PubMed Health⌕ Search

Biomedical subjects

Yves Taeymans

Publications and source records attributed to Yves Taeymans.

11 recordsLinked to original sources
PubMed2005

Stentless vs. stented aortic valve replacement: left ventricular mass regression.

The aim of this retrospective study was to evaluate the time-related regression of left ventricular hypertrophy after stentless vs. stented aortic valve replacement. From January 1992 to December 2002, 145 patients had a Toronto stentless porcine valve and 106 had a stented Carpentier-Edwards aortic valve replacement. Over a 10-year follow-up, survival was superior in the Toronto group vs. the Carpentier-Edwards group (84% vs. 74% at 4 years; 78% vs. 68% at 6 years; p < 0.001). A significant and constant reduction of peak and mean transvalvular gradients after valve replacement resulted in substantial regression of left ventricular mass index in both groups, which did not reach statistical significance. However, this phenomenon stopped at 3 years, and left ventricular mass index increased slowly after 5 years. Stentless and stented bioprostheses both showed good early and late clinical and hemodynamic outcomes, with the advantage of better midterm survival for stentless xenografts.

Adult↗
PubMed2004

Patient doses in gamma-intracoronary radiotherapy: the Radiation Burden Assessment Study.

PURPOSE: To determine accurately the radiation burden of both patients and staff from intracoronary radiotherapy (IRT) with (192)Ir and to investigate the importance of IRT in the patient dose compared with interventional X-rays. METHODS AND MATERIALS: The Radiation Burden Assessment Study (RABAS) population consisted of 9 patients undergoing gamma-IRT after percutaneous transluminal coronary angioplasty and 14 patients undergoing percutaneous transluminal coronary angioplasty only as the control group. For each patient, the dose to the organs and tissues from the internal and external exposure was determined in detail by Monte Carlo N-particle simulations. Patient skin dose measurements with thermoluminescence dosimeters served as verification. Staff dosimetry was performed with electronic dosimeters, thermoluminescence dosimeters, and double film badge dosimetry. RESULTS: With respect to the patient dose from IRT, the critical organs are the thymus (58 mGy), lungs (31 mGy), and esophagus (27 mGy). The mean effective dose from IRT was 8 mSv. The effective dose values from interventional X-rays showed a broad range (2-28 mSv), with mean values of 8 mSv for the IRT patients and 13 mSv for the control group. The mean dose received by the radiotherapist from IRT was 4 microSv/treatment. The doses to the other staff members were completely negligible. CONCLUSION: Our results have shown that the patient and personnel doses in gamma-IRT remain at an acceptable level. The patient dose from IRT was within the variations in dose from the accompanying interventional X-rays.

Adult↗
PubMed2004

Novel use of a high-energy excimer laser catheter for calcified and complex coronary artery lesions.

This study was designed to evaluate safety and effectiveness of the 0.9 mm excimer laser coronary catheter with increased laser parameters. We report a prospective trial of 100 calcified and/or balloon-resistant lesions where a new 0.9 mm excimer laser catheter was used at standard or higher energy level to facilitate angioplasty. Standard in-hospital clinical and angiographic parameters were collected and measured. Laser technical success was obtained in 87 lesions (92%), procedural success was reached in 88 lesions (93%), and clinical success in 82 lesions (86%). Increased laser parameters were used for 29 resistant lesions. This new 0.9 mm excimer laser coronary catheter using higher energy parameters seems to be safe and effective for management of calcified and nondilatable lesions.

Aged↗
PubMed2004

Bovine glue (BioGlue) is catabolized by enzymatic reaction in the vascular dog model.

PURPOSE: The aim of the study is to explore the feasibility, patency, and histologic changes of a sutureless vascular anastomotic technique using biological glue as sole fixation method. DESCRIPTION: Eight mongrel dogs (+/-15 kg) underwent direct reanastomosis of their transsected iliac arteries. Both ends were placed on a 5-mm balloon and the anastomosis was secured with biological glue (BioGlue, Cryolife, Kennesaw, GA). No intravascular suture material was used. All survivors were angiographically controlled for patency after 6 weeks and 3 months. Then the animals were euthanized and tissues were obtained for histologic and pathologic examination by light and electron microscopy. EVALUATION: All procedures were successful except for 1 animal that died of uncontrollable bleeding at the anastomotic site. All first-time angiographically controlled grafts except three were patent. One animal showed manifest signs of fungal infection. Histology detected early granulocyte infiltration with an important enzymatic reaction adjacent to the surface of glue. Later on, the glue gradually regressed to disappear completely. Fibroblastic neointimal lining was noticed in most of the anastomoses, with some marked differences in the endothelium compared with normal. CONCLUSIONS: Good permeability (57%) was observed in this new sutureless anastomotic technique in the canine model. In contrast to previous reported studies we noticed a clear enzymatic breakdown of the glue before total disappearance. It is not yet known to what extend use of the bovine glue was responsible for this phenomenon.

Anastomosis, Surgical↗
PubMed2004

Prediction of the clinical performance of adult arterial cannulas.

The choice of an arterial cannula for cardiac surgery is often difficult. The clinician has to rely on the pressure-flow diagrams provided by the manufacturer that are all produced using water. The conversion of these water data to representative clinical conditions is often difficult if not impossible. In this in vivo study the theory of dynamic similarity is applied to scale the manufacturer's data to the clinical situation, in order to predict the pressure drop desired by the cardiac surgeon. Three hundred and forty-seven samples of pressure drop are obtained in 58 patients. Patients are grouped according to cannula size (20, 22, and 24 Fr). Very good correlation is found between measured and predicted values (r = 0.93; 0.86; 0.87 for 20; 22; 24 Fr). As a result, windows of optimal performance are constructed for each cannula diameter. This technique also allows the construction of an online recommendation for signaling abnormal cannula performance during cardiac surgery.

