51
|
Faletra FF, Pozzoli A, Agricola E, Guidotti A, Biasco L, Leo LA, Taramasso M, Pasotti E, Kuwata S, Moccetti M, Tanner FC, Pedrazzini G, Nietlispach F, Moccetti T, Zuber M, Maisano F. Echocardiographic-fluoroscopic fusion imaging for transcatheter mitral valve repair guidance. Eur Heart J Cardiovasc Imaging 2019; 19:715-726. [PMID: 29718146 DOI: 10.1093/ehjci/jey067] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/04/2018] [Indexed: 11/13/2022] Open
Abstract
The echocardiographic-fluoroscopic fusion imaging is a new imaging system which has recently become available, with the proposal to facilitate catheters and device navigation during catheter-based structural heart disease interventions. Several reports have described the early developments and the first clinical experiences, but literature focusing on the practical applications of fusion imaging technology to mitral valve transcatheter interventions, and on its potential advantages and current limitations, is still limited. In this review, we, therefore, describe the role of this novel imaging system during Mitraclip, Cardioband, and paravalvular leak closure interventions. The technical principles and the fluoroscopic anatomy of the interatrial septum and mitral valve are also described.
Collapse
|
52
|
Andreas M, Russo M, Taramasso M, Zuber M, Mascherbauer J. Novel transcatheter clip device (MitraClip XTR) enables significant tricuspid annular size reduction. Eur Heart J Cardiovasc Imaging 2019; 20:1070. [DOI: 10.1093/ehjci/jez032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/02/2019] [Accepted: 02/19/2019] [Indexed: 11/13/2022] Open
|
53
|
Hahn RT, Nabauer M, Zuber M, Nazif TM, Hausleiter J, Taramasso M, Pozzoli A, George I, Kodali S, Bapat V, Maisano F. Intraprocedural Imaging of Transcatheter Tricuspid Valve Interventions. JACC Cardiovasc Imaging 2019; 12:532-553. [DOI: 10.1016/j.jcmg.2018.07.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 01/12/2023]
|
54
|
Miura M, Zuber M, Gavazzoni M, Lin SI, Pozzoli A, Taramasso M, Maisano F. Possible Left Circumflex Artery Obstruction in a Cardioband Transcatheter Mitral Annuloplasty Caused by Coronary Kinking During Cinching. JACC Cardiovasc Interv 2019; 12:600-601. [DOI: 10.1016/j.jcin.2018.12.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 12/13/2018] [Accepted: 12/26/2018] [Indexed: 11/25/2022]
|
55
|
Boursier V, Join Lambert C, Tamazyan R, Farhat W, Bruandet M, Zuber M. [Improving blood pressure control after a stroke: The place of therapeutic education in the acute phase]. JOURNAL DE MÉDECINE VASCULAIRE 2019; 44:19-27. [PMID: 30770081 DOI: 10.1016/j.jdmv.2018.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES At the Paris Saint-Joseph Hospital Group neurovascular unit, the therapeutic patient education program "Treatment of high blood pressure after stroke" involved integrating a vascular physician. The objectives were to include a significant number of patients, to integrate learning self-measurement, and to make an initial analysis of the results concerning patient knowledge, self-measurement practices, adherence to treatment, and control of blood pressure. METHODS Eighty-six patients under 90 years of age admitted to the neurovascular unit were included in the program between January 1 and October 31, 2017, and participated in an in-hospital educational diagnostic interview followed by an initial session. During this period, 30 patients were reviewed within 3 to 6 months after discharge, with a post-session evaluation for 22 of them. Patient satisfaction was assessed with a questionnaire. A questionnaire was also proposed to the staff. RESULTS The mean blood pressure of the 22 patients reviewed was on target and they had improved their level of knowledge. The number of sphygmomanometers increased from 5 to 20, but the practice of cycles was not yet mastered. Levels of observed compliance changed little. Patients and paramedics appreciated the program and were convinced of its usefulness. These results do not support a direct effect of therapeutic patient education on blood pressure control, but the observed results are positive and encouraging.
