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Article ; Online: Reply to Gasparovic et al.

Knol, Wiebe G / Mahtab, Edris A F / Bogers, Ad J J C

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2022 Volume 62, Issue 4

Language	English
Publishing date	2022-03-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezac190
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Article ; Online: What to do with the equipoise?

Knol, Wiebe G / Papageorgiou, Grigorios / Mokhles, Mostafa M

European heart journal

2019 Volume 40, Issue 22, Page(s) 1815

MeSH term(s)	Computed Tomography Angiography ; Coronary Artery Disease ; Decision Making ; Humans
Language	English
Publishing date	2019-05-03
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehz176
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Zs.A 1563: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: A case report of an interrupted inferior vena cava and azygos continuation: implications for preoperative screening in minimally invasive cardiac surgery.

Knol, Wiebe G / Oei, Frans B / Budde, Ricardo P J / Ter Horst, Maarten

European heart journal. Case reports

2021 Volume 5, Issue 8, Page(s) ytab308

Abstract: Background: Femoral cannulation is commonly used in minimally invasive cardiac surgery to establish extracorporeal circulation. We present a case with a finding that should be evaluated when screening candidates for minimally invasive cardiac surgery.!## ...

Abstract	Background: Femoral cannulation is commonly used in minimally invasive cardiac surgery to establish extracorporeal circulation. We present a case with a finding that should be evaluated when screening candidates for minimally invasive cardiac surgery. Case summary: A 57-year-old male patient was scheduled for minimally invasive repair of the mitral and tricuspid valve and a MAZE procedure. During surgery there was difficulty advancing the venous cannula inserted in the right femoral vein. On transoesophageal echocardiography a guidewire advanced from the femoral vein was observed entering the right atrium from the superior vena cava. Despite inserting a second venous cannula in the jugular vein, venous drainage was insufficient for minimal invasive surgery. The approach was converted to a median sternotomy with bicaval cannulation. Re-examination of the preoperative computed tomography (CT) scan showed an interrupted inferior vena cava (IVC) with azygos continuation. Discussion: In patients with major venous malformations such as the interrupted IVC with azygos continuation a full sternotomy is the preferred approach. The venous system should be evaluated when screening candidates for minimally invasive mitral valve surgery with preoperative CT. Additional cues to suspect interruption of the IVC are polysplenia and a broad superior mediastinal projection on the chest radiograph, mimicking a right paratracheal mass.
Language	English
Publishing date	2021-07-29
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytab308
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Article ; Online: Intimal aortic atherosclerosis in cardiac surgery: surgical strategies to prevent embolic stroke.

Knol, Wiebe G / Budde, Ricardo P J / Mahtab, Edris A F / Bekkers, Jos A / Bogers, Ad J J C

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2021 Volume 60, Issue 6, Page(s) 1259–1267

Abstract: Objectives: Although the incidence of perioperative stroke after cardiac surgery gradually decreased over the last decades, there is much variation between centres. This review aimed to create a concise overview of the evidence on possible surgical ... ...

Abstract	Objectives: Although the incidence of perioperative stroke after cardiac surgery gradually decreased over the last decades, there is much variation between centres. This review aimed to create a concise overview of the evidence on possible surgical strategies to prevent embolic stroke in patients with intimal aortic atherosclerosis. Methods: The PubMed and EMBASE databases were searched for studies on surgical management of aortic atherosclerosis and the association with perioperative stroke in cardiac surgery, including specific searches on the most common types of surgery. Articles were screened with emphasis on studies comparing multiple strategies and studies reporting on the patients' severity of aortic atherosclerosis. The main findings were summarized in a figure, with a grade of the corresponding level of evidence. Results: Regarding embolic stroke risk, aortic atherosclerosis of the tunica intima is most relevant. Although several strategies in general cardiac surgery seem to be beneficial in severe disease, none have conclusively been proven most effective. Off-pump surgery in coronary artery bypass grafting should be preferred with severe atherosclerosis, if the required expertise is present. Although transcatheter aortic valve replacement is used as an alternative to surgery in patients with a porcelain aorta, the risk profile concerning intimal atherosclerosis remains poorly defined. Conclusions: A tailored approach that uses the discussed alternative strategies in carefully selected patients is best suited to reduce the risk of perioperative stroke without compromising other outcomes. More research is needed, especially on the perioperative stroke risk in patients with moderate aortic atherosclerosis.
MeSH term(s)	Aortic Diseases/complications ; Aortic Diseases/epidemiology ; Aortic Diseases/surgery ; Atherosclerosis/complications ; Atherosclerosis/surgery ; Embolic Stroke ; Humans ; Risk Factors ; Stroke/etiology ; Stroke/prevention & control ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome ; Tunica Intima/surgery
Language	English
Publishing date	2021-07-30
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezab344
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Article ; Online: Relapsing low-flow alarms due to suboptimal alignment of the left ventricular assist device inflow cannula.

