Publications by authors named "Krings G"

Objectives: To describe the workflow and value of three-dimensional rotational angiography (3DRA) in percutaneous pulmonary valve implantation (PPVI).

Background: 3DRA offers visualization of the entire topography in the chest and may enhance safety and reduce the risk for complications in PPVI through improved pre-procedural planning and per-procedural guidance.

Methods: All PPVI procedures with the use of 3DRA performed between August 2011 and December 2022 were reviewed.

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Aims: Unusual morphologic patterns of breast carcinomas can raise diagnostic consideration for metastasis or special breast cancer subtypes with management implications. We describe rare invasive breast cancers that mimic serous carcinoma of the gynaecologic tract (serous-like breast carcinomas, SLBC) and characterize their clinicopathologic, immunophenotypic, and genetic features.

Methods And Results: All patients were female (n = 15, median age 49 years) without a history of gynaecologic malignancy.

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Background: Pulmonary artery (PA) stenosis is common after arterial switch operation (ASO) for transposition of the great arteries (TGA). Differences between balloon angioplasty (BA) and stents on right ventricular (RV) and PA pressures are not well studied.

Objectives: The purpose of this study was to analyze percutaneous PA interventions' frequency after ASO, complications, and the effects of BA and stents on RV and PA pressures.

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Article Synopsis
  • Salivary gland-like tumors of the breast are rare and share similar features with salivary gland tumors, indicating a common origin in many cases.
  • The main types include adenoid cystic carcinoma, secretory carcinoma, and mucoepidermoid carcinoma, which are often triple negative but generally have a better prognosis than high-grade triple negative breast cancers.
  • Accurate classification of these tumors is crucial for treatment decisions, as some can be benign while others may behave aggressively, and identifying specific genetic markers can aid in diagnosis and management.
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Background: Branch pulmonary artery (PA) stenosis is one of the most common indications for percutaneous interventions in patients with transposition of the great arteries (TGA), tetralogy of Fallot (ToF), and truncus arteriosus (TA). However, the effects of percutaneous branch PA interventions on exercise capacity remains largely unknown. In addition, there is no consensus about the optimal timing of the intervention for asymptomatic patients according to international guidelines.

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The differential diagnosis of malignant spindle cell neoplasms in the breast most frequently rests between malignant phyllodes tumor (MPT) and metaplastic carcinoma (MBC). Diagnosis of MPT can be challenging due to diffuse stromal overgrowth, keratin (CK) and/or p63 immunopositivity, and absent CD34 expression, which can mimic MBC, especially in core biopsies. Distinction of MPT from MBC has clinical implications, with differences in surgical approach, chemotherapy, and radiation.

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Unlabelled: We sought to evaluate the efficacy of WEE1 inhibitor adavosertib in patients with solid tumor malignancies (cohort A) and clear cell renal cell carcinoma (ccRCC; cohort B). NCT03284385 was a parallel cohort, Simon two-stage, phase II study of adavosertib (300 mg QDAY by mouth on days 1-5 and 8-12 of each 21-day cycle) in patients with solid tumor malignancies harboring a pathogenic SETD2 mutation. The primary endpoint was the objective response rate.

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Background: Transverse aortic arch obstruction is a challenging lesion for which stent implantation provides a potentially important alternate therapy. The objectives were to evaluate the technical, procedural, and medium-to-long-term clinical outcomes of percutaneous stent implantation of transverse aortic arch obstruction.

Methods: This is a retrospective, multicenter study of transverse aortic arch stent implantation.

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Background: Unilateral pulmonary artery (PA) stenosis is common in the transposition of the great arteries (TGA) after arterial switch operation (ASO) but the effects on the right ventricle (RV) remain unclear.

Aims: To assess the effects of unilateral PA stenosis on RV afterload and function in pediatric patients with TGA-ASO.

Methods: In this retrospective study, eight TGA patients with unilateral PA stenosis underwent heart catheterization and cardiac magnetic resonance (CMR) imaging.

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Background: Branch pulmonary artery stenosis is common after surgical repair in patients with biventricular CHD and often requires reinterventions. However, (long-term) effects of percutaneous branch pulmonary artery interventions on exercise capacity, right ventricular function, and lung perfusion remain unclear. This review describes the (long-term) effects of percutaneous branch pulmonary artery interventions on exercise capacity, right ventricular function, and lung perfusion following PRISMA guidelines.

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Article Synopsis
  • Trebananib is a peptibody that stops angiopoietin-1 and -2 from activating Tie2 receptors, which helps inhibit cancer growth, and it was tested alongside paclitaxel in the I-SPY2 breast cancer trial.* -
  • The trial involved patients with high-risk, early-stage breast cancer being randomly assigned to receive either trebananib with paclitaxel or a control, with the main goal being to evaluate the pathologic complete response (pCR) rate.* -
  • Although trebananib did not meet the criteria to advance for further testing, it showed promising pCR rates and improved 3-year event-free survival without significantly increasing side effects, highlighting potential biomarkers
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Article Synopsis
  • CHEK2 germline variants are linked to a moderate increase in breast cancer risk, primarily affecting younger women, with a median age of 45.
  • The study analyzed 44 CHEK2-associated breast cancer cases, finding that most tumors were invasive ductal carcinomas (86%) and predominantly estrogen receptor positive (95%).
  • Despite variable responses to chemotherapy, 85% of patients remained disease-free during the follow-up, although some experienced metastasis, and one patient died over an average follow-up period of 50 months.
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Background: In repaired tetralogy of Fallot (ToF) patients with residual right ventricular (RV) outflow tract obstructions (RVOTO), risk stratification and timing of re-interventions are based on RVOTO gradients. However, this might be insufficient to prevent RV dysfunction. Instead, assessment of RV to pulmonary arterial (RV-PA) coupling allows integrated assessment of RV function in relationship to its afterload and could be of additional value in clinical decision-making.

