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1. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author

Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Clinical Decision-Making, Risk Assessment, Severity of Illness Index, decision making, surgery, Risk Factors, Internal medicine, Intervention (counseling), medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, guidelines, Symptomatic aortic stenosis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, valvular heart disease, Disease Management, aortic stenosis, Aortic Valve Stenosis, Odds ratio, medicine.disease, Europe, Stenosis, Treatment Outcome, Echocardiography, Aortic Valve, Charlson comorbidity index, transcatheter aortic valve replacement, Female, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, surgical aortic valve replacement
Abstract

BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.

Published
2021

2. Prolonged Right Ventricular Ejection Delay in Brugada Syndrome Depends on the Type of SCN5A Variant?- Electromechanical Coupling Through Tissue Velocity Imaging as a Bridge Between Genotyping and Phenotyping

Author

Dominic A.M.J. Theuns, Martine Biervliet, Steven Droogmans, Pedro Brugada, Uschi Peeters, Maryse Bonduelle, Dorien Daneels, Dirk Kerkhove, Guy Van Camp, Sonia Van Dooren, Caroline Weytjens, Sophie Van Malderen, Internal Medicine Specializations, Faculty of Medicine and Pharmacy, Reproduction and Genetics, Cardio-vascular diseases, Clinical sciences, Surgical clinical sciences, and Cardiology

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Genotype, Ventricular Dysfunction, Right, Mutation, Missense, 030204 cardiovascular system & hematology, Asymptomatic, NAV1.5 Voltage-Gated Sodium Channel, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Heart Conduction System, Internal medicine, Electromechanical coupling, medicine, Humans, Brugada syndrome, cardiovascular diseases, 030212 general & internal medicine, Isovolumetric contraction, Genotyping, SCN5A, Tissue velocity, Medicine(all), business.industry, Electrochemical Techniques, General Medicine, Middle Aged, medicine.disease, Cross-Sectional Studies, Phenotype, Bridge (graph theory), Codon, Nonsense, Echocardiography, Cardiology, Female, CONDUCTION DELAY, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Right ventricular ejection delay
Abstract

Background: Patients with Brugada syndrome (BrS) and a history of syncope or sustained ventricular arrhythmia have longer right ventricular ejection delays (RVEDs) than asymptomatic BrS patients. Different types of SCN5A variants leading to different reductions in sodium current (INa) may have different effects on conduction delay, and consequently on electromechanical coupling (i.e., RVED). Thus, we investigated the genotype-phenotype relationship by measuring RVED to establish whether BrS patients carrying more severe SCN5A variants leading to premature protein truncation (T) and presumably 100% INa reduction have a longer RVED than patients carrying missense variants (M) with different degrees of INa reduction. Methods and Results: There were 34 BrS patients (mean [±SD] age 43.3±12.9 years; 52.9% male) carrying an SCN5A variant and 66 non-carriers in this cross-sectional study. Patients carrying a SCN5A variant were divided into T-carriers (n=13) and M-carriers (n=21). Using tissue velocity imaging, RVED and left ventricular ejection delay (LVED) were measured as the time from QRS onset to the onset of the systolic ejection wave at the end of the isovolumetric contraction. T-carriers had longer RVEDs than M-carriers (139.3±15.1 vs. 124.8±11.9 ms, respectively; P=0.008) and non-carriers (127.7±17.3 ms, P=0.027). There were no differences in LVED among groups. Conclusions: Using the simple, non-invasive echocardiographic parameter RVED revealed a more pronounced ‘electromechanical’ delay in BrS patients carrying T variants of SCN5A.

Published
2017

3. Prolonged right ventricular ejection delay identifies high risk patients and gender differences in Brugada syndrome

Author

Marije Meuwissen, Pedro Brugada, Sonia Van Dooren, Caroline Weytjens, Sophie Van Malderen, Dominic A.M.J. Theuns, Guy Van Camp, Maryse Bonduelle, Dorien Daneels, Steven Droogmans, Dirk Kerkhove, Kaoru Tanaka, Internal Medicine Specializations, Cardio-vascular diseases, Clinical sciences, Supporting clinical sciences, Medical Imaging, Reproduction and Genetics, Cardiology, and Psychiatry