Zijderhand, Casper F / Knol, Wiebe G / Budde, Ricardo P J / van der Heiden, Cornelis W / Veen, Kevin M / Sjatskig, Jelena / Manintveld, Olivier C / Constantinescu, Alina A / Birim, Ozcan / Bekkers, Jos A / Bogers, Ad J J C / Caliskan, Kadir

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2022 Volume 62, Issue 4

Abstract: Objectives: This retrospective study investigated the correlation between the angular position of the left ventricular assist device (LVAD) inflow cannula and relapsing low-flow alarms.: Methods: Medical charts were reviewed of all patients with ... ...

Abstract	Objectives: This retrospective study investigated the correlation between the angular position of the left ventricular assist device (LVAD) inflow cannula and relapsing low-flow alarms. Methods: Medical charts were reviewed of all patients with HeartMate 3 LVAD support for relapsing low-flow alarms. A standardized protocol was created to measure the angular position with a contrast-enhanced computed tomography scan. Statistics were done using a gamma frailty model with a constant rate function. Results: For this analysis, 48 LVAD-supported patients were included. The majority of the patients were male (79%) with a median age of 57 years and a median follow-up of 30 months (interquartile range: 19-41). Low-flow alarm(s) were experienced in 30 (63%) patients. Angulation towards the septal-lateral plane showed a significant increase in low-flow alarms over time with a constant rate function of 0.031 increase in low-flow alarms per month of follow-up per increasing degree of angulation (P = 0.048). When dividing this group using an optimal cut-off point, a significant increase in low-flow alarms was observed when the septal-lateral angulation was 28° or more (P = 0.001). Anterior-posterior and maximal inflow cannula angulation did not show a significant difference. Conclusions: This study showed an increasing number of low-flow alarms when the degrees of LVAD inflow cannula expand towards the septal-lateral plane. This emphasizes the importance of the LVAD inflow cannula angular position to prevent relapsing low-flow alarms with the risk of diminished quality of life and morbidity.
MeSH term(s)	Cannula ; Female ; Heart Failure/surgery ; Heart Ventricles ; Heart-Assist Devices ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-08-14
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezac415
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Article ; Online: Incidental findings on routine preoperative noncontrast chest computed tomography and chest radiography prior to cardiac surgery in the multicenter randomized controlled CRICKET study.

Knol, Wiebe G / den Harder, Annemarie M / de Heer, Linda M / Benke, Kálmán / Maurovich-Horvat, Pál / Leiner, Tim / Merkely, Béla / Krestin, Gabriel P / Bogers, Ad J J C / Budde, Ricardo P J

European radiology

2022 Volume 33, Issue 1, Page(s) 294–301

Abstract: Objective: To describe the prevalence and consequences of incidental findings when implementing routine noncontrast CT prior to cardiac surgery.: Methods: In the multicenter randomized controlled CRICKET study, 862 adult patients scheduled for ... ...

