Arnaud Van Linden

Goethe-Universität Frankfurt am Main · Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie

Durch das Fehlen der direkten intraoperativen Sicht auf die Aortenklappe ist die „Transkatheter-Aortenklappenimplantation“ (TAVI) maßgeblich von der standardisierten und präzisen Bildgebung abhängig. Die Echokardiographie dient der eigentlichen Diagnosestellung der Aortenklappenstenose. Zur präoperativen Planung ist die Computertomographie (CT) des...

Comparison of Tranexamic-Acid and Aprotinin regarding the outcome after cardiac surgery Aims: Postoperative bleeding ding is a major complication after cardiac surgery resulting in increased number of blood transfusions and re-thoracotomies with reported mortality-rates up to 22%. The antifibrinolytic-agent Aprotinin as a natural polypeptide is in...

Background: N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) levels correlate with higher peri-procedural mortality after transcatheter aortic valve replacement (TAVR). The long-term prognostic value of NT-proBNP within the first days after TAVR, however, remains unclear. This study examined early changes in NT-proBNP prior to and wit...

Symptomatic mitral regurgitation (MR) is the most common heart valve disease in western countries and cardiac surgery or catheter-based therapy requires a multidisciplinary treatment approach. The MR is etiologically subdivided into primary and secondary MR, which are subject to different treatment strategies. The introduction of catheter-based tre...

Background: The extent of aortic valve calcification is an important determinant of procedural success in transcatheter aortic valve implantation (TAVI). We sought to validate device landing zone calcium volume (DLZ-CV) measurements on contrast-enhanced multidetector computed tomography (MDCT) with non-contrast-enhanced scans as reference. Method...

BACKGROUND: N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) levels correlate with higher peri-procedural mortality after transcatheter aortic valve replacement (TAVR). The long-term prognostic value of NT-proBNP within the first days after TAVR, however, remains unclear. This study examined early changes in NT-proBNP prior to and with...

Background Modern supraannular aortic xenografts offer a special design, thus providing maximized opening area for improved hemodynamics. The aim of this study was a prospectively randomized comparison of the Trifecta and the Perimount Magna Ease valves based on metric annulus sizing. Methods A total of 100 patients with aortic stenosis undergoing...

Objectives: The aim of this study was to perform a comprehensive analysis of factors that affect procedural outcomes of transcatheter aortic valve replacement using the ACURATE neo prosthesis (Symetis/Boston, Ecublens, Switzerland). Background: Predictors of procedural outcomes using the ACURATE neo prosthesis are poorly understood. Methods: A...

Objectives: Due to increasing clinical experience with transcatheter aortic valve implantation (TAVI) procedures, sophisticated imaging and advanced device technology, TAVI complication rates are low; however, patients requiring conversion to surgery are confronted with an increased mortality risk. In this retrospective study, we evaluated the pre...

Background Device landing zone (DLZ) calcification is an important determinant of procedural success in transcatheter aortic valve implantation (TAVI). Objective To evaluate the impact of DLZ calcification on procedural outcome with different types of transcatheter heart valves (THVs). Methods Aortic valve calcium density (AVCdens) was determined b...

Aims: To validate the recently developed STS/ACC TAVR in-hospital mortality risk score for predicting in-hospital mortality and to compare its ability to predict 30-day mortality with that of four other established risk models (EuroScore I, EuroScore II, STS-PROM, and German AKL). Methods and results: The study cohort included 946 consecutive pa...

Zusammenfassung Unter der hybriden koronaren Revaskularisation (HCR) versteht man die kombinierte chirurgische und interventionelle Therapie der koronaren Herzkrankheit bei Patienten mit signifikanter koronarer Mehrgefäßerkrankung. Die HCR wurde als eine Alternative zur konventionellen koronaren Bypassoperation oder zur „multi-vessel“ perkutanen ko...

Background The aim of the present study was to investigate whether transfemoral implantation of the Acurate neo transcatheter heart valve without pre-dilation is feasible. Methods Between December 2014 and December 2016, 294 patients were treated with the Acurate neo prosthesis at our center. Of these, 72 cases were performed without pre-dilation....

Die transkatheter Aortenklappenimplantation (TAVI) ist ein relativ junges, jedoch nunmehr etabliertes Verfahren zur Behandlung von Patienten mit hochgradiger Aortenklappenstenose und hohem operativen Risiko. Ungeachtet der rasanten Fortschritte mit immer besser werdenden Resultaten, ist eine sorgfaltige Evaluation fur eine optimale Therapieplanung...

In the physiology of human handling, the hand always follows the eye. Hence, optimal vision is indispensable to perform surgery. With the advent of minimally invasive cardiac surgery, the unobscured direct vision was no longer possible, and therefore endoscopy was introduced to enable it. Advanced endoscopic techniques, as well as catheterbased int...

Objectives: The purpose of the present study was to investigate whether transfemoral implantation of the balloon-expandable Edwards SAPIEN 3 device without prior balloon valvuloplasty is feasible. Background: Transcatheter aortic valve implantation (TAVI) without predilatation may be advantageous and is feasible with various transcatheter heart...

