Publications by authors named "Bart Meyns"
Fontan-Associated Liver Disease (FALD) is a dramatically emerging problem even if not precisely defined in term of debated diagnosis and surveillance protocols. We analyze FALD prevalence, clinical impact and implications in a European cohort of patients. It's a retrospective observational multicenter study including Fontan patients operated between 1990 and 2022.
View Article and Find Full Text PDFBackground: Extracorporeal membrane oxygenation (ECMO) for COVID-19 was thoroughly assessed during the first pandemic wave, but data on subsequent waves are limited. We aimed to investigate in-hospital and 6-month survival of patients with COVID-19 supported with ECMO from the second pandemic wave (Sept 15, 2020) until the end of the pandemic (March 21, 2023, announced by WHO).
Methods: EuroECMO-COVID is a prospective, observational study including adults (aged ≥16 years) requiring ECMO respiratory support for COVID-19 from 98 centres in 21 countries.
Objectives: This 4th report aimed to provide insights into patient characteristics, outcomes and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centres in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry.
Methods: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. The expected number of events was predicted using penalized logistic regression.
Objective: We aimed to explore the feasibility of an inverted-T upper hemisternotomy approach for pulmonary endarterectomy (PEA) and report the results after 17 cases.
Methods: PEA was conducted through a 7-cm skin incision using an inverted-T upper hemisternotomy across the third intercostal spaces. Cardiopulmonary bypass (CPB) was established through central arterial and percutaneous femoral dual-staged venous cannulation.
Article Synopsis
- Study Purpose
- : The research aimed to determine if using a hemoadsorption device during thoraco-abdominal normothermic regional perfusion (TA-NRP) in heart donation after circulatory death could reduce inflammation and improve heart function.
- Methodology
- : Involved 15 pigs undergoing induced circulatory arrest, followed by TA-NRP with and without a hemoadsorption device. Plasma cytokine levels were measured at various points, and cardiac function was evaluated using pressure-volume loop analysis.
- Findings
- : The hemoadsorption device did not significantly influence cytokine levels or cardiac function post-TA-NRP, indicating that inflammation levels and heart performance were not improved by this intervention
Introduction: Left ventricular assist device (LVAD) therapy may lead to an aortic regurgitation, limiting left ventricular unloading and causing adverse events. Whether concomitant aortic valve replacement may improve outcomes in patients with preoperative mild-to-moderate aortic regurgitation remains unclear.
Methods: A retrospective propensity score-matched analysis of adult patients with preoperative mild-to-moderate aortic regurgitation undergoing durable LVAD implantation between 01/01/2011 and 30/11/2021 was performed.
Background: We conducted a volume-outcome meta-analysis of pulmonary endarterectomy procedures for chronic thromboembolic pulmonary hypertension to objectively determine the minimum required annual case load that can define a high-volume centre.
Methods: Three electronic databases were systematically queried up to 1 May 2024. Centres were divided in volume tertiles.
Defining the causes for Fontan circulatory failure in total cavopulmonary connection patients.
Interdiscip Cardiovasc Thorac Surg
November 2024
Objectives: This study aims to identify the causes of failure in Fontan patients with a total cavopulmonary connection.
Methods: We conducted a comprehensive review of all patients who underwent a total cavopulmonary connection procedure at our centre between 1988 and 2023, aiming to identify and analyse the factors contributing to Fontan failure (defined as mortality, heart transplantation, Fontan takedown, protein-losing enteropathy, plastic bronchitis or New York Heart Association Functional Classification class III or IV).
Results: The study included 217 patients (median age at time of Fontan completion 3.
Background: Apixaban is increasingly used instead of vitamin K antagonists (VKAs) for long-term anticoagulation during HeartMate 3 (HM3) support. However, data on its pharmacokinetics in this context is lacking. We present real-world data on apixaban levels and outcomes in adult and pediatric HM3 patients, and evaluate our dosing strategy based on plasma sampling.
View Article and Find Full Text PDFBackground: Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality.
View Article and Find Full Text PDFBackground: Peak oxygen uptake (pVO) predicts mortality in patients with heart failure on left ventricular assist device (LVAD) support. This follow-up of the PRO-VAD study examines the prognostic value of repeated pVO measurements during long-term follow-up.
Methods: This multicenter follow-up study included patients from the original PRO-VAD cohort who performed a cardiopulmonary exercise test (CPET) twice.
Purpose: Cardiovascular simulators are used in the preclinical testing phase of medical devices. Their reliability increases the more they resemble clinically relevant scenarios. In this study, a physiologically actuated soft robotic left ventricle (SRLV) embedded in a hybrid (in silico- in vitro) simulator of the cardiovascular system is presented, along with its experimental and computational analysis.
