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Article ; Online: Hypoattenuated Leaflet Thickening in Transcatheter and Surgical Aortic Valves.

Kefer, Joelle

Journal of the American College of Cardiology

2020 Volume 75, Issue 19, Page(s) 2443–2445

MeSH term(s)	Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Heart Valve Prosthesis/adverse effects ; Transcatheter Aortic Valve Replacement/adverse effects
Language	English
Publishing date	2020-05-14
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2020.03.048
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Article ; Online: Left Atrial Appendage: Unsuspected Connection With the Kidneys.

Kefer, Joelle

JACC. Cardiovascular interventions

2018 Volume 11, Issue 11, Page(s) 1084–1085

MeSH term(s)	Acute Kidney Injury ; Atrial Appendage ; Atrial Fibrillation ; Humans ; Incidence ; Prognosis ; Stroke ; Treatment Outcome
Language	English
Publishing date	2018-06-07
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2018.02.005
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Article ; Online: Treatment of a severe distal thoracic and abdominal coarctation with cutting balloon and stent implantation in an infant: From fetal diagnosis to adolescence.

Carbonez, Karlien / Kefer, Joëlle / Sluysmans, Thierry / Moniotte, Stephane

Health science reports

2022 Volume 5, Issue 3, Page(s) e625

Abstract: Background and aims: Abdominal coarctations are rare. Surgical treatment is difficult and requires re-interventions to adjust the graft material to patient growth. We report effective treatment by interventional catheterization in an infant with the ... ...

Abstract	Background and aims: Abdominal coarctations are rare. Surgical treatment is difficult and requires re-interventions to adjust the graft material to patient growth. We report effective treatment by interventional catheterization in an infant with the concern to allow adjustment for growth and prevention of vessel damage. Methods and results: After the diagnosis of abdominal coarctation at 27 weeks of gestation, an infant developed hypertension (170/70 mmHg) at 3 months of age despite medical therapy. Angio CT confirmed a 2 mm diameter, 2.3-cm-long coarctation of the descending aorta. At 4 months, a dilatation was performed using a 3 mm cutting balloon and a 5 mm Opta® balloon, Cordis®. Two noncovered Palmaz® Genesis™ XD PG1910P stents were required to keep the aortic lumen open. At 15 months, an Adventa™ V12 vascular 12 × 61 mm long covered stent was implanted to exclude an aneurysm which developed between the two stents. At 3 and 9.5 years, the stents were further dilated with a high-pressure balloon to reach 11 mm aortic diameter with no residual pressure gradient, and normal blood pressure. Conclusions: The use of cutting balloons and stent implantation is an effective way to relieve severe obstruction in middle aortic syndrome in neonates. The technical issues encountered were the need for a low profile sheath and material to avoid femoral artery damage, and the need to use stents that can be further expanded to adult size.
Language	English
Publishing date	2022-04-25
Publishing country	United States
Document type	Journal Article
ISSN	2398-8835
ISSN (online)	2398-8835
DOI	10.1002/hsr2.625
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Article: OLD-TAVR score to predict 2-year mortality in patients aged 75 years and more undergoing transcatheter aortic valve replacement.

de Terwangne, Christophe / Maes, Frédéric / Gilard, Isabelle / Kefer, Joëlle / Cornette, Pascale / Boland, Benoit

European geriatric medicine

2023 Volume 14, Issue 3, Page(s) 493–502

Abstract: Purpose: Decision-making on transcatheter aortic valve replacement (TAVR) in patients aged 75 years and older is complex. It could be facilitated by the identification of predictors of long-term mortality. This study aimed to identify predictors of 2- ... ...

Abstract	Purpose: Decision-making on transcatheter aortic valve replacement (TAVR) in patients aged 75 years and older is complex. It could be facilitated by the identification of predictors of long-term mortality. This study aimed to identify predictors of 2-year mortality to develop a 2-year mortality risk score. Methods: Cohort study of consecutive patients aged ≥ 75 years who underwent TAVR after a comprehensive geriatric assessment (CGA) at our university hospital between 2012 and 2019. Predictors of 2-year mortality were determined using multivariable Cox regression. A point-based predictive model was developed based on risk factors and subsequently internally validated by fivefold cross-validation. Results: The 345 patients (median age 87 years, 54% women) were fit/vulnerable (32%), mildly frail (37%), or moderately/severely frail (31%). The overall 2-year mortality rate was 26%, predicted by atrial fibrillation, hemoglobin ≤ 10 g/dL, age ≥ 87 years, BMI ≤ 24, eGFR ≤ 50 ml/min, and moderate/severe frailty. The risk score (range 0-12), named OLD-TAVR score, for 2-year mortality showed good discriminative power (AUC 0.70) and remained consistent after fivefold cross-validation (cvAUC 0.69). A risk score ≥ 8 (prevalence 20%) predicted a 45% (95%CI: 34-58%) two-year mortality, with high specificity (86%) and good positive predictive power (+ LR 2.43). Conclusion: A 2-year mortality risk score (OLD-TAVR score) for very old patients undergoing TAVR was developed based on six bio-clinical items. A score ≥ 8 identified patients in whom 2-year mortality was very high and thereby the TAVR futile. Trial registration number and date of registration: Study protocol B403, 26/09/2022, retrospectively registered.
MeSH term(s)	Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Transcatheter Aortic Valve Replacement/adverse effects ; Cohort Studies ; Aortic Valve Stenosis/surgery ; Risk Assessment ; Treatment Outcome
Language	English
Publishing date	2023-05-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2556794-9
ISSN	1878-7657 ; 1878-7649
ISSN (online)	1878-7657
ISSN	1878-7649
DOI	10.1007/s41999-023-00794-x
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Article ; Online: Aortic Coarctation Stenting in Adolescents and Adults: A Single-Center Experience.

