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Sierro C, Iglesias JF, Eeckhout E, Vogt P. [Pre-operative cardiac assessment in non-cardiac surgery: a frequent dilemma simplified by a decision tree]. REVUE MEDICALE SUISSE 2010; 6:1117-1121. [PMID: 20572354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In patients undergoing non-cardiac surgery, cardiac events are the most common cause of perioperative morbidity and mortality. It is often difficult to choose adequate cardiologic examinations before surgery. This paper, inspired by the guidelines of the European and American societies of cardiology (ESC, AHA, ACC), discusses the place of standard ECG, echocardiography, treadmill or bicycle ergometer and pharmacological stress testing in preoperative evaluations. The role of coronary angiography and prophylactic revascularization will also be discussed. Finally, we provide a decision tree which will be helpful to both general practitioners and specialists.
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Iglesias JF, Thai HT, Kabir T, Roguelov C, Eeckhout E. Transcatheter coil embolization of multiple bilateral congenital coronary artery fistulae. THE JOURNAL OF INVASIVE CARDIOLOGY 2010; 22:142-145. [PMID: 20197583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Coronary artery fistulae represent the most frequent congenital anomalies of the coronary arteries, but remain a relatively uncommon clinical problem. Moreover, multiple fistulae originating from both the left and the right coronary arteries and draining into the left ventricular chamber are a rare condition. Due to the low prevalence of these anomalies, the appropriate management of patients with symptomatic coronary artery fistulae is controversial. Transcatheter closure approaches have emerged as a less invasive strategy and are nowadays considered a valuable alternative to surgical correction with similar effectiveness, morbidity and mortality. The percutaneous management, however, is mainly limited by the individual anatomic features of the fistula and an appropriate patient's selection is considered as a key determining factor to achieve complete occlusion. Thus, success rates of transcatheter closure techniques reported in the literature are extremely variable and highly dependent upon the nature of the follow up, which, at present, is not standardized. The optimal management of symptomatic patients with multiple coronary artery fistulae still remains a challenging problem and has been traditionally considered as an indication for cardiac surgery. We report here the case of a patient with double bilateral congenital coronary artery fistulae arising from both the left and right coronary arteries and draining individually into the left ventricular chamber. This patient underwent successful transcatheter anterograde closure of both fistulae using a microcoil embolization technique.
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Authors/Task Force Members, Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, Gorenek B, Hennerici MG, Iung B, Kelm M, Kjeldsen KP, Kristensen SD, Lopez-Sendon J, Pelosi P, Philippe F, Pierard L, Ponikowski P, Schmid JP, Sellevold OF, Sicari R, Van den Berghe G, Vermassen F, Hoeks SE, Vanhorebeek I, Vahanian A, Auricchio A, Bax JJ, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, McGregor K, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, De Caterina R, Agewall S, Al Attar N, Andreotti F, Anker SD, Baron-Esquivias G, Berkenboom G, Chapoutot L, Cifkova R, Faggiano P, Gibbs S, Hansen HS, Iserin L, Israel CW, Kornowski R, Eizagaechevarria NM, Pepi M, Piepoli M, Priebe HJ, Scherer M, Stepinska J, Taggart D, Tubaro M. Corrigendum to: 'Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA)' [Eur Heart J 2009;30:2769-2812]. Eur Heart J 2010. [DOI: 10.1093/eurheartj/ehp593] [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: 11/14/2022] Open
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129
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Locca D, Kabir T, Iglesias J, Tapponnier M, Roguelov C, Vogt P, Eeckhout E. Conference Scene: 8th International Congress on Complications During Coronary Interventions: Management and Prevention. Interv Cardiol 2009. [DOI: 10.2217/ica.09.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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130
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131
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Han SH, Gerber TC, Suwaidi JA, Eeckhout E, Lennon R, Rubinshtein R, Lerman A. Relationship between coronary endothelial function and coronary calcification in early atherosclerosis. Atherosclerosis 2009; 209:197-200. [PMID: 19962702 DOI: 10.1016/j.atherosclerosis.2009.08.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 08/14/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The relationship between coronary endothelial function and coronary calcification is not well established. METHODS Forty-six patients 17 men [37%]; age, 47.4+/-11.4 years prospectively underwent testing for coronary endothelial function and measurement of coronary artery calcification (CAC). RESULTS Log CAC scores were not significantly different between patients with normal (n=31) and abnormal (n=15) response of epicardial coronary artery diameter to acetylcholine (%CAD(Ach)) (median (25, 75 percentile) 1.1 (0.0, 3.7) vs. 0.3 (0.0, 2.4), P=.32) and with normal (n=28) and abnormal (n=18) response of coronary blood flow to acetylcholine (%CBF(Ach)) (0.5 (0.0, 3.6) vs. 0.5 (0.0, 3.2), P=.76). Log CAC scores did not correlate with %CAD(Ach) (r=0.08, P=.59), %CBF(Ach) (r=0.14, P=.35). CONCLUSIONS In patients without significant coronary artery disease, coronary endothelial dysfunction showed no apparent association with coronary calcification. Our findings suggest that these 2 markers may represent separate, independent processes in the progression of coronary atherosclerosis.
