Robert Henderson

Robert Henderson
Nottingham University Hospitals NHS Trust · Trent Cardiac Centre

DM FRCP FESC FACC

About

142
Publications
19,663
Reads
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12,706
Citations
Citations since 2017
17 Research Items
6990 Citations
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201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
Additional affiliations
October 1995 - present
Nottingham University Hospitals NHS Trust
Position
  • Consultant cardiologist

Publications

Publications (142)
Article
Full-text available
Aims PFO closure is a percutaneous intervention, which aims to reduce risk of recurrent stroke by preventing paradoxical embolism. The objective of this study was to measure procedural safety and longer-term effectiveness of PFO closure in a UK setting. Methods and results Prospective registry data from patients with cryptogenic stroke eligible fo...
Article
Importance: Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement and is the treatment of choice for patients at high operative risk. The role of TAVI in patients at lower risk is unclear. Objective: To determine whether TAVI is noninferior to surgery in patients at moderately increase...
Article
Full-text available
Aims Non-valvular atrial fibrillation (AF) greatly increases the risk of ischaemic stroke. For people with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) provides a non-pharmacological management alternative. The aim of this study was to measure the procedural safety and longer-term effectiveness of LAAO for AF in...
Article
Full-text available
Aims Percutaneous mitral valve leaflet repair is a treatment option for some people with severe mitral valve regurgitation for whom conventional mitral valve surgery is clinically inappropriate. This study aimed to determine the safety, efficacy, and costs of percutaneous mitral valve leaflet repair, using the MitraClip device in a UK setting. Met...
Article
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Introduction New onset left bundle branch block (LBBB) is the most common conduction disturbance associated with transcatheter aortic valve implantation (TAVI). It has been shown to adversely affect cardiac function and increase re-hospitalisation, although its impact on mortality remains contentious. Methods We conducted an observational cohort a...
Article
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Background Over the last decade, transcatheter treatment of degenerative aortic valve stenosis has been established as an alternative to surgical aortic valve replacement. Late complications of transcatheter treatment of aortic stenosis (AS) are infrequent. Case summary We report an 87-year-old woman treated successfully with 23 mm Sapien 3 transap...
Article
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The Task Force on myocardial revascularization of the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association for Percutaneous Cardiovascular Interventions (EAPCI).
Article
To chart the development of pacing technology and its pitfalls we present the experience of a patient who has benefitted from it but also suffered as a result of it from its earliest days. A 53-year-old physician was referred to us with obstruction of the superior and inferior vena cava on a background of more than 50 years of continuous ventricula...
Article
The Oxford Textbook of Interventional Cardiology is the definitive text, spanning the whole spectrum of interventional cardiology procedures, including management of patients with coronary artery disease, one of the leading killers in western society. This textbook, covering key procedures and fully revised and updated to include the latest trials,...
Article
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Clinical practice guidelines summarize and evaluate all available evidence at the time of the writing process on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome as well as the risk–benefit ratio of particul...
Article
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These Guidelines represent the third time that the ESC and EACTS have brought together cardiologists and cardiac surgeons in a joint Task Force to review the ever-increasing body of evidence, with the mission of drafting balanced, patient-centred practice Guidelines on myocardial revascularization. Summaries of the key changes in comparison with th...
Article
Diagnosis of non-ST segment elevation acute coronary syndrome (NSTE-ACS) is based on clinical assessment, electrocardiogram and serum biomarker concentration. Diagnosis of myocardial infarction requires the detection of a rise of cardiac biomarker concentration with at least one value above the upper reference limit, and at least one feature of myo...
Article
Background: -Paravalvular leak (PVL) occurs in 5-17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. Methods: -All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data was analyzed for association with death and major adv...
Article
We report 2 new cases of transcatheter closure of iatrogenic ventricular septal defects after aortic valve replacement surgery, together with our finding, in a literature review, of 9 additional patients who had undergone this procedure from 2004 through 2013. In all 11 cases, transcatheter device closure was indicated for a substantial intracardia...
Article
Objective Studies reporting an association between treatment delay and outcome for patients with ST segment elevation myocardial infarction (STEMI) have generally not included patients treated by a primary percutaneous coronary intervention (PPCI) service that systematically delivers reperfusion therapy to all eligible patients. We set out to deter...
Article
Regulatory authorities interpret the results of randomized controlled trials according to published principles. The European Medicines Agency (EMA) is planning a revision of the 2000 and 2003 guidance documents on clinical investigation of new medicinal products for the treatment of acute coronary syndrome (ACS) to achieve consistency with current...
Article
Background Abnormal platelet function is associated with increased bleeding risk. Limited evidence suggests that platelet dysfunction is a cause of bleeding in patients with aortic stenosis (AS). Method 40 patients with degenerative AS underwent detailed haematological assessment. Platelet closure time (PCT) in seconds, was measured from a citrated...
