Patients, from neonates to elderly, in need of aortic root replacement have several surgical options for their problem. This thesis describes the outcomes after aortic root replacement with... Show morePatients, from neonates to elderly, in need of aortic root replacement have several surgical options for their problem. This thesis describes the outcomes after aortic root replacement with biological prostheses, focusing on the pulmonary autograft (Ross procedure) and a stentless porcine aortic root prosthesis. These outcomes can be used to inform patients, cardiologists and cardiac surgeons in the shared decision making process of prosthesis choice. Show less
Transcatheter heart valve interventions have transformed the outcomes of patients with valvular heart disease (VHD) who are unfavourable candidates for surgery. Technological advances have allowed... Show moreTranscatheter heart valve interventions have transformed the outcomes of patients with valvular heart disease (VHD) who are unfavourable candidates for surgery. Technological advances have allowed extension of these interventions to younger or lower risk patients and those with other forms of VHD and may in the future permit earlier treatment of VHD in less symptomatic patients or those with moderate disease. The balance of risks and benefits is likely to differ between lower and higher risk patients, and more evidence is needed to evaluate the net benefit of transcatheter technology in these groups As academic researchers clinicians industry and patient stakeholders collaborate to research these broader indications for transcatheter valve interventions, it is essential to address (i) device durability and deliverability, (ii) specific anatomical needs (e.g. bicuspid aortic valves, aortic regurgitation, mitral and tricuspid valve disease), (iii) operator training, and (iv) the reinforced importance of the multidisciplinary Heart Team. Show less
Wall, S.J. van der; Umans, V.A.W.M.; Schotten, J.; Keijzers, M.; Wolterbeek, R.; Jansen, E.K.; ... ; Vonk, A.B.A. 2016
The general introduction of this thesis outlines the epidemiology and the impact of aortic valve disease in the western world. The thesis further discusses the current and future role of advanced... Show moreThe general introduction of this thesis outlines the epidemiology and the impact of aortic valve disease in the western world. The thesis further discusses the current and future role of advanced cardiac imaging modalities, using 3D echocardiography and speckle tracking echocardiography strain imaging in the diagnostic and clinical management of patients with aortic regurgitation. In addition, the clinical applications of multimodality cardiac imaging in (transcatheter aortic valve implantation (TAVI) for the treatment of severe aortic stenosis will be discussed: from pre-procedural patient evaluation, to the understanding of complications post-TAVI such as paravalvular regurgitation, and the assessment and monitoring of patients after TAVI. Show less