Subjects
Adult, Male, medicine.medical_specialty, Heart Ventricles, Syncope, QRS complex, Electrocardiography, Sex Factors, Heart Conduction System, Internal medicine, medicine, gender, Humans, Tissue Velocity Imaging, SCN5A, Brugada syndrome, Brugada Syndrome, Retrospective Studies, Medicine(all), medicine.diagnostic_test, business.industry, Retrospective cohort study, Stroke Volume, Stroke volume, Middle Aged, medicine.disease, Pathophysiology, Cross-Sectional Studies, Echocardiography, Cardiology, Ventricular Function, Right, Female, CONDUCTION DELAY, Electrical conduction system of the heart, Cardiology and Cardiovascular Medicine, business, Conduction delay, Follow-Up Studies
Abstract

Background and objectives: Right ventricular (RV) conduction delay has been suggested as an underlying pathophysiological mechanism in Brugada syndrome (BS). In this cross-sectional study we non-invasively assessed the value of echocardiographic markers reflecting ventricular ejection delay to further assess electromechanical abnormalities in BS and to identify patients at risk for life-threatening arrhythmic events. Furthermore, we sought to assess differences in ejection delays between genders because male BS patients demonstrate a more malignant clinical phenotype. Methods: 124 BS patients (57.3% males) and 62 controls (CTR) (48.4% males) were included. Using Tissue Velocity Imaging, the ejection delay, determined as the time from QRS onset to the onset of the sustained systolic contraction, was measured for both RV free wall (RVED) and lateral LV wall (LVED). From these parameters, the interventricular ejection delay between both walls (IVED) was calculated. Results: BS patients had longer RVEDs and IVEDs compared to the CTR. BS patients with a previous history of syncope or spontaneous ventricular arrhythmia showed the longest RVEDs and IVEDs. Male BS patients demonstrated longer RVEDs and IVEDs than females. Male BS patients with malignant events had the longest delays. No significant differences regarding LVED were observed between BS patients and CTR. Conclusions: We demonstrated that a previous history of malignant events was associated with longer RVEDs. Our findings supported the RV conduction delay mechanism behind BS and demonstrated for the first time that the predominant malignant male Brugada phenotype might also be the result of a more delayed RV conduction in males. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Published
2015

4. Prolonged Right Ventricular Ejection Delay in Brugada Syndrome depends on the type of SCN5a mutation. A bridge between Tissue Velocity Imaging and Genetics

Author

Van Malderen, Sophie, Daneels, Dorien, Van Dooren, Sonia, Dirk, Kerkhove, Peeters, Uschi, Theuns, Damj, Meuwissen, Marije, Biervliet, Martine, Droogmans, Steven, Van Camp, Guy, Weytjens, Caroline, Bonduelle, Mary-Louise, Brugada, Pedro, Faculty of Medicine and Pharmacy, Clinical sciences, Oral Health, Reproduction and Genetics, Medical Genetics, and Cardio-vascular diseases

Subjects
Medicine(all), gender, Brugada syndrome, CONDUCTION DELAY, Tissue Velocity Imaging, SCN5A, Syncope
Abstract

Background Brugada Syndrome (BS) patients with a previous history of syncope or sustained ventricular arrhythmia have longer right ventricular ejection delays (RVED’s) when compared to asymptomatic BS patients. A genotype-phenotype relationship has not been shown for this non-invasive echocardiographic parameter. Different types of SCN5A variants displaying variable amounts of INA reduction, might have an impact on conduction delay and therefore also on RVED measurement. Objectives We aimed to establish whether BS patients carrying a more severe SCN5A variant leading to premature protein truncation (T), demonstrated a longer RVED when compared to missense variants (M). Methods 24 BS patients (mean age 44.0 ± 14.1 years, 50.0% males) with (likely) pathogenic SCN5A variants were enrolled in this cross-sectional study. They were divided into T-carriers (n = 13) and M-carriers (n = 11). Using Tissue Velocity Imaging (TVI), the ejection delay of the RV (RVED, in ms) was measured as the time from the QRS onset to the onset of the systolic ejection wave at the end of the isovolumetric contraction (IVC). Results T-carriers demonstrated longer RVED’s com- pared tot M-carriers (139.3±15.1 vs 123.0±11.5 ms, P = 0.007). Conclusion This is the first report, using non-invasive TVI, to demonstrate that BS patients carrying T-var- iants have longer RVED’s indicating a more severe pheno- type. Given that RVED represents conduction delay, we provide additional evidence to further support the depolarization hypothesis in BS.

