Bettina Marty

University Hospital of Lausanne, Lausanne, Vaud, Switzerland

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Publications (63)128.09 Total impact

  • Bettina Marty
    No preview · Article · Sep 2010 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery
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    Bettina Marty · Bernhard Egger
    Full-text · Article · Sep 2009 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery
  • [Show abstract] [Hide abstract] ABSTRACT: : Intravascular ultrasound (IVUS) generates high definition circumferential cross-sectional images and provides real-time readout of vascular dimensions, including visualization of vessel branches. We have used it as an alternative to angiography in the endovascular thoracic aneurysm repair work-up. : Out of consecutive 203 patients with descending thoracic aortic aneurysm, 89 (43.8%) received endovascular treatment [mean age, 68 ± 8 years; range, 29-82; male, 79 (88.7%); female, 10 (11.3%)] without using angiography during the endovascular procedure. IVUS (6 F, 12.5 MHz probe or 10 F 9 MHz) coupled with fluoroscopy for the placement of radiopaque markers was used for target site identification, landing zone measurement, device positioning, and assessment of endovascular repair. : Hospital mortality was 4/89 (4.5%). Number of devices implanted in each patient was 1.2 (range, 1-3). X-ray exposure time was 12 ± 8 minutes. Median procedure time was 63 ± 20 minutes. Conversion to open surgery was necessary in one patient (1.1%) because of aortic dissection. In nine patients (10.1%) left subclavian artery was covered because of a short neck. Two patients (2.2%) had vascular access lesions and required surgical repair. One patient developed paraplegia (1.1%). Early endoleak was observed in eight patients (8.9%) and 4 (4.5%) required additional procedures (proximal or distal extensions). Late conversion was necessary in one patient (1.1%). : IVUS provides all information necessary for device selection, target site identification as well as safe and correct deployment of thoracic endoprostheses and makes periprocedural angiography unnecessary, thus avoiding the risk of renal failure because of contrast medium.
    No preview · Article · Jan 2009 · Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery
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    Bettina Marty
    Preview · Article · Sep 2008 · European Journal of Cardio-Thoracic Surgery
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    Bettina Marty
    Preview · Article · Aug 2008 · European Journal of Cardio-Thoracic Surgery
  • [Show abstract] [Hide abstract] ABSTRACT: The hybrid treatment of aortic aneurysms is indicated in patients having the ostia of supra aortic or visceral branches taken in to the aneurysm. Indeed, these lesions are not eligible for classic endovascular treatment because the existing endoprostheses cannot provide perfusion of the side branches without inducing major endoleaks. The surgical technique consists of 2 steps: firstly, a by-pass between normal aorta and the major aortic branches involved in the aneurysm is performed to guarantee the perfusion of the organs such as brain, bowel, and after endoprosthesis deployment. Secondly, the endoprosthesis is deployed using the classical technique to isolate the aneurysm. The hybrid approach provides safe and reliable treatment of complex aortic aneurysms with mortality and morbidity rate far below the classical open surgery.
    No preview · Article · Apr 2008 · Revue médicale suisse
  • [Show abstract] [Hide abstract] ABSTRACT: Stents have a long history in traditional valve surgery as both, porcine biological valves as well as pericardial valves are mounted on stents prior to implantation. Recently stent-mounted biological devices have been compressed up to the point, where they can be passed through a catheter. Various routes can be distinguished for implantation: open access, the trans-vascular route in antegrade or retrograde fashion, as well as direct trans-apical or trans-atrial access. Direct access has the potentialforvideo-endoscopic valve replacement. In theory, as well as in the experimental setting, valved stents have been implanted in tricuspid and caval position respectively, as well as in pulmonary, mitral and aortic locations. The largest clinical experience has been achieved in pulmonary position whereas current efforts target the aortic position.
    No preview · Article · Apr 2008 · Revue médicale suisse
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    Bettina Marty
    Preview · Article · Mar 2008 · European Journal of Cardio-Thoracic Surgery
