In this thesis the surgical options for treatment of functional mitral regurgitation (MR) are described. In functional MR, the mitral valve has a normal anatomy, which distinguishes this type of... Show moreIn this thesis the surgical options for treatment of functional mitral regurgitation (MR) are described. In functional MR, the mitral valve has a normal anatomy, which distinguishes this type of insufficiency from organic MR. Regurgitation in functional MR is related to an abnormal geometry of the left ventricle, which can be the result of an infarction or ischaemia, or may be caused by another__intrinsic__disease of the myocardium. Based on aetiology, we can distinguish ischaemic and non-ischaemic functional MR. Patients with functional MR often present with signs and symptoms of heart failure. Current guidelines do not offer clear treatment algorithms for these patients, and an intervention on the mitral valve is often discouraged, mainly because of contradictory results from studies on surgical interventions on the valve. In this thesis, the role of surgery in the multidisciplinary treatment of patients with functional MR, typically associated with heart failure, is evaluated with regard to clinical and echocardiographic outcomes. The ultimate goal is to establish an individualised medico-surgical approach to this pathology. As such, this thesis results from close collaboration between the departments of Cardiothoracic Surgery and Cardiology of the Leiden University Medical Center. Show less
It is the underlying substrate determining ventricular tachycardia (VT) characteristics. Understanding the VT substrate in different diseases and individual patients is crucial. Catheter ablation... Show moreIt is the underlying substrate determining ventricular tachycardia (VT) characteristics. Understanding the VT substrate in different diseases and individual patients is crucial. Catheter ablation can abolish the substrate and plays an increasingly important role in the treatment of VT. This thesis studies the determinants for the substrate causing VT, the VT characteristics and outcome specifically after catheter ablation in patients with structural normal hearts, after myocardial infarction and with cardiomyopathies. Furthermore it is shown that integration of imaging, like magnetic resonance imaging and computed tomography, with catheter mapping is feasible. The use of new mapping criteria and integration of imaging techniques may facilitate successful catheter ablation. Show less