Article
As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures rivaroxaban (Xarelto, Bayer) to submit evidence of the clinical and cost effectiveness of rivaroxaban for the prevention of adverse outcomes in patients after the acute management of acute coronary s...
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Background: In the Fractional flow reserve (FFR) versus angiography in guiding management to optimise outcomes in non-ST elevation myocardial infarction (FAMOUS) clinical trial, FFR was shown to significantly reduce coronary revascularisation, compared to visual interpretation of standard coronary angiography without FFR. We estimated the cost-eff...
Article
Background: The RITA-3 (Third Randomised Intervention Treatment of Angina) trial compared outcomes of a routine early invasive strategy (coronary arteriography and myocardial revascularization, as clinically indicated) to those of a selective invasive strategy (coronary arteriography for recurrent ischemia only) in patients with non-ST-segment ele...
Article
Full-text available
Acute ST-segment-elevation myocardial infarction (STEMI) results from complete obstruction to coronary artery blood flow accompanied by the appearance of ST-segment-elevation on the electrocardiogram. Emergency treatment is required to restore coronary perfusion, thereby limiting the extent of damage to the myocardium and the likelihood of early de...
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Aim We assessed the management and outcomes of non-ST segment elevation myocardial infarction (NSTEMI) patients randomly assigned to fractional flow reserve (FFR)-guided management or angiography-guided standard care. Methods and results We conducted a prospective, multicentre, parallel group, 1 : 1 randomized, controlled trial in 350 NSTEMI patie...
Article
Non-ST segment elevation acute coronary syndrome (NSTE-ACS) is a clinical diagnosis based on history, electrocardiogram and serum biomarker concentration. A diagnosis of myocardial infarction requires the detection of a rise and/or fall of cardiac biomarker concentration with at least one value above the upper reference limit, and at least one feat...
Article
Aortic root rupture during transcatheter aortic valve implantation (TAVI) is an uncommon but almost uniformly fatal complication. We describe a novel surgical management of this complication using a combination of pledgeted sutures and prolonged direct digital compression with biomatrix and lattice adjuncts. Furthermore, our patient underwent percu...
Article
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This is one of a series of occasional articles that highlight areas of practice where management lacks convincing supporting evidence. The series adviser is David Tovey, editor in chief, the Cochrane Library. To suggest a topic, please email us at practice@ bmj.com.
Article
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In patients with acute non-ST-elevation myocardial infarction (NSTEMI), coronary arteriography is usually recommended; but visual interpretation of the angiogram is subjective. We hypothesized that functional assessment of coronary stenosis severity with a pressure-sensitive guide wire (fractional flow reserve [FFR]) would have additive diagnostic,...
Article
The acute management of ST-segment-elevation myocardial infarction (STEMI) has seen significant changes in the past decade. Although the incidence has been declining in the UK, STEMI still gives rise to around 600 hospitalised episodes per million people each year, with many additional cases resulting in death before hospital admission.In-hospital...
Article
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The incidence of myocardial infarction has been declining in the UK over the past 25 years,1 2 but it varies between regions and still averages more than 600 hospitalised cases of ST-segment elevation myocardial infarction (STEMI) per million people each year.3 4 The case fatality rates after myocardial infarction have also fallen, which has been a...
Article
Objectives To report procedural outcome and short-term follow-up data for the Gore septal occluder (GSO), a new device for closure of patent foramen ovale (PFO). Background Transcatheter closure of PFO is an established treatment modality but no current device provides a perfect solution. The GSO has a number of design features, which make it poten...
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In order to optimise care of the adult patients with complex congenital heart disease, there is a need to develop recommendations for interventions. This document is the work of representatives of the three relevant societies and provides recommendations for institutions and operators performing cardiac interventions in these patients.
Data
CMR steady state free precession (SSFP) sequence showing pseudoaneurysm of the LV apex at the incision site.
Data
First pass gadolinium scan showing flow into the pseudoaneurysm.
Data
4 chamber view transthoracic echocardiogram of the LV showing colour flow in and out of the pseudoaneurysm.
Article
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Symptomatic severe aortic stenosis carries a two year survival of only 50%. However many patients are unsuitable for conventional aortic valve replacement as they are considered too high risk due to significant co-morbidities. Transcatheter Aortic Valve Implantation (TAVI) offers a viable alternative for this high risk patient group, either by the...
Article
### Diagnostic strategies The widespread application of specialist clinics for early evaluation of patients with chest pain has focused attention on the effectiveness of diagnostic testing. In a study of nearly 400 000 patients with suspected coronary artery disease, the diagnostic yield of cardiac catheterisation was only 37.6%, leading to calls...
Article
Stable angina is common. In England about 8% of men and 3% of women aged 55-64 years and about 14% of men and 8% of women aged 65-74 years have or have had angina.1 Stable angina is associated with a low but appreciable risk of acute coronary events and increased mortality. However, evidence exists of inconsistencies in management.2 This article su...
Article
Acute coronary syndromes (ACS) (unstable angina, non-ST elevation (NSTEMI) and ST-elevation myocardial infarction (STEMI)) are associated with a significant risk of adverse events, including recurrent myocardial ischaemia and infarction, bleeding complications and mortality. In the most recent report of the Myocardial Ischaemia National Audit Proje...