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Sachdev B, Naber CK, Eeckhout E, Fajadet J. Pioneers, teachers and students: the 'how-to' of cardiovascular interventions. EUROINTERVENTION 2009; 5:285-287. [PMID: 19736150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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133
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Aminian A, Kabir T, Eeckhout E. Treatment of drug-eluting stent restenosis: An emerging challenge. Catheter Cardiovasc Interv 2009; 74:108-16. [DOI: 10.1002/ccd.21938] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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134
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Iglesias JF, Roguelov C, Kabir T, Vogt P, Eeckhout E. [Indications for urgent coronary angiography. Part II: Acute coronary syndromes without ST-segment elevation]. REVUE MEDICALE SUISSE 2009; 5:1202-1209. [PMID: 19517752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The optimal treatment strategy for patients presenting with an acute coronary syndrome without ST elevation is controversial and different therapeutic approaches are recognized. Currently, given the literature available, it is not possible to recommend a universal systematic invasive approach. It is essential to individually risk stratify patients in order to identify those high risk patients that have been shown to benefit from an invasive strategy. Compared to conservative medical treatment, patients at low risk have not been shown to benefit from an invasive strategy. Urgent coronary angiography remains recommended for those patients with persistent or recurrent ischemic symptoms under optimal medical treatment.
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Iglesias JF, Roguelov C, Kabir T, Vogt P, Eeckhout E. [Indications for urgent coronary angiography. Part I: ST-segment elevation acute coronary syndromes]. REVUE MEDICALE SUISSE 2009; 5:1195-1201. [PMID: 19517751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The indications for urgent coronary angiography are stated in the guidelines for treatment of acute coronary syndromes. An invasive approach is considered the treatment of choice for patients presenting with ST elevation myocardial infarction within 12 hours of the beginning of symptoms. In the absence of contraindication, intravenous thrombolysis continues to be a valuable alternative to primary angioplasty within 3 hours of the beginning of clinical symptoms. Urgent coronary angiography continues to be recommended following the failure of thrombolysis, persistent myocardial ischemia after 12 hours of symptoms, recurrent myocardial ischemia following myocardial infarction or in the case of cardiogenic shock.