Background Inverse associations between Body Mass Index (BMI) and Body Surface Area (BSA) with mortality in patients after Transcatheter Aortic Valve Implantation (TAVI) have been reported. This “obesity paradox” is controversial, and it remains unclear which parameter, BMI or BSA, is of greater prognostic value. The aim of this study was to invest...

Aims: Multislice computed tomography (MSCT) is recommended for annular sizing prior to transcatheter aortic valve implantation (TAVI), but it remains unclear whether systolic or diastolic reconstructions should be used and whether the effective annular diameter should be derived by area or perimeter. In this study these different approaches were c...

Transcatheter aortic valve implantation (TAVI) has emerged as an important treatment option for elderly patients with symptomatic aortic stenosis whose risk is too high or prohibitive for conventional surgery. Despite notable progress during the past decade, continuous efforts directed at further improvement of procedural safety and performance are...

Objectives: Treatment of aortic stenosis in patients with a small aortic annulus is challenging and patient prosthesis mismatch should be avoided. The aim of this study was to compare the early hemodynamic performance of 23 mm self-expanding (ACURATE S, Symetis Inc.) versus 23 mm balloon-expanding (SAPIEN 3, Edwards Inc.) transcatheter aortic valve...

Objectives: In the era of transcatheter aortic valve implantation we thought to analyze the outcome of conventional AVR in an all-comers population. Methods: Routine quality control data of all patients who underwent isolated AVR between January 2014 and August 2015 as elective or emergent procedures were evaluated. Results: A total of 405 patients...

Objective: Preballooning (PB) of the stenotic aortic valve can be considered common standard during transcatheter aortic valve implantation (T-AVI). Transcatheter aortic valve implantation without preballooning (noPB) using the Edwards SAPIEN XT prosthesis has been described previously. The aim of this study was to evaluate the outcomes of next-ge...

Transcatheter aortic valve implantation (T-AVI) has become the standard of care for high-risk patients suffering from severe aortic valve stenosis. More than 60,000 implants have been performed to date. While the first-generation T-AVI devices had some specific issues, the advancements in these first-generation devices and the development of second...

Several alternative transapical (TA) aortic prostheses for aortic valve implantation (AVI) have recently become available. Data directly comparing the performance of these different TA-AVI valves, however, are sparse. Therefore, we sought to analyse the performance of the better-established balloon-expandable SAPIEN XT™ valve system, and compare it...

Objectives: We aimed to investigate the diagnostic accuracy of a standardized computed tomography angiography (CTA) for the identification of significant coronary artery disease (CAD) in patients evaluated for transcatheter aortic valve implantation (TAVI). Background: The diagnostic performance of CTA for the detection of CAD in patients with a...

In the present report we describe our clinical experience using specific image-based decision making and anatomic considerations for transcatheter valve-in-valve (ViV) implantation in degenerated xenografts with their pericardial leaflets externally mounted around the stent (Mitroflow [SORIN Group, Milan, Italy] or Trifecta [St. Jude Medical, St Pa...

Objective: Strict outcome monitoring and research about newly adopted surgical techniques is important for quality control and medical progress. To ease this analytical process, we aimed to create an interactive tool allowing for real time analysis. Methods: Using the R statistical computing platform a secure web-based application for analysing arb...

Objectives: Recently, several alternative transapical aortic prostheses became available. Data directly comparing the performance of these different transapical transcatheter aortic valve implantation (TAVI) valves are sparse. Therefore, we sought to compare the long established balloon-expandable SAPIEN XT™ (Edwards Lifesciences Inc., Irvine, CA,...

Background Transcatheter aortic valve implantation (TAVI) without predilatation has fewer procedural steps and thereby potentially fewer complications. This has been demonstrated for the antegrade transapical access; however, whether TAVI can be safely performed without predilatation using the retrograde transfemoral route is unknown.HypothesisWe p...

Background: Myocardial injury after transcatheter aortic valve replacement (TAVR) is common, but its cause and relationship to the extent of myocardial tissue loss remain unclear. Objectives: This study sought to examine the incidence and degree of ischemic myocardial damage using cardiac magnetic resonance imaging and myocardial biomarkers in p...

Transapical aortic valve implantation (TA-AVI) using the Edwards SAPIEN™ prosthesis has evolved into a routine procedure for selected high-risk elderly patients. The recently introduced SAPIEN™ delivery system (Ascendra II+™) with an added nose cone seems to facilitate direct valve implantation without prior balloon valvuloplasty (BAV). Here, we re...

Objectives: Transvenous left ventricular leads (tLV) represents gold standard for cardiac resynchronization therapy (CRT) in adults. Epicardial left ventricular leads (eLV) represent an alternative if tLV implantation fails. Data concerning endurance, performance, impact of surgical access and optimal technical concept of eLV were recently publishe...

