A5036341366- Congenital Heart Disease Studies
- Cardiac Arrhythmias and Treatments
- Cardiovascular Function and Risk Factors
- Cardiac Structural Anomalies and Repair
- Advanced MRI Techniques and Applications
- Tracheal and airway disorders
- Renal and Vascular Pathologies
- Cardiac Valve Diseases and Treatments
- Vascular anomalies and interventions
- Airway Management and Intubation Techniques
- Trauma Management and Diagnosis
- Liver Disease and Transplantation
- Esophageal and GI Pathology
- Congenital Diaphragmatic Hernia Studies
- Cardiac pacing and defibrillation studies
- Mechanical Circulatory Support Devices
- Cardiovascular and Diving-Related Complications
- Fluid Dynamics and Turbulent Flows
- Hemodynamic Monitoring and Therapy
- MRI in cancer diagnosis
- Coronary Artery Anomalies
Leiden University Medical Center
2018-2025
Erasmus University Rotterdam
2022
Erasmus MC
2022
Great Ormond Street Hospital
2014-2020
University College London
2014-2020
National Health Service
2014
Great Ormond Street Hospital for Children NHS Foundation Trust
2014
Valve (United States)
2014
Abstract Fontan-Associated Liver Disease (FALD) is a dramatically emerging problem even if not precisely defined in term of debated diagnosis and surveillance protocols. We analyze FALD prevalence, clinical impact implications European cohort patients. It’s retrospective observational multicenter study including Fontan patients operated between 1990 2022. Anatomical, clinical, surgical liver-related data were collected, defining as spectrum time-related structural–functional liver...
This study explores the relationship between in vivo 4D flow cardiovascular magnetic resonance (CMR) derived blood energetics total cavopulmonary connection (TCPC), exercise capacity and CMR-derived liver fibrosis/congestion. The Fontan circulation, which both caval veins are directly connected with pulmonary arteries (i.e. TCPC) is palliative approach for single ventricle patients. Blood efficiency TCPC has been associated fibrosis using computational fluid dynamic modelling. CMR allows...
Kidney disease is the most important predictor of death in patients with a Fontan circulation, yet its clinical and hemodynamic correlates have not been well established.
To date, it is not known if 16-20-mm extracardiac conduits are outgrown during somatic growth from childhood to adolescence. This study aims determine total cavopulmonary connection (TCPC) haemodynamics in adolescent Fontan patients at rest and simulated exercise assess the relationship between conduit size haemodynamics.Patient-specific, magnetic resonance imaging-based computational fluid dynamic models of TCPC were performed 51 with conduits. Power loss, pressure gradient normalized...
Our study describes and analyses the results from aortopexy for treatment of airway malacia in children.Demographic data, characteristics preoperative, operative outcome details, including need reintervention, were collected children undergoing between 2006 2016.One hundred patients [median age 8.2 months, interquartile range (IQR) 3.3-26.0 months] underwent aortopexy. Sixty-four (64%) had tracheomalacia (TM) only, 24 (24%) TM extending into their bronchus (tracheobronchomalacia) 11 (11%)...
Recent evidence suggests that conduits implanted in Fontan patients at the age of 2-4 years become undersized for adulthood. The objective this study is to use computational fluid dynamic models evaluate effect virtual expansion conduit on haemodynamics and energetics total cavopulmonary connection (TCPC) under resting conditions increased flow conditions.Patient-specific, magnetic resonance imaging-based simulation TCPC were performed during conditions. original 16-mm virtually enlarged 3...
This study aims to evaluate our 45-year experience with the Fontan procedure and identify risk factors for late mortality morbidity.Demographic, preoperative, perioperative postoperative characteristics were retrospectively collected all patients who underwent a in single centre between 1972 2016.The included 277 procedures (44 atriopulmonary connections, 28 Fontan-Björk, 42 lateral tunnels 163 extracardiac conduits). Early failure occurred 17 (6.1%). Median follow-up of cohort was 11.9...