Abstract	Objective: To describe the prevalence and consequences of incidental findings when implementing routine noncontrast CT prior to cardiac surgery. Methods: In the multicenter randomized controlled CRICKET study, 862 adult patients scheduled for cardiac surgery were randomized 1:1 to undergo standard of care (SoC), which included a chest-radiograph, or an additional preoperative noncontrast chest CT-scan (SoC+CT). In this subanalysis, all incidental findings detected on the chest radiograph and CT-scan were analyzed. The influence of smoking status on incidental findings was also evaluated, adjusting for sex, age, and group allocation. Results: Incidental findings were observed in 11.4% (n = 49) of patients in the SoC+CT group and in 3.7% (n = 16) of patients in the SoC-group (p < 0.001). The largest difference was observed in findings requiring follow-up (SoC+CT 7.7% (n = 33) vs SoC 2.3% (n = 10), p < 0.001). Clinically relevant findings changing the surgical approach or requiring specific treatment were observed in 10 patients (1.2%, SoC+CT: 1.6% SoC: 0.7%), including lung cancer in 0.5% of patients (n = 4) and aortic dilatation requiring replacement in 0.2% of patients (n = 2). Incidental findings were more frequent in patients who stopped smoking (OR 1.91, 1.03-3.63) or who actively smoked (OR 3.91, 1.85-8.23). Conclusions: Routine CT-screening increases the rate of incidental findings, mainly by identifying more pulmonary findings requiring follow-up. Incidental findings are more prevalent in patients with a history of smoking, and preoperative CT might increase the yield of identifying lung cancer in these patients. Incidental findings, but not specifically the use of routine CT, are associated with delay of surgery. Key points: • Clinically relevant incidental findings are identified more often after a routine preoperative CT-scan, when compared to a standard of care workup, with some findings changing patient management. • Patients with a history of smoking have a higher rate of incidental findings and a lung cancer rate comparable to that of lung cancer screening trials. • We observed no clear delay in the time to surgery when adding routine CT screening.
Language	English
Publishing date	2022-07-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-022-09001-0
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Article ; Online: Leaflet Thickening and Motion After Transcatheter Aortic Valve Replacement: Design and Rationale of the Rotterdam Edoxaban Trial.

van Wiechen, Maarten P / El Azzouzi, Ikram / Knol, Wiebe G / Adrichem, Rik / Hokken, Thijmen W / Ooms, Joris F / de Ronde-Tillmans, Marjo J / Daemen, Joost / de Jaegere, Peter P / Hirsch, Alexander / Budde, Ricardo P J / Van Mieghem, Nicolas M

Cardiovascular revascularization medicine : including molecular interventions

2022 Volume 44, Page(s) 67–70

Abstract: Background: Multislice computed tomography (MSCT) may reveal hypo-attenuated leaflet thickening (HALT) and/or reduced leaflet motion (RELM) in approximately 15 % of patients after transcatheter aortic valve replacement (TAVR). These supposedly ... ...

Abstract	Background: Multislice computed tomography (MSCT) may reveal hypo-attenuated leaflet thickening (HALT) and/or reduced leaflet motion (RELM) in approximately 15 % of patients after transcatheter aortic valve replacement (TAVR). These supposedly thrombogenic phenomena may be associated with neurological events and increased transprosthetic gradients. It is unclear whether oral anticoagulant therapy -specifically a factor Xa inhibitor- could affect the incidence of HALT/RELM. Study design: The Rotterdam EDOXaban (REDOX) trial is an investigator-initiated, single-center, prospective registry in which 100 patients with no formal indication for oral anticoagulant drugs or dual antiplatelet therapy, will receive a 3-month treatment with edoxaban, followed by a MSCT to detect HALT/RELM. The primary endpoint is the incidence of HALT at 3-months follow-up. Secondary endpoints include the incidence of RELM at 3 months; change in transprosthetic gradients at 1 year and the clinical composite endpoint of all-cause death, myocardial infarction (MI), ischemic stroke, systemic thromboembolism, valve thrombosis and major bleeding (International Society on Thrombosis and Hemostasis [ISTH] definition) at 1 year follow up. The study is powered to demonstrate with 90 % statistical power and a 0.025 alpha a 4 % incidence of HALT with edoxaban as compared to the expected 15 % rate with an antiplatelet regimen and will enroll 100 patients to account for loss of follow-up or CT-drop out. Conclusion: The REDOX trial will investigate the short-term effect of an Xa-inhibitor on the incidence of HALT after TAVR. (ClinicalTrials.gov Identifier: NCT04171726).
MeSH term(s)	Humans ; Anticoagulants/adverse effects ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Factor Xa Inhibitors/adverse effects ; Heart Valve Prosthesis/adverse effects ; Platelet Aggregation Inhibitors/adverse effects ; Thrombosis/diagnostic imaging ; Thrombosis/etiology ; Thrombosis/prevention & control ; Transcatheter Aortic Valve Replacement/adverse effects
Chemical Substances	Anticoagulants ; edoxaban (NDU3J18APO) ; Factor Xa Inhibitors ; Platelet Aggregation Inhibitors
Language	English
Publishing date	2022-06-17
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	2212113-4
ISSN	1878-0938 ; 1553-8389
ISSN (online)	1878-0938
ISSN	1553-8389
DOI	10.1016/j.carrev.2022.06.011
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Article ; Online: The Bachmann bundle and interatrial conduction: comparing atrial morphology to electrical activity.