View Article and Find Full Text PDFArticle Synopsis
- The EUROMACS study aimed to explore how the annual number of LVAD implantations at a medical center affects postoperative outcomes and patient survival.
- It analyzed data from 4,802 patients across 35 centers, categorizing them based on whether the center performed 30 or fewer vs. more than 30 implants per year, focusing on 1-year survival rates and device-related complications.
- Findings indicated that while higher volume centers had patients with more severe conditions, there was no significant difference in 1-year survival; however, higher volume centers had more device-related adverse events, highlighting the need for consistent quality improvement across all centers.
Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study.
Crit Care
August 2024
Article Synopsis
- The study looks at how the location where doctors put tubes in the arteries for heart support affects brain health after surgery.
- They compared three methods: using the aorta, subclavian/axillary arteries, and femoral artery to see which had the least brain problems.
- Results showed that patients using the subclavian/axillary method had more major brain issues compared to the others, and also had more seizures after the surgery.
Successful clinical transplantation of hearts donated after circulatory death using direct procurement followed by hypothermic oxygenated perfusion: A report of the first 3 cases.
J Heart Lung Transplant
November 2024
Article Synopsis
- Acute right ventricular failure (RVF) often occurs in various diseases and can lead to serious health issues, particularly when accompanied by cardiogenic shock (CS).
- Right-sided temporary mechanical circulatory support (tMCS) devices are utilized to relieve heart stress and improve blood circulation in affected patients, although there is no agreed-upon protocol for their use.
- This review aims to outline the current treatments for acute RVF, the decision-making process for using tMCS devices, key management elements like fluid levels and anticoagulation, and guidelines for gradually discontinuing tMCS support.
Objectives: Restrictive cardiomyopathy is rare and is generally associated with worse clinical outcomes compared to other cardiomyopathies. Ventricular assist device (VAD) support for these children is seldom applied and often hampered by the surgical difficulties.
Methods: All paediatric (<19 years) patients with a restricted cardiomyopathy supported by a VAD from the EUROMACS database were included and compared to patients with a dilated cardiomyopathy (retrospective database analyses).
Objectives: The use of ventricular assist devices (VADs) in children is increasing. However, absolute numbers in individual centres and countries remain small. Collaborative efforts such as the Paedi-European Registry for Patients with Mechanical Circulatory Support (EUROMACS) are therefore essential for combining international experience with paediatric VADs.
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- ECLS cannulation in post-cardiotomy patients is uncommon in general wards, with only 39 out of 2058 patients studied undergoing the procedure while at the hospital.
- The majority of these patients faced complications like acute kidney injury and arrhythmias, with a high in-hospital mortality rate of 84.6%, predominantly due to persistent heart failure.
- Findings suggest that ECLS cannulation mainly affects low-risk patients who experience cardiac arrest post-surgery, indicating a need for further research into improving outcomes.
Objectives: The potential risk of autograft dilatation and homograft stenosis after the Ross procedure mandates lifelong follow-up. This retrospective cohort study aimed to determine long-term outcome of the Ross procedure, investigating autograft and homograft failure patterns leading to reintervention.
Methods: All adults who underwent the Ross procedure between 1991 and 2018 at the University Hospitals Leuven were included, with follow-up data collected retrospectively.
Right-sided mechanical support of the Fontan circulation by existing devices has been compounded by the cross-sectional design of vena cava anastomosis to both pulmonary arteries. Our purpose was to investigate whether increasing inferior vena cava (IVC) flow with a rotary blood pump in the IVC only in an ovine animal model of Fontan would lead to acceptable superior vena cava (SVC) pressure. To achieve this, a Fontan circulation was established in four female sheep by anastomosing the SVC to the main pulmonary artery (MPA) and by interposing a Dacron graft between the IVC and the MPA.
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- * Conducted across 34 centers globally from 2000 to 2020, the study included over 2,000 adult patients split into different ECMO duration groups, revealing higher complications and mortality rates associated with longer ECMO durations.
- * The findings suggest that while most in-hospital complications increase with ECMO duration, post-discharge survival rates remain similar across groups, with specific risk factors like age and pre-existing conditions affecting long-term survival for those on ECMO longer than 7 days.
Article Synopsis
- Impaired primary hemostasis and abnormal blood vessel growth (angiogenesis) contribute to gastrointestinal bleeding in patients using continuous-flow left ventricular assist devices (CF-LVADs) in a "two-hit hypothesis."
- A study examined the effects of acute exercise on blood samples from 22 CF-LVAD patients, measuring changes in hemostatic and angiogenic biomarkers.
- Results showed that acute exercise significantly increased platelet count and function, as well as various factors related to blood clotting and vessel growth, suggesting potential benefits for GI bleeding management in these patients.