Adult↗
PubMed2003

Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: a case report.

Percutaneous vertebroplasty is increasingly used for the treatment of vertebral compression fractures. Local leakage of polymethylmethacrylate cement into the perivertebral space is a common complication, but important systemic effects have rarely been reported. The authors describe the case of a 52-year-old patient with central pulmonary embolism after percutaneous vertebroplasty of the eleventh thoracic vertebral body. The large cement embolus was removed from the right pulmonary artery with a hybrid technique combining an interventional catheter procedure with an open heart operation. The patient made an uneventful recovery. The authors review how appropriate arthroplasty techniques might minimize the risk of this dreadful complication.

Acenocoumarol↗
PubMed2003

Lower anticoagulation for mechanical heart valves: experience with the ATS bileaflet valve.

BACKGROUND: The design of the bileaflet ATS (ATS Medical Inc., Minneapolis, USA) mechanical valve incorporates an open pivot at the hinge mechanism. Total washout of the blood at the pivot area was observed using 3-D computational fluid dynamics modelling. This phenomenon could make the valve less vulnerable to clot formation in patients without major thromboembolic risk factors. METHODS: From January 1993 to June 1999, 286 consecutive patients had the ATS valve inserted in the aortic position. Patients were divided into two groups. Group 1 comprised all patients in regular sinus rhythm with good left ventricular function (144 patients). Group 2 included patients in non-sinus rhythm and/or with large hypocontractile left ventricles (142 patients). The anticoagulation regime in group 1 was used to obtain an international normalised ratio (INR) between 1.5 and 2.5. This contrasts with our regular aim to maintain the INR strictly between 2.5 and 3.5 for all mechanical valves, as achieved in group 2. RESULTS: The follow-up period (99% completeness) ranged from 18 to 84 months. Survival (Kaplan-Meier) was 97 and 98% and 92 and 81% at 1 and 5 years in group 1 and group 2, respectively (P = 0.12). Log rank analysis failed to detect a statistical difference in thromboembolism or bleeding between both groups (P > 0.05). However, trends were in favour of group 1. Univariate analysis selected poor ventricular function and an 'erratic' INR value (P = 0.002) as risk factors for death. The sole independent risk factor for bleeding was the use of aspirin (P = 0.025). CONCLUSIONS: The excellent group 1 data and outcome encouraged us to continue our low intensive anticoagulation regime and perhaps should be regarded as a new concept for treatment of selected mechanical valve patients.

Journal Article↗
PubMed2003

Fracture of a circular mapping catheter after entrapment in the mitral valve apparatus during segmental pulmonary vein isolation.

We report on the entrapment of a circular mapping catheter in the mitral valve apparatus during segmental pulmonary vein isolation. In an attempt to remove the catheter by using mild traction in combination with clockwise and counter-clockwise rotation, the circular part and the shaft of the catheter separated. The circular part could be removed without sequelae using a transseptally positioned vascular extraction nipper in combination with a basket catheter.

Adult↗
PubMed2003

Lower-intensity anticoagulation for mechanical heart valves: a new concept with the ATS bileaflet aortic valve.

BACKGROUND AND AIM OF THE STUDY: The design of the bileaflet ATS mechanical valve incorporates an open pivot at the hinge mechanism. Total washout of blood at the pivot area seen using three-dimensional computational fluid dynamics modeling may make the valve less vulnerable for clot formation in patients without major thromboembolic risk factors. METHODS: Between January 1993 and June 1999, the ATS valve was implanted in the aortic position in 286 consecutive patients. Patients were allocated prospectively to two groups: group 1 comprised patients in regular sinus rhythm with good left ventricular (LV) function (n = 144); group 2 included patients in non-sinus rhythm and/or with large hypocontractile left ventricles (n = 142). The anticoagulation regime in group 1 was to achieve an INR of 1.5-2.5, rather than to maintain INR strictly at 2.5-3.5 for mechanical valves (as in group 2). RESULTS: Follow up was 99% complete and ranged from 50 to 120 months. Survival (Kaplan-Meier) was respectively 95% and 90% and 90% and 83% at 2 and 5 years in favor of group 1 (p = 0.0055). Multivariate analysis selected advanced age, poor LV function and 'erratic' INR as risk factors for death. Log rank analysis failed to detect any statistical difference in thromboembolism. Bleeding occurred more frequently in group 2 (p = 0.018); independent risk factors for bleeding were the presence of aspirin (p = 0.0164) and advanced age (p = 0.02). CONCLUSION: The excellent group 1 data and outcome encouraged continuation of the low-intensity anticoagulation regime, and should be regarded as a new concept for the treatment of mechanical valve patients.

Aged↗
PubMedDate not supplied

Scanning electron microscopic surface topography of ablation catheter perforations and calcific tear in an explanted bioprosthetic heart valve.

The authors report a triplet of leaflet destruction in a bioprosthetic aortic valve explanted at 12 years after iatrogenic ablation catheter perforation in a patient who underwent coronary artery bypass surgery and multiple ablative procedures in the interim. Lesions were examined topographically by scanning electron microscopy. Calcium content was evaluated by mass spectrometry and Von Kossa staining. Leaflets exhibited little calcification, except at the commissures of the valve. Scanning electron microscopy revealed distinct lesion topography. The authors present the scanning electron microscopic characteristics of these lesions and of an incision into the valve made for comparison using a pair of scissors. This is believed to be the first report of scanning electron micrographs of ablation catheter perforations and a calcific tear in the same explanted valve. The findings provide a source for comparison in the etiological determination of explanted bioprosthetic valve lesions using scanning electron microscopy.

Aged↗