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Transcatheter aortic valve replacement and stroke： a comprehensive review

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Journal of Geriatric Cardiology 2018年第1期15卷 95-104页

作者： Periklis A Davlouros Virginia C Mplani Ioanna Koniari Grigorios Tsigkas george hahalis Department of Cardiology Patras University Hospital Rion Patras Greece

Transcatheter 大动脉的阀门培植(TAVR ) 与严重大动脉的狭窄和高外科的风险为病人作为一种其他的、很快演变的治疗选择出现了。此后摸破坏复杂并发症主要在 periprocedural 和 30 天的时期追随者 TAVR 正在被限制，与更低、相对经常的... 详细信息

Transcatheter 大动脉的阀门培植(TAVR ) 与严重大动脉的狭窄和高外科的风险为病人作为一种其他的、很快演变的治疗选择出现了。此后摸破坏复杂并发症主要在 periprocedural 和 30 天的时期追随者 TAVR 正在被限制，与更低、相对经常的频率。早击在过程期间主要由于碎片 embolization，而以后的事件与耐心的特定的因素被联系。尽管临床的击的率常常与起始的 TAVR 经验相比一直在减少，有 MRI 的现代 neuro 成像建议新 ischemic 损害 post-TAVR 是几乎通用的。后者的影响大部分是未知的。然而，他们似乎在 neurocognitive 功能与减小相关。因为 TAVR 被设置扩展它的指示降低外科风险的病人，摸预防在期间并且在 TAVR 以后降临到首要的重要性。基于临床并且 pathophysiological 证据，研究的三根线活跃地向这个方向被采用：在有到有钙化的大动脉的拱门的还原剂操作和接触的一个目的阀门和本国的阀门， antithrombotic 治疗，和插子的保护设备的改进。小心的耐心的选择，过程的设计，和尊重这张易碎的人口的流血风险的定制的 antithrombotic 策略对击追随者 TAVR 组成主要防卫。

关键词：大动脉阀门评论保护设备风险并发症 MRI 还原剂

Incidence, pathophysiology, predictive factors and prognostic implications of new onset atrial fibrillation following transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2018年第1期15卷 50-54页

作者： Ioanna Konlari Grigorios Tsigkas Nikolaos Kounisx Dimitrios Velissaris Emmanouil Chourdakis Periklis Davlouros george hahalis Department of Cardiology University Hospital of Patras Rion Patras Greece Department of Internal Medicine University Hospital of Patras Rion Patras Greece Krankenhaus der Barmherzigen Bruder Trier Germany

Atrial fibrillation (AF) constitutes the most frequent cardiac arrhythmia with an increasing prevalence and incidence in the general population, demonstrating a significant impact on cardiovascular morbidity and mortality. AF has been correlated with an increased risk of stroke, systemic embolism and long term morbidity compared to individuals with sinus rhythm. The highest prevalence of AF is reported in elderly as well as in patients with severe aortic stenosis, ranging between 16% and 40% in the latter. In the general population, AF scales the death risk up to 1.5 and 1.9 fold in men and women, respectively.

关键词：纤维性大动脉颤动预兆培植阀门心血管 AF

Endocarditis after transcatheter aortic valve implantation： a current assessment

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Journal of Geriatric Cardiology 2018年第1期15卷 61-65页

作者： Emmanouil Chourdakis Ioanna Koniari george hahalis Nicholas G Kounis Karl Eugen Hauptmann Krankenhaus der Barmherzigen Briider Trier Germany Patras University Hospital: Rio Patras Greece

Transcatheter aortic valve implantation (TAVI) constitutes an established treatment in inoperable or high perioperative risk patients with severe aortic stenosis, demonstrating similar mortality rates (at 30 days and 1 year) with surgical aortic valve replacement (SAVR). Various complications have been reported during TAVI, weeks or months post procedure. The most frequent causes of transcatheter heart valve (THV) failure are paravalvular regurgitation, infective endocarditis (IE), thrombosis and late valve Migration. Post TAVI endocarditis diagnosis can be established according to the valve academic research consortium-2 criteria which include (1) Duke endocarditis criteria; or (2) evidence of abscess, paravalvular leak, pus, or vegetation confirmed by histological or bacteriological studies during a reoperation; or (3) abscess, pus, or vegetation confirmed by an autopsy.

关键词：心内膜炎大动脉阀门培植评价死亡率并发症子过程

Transcatheter Valve-in-Valve implantation after late migration of balloon expandable Sapien- XT prosthesis in a severe pure aortic regurgitation case

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Journal of Geriatric Cardiology 2017年第12期14卷 763-765页

作者： Emmanouil Chourdakis Ioanna Koniari george hahalis Nicholas Kounis Karl Eugen Hauptmann Krankenhaus der Barmherzigen Briider Trier Germany Department of InterventionalElectriphysiology Royal Brompton Hospital London United Kingdom Cardiology Department Patras University Hospital Rio Patras Greece

A 76-year old female, was admitted in our cardiac surgery clinic to perform surgical aortic valve replacement due to a severe aortic regurgitation with symptoms of congestive heart failure. Her past medical history in... 详细信息

关键词：大动脉修复术移植智慧培植盒子外科充血

Restrictive perimembranous ventricular septal defect with left to right Shunt post urgent aortic balloon valvuloplasty and transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2018年第1期15卷 113-116页