Knol, Wiebe G / Teuwen, Christophe P / Kleinrensink, Gert-Jan / Bogers, Ad J J C / de Groot, Natasja M S / Taverne, Yannick J H J

Heart rhythm

2018 Volume 16, Issue 4, Page(s) 606–614

Abstract: Background: The Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to ... ...

Abstract	Background: The Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to anatomical variations. Objectives: The goals of this study were to analyze different activation patterns and couple those wavefronts to epicardial morphological structures on cadaveric hearts. Methods: High-resolution epicardial mapping over BB during sinus rhythm was performed in 185 patients undergoing coronary artery bypass graft surgery. The epicardial atrial musculature was macroscopically examined in 19 postmortem dissected human hearts, which are different from those examined in the mapping study. The morphology of BB and surrounding interatrial connections were evaluated. Activation patterns were subsequently linked to morphological variance found in the dissected hearts. Results: Epicardial mapping showed that BB is activated in a right-to-left direction in the majority of patients. In almost one-third of patients, a wavefront emerging or entering in the middle of BB was also observed. In some patients, left-to-right activation of BB was observed. BB was macroscopically present in all postmortem hearts. In addition, a newly found posterosuperior bundle was consistently seen, joining BB from the posterior border over the interatrial groove. Other connections identified were the septopulmonary bundle and posterior interatrial connections. Conclusion: The morphological interatrial connections correspond to the interatrial pathways observed with high-resolution epicardial mapping of BB. Of these connections, BB and the posterosuperior bundle seem to be most consistent, both morphologically and electrophysiologically.
MeSH term(s)	Atrial Function/physiology ; Cadaver ; Coronary Artery Bypass ; Epicardial Mapping ; Female ; Heart Atria/anatomy & histology ; Humans ; Male
Language	English
Publishing date	2018-10-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2018.10.021
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Article ; Online: Preoperative Chest Computed Tomography Screening for Coronavirus Disease 2019 in Asymptomatic Patients Undergoing Cardiac Surgery.

Knol, Wiebe G / Thuijs, Daniel J F M / Odink, Arlette E / Maurovich-Horvat, Pál / de Jong, Pim A / Krestin, Gabriel P / Bogers, Ad J J C / Budde, Ricardo P J

Seminars in thoracic and cardiovascular surgery

2020 Volume 33, Issue 2, Page(s) 417–424

Abstract: Due to the outbreak of Severe Acute Respiratory Syndrome coronavirus (SARS-Cov-2), an efficient COVID-19 screening strategy is required for patients undergoing cardiac surgery. The objective of this prospective observational study was to evaluate the ... ...

