success at 30 days was in favour of patients w/o LVOT calcification (82.2% vs 73.4%, p=0.007). According to Kaplan-Meier analysis, all-cause mortality one year after TAVI was higher in patients w vs w/o LVOT calcification (12.9 vs 21.4 %, p=0.004)., Conclusions: In patients undergoing TAVI, the presence of significant LVOT calcification is common and associated with worse short-term clinical and functional outcomes as well as higher one-year mortality rates compared to patients w/o LVOT calcification.

Published
2022
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33. Prognostic impact of functional mitral regurgitation prior to left ventricular assist device implantation.

Author

Pausch J, Bhadra O, Mersmann J, Conradi L, Sill B, Barten MJ, Reichenspurner H, and Bernhardt AM

Subjects
Humans, Prognosis, Retrospective Studies, Treatment Outcome, Heart Failure complications, Heart Failure epidemiology, Heart Failure surgery, Heart-Assist Devices adverse effects, Mitral Valve Insufficiency complications, Mitral Valve Insufficiency surgery
Abstract

Background: Functional mitral regurgitation (FMR) is a common finding of advanced heart failure with detrimental effects. The prognostic impact of uncorrected FMR prior to left ventricular assist device (LVAD) implantation remains controversial., Methods: Between 2016 and 2019 77 patients underwent continuous-flow LVAD implantation at our institution. 34 patients showed FMR ≥ 2 (MR-group), whereas 43 patients showed FMR < 2 (Control-group). Data was retrospectively analyzed. Primary composite endpoint comprised freedom from death, stroke, pump-thrombosis, major bleeding and right heart failure (RHF) after 1 year., Results: Baseline characteristics, including the severity of left and right ventricular dysfunction, and periprocedural results were comparable. The overall survival during a mean follow up of 24.9 months was 55.9% in the MR-group versus 58.1% in the Control-group (p = 0.963), whereas 1-year event-free survival was 35.3% in the MR-group compared to 44.2% in the Control-group (p = 0.404). RHF within the first postoperative year occurred more frequently in the MR-group (35.3% vs. 11.6%; p = 0.017). Furthermore, RV function was significantly reduced in comparison to baseline values in the MR-group. 12 months after surgery, 74% of patients in the MR-group were classified as NYHA III in comparison to 24% of patients in the Control-group (p < 0.001)., Conclusions: Preoperative uncorrected FMR prior to LVAD implantation did not affect overall survival, nevertheless it was associated with an impaired RV function and increased incidence of right heart failure during follow-up. Furthermore, preoperative FMR ≥ 2 was associated with persistent symptoms of heart failure., (© 2022. The Author(s).)

Published
2022
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