OBJECTIVES Precise measurements of aortic annulus dimensions are crucial for prosthesis size selection in patients undergoing transcatheter aortic valve implantation (TAVI). The so-called effective diameter (derived from area) measured in multislice computed tomography (MSCT) images has evolved to be the most precise measurement tool. Usually, the...

During the past years transcatheter aortic valve implantation (TAVI) has evolved to a standard technique for the treatment of high risk patients suffering from severe aortic stenosis. Worldwide the number of TAVI procedures is increasing exponentially. In this context both the transapical antegrade (TA) and the transfemoral retrograde (TF) approach...

During the past years TAVI has evolved to a standard technique for the treatment of high risk patients suffering from severe aortic stenosis. Worldwide the number of TAVI procedures is increasing exponentially. In this context both the transapical antegrade (TA) and the transfemoral retrograde (TF) approach are predominantly used and can be conside...

A 75-year-old woman with severe aortic stenosis (European System for Cardiac Operative Risk Evaluation I [EuroSCORE]: 25%; Society of Thoracic Surgeons Predicted Risk of Mortality [STS] score: 6.2%) received transcatheter aortic valve implantation (AVI) by our heart team. After left-sided mini-thoracotomy, the left ventricle (LV) was punctured. In...

Objective This study aimed to identify predictors of mortality in patients with out-of-hospital cardiac arrest (OHCA) undergoing in-hospital extracorporeal life support system (ECLS) treatment. Methods We retrospectively studied the characteristics and clinical outcomes of 28 patients (January 2010 and December 2011) with OHCA and veno-arterial...

Objectives: The aim of this study was to evaluate the initial and short-term results of a new apical access and closure device to facilitate and standardize the transapical (TA) approach to transcatheter aortic valve implantation (TAVI). Methods: The apical access, stabilization and closure (ASC™) device consists of three components: an introduc...

Conventional aortic valve replacement is the standard approach for treating aortic stenosis, it is performed via a full or partial sternotomy, and is associated with low risks for patients and with excellent long-term outcomes. This also holds true for octogenarians, if they present without relevant comorbidities. After resection of the calcified n...

Introduction: Precise imaging of the aortic annulus is crucial for proper patient selection and safe performance of transcatheter aortic valve implantation (TAVI). However, accurate and reproducible 3-dimensional measurement is not trivial and prone to certain sources of error. Aim of our study was to determine the variation of annular dimensions...

Background: Transcatheter aortic valve implantation (T-AVI) by using the Edwards SAPIEN (Edwards Lifesciences LLC, Irvine, California, United States) prosthesis is currently being performed by the implantation of valved stent into the aortic annulus without respecting the native commissural (rotational) orientation. Anatomical orientation may, how...

Aortic valve disease is the most frequent acquired heart valve lesion in humans. In western communities, approximately 90% of patients present with aortic stenosis (AS), predominantly of a calcific degenerative aetiology. The remaining approximately 10% of patients predominantly present with aortic valve incompetence.

Transapical aortic valve implantation (TA-AVI) has evolved as a treatment option for high-risk patients who have severe aortic stenosis. The aim of this study was to evaluate the feasibility of a novel apical closure device to allow for standardized apical access and closure. The Apica ASC system consists of three components: an introducer system,...

Objectives: Prosthesis-patient mismatch (PPM) is defined as a too small effective orifice area (EOA) of the prosthetic valve in relation to the patient's body size and has been documented to be related to adverse outcomes after conventional aortic valve replacement (AVR). Aim of this study was to analyze the incidence of PPM after transcatheter ao...

Transcatheter aortic valve implantation (T-AVI) is a closed heart procedure with lack of direct vision to the native valve. This makes precise imaging important before and during T-AVI. Aortic annulus diameter, distance between coronary ostia and aortic annulus, as well as conditions of the femoral and coronary arteries has to be preoperatively eva...

The precise sizing of the aortic annulus is crucial in order to select the most appropriate valve size for transcatheter aortic valve implantation (TAVI). Owing to the closed heart situation in TAVI, sizing has to be performed based on preoperative imaging when compared with direct sizing during conventional procedures. The aim of the study was to...

Objectives: Precise imaging is paramount during transcatheter aortic valve implantation (TAVI). Intraoperative rotational angiography followed by automatic segmentation and 3-dimensional reconstruction of the aortic root (DynaCT) is a new perioperataive imaging tool during TAVI. Aim of this study was to compare perioperative DynaCT to the current g...

Introduction: Several studies have shown a high incidence of embolic cerebral lesions in up to 84% after transcatheter implantation (T-AVI), leading to a clinical manifest stroke in 2–10%. The existence of aortic arch atheroma >4mm is known as a risk factor for spontaneous stroke. Our objective was to assess the relationship between the incidence o...

Objectives: Transcatheter aortic valve implantation (TAVI) using the antegrade transapical ventricular access has evolved to a safe and simple alternative approach to transfemoral (TF) valve implantation. The potential impact on left ventricular function after the apical access has not been evaluated yet. Aim of the prospective study was to access...