  • [Show abstract] [Hide abstract] ABSTRACT: To review a single-institution experience with endovascular repair of acute traumatic aortic rupture (ATAR) performed on an emergency basis using intravascular ultrasound (IVUS) exclusively as the navigation tool for stent-graft implantation (no arteriography). Between September 1998 and November 2006, 26 consecutive patients (19 men; mean age 38+/-19 years, range 15 to 83) underwent endovascular repair of ATAR performed by a surgical team using IVUS and fluoroscopy for lesion characterization and stent-graft deployment guidance. Transesophageal echocardiography was routinely used in all patients to visualize the aortic lesion and rule out residual flow after device deployment. Sealing of the aortic tear was evaluated by postoperative contrast-enhanced computed tomography. IVUS revealed an extensive disruption of the tunica intima and media (>180 degrees ) in 46% (12/26) of patients; the disruption was circumferential in 3 cases, with pseudocoarctation. The aortic diameter at the site of rupture measured 24+/-4 mm. Primary technical success was 92% (24/26); 1 persistent but small proximal endoleak and an intraoperative death (4% in-hospital mortality) from abdominal bleeding in an octogenarian accounted for the failures. Procedure-related complications (2, 8%) included the aforementioned endoleak and a minor stroke secondary to cerebral embolization. There was no paraplegia associated with the repairs. Endovascular repair of acute traumatic aortic disruption yields promising results, with high technical success and minimal procedure-related morbidity. IVUS as the primary navigation tool for device implantation allows prompt endovascular setup, instant aortic measurements, and precise visualization of the aortic disruption.
    No preview · Article · Oct 2007 · Journal of Endovascular Therapy
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    [Show abstract] [Hide abstract] ABSTRACT: Valved stents are new land for cardiac surgeons even though they are being used more frequently by interventional disciplines. This paper presents simple steps to build a patient-specific pulmonary valved stent and its delivery device. The design concept was tested by random participants at a med-tech meeting. The valved stent is constructed by linking an endoprosthetic graft with a valved-jugular-vein. The delivery device is made from a modified 5-ml syringe. Of 72 participants, 66 (92%) built and 60 participants implanted the device successfully into the targeted pulmonary position via a trans-infundibular access.
    Full-text · Article · Sep 2007 · Interactive Cardiovascular and Thoracic Surgery
  • [Show abstract] [Hide abstract] ABSTRACT: Between 1995 and 2005, the number of aortic aneurysms treated annually using endovascular techniques (EVAR) increased from 0 to 50, including all aortic stages. Our organization includes a large team of surgeons, a stock of three complete families of endoprostheses (straight, conical and bifurcated), a mobile trolley with accessories (arterial introducer/introducer sheath, guide wire, catheters, balloons, etc.) and an appliance on wheels for intravascular ultrasound examination (IVUS). This appliance, together with a mobile fluoroscopy device (c-arm), allows endovascular aneurysms analysis of every operating room in our institution, usually without angiography or the use of contrast medium. In general, we are therefore not depending on substantial preoperative imaging in order to identify candidates for endovascular aneurysms repair and can treat abdominal and thoracic aortic ruptures without delay. For endovascular aortic aneurysms repair we distinguish between process steps on the one hand (determining indications, imaging of the access vessels, measurement using IVUS and road mapping via fluoroscopy, selection of implant, implant insertion, positioning, setting the implant, determining success, reconstruction of the access vessel and follow-up) and the level of competence on the other (assistant, senior and directing physicians). Our ultrasound supported technique for endovascular aneurysms repair has been successfully brought to other hospitals using an IVUS transporter and telementoring.
    No preview · Article · Aug 2007 · Gefässchirurgie
  • No preview · Conference Paper · Jun 2007
  • B Marty · M Enzler
    No preview · Article · Mar 2007 · VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases
  • B Marty · M Depairon
    No preview · Article · Jun 2006 · Praxis
  • B. Marty · M. Depairon
    No preview · Article · May 2006 · Praxis
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    Bettina Marty
    Preview · Article · Jan 2006 · European Journal of Cardio-Thoracic Surgery
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    Full-text · Article · Jan 2006 · European Journal of Cardio-Thoracic Surgery
