Stephan Schubert

Stephan Schubert
Herz- und Diabeteszentrum Nordrhein-Westfalen | HDZ NRW · Department of Pediatric Cardiology and Congenital Heart Disease

Professor
- Chefarzt / Klinikleiter - Vorstandvorsitzender Nationales Register für angeborene Herzfehler- - Studienleiter "MYKKE"-

About

222
Publications
12,239
Reads
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2,905
Citations
Citations since 2016
101 Research Items
1790 Citations
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Introduction
Cardiac Allograft Vasculopathy Pediatric Myocarditis and Cardiomyopathy Image Fusion for Interventional therapy
Additional affiliations
July 2020 - present
Herz- und Diabeteszentrum Nordrhein-Westfalen
Position
  • Head of Department
January 2000 - June 2020
Deutsches Herzzentrum Berlin
Position
  • Consultant
Description
  • Senior Physician

Publications

Publications (222)
Article
Full-text available
Coronary artery lesions represent rare conditions in pediatric congenital heart disease and mainly include coronary artery stenoses (CAS) or coronary artery fistulae (CAF). Due to the small vessel size, pediatric percutaneous coronary interventions (PCI) are demanding and studies concerning long-term results are missing. In this retrospective study...
Article
Full-text available
Background: Myocarditis can be associated with severe heart failure and is caused by different inflammatory and autoimmune responses. The aim of this study was to describe the immunological response in children with myocarditis by analyzing anti-beta-adrenergic receptor antibodies (anti-β-AR Abs). Methods: Sera of children who were hospitalized...
Article
Background Heart failure (HF) due to myocarditis might not respond in the same way to standard therapy as HF due to other aetiologies. The aim of this study was to investigate the value of endomyocardial biopsies (EMB) for clinical decision-making and its relation to the outcome of paediatric patients with myocarditis. Methods Clinical and EMB dat...
Article
Background Infective endocarditis (IE) after pulmonary valve replacements in congenital heart disease is a significant concern. This study aimed to identify specific long‐term risk factors for IE after percutaneous pulmonary valve implantation or surgical pulmonary valve replacement. Methods and Results All patients with congenital heart disease f...
Article
To assess the efficacy and safety of a breakable BabyStent to treat complex aortic coarctation (CoA) in early childhood. Although recommended in several guidelines, there is no approved aortic stent for young infants, because of the dilemma between two mandatory requirements: expandable up to adult size on the one hand, and small enough to fit thro...
Article
Full-text available
Background Cardiovascular magnetic resonance serves as a useful tool in diagnosing myocarditis. Current adult protocols are yet to be validated for children; thus, it remains unclear if the methods used can be applied with sufficient image quality in children. This study assesses the use of cardiovascular magnetic resonance in children with suspect...
Article
Background Transcatheter pulmonary valve (TPV) replacement (TPVR) has become the standard therapy for postoperative pulmonary outflow tract dysfunction in patients with a prosthetic conduit/valve, but there is limited information about risk factors for death or reintervention after this procedure. Objectives This study sought to evaluate mid- and...
Article
Background Cardiac allograft vasculopathy, the leading cause of graft failure in pediatric heart transplant recipients, is characterized by diffuse and concentric coronary intimal thickening. Early treatment yields better outcomes. While coronary angiography is the standard for cardiac allograft vasculopathy screening and diagnosis, it only identif...
Article
Background: Dextro-transposition of the great arteries (D-TGA) is a severe congenital heart defect which affects approximately 1 in 4,000 live births. While there are several reports of D-TGA patients with rare variants in individual genes, the majority of D-TGA cases remain genetically elusive. Familial recurrence patterns and the observation that...
Article
Background Covered stent implantation for treatment of coarctation of the aorta (CoA) is effective and can prevent aortic wall injury. Prospective studies with long-term follow-up, including imaging, are lacking. We report the acute and long-term outcomes for use of the Large Diameter Advanta V12 covered stent for treatment of native and recurrent...
Article
Full-text available
Aim Due to improved therapy in childhood, many patients with congenital heart disease reach adulthood and are termed adults with congenital heart disease (ACHD). ACHD often develop heart failure (HF) as a consequence of initial palliative surgery or complex anatomy and subsequently require advanced HF therapy. ACHD are usually excluded from trials...
Article