Collapse
|
56
|
|
57
|
Pazhenkottil AP, Tanner FC, Buechel RR, Giannopoulos AA, Kaufmann PA, Zuber M. Cardiac hybrid imaging combining 3D-strain echocardiography with coronary computed tomography angiography. Eur Heart J 2019; 40:395-396. [PMID: 30380027 DOI: 10.1093/eurheartj/ehy700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 11/13/2022] Open
|
58
|
Taramasso M, Alessandrini H, Latib A, Asami M, Attinger-Toller A, Biasco L, Braun D, Brochet E, Connelly KA, Denti P, Deuschl F, Englmeier A, Fam N, Frerker C, Hausleiter J, Himbert D, Ho EC, Juliard JM, Kaple R, Kreidel F, Kuck KH, Ancona M, Lauten A, Lurz P, Mehr M, Nazif T, Nickening G, Pedrazzini G, Pozzoli A, Praz F, Puri R, Rodés-Cabau J, Schäfer U, Schofer J, Sievert H, Sievert K, Tang GH, Tanner FC, Vahanian A, Webb JG, Windecker S, Yzeiray E, Zuber M, Maisano F, Leon MB, Hahn RT. Outcomes After Current Transcatheter Tricuspid Valve Intervention. JACC Cardiovasc Interv 2019; 12:155-165. [DOI: 10.1016/j.jcin.2018.10.022] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 10/27/2022]
|
59
|
Gavazzoni M, Pozzoli A, Vicentini L, Miura M, Zuber M, Maisano F, Taramasso M. Single-Center Experience with Catheter-Based Tricuspid Valve Replacement with NaviGate Bioprosthesis for Tricuspid Regurgitation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
60
|
Pozzoli A, Taramasso M, Kuwata S, Cesarovich N, Zuber M, Guidotti A, Andreas M, Emmert Y, Alkadhi H, Manka R, Stoeck C, Maisano F, Plass R. Preclinical Multimodality Fusion Imaging Platform to Optimize Catheter-Based Mitral Valve Interventions. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
61
|
Kuwata S, Taramasso M, Czopak A, Luciani M, Pozzoli A, Ho E, Ferrero Guadagnoli A, Saccocci M, Gaemperli O, Nietlispach F, Zuber M, Feldman T, Maisano F. Continuous Direct Left Atrial Pressure. JACC Cardiovasc Interv 2019; 12:127-136. [DOI: 10.1016/j.jcin.2018.07.051] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/16/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022]
|
62
|
Savic V, Pozzoli A, Gülmez G, Demir H, Batinkov N, Kuwata S, Weber A, Vogel R, Tanner F, Zuber M, Maisano F, Taramasso M. Transcatheter mitral valve chord repair. Ann Cardiothorac Surg 2018; 7:731-740. [PMID: 30598886 DOI: 10.21037/acs.2018.09.09] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The field of mitral valve disease diagnosis and management is rapidly evolving. New understanding of pathophysiology and improvements in the adoption of sophisticated multimodality imaging modalities have led to early diagnosis and to more complex treatment. The most common cause of mitral regurgitation (MR) in the western world is in the primary alteration of the valve, which leads to degenerative leaflet prolapse due to chordal elongation or rupture and annular dilatation. Untreated, significant MR has a negative impact prognosis, leading to reduction of survival. In the setting of degenerative MR, surgical repair currently represents the standard of care. Treatment of asymptomatic patients with severe MR in the Valve Center of Excellence, in which successful repair reaches more than 95% and surgical mortality less than 1%, symbolizes the direction for the next years. Transcatheter mitral valve repair with different devices, more recently the chordal replacement ones, is providing good outcomes and became a therapeutic option in high-risk patients with degenerative MR. In the future, more advances are expected from further development of interventional techniques, careful evaluation and better patient selection. This review will focus on long-term surgical outcomes of mitral valve repair with artificial chordae and on the emerging transcatheter chordal repair devices as therapeutic options for degenerative MR patients.
Collapse
|
63
|
Zuber N, Zuber M, Schwarzwald CC. Assessment of systolic and diastolic function in clinically healthy horses using ambulatory acoustic cardiography. Equine Vet J 2018; 51:391-400. [DOI: 10.1111/evj.13014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 08/21/2018] [Indexed: 12/13/2022]
|
64
|
Messika-Zeitoun D, Nickenig G, Latib A, Kuck KH, Baldus S, Schueler R, La Canna G, Agricola E, Kreidel F, Huntgeburth M, Zuber M, Verta P, Grayburn P, Vahanian A, Maisano F. Transcatheter mitral valve repair for functional mitral regurgitation using the Cardioband system: 1 year outcomes. Eur Heart J 2018; 40:466-472. [DOI: 10.1093/eurheartj/ehy424] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 07/03/2018] [Indexed: 11/13/2022] Open
|
65
|
Latib A, Nickenig G, Kuck KH, Baldus S, Schueler R, Messika-Zeitoun D, La Canna G, Agricola E, Kreidel F, Zuber M, Huntgeburth M, Vahanian A, Maisano F. 3073Up to two-year outcomes from the multicenter CE trial of transcatheter mitral valve repair in patients with functional mitral regurgitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
66
|
Ho E, Fam N, Connelly K, Ong G, Edwards J, Pozzoli A, Kuwata S, Gulmez G, Nietlispach F, Zuber M, Hahn R, Maisano F, Taramasso M. 5324Reduction in heart failure admission rate after transcatheter edge-to-edge tricuspid valve repair for severe tricuspid regurgitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
67
|
Luciani M, Saccocci M, Cesarovic N, Lipiski M, Kuwata S, Guidotti A, Regar E, Zuber M, Maisano F. P4744Correlation of acoustic cardiography parameters with PV loop and echocardiographic measurements in an acute porcine heart failure model. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
68
|
Pozzoli A, Zuber M, Reisman M, Maisano F, Taramasso M. Comparative Anatomy of Mitral and Tricuspid Valve: What Can the Interventionlist Learn From the Surgeon. Front Cardiovasc Med 2018; 5:80. [PMID: 30009160 PMCID: PMC6033960 DOI: 10.3389/fcvm.2018.00080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/11/2018] [Indexed: 11/13/2022] Open
Abstract
Transcatheter valve interventions on the mitral and tricuspid valves entail increasing complexity. Part of the knowledge that has been generated during the development of mitral devices can be transferred to the tricuspid valve (TV). However, a deeper understanding of the peculiar anatomy of the TV and of the right heart chambers, together with differences and similarities between the two valves, is fundamental. This report compares the anatomy of the mitral and tricuspid valves, and its inferences with regard to transcatheter treatments. Condensed abstract This report explores anatomical similarities and differences between the mitral and the tricuspid valves, and their implications with regard to transcatheter treatments.
