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Adriaenssens T, Ughi GJ, Dubois C, De Cock D, Onsea K, Bennett J, Wiyono S, Sinnaeve P, Coosemans M, Ferdinande B, Belmans A, D’hooge J, Desmet W. STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised controlled trial. EUROINTERVENTION 2016; 11:e1619-26. [DOI: 10.4244/eijy14m11_11] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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2
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Kuiten WMM, de Heer LM, van Aarnhem EEHL, Onsea K, van Herwerden LA. Giant left atrial appendage: a rare anomaly. Ann Thorac Surg 2013; 96:1478-1480. [PMID: 24088468 DOI: 10.1016/j.athoracsur.2013.01.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 01/05/2013] [Accepted: 01/10/2013] [Indexed: 11/25/2022]
Abstract
A giant left atrial appendage is a rare congenital anomaly that has been reported on only a few occasions. We report two symptomatic patients with atrial fibrillation combined with a cerebellar infarct in one and dyspnea in the other. Both patients were treated surgically with resection of the giant left atrial appendage and radiofrequency pulmonary vein isolation. Recognition of this uncommon pathology can lead to timely surgical intervention.
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Affiliation(s)
- Wilhelmina M M Kuiten
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands
| | - Linda M de Heer
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands
| | | | - Kevin Onsea
- Department of Cardiology, University Medical Centre Utrecht, The Netherlands
| | - Lex A van Herwerden
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands.
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Onsea K, Adriaenssens T. Very late dehiscence of a Bentall prosthesis. Neth Heart J 2013; 21:157-8. [DOI: 10.1007/s12471-011-0155-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Onsea K, Agostoni P, Voskuil M, Samim M, Stella PR. Infective complications after transcatheter aortic valve implantation: results from a single centre. Neth Heart J 2012; 20:360-4. [PMID: 22890618 PMCID: PMC3430757 DOI: 10.1007/s12471-012-0303-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
After its first introduction in 2002, transcatheter aortic valve implantation (TAVI) has continuously gained more foothold for the treatment of severe aortic stenosis and is nowadays a viable treatment option for inoperable patients or patients at high risk for conventional surgical aortic valve replacement. Although ideally carried out in a so-called hybrid room, incorporating both the strict hygiene and advanced life support possibilities of the operating theatre and the imaging and percutaneous arsenal of the catheterisation suite, in most centres TAVI is at present performed in the catheterisation laboratory. This may raise concern about an increased risk of infection, since there the criteria that are applied regarding disinfection and sterilisation are not as stringent as those of the operating theatre. Therefore, we retrospectively assessed the number of infective complications in patients undergoing TAVI in the catheterisation lab of our institution. Eleven out of 73 patients developed a postprocedural infection, one of which could be attributed to the procedure itself, being superinfection of a surgical groin cut-down. Our conclusion is that percutaneous aortic valve implantation in a catheterisation laboratory is not associated with an increased risk of infective complications.
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Affiliation(s)
- K Onsea
- Division of Cardiology, University Medical Centre Utrecht, UMC Utrecht, Heidelberglaan 100, Utrecht, Postbus 85500, 3508 GA, Utrecht, the Netherlands,
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Abstract
INTRODUCTION Mitral valve stenosis is becoming increasingly rare in industrialized countries thanks to the almost complete extinction of rheumatic valve disease. Nevertheless, every cardiologist will encounter a few cases, notably in elderly with degenerated calcified mitral valves or in younger immigrants coming from parts of the world with endemic rheumatic valve disease. Patients usually present with progressive dyspnoea due to increased left atrial and pulmonary artery pressures and a decline in cardiac output secondary to preload reduction. Introduced by Inoue in 1984, percutaneous balloon mitral valvuloplasty constitutes an elegant treatment modality in patients with appropriate valvular anatomy, with excellent immediate results and long-term outcome.The original Inoue technique, based on the surgically closed commissurotomy, employs the eponymous balloon to crack the mitral commissures to separate the mitral leaflets along their natural plane thereby enlarging the mitral valve area. Similar but slightly different techniques have emerged throughout the years and have extensively been used in the clinic. One of them is the so-called double balloon valvuloplasty, first described in Saoudi Arabia by Al-Zaibag, during which two balloons are positioned side-by-side across the stenotic valve and inflated simultaneously. Mitral regurgitation is relatively common after balloon dilatation, but is mostly mild and caused by excessive commissural tearing or slight prolapse of the anterior leaflet. We present a rare case of severe mitral regurgitation following double balloon mitral valvuloplasty due to papillary muscle rupture.