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Muller O, Windecker S, Cuisset T, Fajadet J, Mason M, Zuffi A, Doganov A, Eeckhout E. Management of two major complications in the cardiac catheterisation laboratory: the no-reflow phenomenon and coronary perforations. EUROINTERVENTION 2009; 4:181-3. [PMID: 19110779 DOI: 10.4244/eijv4i2a32] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kristensen SD, Baumgartner H, Casadei B, Drexler H, Eeckhout E, Filippatos G, Fox KAA, Perk J, Pierard LA, Poldermans D, Schunkert H, Vardas PE, van der Wall EE, Fox K, Bax JJ. Highlights of the 2008 Scientific Sessions of the European Society of Cardiology Munich, Germany, August 30 to September 3, 2008. J Am Coll Cardiol 2009; 52:2032-42. [PMID: 19055996 DOI: 10.1016/j.jacc.2008.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 10/16/2008] [Indexed: 11/19/2022]
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Eeckhout E, Lerman A. "I did not see it coming"...the hard way for the prevention of complications. EUROINTERVENTION 2008; 4:176-7. [PMID: 19110778 DOI: 10.4244/eijv4i2a30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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139
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Van de Walle S, Kabir T, Zuffi A, Roguelov C, Eeckhout E. Interventional cardiology highlights of the european Society of Cardiology congress, 2008. EUROINTERVENTION 2008; 4:309-10. [PMID: 19110802 DOI: 10.4244/eijv4i3a56] [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: 11/23/2022]
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140
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Jaber WA, Yang EH, Nishimura RA, Sorajja P, Rihal CS, Elesber A, Eeckhout E, Lerman A. Immediate improvement in coronary flow reserve after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy. Heart 2008; 95:564-9. [DOI: 10.1136/hrt.2008.148239] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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141
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Sierro C, Berger A, Eeckhout E, Vogt P. Emergency percutaneous coronary interventions for acute myocardial infarction with ST-segment elevation in a regional hospital: a quality control study. Int J Cardiol 2008; 129:100-4. [PMID: 17643523 DOI: 10.1016/j.ijcard.2007.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 05/15/2007] [Accepted: 06/23/2007] [Indexed: 11/17/2022]
Abstract
BACKGROUND An invasive approach of acute myocardial infarction with ST-segment elevation (STEMI) with primary percutaneous coronary intervention (PCI) is currently considered as the most efficient revascularisation strategy and is performed around-the-clock in tertiary hospitals. The present study is aimed at investigating the short term outcome of primary PCI eligible patients after STEMI in a regional institution (CHCV, Sion) in comparison to a University Hospital (CHUV, Lausanne). METHODS From January the 1st to December the 31st 2002, all consecutive STEMI patients of both centres who had an emergency coronary arteriography were included in the analysis. Clinical and angiographic data were retrospectively collected. The primary end point was the combined incidence of in-hospital death, reinfarction, and target vessel revascularisation (TVR) at 7 days. RESULTS The analysis included 58 patients in the CHVC (60+/-13 years, 16% of whom were female) and 160 patients in the CHUV (63+/-12 years, 25% were female). Both populations were identical according to the severity of coronary artery disease and distribution of risk factors, except for smokers (55% in CHCV, 39% CHUV, p=0.04). Most of the patients were treated by PCI in both centres (80% CHCV versus 86% CHUV, p=NS). A low proportion in both groups underwent urgent surgical treatment (3.5% CHCV versus 5.5% CHUV, p=NS). At 7 days, adverse events free survival was not statistically different. CONCLUSION These results were expected because the CHCV fulfils the international guidelines criteria for performance of emergency angioplasty. Our study demonstrates that around-the-clock primary PCI for acute STEMI can safely be done in a regional hospital (CHCV Sion) providing there is strict adherence to all aspects of international guidelines.
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Delabays A, Eeckhout E, Vogt P. Percutaneous closure of a paravalvular leak 4 years after mitral valve replacement. Eur Heart J 2008; 30:169. [PMID: 18689804 DOI: 10.1093/eurheartj/ehn365] [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: 11/14/2022] Open
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143
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Van de Walle S, Lerman A, Chevalier B, Sabate M, Aminian A, Roguelov C, Eeckhout E. Constructing a checklist for the prevention of complications during percutaneous coronary intervention. EUROINTERVENTION 2008; 4:189-92. [DOI: 10.4244/eijv4i2a35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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144
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Vassalli G, Eeckhout E, Vogt P, Kappenberger L. [Microvascular dysfunction and myocardial ischemia]. REVUE MEDICALE SUISSE 2008; 4:1521-1525. [PMID: 18649599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Functional or structural lesions in intramural arterioles influence the ischemic threshold of the myocardium. Microvascular dysfonction is evidenced by a decrease in coronary blood flow during maximum hyperemia in the presence of angiographically normal or near-normal coronary arteries. Microvascular dysfonction may reflect endothelial dysfonction in diabetic or hyperlipidemic patients, as well as structural and functional changes in patients with hypertrophic cardiomyopathy, aortic stenosis or hypertension. Assessing microvascular fonction after thrombolysis or primary angioplasty for acute myocardial infarction allows to estimate the quality of myocardial reperfusion. Assessing microvascular fonction is a major component of the evaluation of myocardial ischemia in the absence of coronary artery stenoses.