Published
2015

5. Screening for silent myocardial ischaemia in patients with type 2 diabetes mellitus: a quest to improve selection of the target screening population

Author

Eva De Keyzer, Bart Keymeulen, Wim Achtergael, Caroline Weytjens, Dirk Kerkhove, Guy Van Camp, Johan De Sutter, Internal Medicine Specializations, Cardio-vascular diseases, and Diabetes Pathology & Therapy

Subjects
Male, medicine.medical_specialty, Heart disease, Population, Myocardial Ischemia, Physical examination, Coronary artery disease, Life Expectancy, Heart Rate, Risk Factors, Internal medicine, Diabetes mellitus, Heart rate, medicine, Humans, education, Aged, education.field_of_study, exercise, medicine.diagnostic_test, business.industry, Patient Selection, Type 2 Diabetes Mellitus, General Medicine, Middle Aged, medicine.disease, Surgery, silent ischaemia, Blood pressure, Diabetes Mellitus, Type 2, diabetes mellitus, Screening, Exercise Test, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Diabetic Angiopathies
Abstract

Objective Despite the association of diabetes mellitus type 2 (DM2) with silent myocardial ischaemia (SMI) and a high prevalence of death due to coronary artery disease (CAD), screening for CAD in patients with DM2 remains controversial because of a lack of proof that it improves cardiac outcome. The aim of this study was to improve the diagnostic yield of the exercise stress test (EST) by introducing recently published life expectancy tables in selecting DM2 patients for coronary screening. Methods 359 patients with DM2 without history or symptoms of CAD were included to perform an EST after a clinical history and brief physical examination. Cardiovascular risk factor profiling was completed with blood and urine analysis. A lower heart rate was defined as bradycardia (heart rate less than 60 bpm), a higher blood pressure as a systolic blood pressure at rest of 130 mmHg of more. Results The prevalence of SMI was 14.5% (n = 52). The average number of additional cardiovascular risk factors per subject was 4. Multivariate logistic regression yields 4 significant predictors: (i) heart rate at rest (P= 0.015), (ii) a family history of cardiovascular disease (P = 0.017), (iii) systolic blood pressure at rest (P = 0.019), and, (iv) an LDL-c of 80 mg/dL or more (P = 0.021). Conclusion Known risk factors for myocardial ischaemia were identified as significantly influencing the prevalence of SMI. No improvement in diagnostic yield could be identified by selecting the screening population using predicted life expectancy tables.

Published
2011

6. Pericardial effusion in atrial fibrillation ablation: a comparison between cryoballoon and radiofrequency pulmonary vein isolation

Author

Steven Droogmans, Andrea Sarkozy, Gaetano Paparella, Dirk Kerkhove, Gian-Battista Chierchia, Andreas Muller-Burri, Lucio Capulzini, Guy Van Camp, Antonio Sorgente, Pedro Brugada, Yoshinao Yazaki, de Asmundis Carlo, Internal Medicine Specializations, Cardio-vascular diseases, and Heartrhythmmanagement

Subjects
Male, medicine.medical_specialty, cryoballoon, medicine.medical_treatment, Catheter ablation, Coronary Artery Disease, Cryosurgery, Pericardial effusion, Pericardial Effusion, Pulmonary vein, surgery, Postoperative Complications, Risk Factors, Physiology (medical), Internal medicine, Cardiac tamponade, Atrial Fibrillation, Humans, Medicine, Aged, Cardiovascular diseases [NCEBP 14], business.industry, Incidence, Atrial fibrillation, Middle Aged, Ablation, medicine.disease, Cardiac Tamponade, Surgery, Treatment Outcome, Effusion, Pulmonary Veins, Hypertension, Catheter Ablation, Cardiology, Atrial fibrillation ablation, Female, Human medicine, Transthoracic echocardiogram, Cardiology and Cardiovascular Medicine, business
Abstract