Collapse
|
69
|
Kuwata S, Zuber M, Nietlispach F, Taramasso M, Maisano F. Transcatheter Mitral Annuloplasty in Barlow's Mitral Regurgitation With Deep Cleft. JACC Cardiovasc Interv 2018; 11:e97-e98. [PMID: 29860076 DOI: 10.1016/j.jcin.2018.01.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/18/2017] [Accepted: 01/02/2018] [Indexed: 10/14/2022]
|
70
|
Pozzoli A, Taramasso M, Kuwata S, Zuber M, Nietlispach F, Maisano F. Echo-fluoro fusion imaging guidance for no contrast transfemoral aortic valve implantation. Eur Heart J Cardiovasc Imaging 2018; 19:710-711. [PMID: 29579166 DOI: 10.1093/ehjci/jey048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
71
|
Toledano-Massiah S, Sayadi A, de Boer R, Gelderblom J, Mahdjoub R, Gerber S, Zuber M, Zins M, Hodel J. Accuracy of the Compressed Sensing Accelerated 3D-FLAIR Sequence for the Detection of MS Plaques at 3T. AJNR Am J Neuroradiol 2018; 39:454-458. [PMID: 29348137 DOI: 10.3174/ajnr.a5517] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/03/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE The use of 3D FLAIR improves the detection of brain lesions in MS patients, but requires long acquisition times. Compressed sensing reduces acquisition time by using the sparsity of MR images to randomly undersample the k-space. Our aim was to compare the image quality and diagnostic performance of 3D-FLAIR with and without compressed sensing for the detection of multiple sclerosis lesions at 3T. MATERIALS AND METHODS Twenty-three patients with relapsing-remitting MS underwent both conventional 3D-FLAIR and compressed sensing 3D-FLAIR on a 3T scanner (reduction in scan time 1 minute 25 seconds, 27%; compressed sensing factor of 1.3). Two blinded readers independently evaluated both conventional and compressed sensing FLAIR for image quality (SNR and contrast-to-noise ratio) and the number of MS lesions visible in the periventricular, intra-juxtacortical, infratentorial, and optic nerve regions. The volume of white matter lesions was measured with automatic postprocessing segmentation software for each FLAIR sequence. RESULTS Image quality and the number of MS lesions detected by the readers were similar between the 2 FLAIR acquisitions (P = .74 and P = .094, respectively). Almost perfect agreement was found between both FLAIR acquisitions for total MS lesion count (Lin concordance correlation coefficient = 0.99). Agreement between conventional and compressed sensing FLAIR was almost perfect for periventricular and infratentorial lesions and substantial for intrajuxtacortical and optic nerve lesions. Postprocessing with the segmentation software did not reveal a significant difference between conventional and compressed sensing FLAIR in total MS lesion volume (P = .63) or the number of MS lesions (P = .15). CONCLUSIONS With a compressed sensing factor of 1.3, 3D-FLAIR is 27% faster and preserves diagnostic performance for the detection of MS plaques at 3T.
