Publications by authors named "Vanhuyse F"

Article Synopsis
  • The text discusses how climate change is increasing the risk to real estate assets, both through physical damage from natural disasters and transitional risks linked to the shift toward a greener economy.
  • The methodology involves systematic mapping to gather existing research on the economic impact of climate risks on real estate, including rigorous testing for comprehensiveness and consistency of the reviewed literature.
  • The final outcome includes a heat map highlighting evidence areas and research gaps, along with insights on quantifying the impact of climate risk on property values, presented in an accessible format with figures and tables.
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  • Predicting outcomes for patients receiving Left Ventricular Assist Devices (LVADs) is crucial, but current methods focusing on right ventricular function are lacking in prognostic value.
  • The study utilized data from the ASSIST-ICD registry to evaluate right ventriculoarterial coupling as a potential predictor of all-cause mortality upon LVAD implantation.
  • Findings showed that while some measures like TAPSE/sPAP and PAPi were not linked to long-term survival, the ratio of right atrial pressure to pulmonary capillary wedge pressure (RAP/PCWP) was significantly associated with increased mortality, maintaining its relevance even after adjusting for other risk factors.
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Article Synopsis
  • - The study aims to determine if the preoperative pulmonary artery pulsatility index (PAPi) can predict mortality after left ventricular assist device (LVAD) implantation, as right ventricular failure is a significant concern following the procedure.
  • - An analysis of 117 patients from 2007 to 2021 revealed that those with a PAPi of 2.84 or higher had a significantly better 3-month survival rate compared to those with lower PAPi levels.
  • - Other factors influencing 2-year mortality included systemic hypertension, diabetes, and whether the LVAD was used as a bridge to transplant, with notable differences in survival outcomes between these groups.
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There is limited evidence on the cost and cost-effectiveness of cash transfer programmes to improve maternal and child health in Kenya and other sub-Saharan African countries. This article presents the economic evaluation results of the Afya trial, assessing the costs, cost-effectiveness and equity impact of a demand-side financing intervention that promotes utilisation of maternal health services in rural Kenya. The cost of implementing the Afya intervention was estimated from a provider perspective.

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Objectives: We report the results of a mixed-methods process evaluation that aimed to provide insight on the Afya conditional cash transfer (CCT) intervention fidelity and acceptability.

Intervention, Setting And Participants: The Afya CCT intervention aimed to retain women in the continuum of maternal healthcare including antenatal care (ANC), delivery at facility and postnatal care (PNC) in Siaya County, Kenya. The cash transfers were delivered using an electronic card reader system at health facilities.

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Background: Isolated exclusion of the non-coronary sinus (NCS) is an attractive strategy in valve-sparing aortic root surgery, which avoids the mobilisation and re-implantation of coronary ostia. However, the long-term durability of aortic valve repair and the fate of remnant sinuses of Valsalva remain unclear.

Method: From January 2006 to December 2013, 29 patients underwent replacement of the ascending aorta extending to the NCS (group NCS) and 56 patients underwent a modified Yacoub procedure (group MY) in our centre by a single surgeon.

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Objectives: Given high maternal and child mortality rates, we assessed the impact of conditional cash transfers (CCTs) to retain women in the continuum of care (antenatal care (ANC), delivery at facility, postnatal care (PNC) and child immunisation).

Design: We conducted an unblinded 1:1 cluster-randomised controlled trial.

Setting: 48 health facilities in Siaya County, Kenya were randomised.

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Article Synopsis
  • The study investigates the outcomes of cardiogenic shock patients receiving temporary circulatory support (TCS) as a bridge to left ventricular assist device (LVAD) implantation, comparing them to patients without TCS.
  • Out of 329 patients analyzed, those under TCS had similar 30-day survival rates to those who had TCS removed or did not use a bridging strategy but experienced longer ICU stays and increased mechanical ventilation time.
  • Key predictors of mortality in the TCS group include combined surgery with LVAD, body mass index (BMI), and duration of heart failure, while the use of TCS itself did not significantly impact survival rates.
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  • Advanced heart failure patients often experience delays in being referred for mechanical circulatory support, specifically left ventricular assist devices (LVAD), which raises concerns about their survival rates post-implantation.
  • The study analyzed data from the ASSIST-ICD registry involving 303 non-inotrope-dependent patients, discovering that factors like older age and certain surgical procedures significantly increase mortality risk after receiving an LVAD.
  • Despite LVAD support, survival rates over five years remain low, highlighting the need for improved patient selection to enhance outcomes in such high-risk individuals.
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Background: The outbreak of coronavirus disease 2019 (COVID-19) exposes vulnerable patients to high risk of mortality. Patients with left ventricular assist device (LVAD) usually have symptoms such as cough, fever, and shortness of breath because of their cardiac condition and comorbidity, therefore these related symptoms challenge the correct diagnosis in time within the COVID-19 pandemic.

Case Summary: We report two case studies of patients with LVAD in whom COVID-19 related symptoms were overlapped by their cardiac status and comorbidities.