Colle, Arnaud / Enciso, Stéphane Kajingu / Brunee, Louise / Sluysmans, Thierry / Kefer, Joëlle / Astarci, Parla / Lacroix, Valerie / Elens, Maxime

Vascular and endovascular surgery

2023 Volume 57, Issue 8, Page(s) 863–868

Abstract: Purpose/background: The aim of this study was to evaluate the short and midterm results of aortic coarctation (AoCo) stenting in an adolescent and adult population.: Methods: All patients with a AoCo older than 14 years treated by stent placement ... ...

Abstract	Purpose/background: The aim of this study was to evaluate the short and midterm results of aortic coarctation (AoCo) stenting in an adolescent and adult population. Methods: All patients with a AoCo older than 14 years treated by stent placement between December 2000 and November 2016 were included in this study. Twenty-eight patients with an invasive peak systolic pressure gradient >20 mmHg were identified. Number of redilations, non-invasive systolic blood pressure, peak systolic pressure gradient, antihypertensive medication intake, claudication status and complications were evaluated. Results: Twenty-two covered and 6 uncovered stents were successfully placed. Peak systolic pressure gradient decreased immediately after stenting from a mean of 32 mmHg to 0 mmHg (± 7 mmHg). Mean AoCo diameter increased from 8 tot 16 mm (± 4 mm). Peripheral arterial injury was seen in 2 patients (7.1%). The mean follow-up time was 60 ± 49 months. Redilation of the stent was required in 4 patients, 2 to accommodate for growth and 2 for restenosis. Six (35%) patients could stop all antihypertensive medication. All claudicants (6/28) became and remained asymptomatic after surgery and during their follow-up. No aneurysms, stent fractures or dissections were noticed. There were 2 stent migrations during the first procedure with only 1 needing additional stent placement. Conclusion: Aortic coarctation stenting is a safe and effective treatment that significantly reduces the peak systolic pressure gradient. Antihypertensive medication can be reduced, and increase of walking distance in claudicants can be obtained. Younger patients may need more frequent reinterventions to accommodate for growth.
MeSH term(s)	Adult ; Humans ; Adolescent ; Aortic Coarctation/diagnostic imaging ; Aortic Coarctation/surgery ; Treatment Outcome ; Antihypertensive Agents/therapeutic use ; Stents ; Time Factors
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2023-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2076272-0
ISSN	1938-9116 ; 1538-5744
ISSN (online)	1938-9116
ISSN	1538-5744
DOI	10.1177/15385744231183476
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Zs.A 622: Show issues

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Article ; Online: Reduction of Lipid-Core Burden Index in Nonculprit Lesions at Follow-Up after ST-Elevation Myocardial Infarction: A Randomized Study of Bioresorbable Vascular Scaffold versus Optimal Medical Therapy.

Kefer, Joelle / Chenu, Patrick / Gurné, Olivier / Maes, Frederic / Tamakloé, Théophile / Beauloye, Christophe

Journal of interventional cardiology

2021 Volume 2021, Page(s) 5590093

Abstract: Background: Non-flow-limiting nonculprit lesions (NCL) that contain a large lipid-rich necrotic core (nonculprit lipid-rich plaques (NC-LRP)) are most likely to cause recurrent acute coronary syndrome after ST-elevation myocardial infarction (STEMI). ... ...