Item does not contain fulltext AIMS: Atrial fibrillation (AF) ablation is increasingly being performed in electrophysiology laboratories. Pericardial effusion (PE) is certainly one of the most frequently observed complications during AF ablation. The aim of our study was to investigate the incidence and outcome of PE following cryothermal energy balloon ablation (CBA) in comparison with conventional circumferential pulmonary vein isolation with a focal radiofrequency (RF) catheter. METHODS AND RESULTS: A total of 133 consecutive patients (105 males) with paroxysmal AF were included in this study. Forty-six patients (36 males) underwent CBA (Arctic Front, Medtronic, USA) and 87 (69 males) point-by-point RF ablation guided by electroanatomical mapping (Carto, Biosense Webster, Diamond Bar, CA, USA). Ablation was performed under general anaesthesia with both techniques. All patients underwent a 2D transthoracic echocardiogram within 24 h before and after the procedure as routinely performed in our centre. Pericardial effusion was detected in 19 (14.2%) of 133 patients. Sixteen patients presented mild effusion, one moderate effusion, and two pericardial tamponades. There was no significant difference in the incidence of PE between the cryoballoon and the RF group (11 vs. 16%). A longer procedural time, coronary artery disease, and arterial hypertension were found to be independent predictors of PE during AF ablation. CONCLUSION: Pericardial effusion occurred in a similar proportion following CBA and RF ablation for AF. Pericardial effusion was mostly mild and asymptomatic, with benign clinical outcome not requiring additional hospitalization days. 01 maart 2010

Published
2010

8. Prolonged right ventricular ejection delay identifies high risk patients in Brugada Syndrome. Tissue velocity imaging rechallenges risk stratification

Author

Van Malderen, Sophie, Theuns, Damj, Weytjens, Caroline, Dirk, Kerkhove, Droogmans, Steven, Tanaka, Kaoru, Brugada, Pedro, Van Camp, Guy, Bonduelle, Mary-Louise, Internal Medicine Specializations, Cardio-vascular diseases, Medical Imaging and Physical Sciences, Clinical sciences, Reproduction and Genetics, and Medical Imaging

Subjects
Brugada syndrome
Published
2014

9. Short course radiotherapy with simultaneous integrated boost for stage I-II breast cancer, early toxicities of a randomized clinical trial

Author

Guy Storme, K Leysen, Truus Reynders, Mark De Ridder, Daniel Schuermans, Shane Hanon, Hilde Van Parijs, Vincent Vinh-Hung, Geertje Miedema, Walter Vincken, Dirk Kerkhove, Dirk Verellen, Sylvia Verbanck, Guy Van Camp, Nele Adriaenssens, Medicine and Pharmacy academic/administration, Faculty of Medicine and Pharmacy, Pneumology, Radiation Therapy, Translational Radiation Oncology and Physics, Clinical sciences, Physical Medicine and Rehabilitation, Anatomical Research and Clinical Studies, Physiotherapy, Human Physiology and Anatomy, Rehabilitation Research, and Vriendenkring VUB

Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine, Adult, lcsh:R895-920, medicine.medical_treatment, Image guided radiation treatment (IGRT), Breast Neoplasms, Intensity modulated radiotherapy (IMRT), lcsh:RC254-282, Tomotherapy, law.invention, Breast cancer, Randomized controlled trial, law, medicine, Humans, Radiology, Nuclear Medicine and imaging, early breast cancer, Lung, Aged, Neoplasm Staging, Computer. Automation, Radiotherapy, business.industry, Cumulative dose, hypofractionation, Simultaneous integrated boost (SIB), Research, Dose fractionation, Heart, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Radiation therapy, Exact test, Oncology, Radiology Nuclear Medicine and imaging, Female, Human medicine, Dose Fractionation, Radiation, Nuclear medicine, business, Mastectomy
Abstract