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Article Synopsis
  • A malignant tumor in the breast exhibits both spindle cell and chondroid characteristics and has spread to a lymph node.
  • The presence of lymph node metastases suggests a metaplastic carcinoma, but this case shows evidence favoring a diagnosis of a malignant phyllodes tumor (MPT).
  • Genetic analysis revealed specific mutations in the MED12 gene and TERT gene promoter, providing strong support for the MPT diagnosis.
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Adenoid cystic carcinoma (AdCC) is a rare triple-negative breast cancer analogous to its extramammary counterparts. Diagnosis of the more aggressive solid-basaloid variant of AdCC (SB-AdCC) can be challenging due to poorly defined histopathologic and molecular features. We characterized 22 invasive and in situ basaloid carcinomas by morphology, immunohistochemistry, genetics, and MYB status using multiple platforms and assessed clinical behavior and neoadjuvant chemotherapy responses.

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Article Synopsis
  • - Pulmonary artery (PA) stenosis is a frequent issue after the arterial switch operation (ASO) for transposition of the great arteries (TGA), and this study aimed to compare flow measurements using 4D flow CMR and 2D phase-contrast MRI (2D PCMR) alongside echocardiography.
  • - The research included 39 patients, revealing that 4D flow CMR consistently reported higher maximum velocities for PAs than 2D PCMR (significant difference of 65 cm/s for the main PA and 77 cm/s for the side PAs).
  • - Echocardiography was often ineffective for PA assessment in most patients, while stroke volume measurements showed a good
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Mucoepidermoid carcinoma (MEC) is exceedingly rare in the breast, with <45 cases reported in the literature. Although estrogen receptor/progesterone receptor/human epidermal growth factor 2 triple-negative, MEC is characterized as a special subtype of breast carcinoma with significantly better prognosis than conventional basal-type tumors. Cutaneous hidradenoma (HA) is considered a benign adnexal neoplasm showing histomorphologic overlap with MEC.

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Spindle cell lesions of the breast elicit a specific, relatively limited differential diagnosis, and accurate classification often requires careful morphologic evaluation and immunohistochemical workup. Low-grade fibromyxoid sarcoma (LGFMS) is a rare malignant fibroblastic tumor with deceptively bland spindle cell morphology. Involvement of the breast is exceedingly rare.

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Background: In order to prevent right ventricular (RV) dysfunction, closure of secundum type atrial septal defects (ASD) is often indicated and percutaneous closure is the preferred treatment modality to do so. The magnitude and time course of RV remodeling is still incompletely understood.

Methods: This retrospective cohort study included consecutive patients who underwent percutaneous secundum ASD closure in two tertiary referral centers in The Netherlands.

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Triple-negative apocrine carcinomas (TNACs) are rare breast tumors with limited studies evaluating their molecular characteristics and clinical behavior. We performed a histologic, immunohistochemical, genetic, and clinicopathologic assessment of 42 invasive TNACs (1 with a focal spindle cell component) from 41 patients, 2 pure apocrine ductal carcinomas in situ (A-DCIS), and 1 A-DCIS associated with spindle cell metaplastic carcinoma (SCMBC). All TNACs had characteristic apocrine morphology and expressed androgen receptor (42/42), gross cystic disease fluid protein 15 (24/24), and CK5/6 (16/16).

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Background: Ureteropelvic junction obstruction (UPJO) and renal calculi are associated in 20 to 30% of cases and treatment is mandatory. The simultaneous surgical management is a therapeutic challenge that is still a source of controversy. We describe our technique combining robot-assisted laparoscopic pyeloplasty and transcutaneous retrograde flexible ureteroscopy (fURS), assessing the feasibility of simultaneous treatment through an original technique.

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Importance: Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer strongly correlates with overall survival and has become the standard end point in neoadjuvant trials. However, there is controversy regarding whether the definition of pCR should exclude or permit the presence of residual ductal carcinoma in situ (DCIS).

Objective: To examine the association of residual DCIS in surgical specimens after neoadjuvant chemotherapy for breast cancer with survival end points to inform standards for the assessment of pathologic complete response.

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Context.—: Neoadjuvant systemic therapy refers to the use of systemic agent(s) for malignancy prior to surgical treatment and has recently emerged as an option for most breast cancer patients eligible for adjuvant systemic therapy. Consequently, treated breast carcinomas have become routine specimens in pathology practices.

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. With the increasing survival of the congenital heart disease population, there is a growing need for in-depth understanding of blood circulation in these patients. Mock loops provide the opportunity for comprehensive hemodynamic studies without burden and risks for patients.

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