The Experts below are selected from a list of 381 Experts worldwide ranked by ideXlab platform

Saibal Kar - One of the best experts on this subject based on the ideXlab platform.

  • left atrial pressure is associated with iatrogenic atrial septal defect after Mitral Valve Clip
    Heart, 2019
    Co-Authors: Hiroki Ikenaga, Robert J Siegel, Saibal Kar, Atsushi Hayashi, Takafumi Nagaura, Satoshi Yamaguchi, Jun Yoshida, Florian Rader, Takahiro Shiota
    Abstract:

    Objectives Mitral Valve (MV) Clip procedure requires interatrial trans-septal puncture to access the left atrium (LA). Iatrogenic atrial septal defect (iASD) is not uncommon and may remain for a while. However, haemodynamic and echocardiographic determinants of persistent iASD are not well investigated. We sought to find haemodynamic and echocardiographic determinants of iASD after MV Clip. Methods A total of 131 patients with grades 3 to 4+ Mitral regurgitation who underwent MitraClip and completed invasive haemodynamic measurement, baseline, 1 month and approximately 12 months of transthoracic echocardiography (TTE) follow-up were retrospectively reviewed. Results TTE at 1 month showed persistent iASD in 57% (1M-iASD). Mean LA pressure after Clip was significantly higher in patients with 1M-iASD than patients without 1M-iASD (17±6 mm Hg vs 15±5 mm Hg, p=0.01). Among patients with 1M-iASD, 24 patients (35%) had persistent iASD at 12 months (12M-iASD). Mean LA pressure after Clip was significantly higher in patients with 12M-iASD than patients without 12M-iASD (19±6 mm Hg vs 16±6 mm Hg, p=0.04). Patients with 12M-iASD did not significantly differ from patients without 12M-iASD in terms of right heart enlargement, estimated systolic pulmonary artery pressure, New York Heart Association functional class and brain natriuretic peptide at 12 months. Logistic regression analysis, however, showed that mean LA pressure after Clip was significantly associated with persistent iASD at 12 months in patients with 1M-iASD even after adjustment for cardiac index after Clip and the prevalence of Mitral regurgitation ≥3+ at 12 months (OR 1.10 per 1 mm Hg, 95% CI 1.01 to 1.21, p=0.04). Conclusions Elevated LA pressure after MV Clip was associated with persistent iASD.

  • echocardiographic evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip insertion
    American Journal of Cardiology, 2012
    Co-Authors: Takeji Saitoh, Masaki Izumo, Azusa Furugen, Jun Tanaka, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar, Yoko Miyatafukuoka, Takahiro Shiota
    Abstract:

    The geometries and sizes of persistent iatrogenic atrial septal defects (IASDs) after transseptal puncture during catheter-based Mitral Valve Clip insertion (MVCI) have not been detailed. In this study, 11 IASDs were investigated in 10 patients who underwent MVCI using a guide catheter (24Fr proximally and 22Fr at the atrial septum). The diameters of the long and short axes and the area at maximum and minimum during a cardiac cycle were measured after MVCI using real-time 3-dimensional (RT3D) transesophageal echocardiography (TEE). A circular shape was assumed on 2-dimensional TEE, resulting in an area calculation of π × (dimension/2) 2 . The anatomic geometries of IASDs were visualized in a 3-dimensional en face view of the atrial septum. Furthermore, 1 month after MVCI, IASDs were evaluated using echocardiography. The IASDs had a variety of irregular geometries. The mean long-axis diameter was 1.0 ± 0.24 cm, the mean short-axis diameter was 0.51 ± 0.22 cm, and the mean area was 0.40 ± 0.24 cm 2 on RT3D TEE. The diameters and area changed significantly between the maximal and minimal values during the cardiac cycle. Importantly, 2-dimensional TEE underestimated the maximal diameters of IASDs (0.54 ± 0.17 vs 1.0 ± 0.24 cm by RT3D TEE, p 2 by RT3D TEE, p

  • the evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip repair two and three dimensional echocardiography study
    Journal of the American College of Cardiology, 2012
    Co-Authors: Takeji Saito, Masaki Izumo, Yoko Fukuoka, Azusa Furugen, Jun Tanaka, Kenji Harada, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar
    Abstract:

    Geometry and size of persistent iatrogenic atrial septal defect (IASD) after transseptal puncture during catheter-based Mitral Valve Clip repair (MVCR) has not been detailed. We investigated 11 lASDs in 10 patients who underwent MVCR using the guide catheter with 22-F at the atrial septum. The

  • utility of combined two dimensional and three dimensional transesophageal imaging for catheter based Mitral Valve Clip repair of Mitral regurgitation
    Journal of The American Society of Echocardiography, 2011
    Co-Authors: Saibal Kar, Takahiro Shiota, Simon Biner, Gila Perk, Asim M Rafique, James Slater, Asma Hussaini, Stanley Chou, Itzhak Kronzon
    Abstract:

    Background Catheter-based Mitral Valve Clip repair (CBMCR) is feasible for selected patients with Mitral regurgitation (MR). Two-dimensional (2D) transesophageal echocardiography (TEE) is the standard modality for evaluating MR and procedural guidance. Recently, real-time three-dimensional TEE became available. The aim of this study was to evaluate the value of combined 2D and three-dimensional TEE for CBMCR. In evaluating MR for CBMCR, the confidence of interpretation of 2D TEE was compared with that of combined imaging for the localization of major Valve pathology. In patients who underwent CBMCR, the outcomes and the duration of CBMCR were compared. Methods In this retrospective study, MR evaluation was performed by 2D TEE alone and by combined imaging in 80 and 57 patients, respectively. CBMCR was guided by 2D TEE alone in 20 patients and by combined imaging in 39 patients. Results Examination by combined imaging allowed en face visualization of Mitral Valve anatomy and MR jet origin. The confidence of interpretation by combined imaging was higher than for 2D TEE (1.1 ± 0.3 vs 1.8 ± 0.7, P P  = .035). Conclusions The use of combined imaging compared with 2D TEE alone appears to enhance the confidence of interpretation concerning Mitral pathology and catheter-Clip system location and may also reduce CBMCR time.

Takahiro Shiota - One of the best experts on this subject based on the ideXlab platform.

  • left atrial pressure is associated with iatrogenic atrial septal defect after Mitral Valve Clip
    Heart, 2019
    Co-Authors: Hiroki Ikenaga, Robert J Siegel, Saibal Kar, Atsushi Hayashi, Takafumi Nagaura, Satoshi Yamaguchi, Jun Yoshida, Florian Rader, Takahiro Shiota
    Abstract:

    Objectives Mitral Valve (MV) Clip procedure requires interatrial trans-septal puncture to access the left atrium (LA). Iatrogenic atrial septal defect (iASD) is not uncommon and may remain for a while. However, haemodynamic and echocardiographic determinants of persistent iASD are not well investigated. We sought to find haemodynamic and echocardiographic determinants of iASD after MV Clip. Methods A total of 131 patients with grades 3 to 4+ Mitral regurgitation who underwent MitraClip and completed invasive haemodynamic measurement, baseline, 1 month and approximately 12 months of transthoracic echocardiography (TTE) follow-up were retrospectively reviewed. Results TTE at 1 month showed persistent iASD in 57% (1M-iASD). Mean LA pressure after Clip was significantly higher in patients with 1M-iASD than patients without 1M-iASD (17±6 mm Hg vs 15±5 mm Hg, p=0.01). Among patients with 1M-iASD, 24 patients (35%) had persistent iASD at 12 months (12M-iASD). Mean LA pressure after Clip was significantly higher in patients with 12M-iASD than patients without 12M-iASD (19±6 mm Hg vs 16±6 mm Hg, p=0.04). Patients with 12M-iASD did not significantly differ from patients without 12M-iASD in terms of right heart enlargement, estimated systolic pulmonary artery pressure, New York Heart Association functional class and brain natriuretic peptide at 12 months. Logistic regression analysis, however, showed that mean LA pressure after Clip was significantly associated with persistent iASD at 12 months in patients with 1M-iASD even after adjustment for cardiac index after Clip and the prevalence of Mitral regurgitation ≥3+ at 12 months (OR 1.10 per 1 mm Hg, 95% CI 1.01 to 1.21, p=0.04). Conclusions Elevated LA pressure after MV Clip was associated with persistent iASD.