Article
Acute coronary syndromes are due to rupture or erosion of an atherosclerotic coronary artery plaque with superimposed platelet aggregation and coronary thrombosis. Complete thrombotic occlusion of a coronary artery generally causes acute ST-elevation myocardial infarction (STEMI), whereas incomplete occlusion will usually cause some myocardial necr...
Article
Patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) are at increased risk of adverse cardiovascular outcomes, particularly within the first few days of presentation. All patients should be risk stratified with an established risk scoring system (e.g. GRACE) to identify those who will benefit from evidence-based treatments. Patients w...
Chapter
Advances in the prevention and treatment of coronary heart disease (CHD) have led to significant improvements in prognosis and quality of life, but globally CHD remains a leading cause of premature death and disability. In 2001 CHD was responsible for 11.8% of all deaths in low- and middle-income countries and 17.3% in high-income countries, accoun...
Article
Background The optimal strategy for treating coronary bifurcation lesions remains a subject of debate. With bare-metal stents, single-stent approaches appear to be superior to systematic 2-stent strategies. Drug-eluting stents, however, have low rates of restenosis and might offer improved outcomes with complex stenting techniques. Methods and Resu...
Article
The optimal strategy for treating coronary bifurcation lesions remains a subject of debate. With bare-metal stents, single-stent approaches appear to be superior to systematic 2-stent strategies. Drug-eluting stents, however, have low rates of restenosis and might offer improved outcomes with complex stenting techniques. Patients with significant c...
Article
The Randomised Intervention Treatment of unstable Angina (RITA-3) found that non-ST-elevation myocardial infarction and unstable angina patients randomised to routine early arteriography experienced a lower rate of death or myocardial infarction than patients randomised to conservative therapy over a five year period of follow up. This paper uses d...
Article
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Evidence suggests that an early interventional strategy for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can improve health outcomes but also increase costs when compared with a conservative strategy. The aim of this study was to assess the cost-effectiveness of an early interventional strategy in different risk groups from a U...
Article
Aims: Excessive movement of coronary stents within the artery can make precise stent placement difficult. This study assessed the use of rapid right ventricular pacing to reduce stent motion to improve the accuracy of placement. Methods and results: During percutaneous coronary intervention, if excessive stent movement prevented accurate stent p...
Article
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To determine whether, in acute non-ST elevation coronary syndrome, the benefit from early invasive coronary intervention compared with a conservative strategy of later symptom-guided intervention varies over time. In RITA 3 (Randomised Intervention Trial of unstable Angina 3) patients were randomly assigned to coronary angiography (median 2 days af...
Article
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The appropriate treatment for patients in whom reperfusion fails to occur after thrombolytic therapy for acute myocardial infarction remains unclear. There are few data comparing emergency percutaneous coronary intervention (rescue PCI) with conservative care in such patients, and none comparing rescue PCI with repeated thrombolysis. We conducted a...
Article
The long-term outcome of an interventional strategy in patients with non-ST-elevation acute coronary syndrome is unknown. We tested whether an interventional strategy (routine angiography followed by revascularisation) was better than a conservative strategy (ischaemia-driven or symptom-driven angiography) over 5 years' follow-up. In a multicentre...
Article
We sought to compare the effects of an early interventional strategy (IS) versus a conservative strategy (CS) on health-related quality of life (HRQOL) in patients with non-ST-segment elevation acute coronary syndromes (ACS). The third Randomized Intervention Trial of unstable Angina (RITA-3) evaluated early IS (n = 895) versus CS (n = 915). We rep...
Article
OBJECTIVES: We sought to compare the effects of an early interventional strategy (IS) versus a conservative strategy (CS) on health-related quality of life (HRQOL) in patients with non-ST-segment elevation acute coronary syndromes (ACS). BACKGROUND: The third Randomized Intervention Trial of unstable Angina (RITA-3) evaluated early IS (n = 895) ver...
Article
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To examine the clinical effectiveness and cost-effectiveness of two alternative antiplatelet agents, clopidogrel and modified-release (MR)-dipyridamole, relative to prophylactic doses of aspirin for the secondary prevention of occlusive vascular events. Electronic databases. A total of 2906 titles and abstracts were rigorously screened and 441 stud...
Article
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To review systematically the clinical effectiveness and the cost-effectiveness of clopidogrel used in combination with standard therapy including aspirin, compared with standard therapy alone for the treatment of non-ST-segment elevation acute coronary syndromes (ACS). Electronic databases. Manufacturers' submissions. Studies were selected using ri...
Article
The RITA 3 trial randomized patients with non-ST-elevation myocardial infarction or unstable angina to strategies of early intervention (angiography followed by revascularization) or conservative care (ischaemia or symptom driven angiography). The aim of this analysis was to investigate the impact of gender on the effect of these two strategies. In...
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The anti-migraine agent sumatriptan sometimes causes chest tightness, presumed to be secondary to coronary artery spasm. Another proposed factor in coronary artery spasm is thyrotoxicosis. The combination may be hazardous.