Collapse
|
72
|
Pozzoli A, Taramasso M, Russo M, Zuber M, Maisano F. Echo-navigation to guide challenging transseptal puncture during transfemoral repair of mitral and tricuspid valve. J Cardiovasc Med (Hagerstown) 2017; 19:73-74. [PMID: 29251698 DOI: 10.2459/jcm.0000000000000612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
73
|
Pozzoli A, Taramasso M, Zuber M, Maisano F. Transcatheter tricuspid valve repair with the MitraClip system using intracardiac echocardiography: proof of concept. EUROINTERVENTION 2017. [PMID: 28649955 DOI: 10.4244/eij-d-17-00360] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
74
|
Rodriguez Cetina Biefer H, Taramasso M, Kuwata S, Nietlispach F, Zuber M, Maisano F. Optimizing echo guidance during MitraClip using fluoroscopy: how to see better! Cardiovasc Interv Ther 2017; 33:398-399. [PMID: 29043606 DOI: 10.1007/s12928-017-0494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/23/2017] [Indexed: 11/24/2022]
|
75
|
Pozzoli A, Maisano F, Kuwata S, Guidotti A, Plass A, Zuber M, Russo M, Nietlispach F, Taramasso M. Fluoroscopic anatomy of the tricuspid valve: Implications for Transcatheter procedures. Int J Cardiol 2017; 244:119-120. [DOI: 10.1016/j.ijcard.2017.06.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/08/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
|
76
|
Beeler R, Schoenenberger A, Zuber M, Bauer P, Bergner M, Erne S, Schlaepfer R, Erne P. P3374Sustained improvements to ventricular function due to asymptomatic diaphragmatic stimulation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
77
|
Beeler R, Schoenenberger A, Zuber M, Bauer P, Erne S, Schlaepfer R, Erne P. Stability of AsymptomaticDiaphragmatic Stimulation Thresholds after 1 Year: Results of the Epiphrenic IIPilot. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.07.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
78
|
Beeler R, Schoenenberger A, Zuber M, Bauer P, Erne S, Schlaepfer R, Erne P. Sustained Improvements toVentricular Function Due to Asymptomatic Diaphragmatic Stimulation. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.07.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
79
|
de Boysson H, Boulouis G, Parienti JJ, Touzé E, Zuber M, Arquizan C, Dequatre N, Detante O, Bienvenu B, Aouba A, Guillevin L, Pagnoux C, Naggara O. Concordance of Time-of-Flight MRA and Digital Subtraction Angiography in Adult Primary Central Nervous System Vasculitis. AJNR Am J Neuroradiol 2017; 38:1917-1922. [PMID: 28751515 DOI: 10.3174/ajnr.a5300] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/20/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 3D-TOF-MRA and DSA are 2 available tools to demonstrate neurovascular involvement in primary central nervous system vasculitis. We aimed to compare the diagnostic concordance of vessel imaging using 3D-TOF-MRA and DSA in patients with primary central nervous system vasculitis. MATERIALS AND METHODS We retrospectively identified all patients included in the French primary central nervous system vasculitis cohort of 85 patients who underwent, at baseline, both intracranial 3D-TOF-MRA and DSA in an interval of no more than 2 weeks and before treatment initiation. Two neuroradiologists independently reviewed all 3D-TOF-MRA and DSA imaging. Brain vasculature was divided into 25 arterial segments. Concordance between 3D-TOF-MRA and DSA for the identification of arterial stenosis was assessed by the Cohen κ Index. RESULTS Thirty-one patients met the inclusion criteria, including 20 imaged with a 1.5T MR unit and 11 with a 3T MR unit. Among the 25 patients (81%) with abnormal DSA findings, 24 demonstrated abnormal 3D-TOF-MRA findings, whereas all 6 remaining patients with normal DSA findings had normal 3D-TOF-MRA findings. In the per-segment analysis, concordance between 1.5T 3D-TOF-MRA and DSA was 0.82 (95% CI, 0.75-0.93), and between 3T 3D-TOF-MRA and DSA, it was 0.87 (95% CI, 0.78-0.91). CONCLUSIONS 3D-TOF-MRA shows a high concordance with DSA in diagnostic performance when analyzing brain vasculature in patients with primary central nervous system vasculitis. In patients with negative 3T 3D-TOF-MRA findings, the added diagnostic value of DSA is limited.
Collapse
|
80
|
Taramasso M, Zuber M, Kuwata S, Nietlispach F, Maisano F. Clipping of the tricuspid valve: proposal of a "Rosetta Stone" nomenclature for procedural 3D transoesophageal guidance. EUROINTERVENTION 2017; 12:e1825-e1827. [PMID: 27916743 DOI: 10.4244/eij-d-16-00307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Although preliminary experience has shown the feasibility of tricuspid valve clipping, intraprocedural guidance remains a major issue. The aim of this report is to provide a simple nomenclature for intra-procedural 3D TEE guidance during transcatheter tricuspid valve interventions. METHODS AND RESULTS The identification of the location of the aortic valve (AV) is fundamental to understanding the orientation of the leaflets: the leaflet opposite the AV is the posterior leaflet (P). Anterior (A) and septal (S) leaflets are easily identified counterclockwise. The movements of the guiding catheter in the right atrium can be divided for orientation: towards the AV ("Aortic" direction) or towards the posterior leaflet ("Posterior" direction); the movement perpendicular to the previous one can be towards the anterior ("Anterior" direction) or towards the septal leaflet ("Septal" direction). CONCLUSIONS We have provided a simple nomenclature, which can be shared between the person performing the procedure and the person who is guiding, that could serve as a "Rosetta Stone" for TV clipping, and for transcatheter TV interventions in general.