Abstract	Background: Non-flow-limiting nonculprit lesions (NCL) that contain a large lipid-rich necrotic core (nonculprit lipid-rich plaques (NC-LRP)) are most likely to cause recurrent acute coronary syndrome after ST-elevation myocardial infarction (STEMI). Near-infrared spectroscopy (NIRS) detects LRPs using the maximum 4 mm lipid-core burden index (maxLCBI Methods and results: In total, 33 non-flow-limiting NCLs from 29 STEMI patients were included in this study. Of these, 15 were LRPs and were randomly assigned to either the BVS + optimal medical therapy (OMT) arm (group 1; Conclusions: BVS + OMT and OMT appear as similarly safe and effective in reducing maxLCBI
MeSH term(s)	Absorbable Implants ; Coronary Angiography ; Follow-Up Studies ; Fractional Flow Reserve, Myocardial ; Humans ; Lipids ; Male ; Percutaneous Coronary Intervention/adverse effects ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/surgery ; Treatment Outcome
Chemical Substances	Lipids
Language	English
Publishing date	2021-07-01
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1155/2021/5590093
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Zs.A 2719: Show issues

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Article ; Online: Impact of Computational Modeling on Transcatheter Left Atrial Appendage Closure Efficiency and Outcomes.

De Backer, Ole / Iriart, Xavier / Kefer, Joelle / Nielsen-Kudsk, Jens Erik / Aminian, Adel / Rosseel, Liesbeth / Kofoed, Klaus Fuglsang / Odenstedt, Jacob / Berti, Sergio / Saw, Jacqueline / Søndergaard, Lars / Garot, Philippe

JACC. Cardiovascular interventions

2023 Volume 16, Issue 6, Page(s) 655–666

Abstract: Background: When performing transcatheter left atrial appendage (LAA) closure, peridevice leaks and device-related thrombus (DRT) have been associated with worse clinical outcomes-hence, their risk should be mitigated.: Objectives: The authors sought ...

Abstract	Background: When performing transcatheter left atrial appendage (LAA) closure, peridevice leaks and device-related thrombus (DRT) have been associated with worse clinical outcomes-hence, their risk should be mitigated. Objectives: The authors sought to assess whether use of preprocedural computational modeling impacts procedural efficiency and outcomes of transcatheter LAA closure. Methods: The PREDICT-LAA trial (NCT04180605) is a prospective, multicenter, randomized trial in which 200 patients were 1:1 randomized to standard planning vs cardiac computed tomography (CT) simulation-based planning of LAA closure with Amplatzer Amulet. The artificial intelligence-enabled CT-based anatomical analyses and computer simulations were provided by FEops (Belgium). Results: All patients had a preprocedural cardiac CT, 197 patients underwent LAA closure, and 181 of these patients had a postprocedural CT scan (standard, n = 91; CT + simulation, n = 90). The composite primary endpoint, defined as contrast leakage distal of the Amulet lobe and/or presence of DRT, was observed in 41.8% in the standard group vs 28.9% in the CT + simulation group (relative risk [RR]: 0.69; 95% CI: 0.46-1.04; P = 0.08). Complete LAA closure with no residual leak and no disc retraction into the LAA was observed in 44.0% vs 61.1%, respectively (RR: 1.44; 95% CI: 1.05-1.98; P = 0.03). In addition, use of computer simulations resulted in improved procedural efficiency with use of fewer Amulet devices (103 vs 118; P < 0.001) and fewer device repositionings (104 vs 195; P < 0.001) in the CT + simulation group. Conclusions: The PREDICT-LAA trial demonstrates the possible added value of artificial intelligence-enabled, CT-based computational modeling when planning for transcatheter LAA closure, leading to improved procedural efficiency and a trend toward better procedural outcomes.
MeSH term(s)	Humans ; Prospective Studies ; Atrial Fibrillation ; Atrial Appendage/diagnostic imaging ; Artificial Intelligence ; Treatment Outcome ; Computer Simulation ; Cardiac Catheterization/adverse effects ; Echocardiography, Transesophageal
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2023.01.008
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Article: Inoperable severe aortic valve stenosis in geriatric patients: treatment options and mortality rates.

Paul, Julie / Kefer, Joëlle / Beeckmans, Marianne / Speybroeck, Niko / Boland, Benoit

Journal of geriatric cardiology : JGC

2018 Volume 15, Issue 11, Page(s) 703–707

Language	English
Publishing date	2018-11-26
Publishing country	China
Document type	Journal Article
ZDB-ID	2421391-3
ISSN	1671-5411
ISSN	1671-5411
DOI	10.11909/j.issn.1671-5411.2018.11.001
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Article ; Online: Transcatheter aortic valve implantation versus surgical aortic valve replacement in severe aortic stenosis patients at low surgical mortality risk: a cost-effectiveness analysis in Belgium.

