The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.

https://biblio.ugent.be/publication/5953422/file/5953443.pdf

Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC).

1. Place animal in induction chamber and anesthetize the mouse and ensure sedation. 2. Once the animal is sedated, move it to a nose cone for hair removal using cream. Only apply cream to the area of the chest that will be utilized for imaging. Once the hair is removed, wipe area with wet gauze to ensure all hair is removed. 3. Move the animal to the imaging platform and tape its paws to the ECG lead plates and insert rectal probe. Body temperature should be maintained at 36-37°C. During imaging, reduce anesthesia to maintain proper heart rate. If the animal shows signs of being awake, use a higher concentration of anesthetic.

人唾液天疱疮抗原的纯化

Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes.

Autores/Miembros del Grupo de Trabajo: Raimund Erbel (Coordinador) (Alemania), Victor Aboyans (Coordinador) (Francia), Catherine Boileau (Francia), Eduardo Bossone (Italia), Roberto Di Bartolomeo (Italia), Holger Eggebrecht (Alemania), Arturo Evangelista (Espana), Volkmar Falk (Suiza), Herbert Frank (Austria), Oliver Gaemperli (Suiza), Martin Grabenwoger (Austria), Axel Haverich (Alemania), Bernard Iung (Francia), Athanasios John Manolis (Grecia), Folkert Meijboom (Paises Bajos), Christoph A. Nienaber (Alemania), Marco Roffi (Suiza), Herve Rousseau (Francia), Udo Sechtem (Alemania), Per Anton Sirnes (Noruega), Regula S. von Allmen (Suiza) y Christiaan J.M. Vrints (Belgica)

2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases

Three-dimensional echocardiography in mitral valve assessment Using two-dimensional echocardiography, the complex anatomy of the mitral valve needs mental reconstruction into its three-dimensional shape. The power of both transthoracic and transesophageal three-dimensional echocardiography (3DE) lies in its possibility of showing the complex mitral valve anatomy in one single image, as opposed to themental reconstruction based on multiple two-dimensional images and schematic assumptions. Several 3DEmodalities are used in daily life, including real time (“live”) modes as wells as postprocessed images. 3DE is of special interest in the evaluation of mitral stenosis, complex mitral valve prolapse andmitral valve prostheses. It has an established role in the perioperative mitral valve assessment during mitral valve surgery as well as during percutaneous mitral valve procedures. Limitations of 3DE are relatively low frame rates, an important learning curve as well as timeconsuming processing.

/pdf/dreidimensionale-echokardiographie-zur-beurteilung-der-4y65hu1j8a.pdf

Dreidimensionale Echokardiographie zur Beurteilung der Mitralklappe

Zusammenfassung. Die Prävalenz von multivalvulären Herzerkrankungen ist bei TAVI (Transcatheter Aortic Valve Implantation)-Patientinnen und -Patienten hoch. Am häufigsten findet sich die Kombination Aortenklappenstenose (AS) und Mitralinsuffizienz, gefolgt von der Kombination AS und Trikuspidalinsuffizienz oder AS und Mitralstenose. Die Graduierung von multivalvulären Erkrankungen ist anspruchsvoll und führt oft zu einer Unterschätzung des Krankheitsstadiums. Daher ist ein profundes Wissen über die pathophysiologischen Zusammenhänge zentral, und die Patientinnen und Patienten sollten stets multimodal abgeklärt werden. Nach einer erfolgreichen TAVI können sich sekundäre zusätzliche Klappenprobleme verbessern, aber auch unbeeinflusst bleiben oder sich sogar verschlechtern. Die wissenschaftliche Datenlage bei multivalvulären Erkrankungen ist spärlich. Nicht zuletzt deshalb bleibt die Rolle des «Heart Teams» zentral, um Patientinnen und Patienten einen individuell angepassten Therapievorschlag unterbreiten zu können.

Transkatheter-Aortenklappenimplantation (TAVI) bei multivalvulären Herzerkrankungen

Transcatheter Aortic Valve Implantation in Multivalvular Heart Disease Abstract. The prevalence of multivaluvular heart disease is high in patients undergoing transcatheter aortic valve implantation (TAVI). The most common combination is aortic valve stenosis (AS) and mitral regurgitation, followed by the combination of AS with a tricuspid regurgitation or mitral stenosis. Grading of multivalvular disease is challenging and can quickly lead to underestimation of the disease stage. Therefore, a profound knowledge of pathophysiologic interactions is essential, and the patient should always undergo multimodal evaluation. After a successful TAVI intervention, secondary heart valve defects may improve, deteriorate, or remain unchanged. Due to the still sparse scientific data in this field, the role of the heart team remains central to provide the patient with an individually adapted therapy plan.

[Transcatheter Aortic Valve Implantation in Multivalvular Heart Disease].

OBJECTIVE
Transcatheter aortic valve implantation (TAVI) is an off-label procedure for selected patients at high surgical risk with native non- or mildly calcified aortic regurgitation (AR). Traditionally, self-expanding transcatheter heart valves (THV) have been favored over balloon-expandable THV's probably due to assumed better device fixation. We report a series of patients with native severe AR successfully treated with a balloon-expandable THV.


METHODS
Between 2019 and 2022, 8 consecutive patients (5 male, 82 (interquartile range 80-85) years old, STS PROM 4.0 % (interquartile range 2.9-6.0), EuroSCORE II 5.5% (IQR 4.1-7.0) with non- or mildly calcified pure AR were treated with a balloon-expandable THV. All procedures were performed after heart team discussion and standardized diagnostic workup. Clinical endpoints were collected prospectively and included device success, procedural complications (according to VARC-2 definitions) and 1-month survival.


RESULTS
Device success was 100% with no device embolization or migration. Two preprocedural nonfatal complications were reported (one access site complication that required stent implantation and one pericardial tamponade). Two patients required permanent pacemaker implantation for complete AV block. At discharge and at 30-day follow-up all patients were alive and no patient showed more than minimal AR.


CONCLUSION
This series documents that treatment of native non- or mildly calcified AR with balloon-expandable THV is feasible, safe and offers favorable short-term clinical outcomes. Hence, TAVI with balloon-expandable THVs may offer a valuable treatment option in patients with native AR at high surgical risk.

Transcatheter Aortic Valve Implantation With Balloon-Expandable Valve Prostheses in Patients With Pure Native Non- or Mildly Calcified Aortic Regurgitation: A Case-Series and Literature Review.

A 47-year-old man with a history of systemic hypertension and type 2 diabetes mellitus was admitted to our centre in cardiogenic shock. He experienced rapidly progressive shortness of breath for the past 3 weeks. The ECG on admission showed atrial flutter with 2:1 conduction and a ventricular rate of 142 b.p.m. ( Panel A ). Transoesophageal echocardiography prior to cardioversion ( Panels B and C , …

/pdf/triple-trouble-in-the-heart-4zhw5pdkzs.pdf

Patric Biaggi

Papers

Dreidimensionale Echokardiographie zur Beurteilung der Mitralklappe

Transkatheter-Aortenklappenimplantation (TAVI) bei multivalvulären Herzerkrankungen

[Transcatheter Aortic Valve Implantation in Multivalvular Heart Disease].

Transcatheter Aortic Valve Implantation With Balloon-Expandable Valve Prostheses in Patients With Pure Native Non- or Mildly Calcified Aortic Regurgitation: A Case-Series and Literature Review.

Triple trouble in the heart.