Abstract	Due to the outbreak of Severe Acute Respiratory Syndrome coronavirus (SARS-Cov-2), an efficient COVID-19 screening strategy is required for patients undergoing cardiac surgery. The objective of this prospective observational study was to evaluate the role of preoperative computed tomography (CT) screening for COVID-19 in a population of COVID-19 asymptomatic patients scheduled for cardiac surgery. Between the 29th of March and the 26th of May 2020, patients asymptomatic for COVID-19 underwent a CT-scan the day before surgery, with reverse-transcriptase polymerase-chain reaction (RT-PCR) reserved for abnormal scan results. The primary endpoint was the prevalence of abnormal scans, which was evaluated using the CO-RADS score, a COVID-19 specific grading system. In a secondary analysis, the rate of abnormal scans was compared between the screening cohort and matched historical controls who underwent routine preoperative CT-screening prior to the SARS-Cov-2 outbreak. Of the 109 patients that underwent CT-screening, an abnormal scan result was observed in 7.3% (95% confidence interval: 3.2-14.0%). One patient, with a normal screening CT, was tested positive for COVID-19, with the first positive RT-PCR on the ninth day after surgery. A rate of preoperative CT-scan abnormalities of 8% (n = 8) was found in the unexposed historical controls (P > 0.999). In asymptomatic patients undergoing cardiac surgery, preoperative screening for COVID-19 using computed tomography will identify pulmonary abnormalities in a small percentage of patients that do not seem to have COVID-19. Depending on the prevalence of COVID-19, this results in an unfavorable positive predictive value of CT screening. Care should be taken when considering CT as a screening tool prior to cardiac surgery.
MeSH term(s)	COVID-19 ; Cardiac Surgical Procedures/adverse effects ; Humans ; Mass Screening ; SARS-CoV-2 ; Tomography, X-Ray Computed
Keywords	covid19
Language	English
Publishing date	2020-10-17
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1038278-1
ISSN	1532-9488 ; 1043-0679
ISSN (online)	1532-9488
ISSN	1043-0679
DOI	10.1053/j.semtcvs.2020.09.027
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Article ; Online: Screening for coronary artery disease in early surgical treatment of acute aortic valve infective endocarditis.

Knol, Wiebe G / Wahadat, Ali R / Roos-Hesselink, Jolien W / Van Mieghem, Nicolas M / Tanis, Wilco / Bogers, Ad J J C / Budde, Ricardo P J

Interactive cardiovascular and thoracic surgery

2020 Volume 32, Issue 4, Page(s) 522–529

Abstract: Objectives: In patients with unknown coronary status undergoing surgery for acute infective endocarditis (IE), the need to screen for coronary artery disease (CAD) and the risk of embolization during invasive coronary angiography (ICA) are debated. ... ...

Abstract	Objectives: In patients with unknown coronary status undergoing surgery for acute infective endocarditis (IE), the need to screen for coronary artery disease (CAD) and the risk of embolization during invasive coronary angiography (ICA) are debated. Coronary computed tomography angiography (CCTA) is a non-invasive alternative in these patients. We aimed to evaluate the safety and feasibility of ICA and CCTA to diagnose CAD, and the necessity to treat CAD to prevent CAD-related postoperative complications. Methods: In this single-centre retrospective cohort study, all patients with acute aortic IE between 2009 and 2019 undergoing surgery were selected. Outcomes were any clinically evident embolization after preoperative ICA, in-hospital mortality, perioperative myocardial infarction or unplanned revascularization and postoperative renal function. Results: Of the 159 included patients, CAD status was already known in 14. No preoperative diagnostics for CAD was done in 46/145, a CCTA was performed in 54/145 patients and an ICA in 52/145 patients. Significant CAD was found after CCTA in 22% and after ICA in 21% of patients. In 1 of the 52 (2%) patients undergoing preoperative ICA, a cerebral embolism occurred. The rate of perioperative myocardial infarction or unplanned revascularization in patients not screened for CAD was 2% (1 out of 46 patients). Conclusions: Although the risk of embolism after preoperative ICA is low, it should be carefully weighed against the estimated risk of CAD-related perioperative complications. CCTA can serve as a gatekeeper for ICA in most patients with acute aortic IE.
MeSH term(s)	Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Endocarditis ; Humans ; Infections ; Retrospective Studies
Language	English
Publishing date	2020-12-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivaa313
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