  • echocardiographic evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip insertion
    American Journal of Cardiology, 2012
    Co-Authors: Takeji Saitoh, Masaki Izumo, Azusa Furugen, Jun Tanaka, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar, Yoko Miyatafukuoka, Takahiro Shiota
    Abstract:

    The geometries and sizes of persistent iatrogenic atrial septal defects (IASDs) after transseptal puncture during catheter-based Mitral Valve Clip insertion (MVCI) have not been detailed. In this study, 11 IASDs were investigated in 10 patients who underwent MVCI using a guide catheter (24Fr proximally and 22Fr at the atrial septum). The diameters of the long and short axes and the area at maximum and minimum during a cardiac cycle were measured after MVCI using real-time 3-dimensional (RT3D) transesophageal echocardiography (TEE). A circular shape was assumed on 2-dimensional TEE, resulting in an area calculation of π × (dimension/2) 2 . The anatomic geometries of IASDs were visualized in a 3-dimensional en face view of the atrial septum. Furthermore, 1 month after MVCI, IASDs were evaluated using echocardiography. The IASDs had a variety of irregular geometries. The mean long-axis diameter was 1.0 ± 0.24 cm, the mean short-axis diameter was 0.51 ± 0.22 cm, and the mean area was 0.40 ± 0.24 cm 2 on RT3D TEE. The diameters and area changed significantly between the maximal and minimal values during the cardiac cycle. Importantly, 2-dimensional TEE underestimated the maximal diameters of IASDs (0.54 ± 0.17 vs 1.0 ± 0.24 cm by RT3D TEE, p 2 by RT3D TEE, p

  • utility of combined two dimensional and three dimensional transesophageal imaging for catheter based Mitral Valve Clip repair of Mitral regurgitation
    Journal of The American Society of Echocardiography, 2011
    Co-Authors: Saibal Kar, Takahiro Shiota, Simon Biner, Gila Perk, Asim M Rafique, James Slater, Asma Hussaini, Stanley Chou, Itzhak Kronzon
    Abstract:

    Background Catheter-based Mitral Valve Clip repair (CBMCR) is feasible for selected patients with Mitral regurgitation (MR). Two-dimensional (2D) transesophageal echocardiography (TEE) is the standard modality for evaluating MR and procedural guidance. Recently, real-time three-dimensional TEE became available. The aim of this study was to evaluate the value of combined 2D and three-dimensional TEE for CBMCR. In evaluating MR for CBMCR, the confidence of interpretation of 2D TEE was compared with that of combined imaging for the localization of major Valve pathology. In patients who underwent CBMCR, the outcomes and the duration of CBMCR were compared. Methods In this retrospective study, MR evaluation was performed by 2D TEE alone and by combined imaging in 80 and 57 patients, respectively. CBMCR was guided by 2D TEE alone in 20 patients and by combined imaging in 39 patients. Results Examination by combined imaging allowed en face visualization of Mitral Valve anatomy and MR jet origin. The confidence of interpretation by combined imaging was higher than for 2D TEE (1.1 ± 0.3 vs 1.8 ± 0.7, P P  = .035). Conclusions The use of combined imaging compared with 2D TEE alone appears to enhance the confidence of interpretation concerning Mitral pathology and catheter-Clip system location and may also reduce CBMCR time.

Robert J Siegel - One of the best experts on this subject based on the ideXlab platform.

  • left atrial pressure is associated with iatrogenic atrial septal defect after Mitral Valve Clip
    Heart, 2019
    Co-Authors: Hiroki Ikenaga, Robert J Siegel, Saibal Kar, Atsushi Hayashi, Takafumi Nagaura, Satoshi Yamaguchi, Jun Yoshida, Florian Rader, Takahiro Shiota
    Abstract:

    Objectives Mitral Valve (MV) Clip procedure requires interatrial trans-septal puncture to access the left atrium (LA). Iatrogenic atrial septal defect (iASD) is not uncommon and may remain for a while. However, haemodynamic and echocardiographic determinants of persistent iASD are not well investigated. We sought to find haemodynamic and echocardiographic determinants of iASD after MV Clip. Methods A total of 131 patients with grades 3 to 4+ Mitral regurgitation who underwent MitraClip and completed invasive haemodynamic measurement, baseline, 1 month and approximately 12 months of transthoracic echocardiography (TTE) follow-up were retrospectively reviewed. Results TTE at 1 month showed persistent iASD in 57% (1M-iASD). Mean LA pressure after Clip was significantly higher in patients with 1M-iASD than patients without 1M-iASD (17±6 mm Hg vs 15±5 mm Hg, p=0.01). Among patients with 1M-iASD, 24 patients (35%) had persistent iASD at 12 months (12M-iASD). Mean LA pressure after Clip was significantly higher in patients with 12M-iASD than patients without 12M-iASD (19±6 mm Hg vs 16±6 mm Hg, p=0.04). Patients with 12M-iASD did not significantly differ from patients without 12M-iASD in terms of right heart enlargement, estimated systolic pulmonary artery pressure, New York Heart Association functional class and brain natriuretic peptide at 12 months. Logistic regression analysis, however, showed that mean LA pressure after Clip was significantly associated with persistent iASD at 12 months in patients with 1M-iASD even after adjustment for cardiac index after Clip and the prevalence of Mitral regurgitation ≥3+ at 12 months (OR 1.10 per 1 mm Hg, 95% CI 1.01 to 1.21, p=0.04). Conclusions Elevated LA pressure after MV Clip was associated with persistent iASD.

  • echocardiography in transcatheter aortic Valve implantation and Mitral Valve Clip
    The Korean Journal of Internal Medicine, 2012
    Co-Authors: Robert J Siegel, Huai Luo
    Abstract:

    Transcatheter aortic Valve implantation and transcatheter Mitral Valve repair (MitraClip) procedures have been performed worldwide. In this paper, we review the use of two-dimensional and three-dimensional transesophageal echo for guiding transcatheter aortic Valve replacement and Mitral Valve repair.

  • echocardiographic evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip insertion
    American Journal of Cardiology, 2012
    Co-Authors: Takeji Saitoh, Masaki Izumo, Azusa Furugen, Jun Tanaka, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar, Yoko Miyatafukuoka, Takahiro Shiota
    Abstract:

    The geometries and sizes of persistent iatrogenic atrial septal defects (IASDs) after transseptal puncture during catheter-based Mitral Valve Clip insertion (MVCI) have not been detailed. In this study, 11 IASDs were investigated in 10 patients who underwent MVCI using a guide catheter (24Fr proximally and 22Fr at the atrial septum). The diameters of the long and short axes and the area at maximum and minimum during a cardiac cycle were measured after MVCI using real-time 3-dimensional (RT3D) transesophageal echocardiography (TEE). A circular shape was assumed on 2-dimensional TEE, resulting in an area calculation of π × (dimension/2) 2 . The anatomic geometries of IASDs were visualized in a 3-dimensional en face view of the atrial septum. Furthermore, 1 month after MVCI, IASDs were evaluated using echocardiography. The IASDs had a variety of irregular geometries. The mean long-axis diameter was 1.0 ± 0.24 cm, the mean short-axis diameter was 0.51 ± 0.22 cm, and the mean area was 0.40 ± 0.24 cm 2 on RT3D TEE. The diameters and area changed significantly between the maximal and minimal values during the cardiac cycle. Importantly, 2-dimensional TEE underestimated the maximal diameters of IASDs (0.54 ± 0.17 vs 1.0 ± 0.24 cm by RT3D TEE, p 2 by RT3D TEE, p

  • the evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip repair two and three dimensional echocardiography study
    Journal of the American College of Cardiology, 2012
    Co-Authors: Takeji Saito, Masaki Izumo, Yoko Fukuoka, Azusa Furugen, Jun Tanaka, Kenji Harada, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar
    Abstract:

    Geometry and size of persistent iatrogenic atrial septal defect (IASD) after transseptal puncture during catheter-based Mitral Valve Clip repair (MVCR) has not been detailed. We investigated 11 lASDs in 10 patients who underwent MVCR using the guide catheter with 22-F at the atrial septum. The

Simon Biner - One of the best experts on this subject based on the ideXlab platform.