Dubois, Christophe / Adriaenssens, Tom / Annemans, Lieven / Bosmans, Johan / Callebaut, Britt / Candolfi, Pascal / Cornelis, Kristoff / Delbaere, Alexis / Green, Michelle / Kefer, Joelle / Lancellotti, Patrizio / Rosseel, Michael / Shore, Judith / Van Der Heyden, Jan / Vermeersch, Sebastian / Wyffels, Eric

Acta cardiologica

2023 Volume 79, Issue 1, Page(s) 46–57

Abstract: Background: Transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 device has recently shown significant clinical benefits, compared to surgical aortic valve replacement (SAVR), in patients at low risk for surgical mortality (PARTNER 3 trial, ... ...

Abstract	Background: Transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 device has recently shown significant clinical benefits, compared to surgical aortic valve replacement (SAVR), in patients at low risk for surgical mortality (PARTNER 3 trial, NCT02675114). Currently in Belgium, TAVI use is restricted to high-risk or inoperable patients with severe symptomatic aortic stenosis (sSAS). This cost-utility analysis aimed to assess whether TAVI with SAPIEN 3 could lead to potential cost-savings compared with SAVR, in the low-risk sSAS population in Belgium. Methods: A previously published, two-stage, Markov-based cost-utility model was used. Clinical outcomes were captured using data from PARTNER 3 and the model was adapted for the Belgian context using cost data from the perspective of the Belgian National Healthcare System, indexed to 2022. A lifetime horizon was chosen. The model outputs included changes in direct healthcare costs, survival and health-related quality of life using TAVI versus SAVR. Results: TAVI with SAPIEN 3 provides meaningful clinical and cost benefits over SAVR, in terms of an increase in quality-adjusted life years (QALYs) of 0.94 and cost-saving of €3 013 per patient. While initial procedure costs were higher for TAVI compared with SAVR, costs related to rehabilitation, disabling stroke, treated atrial fibrillation, and rehospitalization were lower. The cost-effectiveness of TAVI over SAVR remained robust in sensitivity analyses. Conclusion: TAVI with SAPIEN 3 may offer a meaningful alternative intervention to SAVR in Belgian low-risk patients with sSAS, showing both clinical benefits and cost savings associated with post-procedure patient management.
MeSH term(s)	Humans ; Aortic Valve/surgery ; Aortic Valve Stenosis/surgery ; Belgium/epidemiology ; Constriction, Pathologic ; Cost-Effectiveness Analysis ; Quality of Life ; Transcatheter Aortic Valve Replacement ; Clinical Trials as Topic
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	390197-x
ISSN	1784-973X ; 0001-5385
ISSN (online)	1784-973X
ISSN	0001-5385
DOI	10.1080/00015385.2023.2282283
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Article ; Online: Antithrombotic Therapy Duration after Patent Foramen Ovale Closure for Stroke Prevention: Impact on Long-Term Outcome.

Kefer, Joelle / Carbonez, Karlien / Pierard, Sophie / Mouthuy, François-Pierre / Peeters, Andre / Hermans, Cedric / Lambert, Catherine / DeMeester, Christophe / Sluysmans, Thierry / Pasquet, Agnes

Journal of interventional cardiology

2022 Volume 2022, Page(s) 6559447

Abstract: Background: The optimal duration of antithrombotic therapy (ATT) after patent foramen ovale (PFO) closure remains under debate. This study sought to compare the clinical outcome of patients receiving antithrombotic agents for a short (6 months) versus ... ...

Abstract	Background: The optimal duration of antithrombotic therapy (ATT) after patent foramen ovale (PFO) closure remains under debate. This study sought to compare the clinical outcome of patients receiving antithrombotic agents for a short (6 months) versus extended (>6 months) period after the procedure. Methods: This was a retrospective cohort study using a propensity score matching analysis on 259 consecutive patients (131 males, 43 ± 10 years) undergoing PFO closure due to cryptogenic stroke, with complete follow-up (median duration of 10 [4-13] years). The outcome was compared between patients receiving short-term (Group short, Results: The PFO closure device was successfully implanted in all cases, with 3% of minor complications. After propensity score matching, there were no differences between Groups short and long in the rate of stroke (0.3 vs. 0.4% patient-year, Conclusions: Short-term (6 months) ATT after PFO closure did not impair the clinical outcome, with a preserved low rate of recurrent stroke (0.3% patient-year) and device thrombosis (0.2% patient-year) at 10-year follow-up.
MeSH term(s)	Male ; Humans ; Foramen Ovale, Patent/complications ; Foramen Ovale, Patent/surgery ; Fibrinolytic Agents/therapeutic use ; Secondary Prevention/methods ; Retrospective Studies ; Stroke/prevention & control ; Stroke/complications ; Treatment Outcome ; Septal Occluder Device/adverse effects ; Recurrence ; Cardiac Catheterization/adverse effects
Chemical Substances	Fibrinolytic Agents
Language	English
Publishing date	2022-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1155/2022/6559447
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