Objectives: We evaluated 4384 procedures performed between 1957 and 2018, collected in the National Register for Congenital Heart Defects, conducted on 997 patients with 1823 pulmonary valve replacements (PVRs), including 226 implanted via catheter [transcatheter valve (TCV)]. Main study targets are as follows: TCV benefit, valve type durability,...
Article
Full-text available
Background CNI-free immunosuppression with conversion to mTORi-based immunosuppression has been demonstrated to reduce CNI-toxicity and to exhibit anti-proliferative properties. However, the experience of CNI-free immunosuppression in paediatric heart transplantation is limited. Methods A retrospective analysis was conducted of 129 paediatric hear...
Article
Background: Endocarditis has emerged as one of the most impactful adverse events after transcatheter pulmonary valve replacement (TPVR), but there is limited information about risk factors for and outcomes of this complication. Objectives: The purpose of this study was to evaluate risk factors for and outcomes of endocarditis in a large multicen...
Article
Full-text available
Rationale and Aim: Infants with Congenital Heart Disease (CHD) are at risk for neurodevelopmental delays, emotional, social and behavioral difficulties. Hospitalization early in life and associated stressors may contribute to these challenges. Family-centered Care (FCC) is a health care approach that is respectful of and responsive to the needs and...
Chapter
Multimodal picture integration has been developed for improved visualization of interventional procedure in congenital and structural heart disease. 3D rotational angiography (3DRA) was used for that purpose in the past, and a 3D dataset was than imposed as an overlay for fluoroscopy. But 3DRA includes a 180° turn of the X-ray arm in order to gener...
Article
Background - Myocarditis is one of the most common causes leading to heart failure in children and a possible genetic background has been postulated. We sought to characterize the clinical and genetic characteristics in patients with myocarditis ≤18 years of age to predict outcome. Methods - A cohort of 42 patients (MYCPEDIG) with biopsy-proven myo...
Chapter
In this chapter, the unusual vascular access is described. Axillary, transhepatic, paravertebral, and iliac vascular access are demonstrated in order to perform cardiac catheterization or central line placement in patients with complex anatomic variation or thrombosis or stenosis of the central vessels.
Article
Full-text available
About ~50% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients is frequently unknown and a genetic contribution might be underes...
Article
Background Pharmacological stress testing can help to uncover pathological hemodynamic conditions and is, therefore, used in the clinical routine to assess patients with structural heart diseases such as aortic coarctation with borderline indication for treatment. The aim of this study was to develop and test a reduced-order model predicting dobuta...
Article
Full-text available
Interventional closure of congenital ventricular septal defects (VSD) is recording a continuous rise in acceptance. Complete atrioventricular block (cAVB) and residual shunting are major concerns during follow-up, but long-term data for both are still limited. We retrospectively evaluated the outcome of patients with interventional VSD closure and...
Article
Objectives: Fontan-associated liver disease (FALD) is a hallmark of the failing Fontan circulation, but no general classification of FALD severity exists. In this study, we propose a scoring system to grade the severity of FALD and analyse its applicability for evaluation of Fontan failure. Methods: From 2017 to 2019, a total of 129 successive F...
Article
Objective Protein-losing enteropathy is an infrequent but severe condition occurring after Fontan procedure. The multifactorial pathogenesis remains unclear and no single proposed treatment strategy has proven universally successful. Therefore, we sought to describe different treatment strategies and their effect on clinical outcome and mortality....
Article
Full-text available
Fontan-palliated patients are at risk for the development of Fontan-associated liver disease (FALD). In this study, we performed a detailed hemodynamic and hepatic assessment to analyze the incidence and spectrum of FALD and its association with patients' hemodynamics. From 2017 to 2019, 145 patients underwent a detailed, age-adjusted hepatic exami...
Article
Purpose Myocarditis is one major cause for the development of acute or chronic heart failure where immunosuppressive therapies are still divergently discussed. The aim of this study was to analyze cytokines in children with suspected myocarditis to describe their immunologic patterns and to reveal potential therapeutic targets. Methods Sera of chi...
Article
Full-text available
Objective We aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation. Design Cross-sectional study. Setting The study was conducted at two university medical centres, located in Berlin and Londo...