Background TomoBreast is a unicenter, non-blinded randomized trial comparing conventional radiotherapy (CR) vs. hypofractionated Tomotherapy (TT) for post-operative treatment of breast cancer. The purpose of the trial is to compare whether TT can reduce heart and pulmonary toxicity. We evaluate early toxicities. Methods The trial started inclusion in May 2007 and reached its recruitment in August 2011. Women with stage T1-3N0M0 or T1-2N1M0 breast cancer completely resected by tumorectomy (BCS) or by mastectomy (MA) who consented to participate were randomized, according to a prescribed computer-generated randomization schedule, between control arm of CR 25x2 Gy/5 weeks by tangential fields on breast/chest wall, plus supraclavicular-axillary field if node-positive, and sequential boost 8x2 Gy/2 weeks if BCS (cumulative dose 66 Gy/7 weeks), versus experimental TT arm of 15x2.8 Gy/3 weeks, including nodal areas if node-positive and simultaneous integrated boost of 0.6 Gy if BCS (cumulative dose 51 Gy/3 weeks). Outcomes evaluated were the pulmonary and heart function. Comparison of proportions used one-sided Fisher's exact test. Results By May 2010, 70 patients were randomized and had more than 1 year of follow-up. Out of 69 evaluable cases, 32 were assigned to CR (21 BCS, 11 MA), 37 to TT (20 BCS, 17 MA). Skin toxicity of grade ≥1 at 2 years was 60% in CR, vs. 30% in TT arm. Heart function showed no significant difference for left ventricular ejection fraction at 2 years, CR 4.8% vs. TT 4.6%. Pulmonary function tests at 2 years showed grade ≥1 decline of FEV1 in 21% of CR, vs. 15% of TT and decline of DLco in 29% of CR, vs. 7% of TT (P = 0.05). Conclusions There were no unexpected severe toxicities. Short course radiotherapy of the breast with simultaneous integrated boost over 3 weeks proved feasible without excess toxicities. Pulmonary tests showed a slight trend in favor of Tomotherapy, which will need confirmation with longer follow-up of patients. Trail registration ClinicalTrials.gov NCT00459628

Published
2012

10. Paradoxical embolism in a patient with a large tricuspid myxoma and patent foramen ovale

Author

Wim Van Hecke, Dirk Kerkhove, Kaoru Tanaka, Sophie Van Malderen, Guy Van Camp, Faculty of Medicine and Pharmacy, Cardio-vascular diseases, Medical Imaging and Physical Sciences, Medical Imaging, and Pathological Anatomy

Subjects
Male, medicine.medical_specialty, Embolism, Foramen Ovale, Patent, Magnetic Resonance Imaging, Cine, Enhancement pattern, Inversion recovery, Transient ischaemic attacks, Heart Neoplasms, Paradoxical embolism, TRICUSPID, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, business.industry, Myxoma, General Medicine, Middle Aged, medicine.disease, Ischemic Attack, Transient, cardiovascular system, Patent foramen ovale, Cardiology, Radiology, PATENT FORAMEN OVALE, Tricuspid Valve, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Gradient echo, Embolism, Paradoxical
Abstract

A 61-year-old man with an uneventful medical history presented with two transient ischaemic attacks (TIA) with bulbar and peripheral deficit. Transthoracal and transoesophageal echocardiography revealed a patent foramen ovale (PFO) and a large, lobulated, pedunculated, non-calcified, and heterogenic mass attached to the septal tricuspid leaflet ( Panels 1–3 ) with important mobility. MRI suggested a myxoma, being isointense on T1-weighted turbo spin echo (TSE), iso-hyperintense on T2-weighted TSE, and hypointense on spoiled gradient echo. First-pass perfusion showed a heterogeneous and hypoperfused enhancement pattern, while contrast-enhanced inversion recovery images showed diffuse hyperenhancement ( Panels 4 and 5 ). Carotid echo-Doppler, Holter monitoring, and a …

Published
2011

11. Drug-induced valvular heart disease

Author

Steven Droogmans, Bernard Cosyns, Bram Roosens, Dirk Kerkhove, Guy Van Camp, Cardio-vascular diseases, and Medical Imaging and Physical Sciences

Subjects
drug-induced valvulopathy
Abstract

None

Published
2009

12. First experience with real-time three-dimensional transoesophageal echocardiography-guided transseptal in patients undergoing atrial fibrillation ablation

Author

Lucio Capulzini, Andrea Sarkozy, Guy Van Camp, Gian-Battista Chierchia, Tim Boussy, Carlo de Asmundis, Pedro Brugada, Markus Roos, Dirk Kerkhove, Gaetano Paparella, Internal Medicine Specializations, Cardio-vascular diseases, and Heartrhythmmanagement

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Echocardiography, Three-Dimensional, Pilot Projects, Punctures, surgery, Physiology (medical), medicine.artery, Atrial Fibrillation, Medical imaging, medicine, Heart Septum, Humans, Fluoroscopy, echocardiography, General anaesthesia, Fossa ovalis, Aged, Aorta, medicine.diagnostic_test, business.industry, Atrial fibrillation, Middle Aged, Real Time 3D echocardiography, medicine.disease, Ablation, Heart septum, Surgery, Treatment Outcome, medicine.anatomical_structure, Surgery, Computer-Assisted, Female, Atrial fibrillation ablation, Human medicine, Radiology, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Transseptal puncture
Abstract