To study flow-related energetics in multiple anatomical segments of the total cavopulmonary connection (TCPC) Fontan patients from four-dimensional (4D) flow magnetic resonance imaging (MRI), and to relationship between adverse patterns segment-specific energetics.Twenty-six extracardiac underwent 4D MRI TCPC. A segmentation TCPC was automatically divided into five [conduit, superior vena cava (SVC), right/left pulmonary artery (LPA), confluence]. The presence vortical arteries or confluence...
In patients with the Fontan circulation, systemic venous return flows passively towards lungs. Because of absence subpulmonary ventricle, favourable blood flow patterns minimal energy loss are clinically relevant. The region where inferior vena cava, hepatic veins and extracardiac conduit join (IVC–conduit junction) is a potential source increased loss. aim this study was to evaluate relationship between geometry in IVC–conduit junction associated kinetic using 4-dimensional magnetic...
The study objective was to analyze survival and incidence of Fontan completion patients with single-ventricle concomitant unbalanced atrioventricular septal defect.Data from 4 Dutch 3 Belgian institutional databases were retrospectively collected. A total 151 defect selected; 36 underwent an valve procedure (valve surgery group). End points survival, completion, freedom reoperation.Median follow-up 13.4 years. Cumulative 71.2%, 70%, 68.5% at 10, 15, 20 years, respectively. An not a risk...
Adequacy of 16-20mm extracardiac conduits for adolescent Fontan patients remains unknown. This study aims to evaluate conduit adequacy using the inferior vena cava (IVC)-conduit velocity mismatch factor along respiratory cycle.Real-time 2D flow MRI was prospectively acquired in 50 (16-20mm conduits) (mean age 16.9 ± 4.5 years) at subhepatic IVC, and superior cava. Hepatic venous determined by subtracting IVC from flow. The cross-sectional area (CSA) reported each vessel. Mean calculated...
Fontan patients require a balanced hepatic blood flow distribution (HFD) to prevent pulmonary arteriovenous malformations. Currently, HFD is quantified by tracking conduit flow, assuming venous (HV) be uniformly distributed within the conduit. However, this assumption may unvalid leading inaccuracies in quantification with potential clinical impact. The aim of study was (i) assess mixing HV and inferior vena caval (IVC) (ii) quantify directly quantitatively comparing results conventional...
Abstract Long scan times prohibit a widespread clinical applicability of 4D flow MRI in Fontan patients. As pulsatility the pathway is minimal during cardiac cycle, acquiring non-ECG gated 3D may result reduction time while accurately obtaining time-averaged parameters comparison with 2D and MRI. Thirty-two patients prospectively underwent (reference), pathway. Multiple were assessed from rates, including right-to-left pulmonary distribution (main endpoint) systemic-to-pulmonary collateral...
Abstract Pulmonary artery (PA) stenosis is a common complication after the arterial switch operation (ASO) for transposition of great arteries (TGA). Four-dimensional flow (4D flow) CMR provides ability to quantify within an entire volume instead single plane. The aim this study was compare PA maximum velocities and stroke volumes between 4D CMR, two-dimensional phase-contrast (2D PCMR) echocardiography. A prospective including TGA patients ASO performed December 2018 October 2020. All...
Summary Objectives This study describes the microbial colonization profile of airway in children after slide tracheoplasty (STP) with and without stents, compares to undergoing cardiothoracic surgical procedures related disease. Methods A 14‐year retrospective single case note review was performed on patients STP stent insertion. Nose throat (NT) bronchoalveolar lavage (BAL) specimens were analyzed for expressed as cumulative mean microorganisms per patient (MMP). Results Forty‐three (median...
Single ventricle patients with unrestrictive pulmonary blood flow and (potential) subaortic stenosis are challenging to manage optimal surgical strategy is unknown. Direct relief of by enlargement the ventricular septal defect and/or chamber has generally been replaced a Damus-Kaye-Stansel or Norwood procedure due concerns iatrogenic heart block, reobstruction, dysfunction. Studies reporting long-term outcome after direct approach limited. The aim our study was describe analyze experience in...