Article
Background: Endomyocardial biopsies (EMB) are the gold standard for the diagnosis of myocarditis in children and adults. The existing WHO/ISFC criteria for lymphocytic cell infiltrates by are based on the myocardium of adults. The aim of this study was to present a paediatric control cohort for the evaluation of inflammation in EMB of children. M...
Article
Full-text available
The underlying genetic mechanisms and early pathological events of children with primary cardiomyopathy (CMP) are insufficiently characterized. In this study we aimed to characterize the mutational spectrum of primary CMP in a large cohort of patients ≤18 years referred to a tertiary center. Eighty unrelated index patients with pediatric primary CM...
Article
Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear....
Article
Full-text available
Introduction: Exercise testing has become a diagnostic standard in the evaluation and management of heart disease. While different methods of exercise and pharmacological stress testing exist, only little is known about their comparability. We aimed to assess hemodynamic changes during dynamic exercise, isometric exercise, and dobutamine stress tes...
Article
Full-text available
Introduction: Exercise testing has become a diagnostic standard in the evaluation and management of heart disease. While different methods of exercise and pharmacological stress testing exist, only little is known about their comparability. We aimed to assess hemodynamic changes during dynamic exercise, isometric exercise and dobutamine stress test...
Article
Background: Transcatheter aortic and pulmonary valves have been used to treat stenosis or regurgitation after prior surgical tricuspid valve (TV) replacement or repair. Little is known about intermediate-term valve-related outcomes after transcatheter tricuspid valve replacement (TTVR), including valve function, thrombus, and endocarditis. Object...
Chapter
Multimodal picture integration has been developed for improvements of visualization of interventional procedure in congenital and structural heart disease. 3D rotational angiography (3DRA) was used for that purpose in the past, and a 3D dataset was than imposed as an overlay for fluoroscopy. But 3DRA includes a 180° turn of the X-ray arm in order t...
Article
Full-text available
Introduction: Until recently, two-dimensional (2D) angiography was the mainstay of guidance for percutaneous pulmonary valve implantation (PPVI). Recent advances in fusion software have enabled direct fusion of pre-intervention imaging, magnetic resonance imaging (MRI) or computed tomography (CT) scans, to create a reliable three-dimensional (3D)...
Article
Background Invasive peak‐to‐peak pressure gradients are the current clinical reference standard for assessing aortic coarctation. To obtain them, patients need to undergo arterial heart catheterization. Unless an intervention is performed, the procedure remains purely diagnostic, while the concomitant risks remain. Purpose To validate MRI‐based pr...
Article
Full-text available
Aims: Endomyocardial biopsies (EMBs) are performed infrequently in children owing to significant past complication rates and controversial discussions about the therapeutic value of results. The objective of this study is to investigate the safety and feasibility of EMBs for suspected myocardial disease in relation to their clinical value. Method...
Article
Objectives: This study sought to describe the initial findings from the International Pediatric Optical Coherence Tomography (OCT) registry in pediatric heart transplant recipients. Background: Cardiac allograft vasculopathy (CAV) is a common cause of late graft failure and mortality in pediatric heart transplant recipients. Early diagnosis may...
Article
Full-text available
Treatment of aneurysmal lesions in the context of coarctation of the aorta (CoA) is a challenging task and these lesions are rare in children. An 11‐year‐old boy was incidentally diagnosed with native CoA and concomitant complex aneurysmal lesions during medical check‐up for arterial hypertension. Pre‐catheterization imaging was performed with comp...
Article
Full-text available
Non-invasive three-dimensional (3D) imaging belongs in routine practice in diagnosis and treatment planning of many congenital and acquired cardiovascular defects. Improvements in the development of fusion imaging software have led to the introduction of 3D reconstructed images for guidance of various transcatheter therapies, with three-dimensional...
Article
Aims: The GORE® CARDIOFORM Septal Occluder (GSO) is a novel device designed for rapid and effective closure of patent foramen ovale (PFO) which has distinctive features making it suitable for a broad spectrum of anatomical variations. We report the procedural and 6 months follow-up results of the first prospective, multicenter study using GSO. Me...