Aims Transseptal (TS) puncture during atrial fibrillation (AF) ablation is a relatively safe procedure in experienced hands. However, major and minor complications cannot be completely ruled out. Real-time three-dimensional transeosophageal echocardiography (RT 3D TEE) is a novel imaging technology that permits direct visualization of the fossa ovalis in a 3D perspective, thereby sensibly lowering the likelihood of potential adverse effects during TS. In our study, we describe the technique and assess the feasibility, advantages, and safety of this novel imaging method in guiding TS puncture in a series of consecutive patients undergoing AF ablation. Methods and results We performed TS puncture guided by RT 3D TEE under general anaesthesia in 24 consecutive patients (16 male, 55.4 +/- 8.1 years) undergoing ablation for drug refractory AF. The fossa ovalis could clearly be seen and easily be distinguished from surrounding anatomical structures in all 24 patients. All punctures required a single attempt to access left atrium. Mean orientation of the needle hub when puncturing was 4.30 o'clock (ranging from 3 o'clock to 6.30 o'clock), and mean distances from the needle tip to the aortic and to the posterior wall were, respectively, 13.5 +/- 7 and 35 +/- 7.3 mm. Total fluoroscopic time was 120.6 +/- 34 s. No major or minor complications were experienced. Conclusion Real-time three-dimensional transeosophageal is a very useful tool in guiding TS puncture in patients undergoing AF ablation with the invaluable advantage of the 3D direct visualization of the fossa ovalis. This permits fast and safe transatrial access with a single puncture attempt.

Published
2008

14. EP-1017 HYPOFRACTIONATION WITH SIMULTANEOUS INTEGRATED BOOST FOR STAGE I-II BREAST CANCER, RANDOMIZED CLINICAL TRIAL

Author

Geertje Miedema, Sylvia Verbanck, Dirk Verellen, M. De Ridder, H. Van Parijs, T Reynders, Vincent Vinh-Hung, Dirk Kerkhove, Nele Adriaenssens, and G.A. Storme

Subjects
Simultaneous integrated boost, Oncology, medicine.medical_specialty, business.industry, Hematology, medicine.disease, Stage i ii, law.invention, Breast cancer, Randomized controlled trial, law, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, business
Published
2012

15. Usefulness and Feasibility of Pocket-size Echocardiography in the Emergency Department

Author

Dirk Kerkhove, Caroline Weytjens, Guy Van Camp, Steven Droogmans, and Bernard Cosyns

Subjects
business.industry, polycyclic compounds, Medicine, Emergency department, Medical emergency, biochemical phenomena, metabolism, and nutrition, Cardiology and Cardiovascular Medicine, business, medicine.disease
Abstract

Pocket-size echocardiography (PSE) has entered the clinical arena and is a very attractive tool for point-of-care cardiac ultrasound. It has proven its utility in non-urgent settings such as the outpatient clinic and the patient’s bedside in hospital. In those environments, it increases the diagnostic power of the physical examination and can be seen as a ‘super stethoscope’. The accuracy of PSE is highly dependent on training and expertise. Introducing PSE in the accident and emergency (A&E) department will also increase the diagnostic power of the physical examination; however, in that setting, there is no room for error, and the use of a PSE device should never prevent a patient from undergoing a necessary comprehensive echocardiographic examination. Mobile portable computer ultrasound devices are widely available in the A&E department. This leads to the inevitable question: will literature support the supplementary use of PSE by nonechocardiographists and non-cardiologists in the A&E department, without raising medico-legal issues regarding patient safety? Another setting were PSE could result in a diagnostic bonus, since no competing technology is available, is the ambulance, but in that setting as well education and quality control will be of the utmost importance.