Collapse
|
81
|
Haueter R, Schütz T, Raptis DA, Clavien PA, Zuber M. Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis. Br J Surg 2017; 104:1141-1159. [PMID: 28569406 DOI: 10.1002/bjs.10574] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/29/2016] [Accepted: 03/29/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate improvements in cosmetic results and postoperative morbidity for single-incision laparoscopic cholecystectomy (SILC) in comparison with multiport laparoscopic cholecystectomy (MLC). METHODS A literature search was undertaken for RCTs comparing SILC with MLC in adult patients with benign gallbladder disease. Primary outcomes were body image and cosmesis scores at different time points. Secondary outcomes included intraoperative and postoperative complications, postoperative pain and frequency of port-site hernia. RESULTS Thirty-seven RCTs were included, with a total of 3051 patients. The body image score favoured SILC at all time points (short term: mean difference (MD) -2·09, P < 0·001; mid term: MD -1·33, P < 0·001), as did the cosmesis score (short term: MD 3·20, P < 0·001; mid term: MD 4·03, P < 0·001; long-term: MD 4·87, P = 0·05) and the wound satisfaction score (short term: MD 1·19, P = 0·03; mid term: MD 1·38, P < 0·001; long-term: MD 1·19, P = 0·02). Duration of operation was longer for SILC (MD 13·56 min; P < 0·001) and SILC required more additional ports (odds ratio (OR) 6·78; P < 0·001). Postoperative pain assessed by a visual analogue scale (VAS) was lower for SILC at 12 h after operation (MD in VAS score -0·80; P = 0·007). The incisional hernia rate was higher after SILC (OR 2·50, P = 0·03). All other outcomes were similar for both groups. CONCLUSION SILC is associated with better outcomes in terms of cosmesis, body image and postoperative pain. The risk of incisional hernia is four times higher after SILC than after MLC.
Collapse
|
82
|
Taramasso M, Alessandrini H, Kuwata S, Biasco L, Nietlispach F, Gaemperli O, Zuber M, Linka A, Pedrazzini G, Kreidel F, Frerker C, Kuck KH, Maisano F. Multicenter Experience With Treatment of Residual Mitral Regurgitation After MitraClip Implantation Using Amplatzer Closure Device. JACC Cardiovasc Interv 2017; 10:966-970. [DOI: 10.1016/j.jcin.2017.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 01/31/2017] [Accepted: 02/09/2017] [Indexed: 11/25/2022]
|
83
|
Amicarella F, Muraro MG, Hirt C, Cremonesi E, Padovan E, Mele V, Governa V, Han J, Huber X, Droeser RA, Zuber M, Adamina M, Bolli M, Rosso R, Lugli A, Zlobec I, Terracciano L, Tornillo L, Zajac P, Eppenberger-Castori S, Trapani F, Oertli D, Iezzi G. Dual role of tumour-infiltrating T helper 17 cells in human colorectal cancer. Gut 2017; 66:692-704. [PMID: 26719303 PMCID: PMC5529969 DOI: 10.1136/gutjnl-2015-310016] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/11/2015] [Accepted: 11/30/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND The immune contexture predicts prognosis in human colorectal cancer (CRC). Whereas tumour-infiltrating CD8+ T cells and myeloid CD16+ myeloperoxidase (MPO)+ cells are associated with favourable clinical outcome, interleukin (IL)-17-producing cells have been reported to correlate with severe prognosis. However, their phenotypes and functions continue to be debated. OBJECTIVE To investigate clinical relevance, phenotypes and functional features of CRC-infiltrating, IL-17-producing cells. METHODS IL-17 staining was performed by immunohistochemistry on a tissue microarray including 1148 CRCs. Phenotypes of IL-17-producing cells were evaluated by flow cytometry on cell suspensions obtained by enzymatic digestion of clinical specimens. Functions of CRC-isolated, IL-17-producing cells were assessed by in vitro and in vivo experiments. RESULTS IL-17+ infiltrates were not themselves predictive of an unfavourable clinical outcome, but correlated with infiltration by CD8+ T cells and CD16+ MPO+ neutrophils. Ex vivo analysis showed that tumour-infiltrating IL-17+ cells mostly consist of CD4+ T helper 17 (Th17) cells with multifaceted properties. Indeed, owing to IL-17 secretion, CRC-derived Th17 triggered the release of protumorigenic factors by tumour and tumour-associated stroma. However, on the other hand, they favoured recruitment of beneficial neutrophils through IL-8 secretion and, most importantly, they drove highly cytotoxic CCR5+CCR6+CD8+ T cells into tumour tissue, through CCL5 and CCL20 release. Consistent with these findings, the presence of intraepithelial, but not of stromal Th17 cells, positively correlated with improved survival. CONCLUSIONS Our study shows the dual role played by tumour-infiltrating Th17 in CRC, thus advising caution when developing new IL-17/Th17 targeted treatments.