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Han SH, Bae JH, Holmes DR, Lennon RJ, Eeckhout E, Barsness GW, Rihal CS, Lerman A. Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis. Eur Heart J 2008; 29:1359-69. [DOI: 10.1093/eurheartj/ehn142] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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146
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Roguelov C, Yerly P, Monney P, Pascale P, Eeckhout E, Vogt P. [Trends in cardiology]. REVUE MEDICALE SUISSE 2008; 4:104-111. [PMID: 18309872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The year 2007 has been, as always, a very productive year in terms of new trials, publications and newly edited guidelines. The present article does not pretend to offer a complete overview. The different authors provide a particular choice of clinical research and guidelines in the field of heart failure, endocarditis and interventional cardiology.
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Kristensen SD, Baumgartner H, Drexler H, Eeckhout E, Filippatos G, Gitt AK, Linde C, Pierard LA, Poldermans D, Schunkert H, Sipido KR, van der Wall EE, Fox K, Bax JJ. Highlights of the 2007 scientific sessions of the European Society of Cardiology Vienna, Austria, September 1-5, 2007. J Am Coll Cardiol 2008; 50:2421-30. [PMID: 18154969 DOI: 10.1016/j.jacc.2007.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Accepted: 10/25/2007] [Indexed: 11/19/2022]
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148
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Kabir T, Aminian A, Zuffi A, Rogeulov C, Eeckhout E. Rescue Percutaneous Coronary Intervention with a Clear Conscience in 2008? Eur Cardiol 2008. [DOI: 10.15420/ecr.2008.4.2.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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149
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Van de Walle S, Roguelov C, Zuffi A, Eeckhout E. Interventional cardiology highlights: ESC Vienna 2007. EUROINTERVENTION 2008; 3:447-9. [DOI: 10.4244/eijv3i4a80] [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: 11/23/2022]
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150
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Rubboli A, Halperin JL, Airaksinen KEJ, Buerke M, Eeckhout E, Freedman SB, Gershlick AH, Schlitt A, Tse HF, Verheugt FWA, Lip GYH. Antithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillation. Ann Med 2008; 40:428-36. [PMID: 18608125 DOI: 10.1080/07853890802089786] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Dual antiplatelet treatment with aspirin and clopidogrel is recommended after coronary stenting (PCI-S). There is scant evidence defining optimal post-PCI-S antithrombotic therapy in patients with atrial fibrillation (AF) in whom oral anticoagulation (OAC) is mandated. To evaluate the safety and efficacy of the antithrombotic strategies for this population, we conducted a systematic review of the available evidence in patients treated with OAC undergoing PCI-S. AF was the most frequent indication for OAC. Post-PCI-S management was highly variable, and triple therapy with warfarin, aspirin, and clopidogrel was the most frequent and effective combination. Warfarin plus aspirin alone was not sufficiently effective in the early period after PCI-S and should not be prescribed. While acknowledging that the optimal antithrombotic treatment for patients with AF at medium or high thromboembolic risk undergoing PCI-S is currently undefined, triple therapy of warfarin, aspirin, and clopidogrel is currently recommended, although associated with an increased risk of major bleeding. Restrictive use of drug-eluting stent is also recommended, due to the need for prolonged multiple-drug antithrombotic therapy which may increase the bleeding risk. Whether the combination of warfarin and clopidogrel (without aspirin) will preserve efficacy and produce less bleeding is an important issue still needing to be addressed.
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