  • utility of combined two dimensional and three dimensional transesophageal imaging for catheter based Mitral Valve Clip repair of Mitral regurgitation
    Journal of The American Society of Echocardiography, 2011
    Co-Authors: Saibal Kar, Takahiro Shiota, Simon Biner, Gila Perk, Asim M Rafique, James Slater, Asma Hussaini, Stanley Chou, Itzhak Kronzon
    Abstract:

    Background Catheter-based Mitral Valve Clip repair (CBMCR) is feasible for selected patients with Mitral regurgitation (MR). Two-dimensional (2D) transesophageal echocardiography (TEE) is the standard modality for evaluating MR and procedural guidance. Recently, real-time three-dimensional TEE became available. The aim of this study was to evaluate the value of combined 2D and three-dimensional TEE for CBMCR. In evaluating MR for CBMCR, the confidence of interpretation of 2D TEE was compared with that of combined imaging for the localization of major Valve pathology. In patients who underwent CBMCR, the outcomes and the duration of CBMCR were compared. Methods In this retrospective study, MR evaluation was performed by 2D TEE alone and by combined imaging in 80 and 57 patients, respectively. CBMCR was guided by 2D TEE alone in 20 patients and by combined imaging in 39 patients. Results Examination by combined imaging allowed en face visualization of Mitral Valve anatomy and MR jet origin. The confidence of interpretation by combined imaging was higher than for 2D TEE (1.1 ± 0.3 vs 1.8 ± 0.7, P P  = .035). Conclusions The use of combined imaging compared with 2D TEE alone appears to enhance the confidence of interpretation concerning Mitral pathology and catheter-Clip system location and may also reduce CBMCR time.

Swaminatha V Gurudevan - One of the best experts on this subject based on the ideXlab platform.

  • echocardiographic evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip insertion
    American Journal of Cardiology, 2012
    Co-Authors: Takeji Saitoh, Masaki Izumo, Azusa Furugen, Jun Tanaka, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar, Yoko Miyatafukuoka, Takahiro Shiota
    Abstract:

    The geometries and sizes of persistent iatrogenic atrial septal defects (IASDs) after transseptal puncture during catheter-based Mitral Valve Clip insertion (MVCI) have not been detailed. In this study, 11 IASDs were investigated in 10 patients who underwent MVCI using a guide catheter (24Fr proximally and 22Fr at the atrial septum). The diameters of the long and short axes and the area at maximum and minimum during a cardiac cycle were measured after MVCI using real-time 3-dimensional (RT3D) transesophageal echocardiography (TEE). A circular shape was assumed on 2-dimensional TEE, resulting in an area calculation of π × (dimension/2) 2 . The anatomic geometries of IASDs were visualized in a 3-dimensional en face view of the atrial septum. Furthermore, 1 month after MVCI, IASDs were evaluated using echocardiography. The IASDs had a variety of irregular geometries. The mean long-axis diameter was 1.0 ± 0.24 cm, the mean short-axis diameter was 0.51 ± 0.22 cm, and the mean area was 0.40 ± 0.24 cm 2 on RT3D TEE. The diameters and area changed significantly between the maximal and minimal values during the cardiac cycle. Importantly, 2-dimensional TEE underestimated the maximal diameters of IASDs (0.54 ± 0.17 vs 1.0 ± 0.24 cm by RT3D TEE, p 2 by RT3D TEE, p

  • the evaluation of iatrogenic atrial septal defect after catheter based Mitral Valve Clip repair two and three dimensional echocardiography study
    Journal of the American College of Cardiology, 2012
    Co-Authors: Takeji Saito, Masaki Izumo, Yoko Fukuoka, Azusa Furugen, Jun Tanaka, Kenji Harada, Swaminatha V Gurudevan, Kirsten Tolstrup, Robert J Siegel, Saibal Kar
    Abstract:

    Geometry and size of persistent iatrogenic atrial septal defect (IASD) after transseptal puncture during catheter-based Mitral Valve Clip repair (MVCR) has not been detailed. We investigated 11 lASDs in 10 patients who underwent MVCR using the guide catheter with 22-F at the atrial septum. The