Published
2012

17. Role of echocardiography in toxic heart valvulopathy

Author

Dirk Kerkhove, Bernard Cosyns, Steven Droogmans, Guy Van Camp, and Cardio-vascular diseases

Subjects
Male, Drug, Toxic valvulopathy, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, media_common.quotation_subject, Heart Valve Diseases, MEDLINE, Ergot-derived dopamine agonists, chemistry.chemical_compound, Serotonin Agents, Risk Factors, Internal medicine, Fenfluramine, medicine, echocardiography, Animals, Humans, Radiology, Nuclear Medicine and imaging, media_common, Benfluorex, Natural course, business.industry, Amphetamines, valvular heart disease, General Medicine, medicine.disease, Echocardiography, Doppler, Color, chemistry, Anesthesia, Cardiology, Female, Anorexigens, Cardiology and Cardiovascular Medicine, business
Abstract

The notion that drugs can induce valvular heart disease (VHD) has occurred since the 1960s and has received a lot of attention in recent years. This review focuses on different aspects of this distinct valvulopathy in seven sections: (i) historical background, (ii) drug-induced VHD, is this a real entity?, (iii) its morphological and echocardiographic features, (iv) drugs associated with VHD, (v) the influence of cumulative drug dose and risk factors, (vi) the natural course of toxic valvulopathy, and (vii) practical recommendations when using potential valvulopathic drugs.

18. How to monitor cardiac toxicity of chemotherapy: time is muscle!

Author

Nico Van de Veire, K Tanaka, Christel Fontaine, Guy Van Camp, S. Droogmans, Dirk Kerkhove, J De Greve, Cardio-vascular diseases, Medical Imaging and Physical Sciences, Laboratory of Molecular and Medical Oncology, and Medical Imaging

Subjects
Diagnostic Imaging, medicine.medical_specialty, Time Factors, Heart Diseases, Anthracycline, Population, Antineoplastic Agents, Electrocardiography, Neoplasms, Internal medicine, Epidemiology, medicine, Humans, Ventricular Function, education, Monitoring, Physiologic, Cardiotoxicity, education.field_of_study, Ejection fraction, business.industry, Cancer, Gold standard (test), medicine.disease, Surgery, Imaging and diagnostics, Heart failure, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Cancer and cardiovascular (CV) disease are the leading causes of death in the western world. The increasing age of the western population and the improved global cancer survival, due to ongoing advances in anticancer treatments, point to further increases in the CV burden in cancer survivors as a consequence of exposure to cardiotoxic drugs. Since it is not desirable to improve cancer survival at the price of increased CV mortality and morbidity, more and more cardio-oncological papers are seeking methods to enhance the early diagnosis of cardiotoxicity. Before being able to determine which tests are best at identifying cardiotoxicity in a quick, accurate and prognostically relevant way, we have to understand how cardiotoxicity has been defined. Histological proof of cardiotoxicity remains the diagnostic gold standard, but its correlation with functional cardiac status is unclear, and additional practical limitations make it unsuitable for detecting cardiotoxicity. Historically, left ventricular ejection fraction (LVEF) was chosen as the parameter for monitoring/identifying cardiotoxicity in clinical practice with proven impact on prognosis. LVEF expresses global LV systolic function, it correlates well with functional status for the majority of the population, and several well studied methods can measure LVEF with acceptable to high accuracy. However, its limitations have been well established over the last 10 years, ranging from methodological through mathematical to statistical ones. Cardiotoxicity was first defined by Schwartz et al 1 in an anthracycline treated population, using multiple gated acquisition (MUGA) scanning to determine LVEF during and after anthracycline treatment. The diagnosis of cardiotoxicity was fulfilled in the case of an absolute 10% drop in LVEF or a decrease to below 50% in patients with baseline LVEF >50%, or an absolute 10% drop in LVEF or a drop below 30% in patients with baseline LVEF

19. Role of echocardiography in toxic heart valvulopathy.

Author

Steven Droogmans, Dirk Kerkhove, Bernard Cosyns, and Guy Van Camp

Abstract

The notion that drugs can induce valvular heart disease (VHD) has occurred since the 1960s and has received a lot of attention in recent years. This review focuses on different aspects of this distinct valvulopathy in seven sections: (i) historical background, (ii) drug-induced VHD, is this a real entity?, (iii) its morphological and echocardiographic features, (iv) drugs associated with VHD, (v) the influence of cumulative drug dose and risk factors, (vi) the natural course of toxic valvulopathy, and (vii) practical recommendations when using potential valvulopathic drugs. [ABSTRACT FROM AUTHOR]

Published
2009
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