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    [Show abstract] [Hide abstract] ABSTRACT: Five years of experience with endovascular infrarenal aneurysm repair at our institution is reviewed. Implantation of endoprostheses in 88 patients has been performed by surgeons using exclusively intravascular ultrasound (IVUS) and fluoroscopy. IVUS identified the target site of deployment in all cases. In-hospital morbidity was 22% (19/88). Two percent mortality (2/88) and 5% early conversion (4/88) as a consequence of type I endoleaks were noted only in the first 53 patients with early devices (NS). Early endoleaks were present in 36% (32/88) including twenty-two type I, five type II and five type III endoleaks. Proximal endoleaks were associated with early devices (P<0.001), and technical difficulties with deployment. Tube grafts used in the beginning, performed poorly with 54% (7/13) type I endoleaks. Endoleaks diminished to 10% (9/88) by spontaneous closure and secondary endovascular procedures that were necessary in 24% (21/88) and consisted of coil embolization/cuff extension (9), late conversion (6), and limb recanalization or femoral cross-over bypass (6). Endovascular aneurysm repair using IVUS is a valid alternative technique. Improved devices and systematic use of bifurcated endoprostheses for infrarenal aneurysms reduce the occurrence of type I endoleaks.
    Preview · Article · Jun 2005 · Interactive Cardiovascular and Thoracic Surgery
  • [Show abstract] [Hide abstract] ABSTRACT: To explore the use of telementoring for distant teaching and training in endovascular aortic aneurysm repair (EVAR). According to a prospectively designed study protocol, 48 patients underwent EVAR: the first 12 patients (group A) were treated at a secondary care center by an experienced interventionist, who was training the local team; a further 12 patients (group B) were operated by the local team at their secondary center with telementoring by the experienced operator from an adjacent suite; and the last 24 patients (group C) were operated by the local team with remote telementoring support from the experienced interventionist at a tertiary care center. Telementoring was performed using 3 video sources; images were transmitted using 4 ISDN lines. EVAR was performed using intravascular ultrasound and simultaneous fluoroscopy to obtain road mapping of the abdominal aorta and its branches, as well as for identifying the origins of the renal arteries, assessing the aortic neck, and monitoring the attachment of the stent-graft proximally and distally. Average duration of telementoring was 2.1 hours during the first 12 patients (group B) and 1.2 hours for the remaining 24 patients (group C). There was no difference in procedural duration (127+/-59 minutes in group A, 120+/-4 minutes in group B, and 119+/-39 minutes in group C; p=0.94) or the mean time spent in the ICU (26+/-15 hours in group A, 22+/-2 hours in group B, and 22+/-11 hours for group C; p=0.95). The length of hospital stay (11+/-4 days in group A, 9+/-4 days in group B, and 7+/-1 days in group C; p=0.002) was significantly different only for group C versus A (p=0.002). Only 1 (8.3%) patient (in group A: EVAR performed by the experienced operator) required conversion to open surgery because of iliac artery rupture. This was the only conversion (and the only death) in the entire study group (1/12 in group A versus 0/36 in groups B + C, p=0.31). Telementoring for EVAR is feasible and shows promising results. It may serve as a model for development of similar projects for teaching other invasive procedures in cardiovascular medicine.
    No preview · Article · May 2005 · Journal of Endovascular Therapy
  • [Show abstract] [Hide abstract] ABSTRACT: The advent of stents has profoundly changed percutaneous transluminal coronary angioplasty (PTCA), peripheral transluminal artery angioplasty (PTA), and treatment strategies of numerous other problems. Similar developments can be observed for stent applications in peripheral vascular lesions, cerebro-vascular disease, and many other fields. With the advent of covered stent-grafts, aneurysm surgery, has been put up for competitive treatment approaches. Such new approaches are perceived as less invasive, and draw significant attention. Endovsacular aneurysm repair (EVAR) is here to stay. In addition new developments are coming in many ways and stent derived devices can by now be found everywhere in the cardio-vascular system. This includes stenosed vessels, aneurysmal vessels, diseased valves, all sorts of congenital heart defects, and even cardiopulmonary bypass. The key technologies and know-how for EVAR are available or can be made available in most cardio-vascular surgical units. Special interest in this field (clinical and/or experimental) can enhance recruitment of patients. The opposite is also true...
    No preview · Article · Jan 2005 · European Journal of Cardio-Thoracic Surgery

Publication Stats

456 Citations
128.09 Total Impact Points


  • 1996-2010
    • University Hospital of Lausanne
      • Service de chirurgie cardio-vasculaire (CCV)
      Lausanne, Vaud, Switzerland
    • Schulthess Klinik, Zürich
      Zürich, Zurich, Switzerland
  • 2009
    • Cantonal Hospital of Schwyz
      Schwyz, Schwyz, Switzerland