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Affiliation(s)
- Kevin Onsea
- Division of Cardiology, University Medical Centre, Utrecht, The Netherlands
| | - Steven Chamuleau
- Division of Cardiology, University Medical Centre, Utrecht, The Netherlands
| | - Pieter Stella
- Division of Cardiology, University Medical Centre, Utrecht, The Netherlands
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Onsea K, Agostoni P, Samim M, Voskuil M, Kluin J, Budde R, Hendrikse J, Ramjankhan F, van Klarenbosch J, Doesburg P, Sieswerda G, Stella P. First-in-man experience with a new embolic deflection device in transcatheter aortic valve interventions. EUROINTERVENTION 2012; 8:51-6. [PMID: 22580248 DOI: 10.4244/eijv8i1a9] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kevin Onsea
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Onsea K, Bogaard M, Asselbergs F, Stella P. Simultaneous pulmonary, cerebral and coronary emboli. Int J Cardiol 2012; 157:e18-20. [DOI: 10.1016/j.ijcard.2011.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
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Tu S, Jing J, Holm NR, Onsea K, Zhang T, Adriaenssens T, Dubois C, Desmet W, Thuesen L, Chen Y, Reiber JHC. In vivo assessment of bifurcation optimal viewing angles and bifurcation angles by three-dimensional (3D) quantitative coronary angiography. Int J Cardiovasc Imaging 2011; 28:1617-25. [PMID: 22169957 PMCID: PMC3473185 DOI: 10.1007/s10554-011-9996-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 12/02/2011] [Indexed: 01/02/2023]
Abstract
Evaluation and stenting of coronary bifurcation lesions may benefit from optimal angiographic views. The anatomy-defined bifurcation optimal viewing angle (ABOVA) is characterized by having an orthogonal view of the bifurcation, such that overlap and foreshortening at the ostium are minimized. However, due to the mechanical constraints of the X-ray systems, certain deep angles cannot be reached by the C-arm. Therefore, second best or, so-called obtainable bifurcation optimal viewing angle (OBOVA) has to be used as an alternative. This study assessed the distributions of ABOVA and OBOVA using 3D quantitative coronary angiography in a typical patient population. In addition, the bifurcation angles in four main coronary bifurcations were assessed and compared. Patients with obstructive coronary bifurcation disease were included in this multicenter registry. A novel and validated 3D QCA software package was applied to reconstruct the bifurcations and to calculate the bifurcation angles in 3D. A list of optimal viewing angle candidates including ABOVA was also automatically proposed by the software. In a next step, the operator selected the best viewing angle as OBOVA, while applying a novel overlap prediction approach to assure no overlap between the target bifurcation and other major coronary arteries. A total of 194 bifurcations from 181 patients were assessed. The ABOVA could not be reached in 56.7% of the cases; being 40 (81.6%), 40 (78.4%), 9 (17.6%), and 21 (48.8%) cases for LM/LAD/LCx, LAD/Diagonal, LCx/OM, and PDA/PLA, respectively. Both ABOVA and OBOVA distributed sparsely with large ranges of variance: LM/LAD/LCx, 5 ± 33 RAO, 47 ± 35 Caudal versus 4 ± 39 LAO, 35 ± 16 Caudal; LAD/Diagonal, 4 ± 38 RAO, 50 ± 14 Cranial versus 14 ± 28 LAO, 33 ± 5 Cranial; LCx/OM, 21 ± 32 LAO, 27 ± 17 Caudal versus 18 ± 31 LAO, 25 ± 13 Caudal; PDA/PLA, 34 ± 21 LAO, 36 ± 21 Cranial versus 28 ± 25 LAO, 29 ± 15 Cranial. LM/LAD/LCx had the smallest proximal bifurcation angle (128° ± 24°) and the largest distal bifurcation angle (80° ± 21°), as compared with LAD/Diagonal (151° ± 13º and 48° ± 16º), LCx/OM (146° ± 18º and 57° ± 16°), and PDA/PLA (145° ± 19° and 59° ± 17°). In conclusion, large variabilities in optimal viewing angles existed for all main coronary bifurcations. The anatomy-defined bifurcation optimal viewing angle could not be reached in vivo in roughly half of the cases due to the mechanical constraints of the current X-ray systems. Obtainable bifurcation optimal viewing angle should be provided as an alternative or second best. The bifurcation angles in the left main bifurcation demonstrated the largest variabilities.