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  • LVAD implantation in patients with recently diagnosed cardiomyopathy is under-researched, and this study aims to explore characteristics and outcomes of such patients within 30 days of their diagnosis.
  • Out of 652 patients studied, 117 had recently diagnosed cardiomyopathy and experienced LVAD implantation after an average of 15 days, showing they were generally younger and had more severe symptoms compared to those with remote diagnoses.
  • Although immediate postoperative survival rates were similar between groups, patients with recently diagnosed cardiomyopathy had improved long-term survival, with certain factors like sudden cardiac arrest identified as risk indicators for higher mortality.
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  • LVAD implantation can be a viable treatment option for elderly patients (70+) with heart failure who aren't suitable for heart transplants.
  • An observational study analyzed 652 patients from 2006 to 2016, with 74 (11.3%) being elderly, showing similar hospitalization patterns and complication rates between elderly and younger patients.
  • The findings indicate that elderly patients receiving LVADs have comparable mid-term survival rates to younger patients, supporting the use of LVADs in this age group.
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  • The study examined how low and high body mass index (BMI) affect survival outcomes in patients who underwent left-ventricular assist device (LVAD) surgery across 19 medical centers from 2006 to 2016.
  • Out of 652 patients studied, those with high BMI typically had more co-existing health issues and were mostly male, while underweight patients had the lowest survival rates overall.
  • Four key predictors of mortality were identified for patients with abnormal BMI: high total bilirubin levels, hypertension, whether they were receiving LVAD as destination therapy, and previous cardiac surgeries, categorizing patients into low, intermediate, and high risk for 1-year mortality.
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  • The study aimed to assess the usage and outcomes of left ventricular assist devices (LVADs) in France from 2007 to 2016 using data from the ASSIST-ICD registry, involving 671 patients across 20 hospitals.
  • The overall survival rates for LVAD support or transplantation were 65.2% at 1 year, steadily decreasing to 47.7% by 5 years, with significant complications such as infections and strokes noted.
  • The findings highlight improved survival outcomes compared to earlier registries, despite patients being older and having more severe conditions, indicating differences in national treatment approaches and patient profiles.
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  • The study aimed to assess how uncommon etiologies of cardiomyopathy affect patient outcomes in those receiving Left-ventricular assist devices (LVADs) compared to more common ischemic or idiopathic dilated cardiomyopathies.
  • Conducted over 19 centers from 2006 to 2016, the research found that out of 652 LVAD recipients, 90.5% had ischemic/idiopathic causes, while 9.5% had uncommon causes like hypertrophic cardiomyopathy, cancer-related cardiac dysfunction, and myocarditis.
  • Although both groups had similar survival rates during a 9.1-month follow-up, those with hypertrophic cardiomyopathy,
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Article Synopsis
  • The Afya trial aims to improve maternal and child health in rural Kenya by assessing the effectiveness of conditional cash transfers to encourage pregnant women to use antenatal, facility delivery, and postnatal services, which are currently underutilized.
  • The economic evaluation will focus on comparing the costs and health outcomes of the cash transfer program to standard care, involving cost-effectiveness ratios and analyzing both affordability and equity impacts.
  • The study is ethically approved by Maseno University, and findings will be shared through a peer-reviewed journal and at international conferences to reach a wider audience.
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  • The study investigates the occurrence and impact of early ventricular arrhythmias (VAs) in patients who received left ventricular assist devices (LVAD) post-surgery, focusing on the first 30 days after implantation.
  • Significant predictors of early VAs include a prior history of VAs and undergoing additional surgeries alongside the LVAD procedure, with early VAs notably increasing the risk of death within the first month.
  • Despite early VAs raising the risk of 30-day mortality, they do not affect long-term survival rates in patients who are discharged alive from the hospital.*
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Background: Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes.

Objective: We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients.

Methods: Patients analyzed were those included in the multicenter ASSIST-ICD observational study.

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Background: Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections.

Methods: Patients included in the ASSIST-ICD study (19 centers) were enrolled.

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Background: Antenatal care (ANC), facility delivery and postnatal care (PNC) are proven to reduce maternal and child mortality and morbidity in high-burden settings. However, few pregnant rural women use these services sufficiently. This study aims to assess the impact, cost-effectiveness and scalability of conditional cash transfers to promote increased contact between pregnant women or women who have recently given birth and the formal healthcare system in Kenya.

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Article Synopsis
  • * Conducted at 19 centers over a decade, the study tracked 659 LVAD recipients, finding that 26.9% experienced late VAs, defined as sustained arrhythmias requiring treatment more than 30 days post-implant.
  • * Researchers identified six key risk factors for late VAs, leading to the development of a "VT-LVAD score" that categorizes patients into risk groups, potentially aiding in decision-making for ICD implantation.
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Objectives: Transcatheter aortic valve implantation is a well-recognized treatment option for high-risk patients with aortic stenosis. The femoral approach is possible in 80% of cases and remains the access of choice. When this approach is not feasible, other alternative routes have been proposed such as transapical, transaortic and subclavian.

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Aim: To investigate the survival benefit of bilateral internal mammary artery (BIMA) grafts in patients with left ventricular dysfunction.

Methods: Between 1996 and 2009, we performed elective, isolated, primary, multiple cardiac arterial bypass grafting in 430 consecutive patients with left ventricular ejection fraction ≤ 40%. The early and long-term results were compared between 167 patients undergoing BIMA grafting and 263 patients using left internal mammary artery (LIMA)-saphenous venous grafting (SVG).

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Background: There is currently no recommendation for the mean arterial pressure target in the particular setting of Extracorporeal Cardiopulmonary Resuscitation (ECPR) in the first hours following cardiogenic shock complicated by cardiac arrest. This study aimed to assess the effects of two different levels of mean arterial pressure on macrocirculatory, microcirculatory, and metabolic functions.

Design: Randomized animal study.

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