Publications by authors named "Lars S Witte"
(1) Background: Prevalence of patent foramen ovale (PFO) in the general population is estimated at around 24%. We hypothesized that right-to-left shunting (RLS) resulting from PFO might contribute to angina symptoms in patients with coronary artery spasm (CAS), potentially triggered by vasoactive metabolites. Therefore, the aim of this study was to investigate the prevalence of PFO-related RLS in patients with documented CAS.
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- Lipoprotein(a) [Lp(a)] is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD), but there are gaps in its measurement among cardiologists according to current guidelines.
- The review presents four clinical cases showing the link between elevated Lp(a) levels and coronary artery disease (CAD), supported by consensus statements from leading heart organizations.
- Emphasizing routine Lp(a) measurement can help identify high-risk patients, guiding more aggressive treatment and tailored care in catheterization settings, while ongoing clinical trials explore Lp(a)-lowering therapies.
Article Synopsis
- About 25% of the population has a patent foramen ovale (PFO), which is usually asymptomatic, but it can sometimes cause right-to-left shunt (RLS)-mediated hypoxaemia, a rare condition.
- In a case involving a 73-year-old woman, her oxygen levels significantly improved from 87% to 98% after undergoing percutaneous PFO closure due to her progressive difficulty breathing.
- While most PFOs don't cause problems, RLS-mediated hypoxaemia can occur even in older adults, and percutaneous closure is a safe and effective treatment that provides quick relief.
Article Synopsis
- Young patients with cryptogenic stroke and a patent foramen ovale (PFO) sometimes receive device closure to prevent future strokes, but about 25% may still have a residual right-to-left shunt after 6 months.
- In a study of 227 patients, it was found that at 6 months post-closure, 72.7% had no shunt, while the rest had varying degrees of residual shunt.
- By 12 months, many of these residual shunts had either diminished or closed completely, indicating that while residual shunts are common at 6 months, most are small and tend to close over time.
Article Synopsis
- Increasing survival rates in adults with congenital heart disease (ACHD) lead to complications like arrhythmias and heart failure; therefore, transcatheter valve interventions are emerging as a viable treatment option.
- A study at the Center of Congenital Heart Disease Amsterdam-Leiden analyzed ACHD patients with severe atrioventricular (AV) valve regurgitation who underwent various transcatheter procedures from 2020 to 2022, noting improvements in condition without complications.
- The findings suggest that while transcatheter valve repair can be safe and effective for complex ACHD patients, ongoing collaboration and individualized treatment strategies from a dedicated heart team are crucial for optimizing outcomes and future evaluations are needed to assess long-term results.
Anatomical predictors for suture-based closure of the patent foramen ovale: A multicenter experience.
Catheter Cardiovasc Interv
August 2023
Background: NobleStitch EL is a novel suture-based technique used for patent foramen ovale (PFO) closure and an alternative to traditional double-disc devices without the need for antithrombotic therapy. However, successful closure rates are still unknown, and certain anatomies may be unfavorable for successful closure.
Aims: We assessed the efficacy of the NobleStitch EL and sought to identify patient-related anatomical features associated with successful suture-based closure.
This report describes the case of a symptomatic patient with a right coronary artery fistula draining into the coronary sinus who underwent transcatheter closure, which was deployed in the drainage site to seal off the exit of the fistula. ().
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