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Affiliation(s)
- Shengxian Tu
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Jing Jing
- Department of Cardiology, Chinese PLA General Hospital, No. 28 Fuxin Road, Haidian District, Beijing, 100853 China
| | - Niels R. Holm
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Kevin Onsea
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Tao Zhang
- Department of Cardiology, Chinese PLA General Hospital, No. 28 Fuxin Road, Haidian District, Beijing, 100853 China
| | - Tom Adriaenssens
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Dubois
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Walter Desmet
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Leif Thuesen
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Yundai Chen
- Department of Cardiology, Chinese PLA General Hospital, No. 28 Fuxin Road, Haidian District, Beijing, 100853 China
| | - Johan H. C. Reiber
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
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Agostoni P, Voskuil M, Onsea K, Vermeersch P, Stella P. Tools & Techniques: Percutaneous intervention of saphenous vein graft lesions. EUROINTERVENTION 2011; 7:878-879. [DOI: 10.4244/eijv7i7a136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Abstract
We present a case of iatrogenic left main coronary artery dissection, successfully treated by prompt bail-out stenting, and provide a brief discussion on its occurrence and treatment, as well as the immediate and long-term outcome of percutaneous coronary intervention, including our own single-centre experience, for this potentially catastrophic complication.
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Affiliation(s)
- K Onsea
- Department of Cardiology, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium,
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Onsea K, Van Cleemput J, Desmet W. Radiation induced cardiovascular disease. Acta Clin Belg 2011; 66:323-4. [PMID: 21938993 DOI: 10.2143/acb.66.4.2062579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- K Onsea
- Department of Cardiology, University Hospital Leuven, Leuven, Belgium.
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Onsea K, Dubois CL. The vulnerability of fractional flow reserve. Acta Cardiol 2011; 66:519-22. [PMID: 21894811 DOI: 10.1080/ac.66.4.2126603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kevin Onsea
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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Debonnaire P, Onsea K, Desmet W. Straddling thrombus through a patent foramen ovale secondary to saddle embolism. Acta Clin Belg 2011; 66:243. [PMID: 21837941 DOI: 10.2143/acb.66.3.2062560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- P Debonnaire
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
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Onsea K, Coosemans M. Resuscitation with a twist. Neth Heart J 2011; 19:262. [DOI: 10.1007/s12471-011-0123-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Adriaenssens T, Dens J, Ughi G, Coosemans M, Onsea K, Dubois C, Sinnaeve P, Vrolix M, Desmet W. Optical coherence tomography (OCT) in PCI for in-stent restenosis (ISR): rationale and design of the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) study. EUROINTERVENTION 2011; 7 Suppl K:K100-5. [DOI: 10.4244/eijv7ska17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- K Onsea
- Department of Cardiology, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium,
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Affiliation(s)
| | - Paul Herijgers
- Department of Cardiac surgery, University Hospitals Leuven, Leuven, Belgium
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Onsea K, Goetschalckx K, Bogaert J, Adriaenssens T. Anomalous right coronary artery causing inferior myocardial infarction, diagnosed on the occasion of a life-insurance medical exam. Acta Cardiol 2011; 66:255-7. [PMID: 21591588 DOI: 10.1080/ac.66.2.2071261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present a case of an anomalous right coronary artery (RCA) originating from the opposite aortic sinus causing a transmural inferior myocardial infarction in a former competitive cyclist, followed by a brief discussion of the epidemiology, presentation, diagnosis and treatment of this coronary anomaly.
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Affiliation(s)
- Kevin Onsea
- Department of Cardiovascular medicine, University Hospitals Leuven, Leuven, Belgium
| | - Kaatje Goetschalckx
- Department of Cardiovascular medicine, University Hospitals Leuven, Leuven, Belgium
| | - Jan Bogaert
- Department of Cardiovascular medicine, University Hospitals Leuven, Leuven, Belgium
| | - Tom Adriaenssens
- Department of Cardiovascular medicine, University Hospitals Leuven, Leuven, Belgium
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Onsea K, Houthoofd S, Adriaenssens T. Ulnar and cerebellar embolization from an ulcerative subclavian artery lesion. Acta Cardiol 2010; 65:693-4. [PMID: 21302676 DOI: 10.1080/ac.65.6.2059867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kevin Onsea
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Sabrina Houthoofd
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Tom Adriaenssens
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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Affiliation(s)
- Kevin Onsea
- Department of Cardiology, University Hospital Leuven, Leuven, Belgium.
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Onsea K, Wisanto E, Van Lier D, Van de Werf F. Diagnostic work-up of cardiac amyloidosis. Acta Cardiol 2010; 65:487-488. [PMID: 20821947 DOI: 10.2143/ac.65.4.2053913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Kevin Onsea
- Dept. of Cardiology, University Hospitals Leuven, Leuven, Belgium.
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Affiliation(s)
- Kevin Onsea
- Department of Cardiology, UZLeuven Hospitals, Leuven, Belgium.
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Abstract
Sinus node dysfunction after surgical repair of an atrial septal defect is a rather uncommon complication. We report a case of protracted post-operative sinus node dysfunction which was managed successfully by oral theophyllines and 'watchful' waiting. This strategy could avoid placement of a permanent pacemaker in this patient group of younger age.
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Affiliation(s)
- Kevin Onsea
- Department of Cardiology, Virga Jesse Ziekenhuis, Hasselt, Belgium
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