Collapse
|
84
|
Kuwata S, Taramasso M, Zuber M, Suetsch G, Attinger-Toller A, Wicki D, Maisano F, Nietlispach F. Feasibility of concomitant MitraClip and left atrial appendage occlusion. EUROINTERVENTION 2017; 12:1940-1945. [DOI: 10.4244/eij-d-16-00784] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
85
|
Taramasso M, Calen C, Guidotti A, Kuwata S, Biefer HRC, Nietlispach F, Zuber M, Maisano F. Management of Tricuspid Regurgitation: The Role of Transcatheter Therapies. Interv Cardiol 2017; 12:51-55. [PMID: 29588731 DOI: 10.15420/icr.2017:3:2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Surgical treatment is the gold standard treatment of functional tricuspid regurgitation (FTR) but this carries high risks of morbidity and mortality. Percutaneous procedures are an attractive alternative to surgery for selected patients deemed to be high-risk surgical candidates. A number of tricuspid transcatheter devices have been developed to treat FTR, but at present, evidence of their efficacy and safety is scarce. Preliminary data have shown promising results, but ongoing and future studies will provide a clearer picture of the benefits of these new techniques.
Collapse
|
86
|
De Boysson H, Boulouis G, Néel A, Arquizan C, Detante O, Zuber M, Touzé E, Aouba A, Bienvenu B, Guillevin L, Naggara O, Pagnoux C. Les formes pseudo-tumorales de vascularite primitive du système nerveux central. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
87
|
De Boysson H, Detante O, Arquizan C, Touzé E, Bienvenu B, Aouba A, Guillevin L, Zuber M, Pagnoux C. Vascularites primitives du système nerveux central : facteurs associés à une biopsie cérébro-méningée positive. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
88
|
Taramasso M, Zuber M, Ruiz CE, Maisano F. Echo-navigation to guide transfemoral tricuspid edge-to-edge repair. Eur Heart J 2016; 37:3420. [PMID: 27371718 DOI: 10.1093/eurheartj/ehw252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
89
|
Hodel J, Leclerc X, Kalsoum E, Zuber M, Tamazyan R, Benadjaoud MA, Pruvo JP, Piotin M, Baharvahdat H, Zins M, Blanc R. Intracranial Arteriovenous Shunting: Detection with Arterial Spin-Labeling and Susceptibility-Weighted Imaging Combined. AJNR Am J Neuroradiol 2016; 38:71-76. [PMID: 27789452 DOI: 10.3174/ajnr.a4961] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/16/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling and susceptibility-weighted imaging are 2 MR imaging techniques that do not require gadolinium. The study aimed to assess the accuracy of arterial spin-labeling and SWI combined for detecting intracranial arteriovenous shunting in comparison with conventional MR imaging. MATERIALS AND METHODS Ninety-two consecutive patients with a known (n = 24) or suspected arteriovenous shunting (n = 68) underwent digital subtraction angiography and brain MR imaging, including arterial spin-labeling/SWI and conventional angiographic MR imaging (3D TOF, 4D time-resolved, and 3D contrast-enhanced MRA). Arterial spin-labeling/SWI and conventional MR imaging were reviewed separately in a randomized order by 2 blinded radiologists who judged the presence or absence of arteriovenous shunting. The accuracy of arterial spin-labeling/SWI for the detection of arteriovenous shunting was calculated by using the area under receiver operating curve with DSA as reference standard. κ coefficients were computed to determine interobserver and intermodality agreement. RESULTS Of the 92 patients, DSA showed arteriovenous shunting in 63 (arteriovenous malformation in 53 and dural arteriovenous fistula in 10). Interobserver agreement was excellent (κ =0.83-0.95). In 5 patients, arterial spin-labeling/SWI correctly detected arteriovenous shunting, while the conventional angiographic MR imaging did not. Compared with conventional MR imaging, arterial spin-labeling/SWI was significantly more sensitive (0.98 versus 0.90, P = .04) and equally specific (0.97) and showed significantly higher agreement with DSA (κ = 0.95 versus 0.84, P = .01) and higher area under the receiver operating curve (0.97 versus 0.93, P = .02). CONCLUSIONS Our study showed that the combined use of arterial spin-labeling and SWI may be an alternative to contrast-enhanced MRA for the detection of intracranial arteriovenous shunting.
Collapse
|
90
|
Possner M, Vontobel J, Nguyen-Kim TDL, Zindel C, Holy EW, Stämpfli SF, Zuber M, Kaufmann PA, Nietlispach F, Maisano F, Niemann M, Tanner FC. Prognostic value of aortic regurgitation after TAVI in patients with chronic kidney disease. Int J Cardiol 2016; 221:180-7. [DOI: 10.1016/j.ijcard.2016.06.145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/11/2016] [Accepted: 06/24/2016] [Indexed: 11/15/2022]
|
91
|
Miesel R, Zuber M, Hartung R, Haas R, Kröger H. Total radical-trapping antioxidative capacity of plasma and whole blood chemiluminescence in patients with inflammatory and autoimmune rheumatic diseases. Redox Rep 2016; 1:323-30. [DOI: 10.1080/13510002.1995.11747006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
92
|
Sürder D, Manka R, Moccetti T, Lo Cicero V, Emmert MY, Klersy C, Soncin S, Turchetto L, Radrizzani M, Zuber M, Windecker S, Moschovitis A, Bühler I, Kozerke S, Erne P, Lüscher TF, Corti R. Effect of Bone Marrow-Derived Mononuclear Cell Treatment, Early or Late After Acute Myocardial Infarction: Twelve Months CMR and Long-Term Clinical Results. Circ Res 2016; 119:481-90. [PMID: 27267068 DOI: 10.1161/circresaha.116.308639] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 06/03/2016] [Indexed: 02/01/2023]
Abstract
RATIONALE Intracoronary delivery of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction (AMI). OBJECTIVE To demonstrate long-term efficacy of BM-MNC treatment after AMI. METHODS AND RESULTS In a multicenter study, we randomized 200 patients with large AMI in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were either administered 5 to 7 days (early) or 3 to 4 weeks (late) after AMI. Cardiac magnetic resonance imaging was performed at baseline and after 12 months. The current analysis investigates the change from baseline to 12 months in global LV ejection fraction, LV volumes, scar size, and N-terminal pro-brain natriuretic peptide values comparing the 2 treatment groups with control in a linear regression model. Besides the complete case analysis, multiple imputation analysis was performed to address for missing data. Furthermore, the long-term clinical event rate was computed. The absolute change in LV ejection fraction from baseline to 12 months was -1.9±9.8% for control (mean±SD), -0.9±10.5% for the early treatment group, and -0.7±10.1% for the late treatment group. The difference between the groups was not significant, both for complete case analysis and multiple imputation analysis. A combined clinical end point occurred equally in all the groups. Overall, 1-year mortality was low (2.25%). CONCLUSIONS Among patients with AMI and LV dysfunction, treatment with BM-MNC either 5 to 7 days or 3 to 4 weeks after AMI did not improve LV function at 12 months, compared with control. The results are limited by an important drop out rate. CLINICAL TRIAL REGISTRATION INFORMATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186.
Collapse
|
93
|
Taramasso M, Inderbitzin DT, Guidotti A, Nietlispach F, Gaemperli O, Zuber M, Maisano F. Transcatheter direct mitral valve annuloplasty with the Cardioband system for the treatment of functional mitral regurgitation. Multimed Man Cardiothorac Surg 2016; 2016:mmw004. [PMID: 27247326 DOI: 10.1093/mmcts/mmw004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/28/2016] [Indexed: 06/05/2023]
Abstract
Direct mitral valve annuloplasty is a transcatheter mitral valve repair approach that mimics the conventional surgical approach to treat functional mitral regurgitation. The Cardioband system (Valtech Cardio, Inc., Or-Yehuda, Israel) is delivered by a trans-septal approach and the implant is performed on the atrial side of the mitral annulus, under live echo and fluoroscopic guidance using multiple anchor elements. The Cardioband system obtained CE mark approval in October 2015, and initial clinical experiences are promising with regard to feasibility, safety and efficacy.
Collapse
|
94
|
Taramasso M, Zuber M, Gruner C, Gaemperli O, Nietlispach F, Maisano F. First-in-man report of residual “intra-clip” regurgitation between two MitraClips treated by AMPLATZER Vascular Plug II. EUROINTERVENTION 2016; 11:1537-40. [DOI: 10.4244/eijy14m12_04] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
95
|
Weixler B, Warschkow R, Güller U, Zettl A, von Holzen U, Schmied BM, Zuber M. Isolated tumor cells in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival. BMC Cancer 2016; 16:106. [PMID: 26879046 PMCID: PMC4754888 DOI: 10.1186/s12885-016-2130-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 02/04/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Lymph node (LN) involvement represents the strongest prognostic factor in colon cancer patients. The objective of this prospective study was to assess the prognostic impact of isolated tumor cells (ITC, defined as cell deposits ≤ 0.2 mm) in loco-regional LN of stage I & II colon cancer patients. METHODS Seventy-four stage I & II colon cancer patients were prospectively enrolled in the present study. LN at high risk of harboring ITC were identified via an in vivo sentinel lymph node procedure and analyzed with multilevel sectioning, conventional H&E and immunohistochemical CK-19 staining. The impact of ITC on survival was assessed using Cox regression analyses. RESULTS Median follow-up was 4.6 years. ITC were detected in locoregional lymph nodes of 23 patients (31.1%). The presence of ITC was associated with a significantly worse disease-free survival (hazard ratio = 4.73, p = 0.005). Similarly, ITC were associated with significantly worse overall survival (hazard ratio = 3.50, p = 0.043). CONCLUSIONS This study provides compelling evidence that ITC in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival. Based on these data, the presence of ITC should be classified as a high risk factor in stage I & II colon cancer patients who might benefit from adjuvant chemotherapy.
Collapse
|
96
|
Toggweiler S, Zuber M, Lüscher TF. Authors’ Response. THE JOURNAL OF INVASIVE CARDIOLOGY 2016; 28:E28. [PMID: 27257655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
97
|
Maisano F, Taramasso M, Nickenig G, Hammerstingl C, Vahanian A, Messika-Zeitoun D, Baldus S, Huntgeburth M, Alfieri O, Colombo A, La Canna G, Agricola E, Zuber M, Tanner FC, Topilsky Y, Kreidel F, Kuck KH. Cardioband, a transcatheter surgical-like direct mitral valve annuloplasty system: early results of the feasibility trial. Eur Heart J 2015; 37:817-25. [DOI: 10.1093/eurheartj/ehv603] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/13/2015] [Indexed: 11/14/2022] Open
|
98
|
Toggweiler S, van Schie B, Zuber M, Sabti Z, Özkartal T, Lüscher TF, Erne P. Natural Course of Paravalvular Regurgitation After Implantation of the Self-Expanding CoreValve: Insights From Serial TEE Measurements. THE JOURNAL OF INVASIVE CARDIOLOGY 2015; 27:435-440. [PMID: 26332879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED This study investigates the natural course of paravalvular regurgitation (PAR) with serial transesophageal echocardiography (TEE) measurements. METHODS TEE studies were performed at 30 days and 1 year post TAVI with the self-expanding CoreValve for the treatment of severe aortic valve stenosis in 50 patients. In addition to conventional measurements, PAR perimeter and orifice area were assessed in the cross-sectional short-axis view at the level of the native aortic annulus. RESULTS At 30 days, PAR was classified as none in 26 patients (52%), mild in 19 patients (38%) and moderate in 5 patients (10%). Between 30 days and 1 year, the number and size of PAR jets decreased and PAR was absent in 30 patients (60%) (P=.58 compared with 30-day results). Paravalvular regurgitation perimeter decreased from 8.2 ± 10.9% to 4.7 ± 7.7% (P<.01), a relative reduction of 43%. Cross-sectional area of regurgitation decreased from 0.22 ± 0.36 cm² to 0.12 ± 0.20 cm² (P=.01), a relative reduction of 45%. This improvement was observed in patients with mild and moderate PAR. No patient without PAR at 30 days developed PAR at 1-year follow-up. CONCLUSIONS PAR perimeter and area as visualized by Color-Doppler TEE in the cross-sectional view decreased by about 45% between 30 days and 1 year post implantation of the self-expanding CoreValve.
Collapse
|
99
|
Sürder D, Gisler V, Corti R, Moccetti T, Klersy C, Zuber M, Windecker S, Moschovitis A, Kozerke S, Lüscher TF, Erne P, Manka R. Thrombus formation in the left ventricle after large myocardial infarction – assessment with cardiac magnetic resonance imaging. Swiss Med Wkly 2015; 145:w14122. [PMID: 26098589 DOI: 10.4414/smw.2015.14122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Left ventricular thrombus (LVT) formation may worsen the post-infarct outcome as a result of thromboembolic events. It also complicates the use of modern antiplatelet regimens, which are not compatible with long-term oral anticoagulation. The knowledge of the incidence of LVT may therefore be of importance to guide antiplatelet and antithrombotic therapy after acute myocardial infarction (AMI). METHODS In 177 patients with large, mainly anterior AMI, standard cardiac magnetic resonance imaging (CMR) including cine and late gadolinium enhancement (LGE) imaging was performed shortly after AMI as per protocol. CMR images were analysed at an independent core laboratory blinded to the clinical data. Transthoracic echocardiography (TTE) was not mandatory for the trial, but was performed in 64% of the cases following standard of care. In a logistic model, 3 out of 61 parameters were used in a multivariable model to predict LVT. RESULTS LVT was detected by use of CMR in 6.2% (95% confidence interval [CI] 3.1%-10.8%). LGE sequences were best to detect LVT, which may be missed in cine sequences. We identified body mass index (odds ratio 1.18; p = 0.01), baseline platelet count (odds ratio 1.01, p = 0.01) and infarct size as assessed by use of CMR (odds ratio 1.03, p = 0.02) as best predictors for LVT. The agreement between TTE and CMR for the detection of LVT is substantial (kappa = 0.70). DISCUSSION In the current analysis, the incidence of LVT shortly after AMI is relatively low, even in a patient population at high risk. An optimal modality for LVT detection is LGE-CMR but TTE has an acceptable accuracy when LGE-CMR is not available.
Collapse
|
100
|
Picerno T, Zuber M, Gonzalez Rios A, Taylor N, Hoffman M, Borowsky M. Morcellation and the incidence of occult malignancy: A dual-institution review. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|