作者： Emmanouil Chourdakis Ioanna Konlari Nicholas G Kounis Dimitrios Velissaris george hahalis Karl Eugen Hauptmann Cardiology Department Hospital of the Brothers of Mercy Trier Germany Cardiology Department Queen Elizabeth University Hospital Birmingham UK Cardiology Department Patras University Hospital Rio Patras Greece

An 86-year-old male patient was admitted in our cardiology ward with signs of congestive biventricular heart failure. The patient presented with deteriorating dyspnea on mild exertion and at rest the last days, compatible with class NYHA III-IV heart failure, bilateral peripheral oedema, increased NT-proBNP (9198 pg/mL), mildly elevated Troponin (TnT 64 pg/mL), interstitial pulmonary oedema and bilateral pleural effusions in chest X ray. Permanent atrial fibrillation, known left branch bundle block (QRS = 170 ms), hypertension, and chronic renal failure were referred as co-morbidities. The transthoracic echocardiogram (TTE) revealed severely impaired left ventricle (LV) function [ejection fraction (EF) = 25%-30%] with diffuse wall hypokinesia, a high-grade aortic stenosis with mean trans valvular pressure gradient of 44 mmHg, despite the low ejection fraction, accompanied with mild-moderate aortic regurgitation in the context of a severe degenerative tricuspid aortic valve disease, an ascending aorta aneurysm with 5.4 cm diameter, as well as severe pulmonary hypertension (85 mmHg). The patient demonstrated mild clinical improvement with intravenous diuretic therapy and given the very high surgical risk (estimated logistic Euroscore II = 41%) for aortic valve replacement, retrograde aortic balloon valvuloplasty as a bridge to transcatheter aortic valve replacement (TAVR) was decided.

关键词：大动脉柱子分流阀门呼吸困难 TnT 水肿双边

Acute Myocardial Infarction Induced by Anaphylaxis in China： The Kounis Syndrome

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Chinese Medical Journal 2018年第19期131卷 2392-2393页

作者： Nicholas G Kounis Ioanna Koniari Emmanouil Chourdakis george D Soufras Grigorios Tsigkas Periklis Davlouros george hahalis Department of Cardiology Patras University General Hospital Rion Patras Achaia 26504 Greece Department of Electrophysiology Queen Elizabeth Hospital Birmingham B15 2TH UK Department of Cardiology Krankenhaus der Barmherzigen Bruder Trier Nordallee 154292 Trier Germany Department of Cardiology "Saint Andrews" State General Hospital Patras 26226 Greece

In the very interesting report published in Chinese Medical Journal concerning a 65-year-old hypertensive and hyperlipidemic male patient, with stent implantation 5 years previously, the patient developed anaphylactic shock accompanied by chest discomfort, palpitation, itchiness, nausea, vomiting, dyspnea, wheezing, abdominal pain, sweating, pale complexion, dizziness, and syncope following bread and milk consumption. The clinical symptomatology was associated with electrocardiographic and laboratory evidence of acute inferolateral myocardial infarction, and the patient recovered with epinephrine, antiallergic, and myocardial infarction protocol therapy including ticagrelor and Clexane. Coronary arteriography demonstrated lesions in the left trunk and the three coronary branches, but the stented areas were unobstructed. The allergen test revealed a Grade 2 （2.11 kUA/L） for wheat and Grade 0 for milk.

关键词： SECONDARY HYPERSENSITIVITY INGESTION STENT

Emergence, development, and future of cardio-oncology in China: cardiohypersensitivity, cardiotoxicity and the Kounis syndrome

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Chinese Medical Journal 2019年第6期132卷 753-754页

作者： Nicholas G. Kounis Ioanna Koniari Panagiotis Plotas george D. Soufras Grigorios Tsigkas Periklis Davlouros george hahalis Department of Cardiology University of Patras Medical School Rion Patras Achaia Greece Department of Electrophysiology Queen Elizabeth Hospital Birmingham England United Kingdom Department of Public Health School of Medicine University of Patras Greece Department of Cardiology "Saint Andrews" State General Hospital Patras Achaia Greece

To the Editor:Cancer and cardiovascular disease constitute the two major causes of death worldwide. Whereas the incidence of cancer increases among adults up to 74 years of age, above this age the cardiovascular disease surpasses cancer as the primary cause of mortality.[1] Currently, chemotherapy, radiation therapy, and surgery are the main modalities for the treatment of cancer. However, chemotherapy can induce cardiovascular worsening, manifesting as acute and chronic symptomatology. Therefore, the verv interesting report published in Chinese Medical Journal[2] concerning a 60-year-old male patient suffering from coronary artery disease and squamous cell carcinoma of the left lung who developed an ST segment elevation myocardial infarction following treatment with afatinib (tyrosine kinase inhibitor) and gemcitabine (antimetabolite pyrimidine antagonist) and cisplatin (platinum based DNA replication inhibitor) and the subsequent discussion raise several important considerations on cardiac toxicity, cardiac hypersensitivity and the Kounis-hypersensitivity acute coronary syndrome.

关键词： To the Editor Emergence development cardio-oncology

Kounis syndrome caused by double allergens: the more allergens present, the easier, the quicker, and the more severe the anaphylaxis

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Chinese Medical Journal 2020年第15期133卷 1889-1890页

作者： Nicholas G.Kounis Ioanna Koniari Panagiotis Plotas george D.Soufras Grigorios Tsigkas Periklis Davlouros george hahalis Department of Cardiology University of Patras Medical SchoolRionPatrasAchaiaGreece Electrophysiology and Device Department University Hospital of South Manchester NHS Foundation TrustManchesterUK Department of Cardiology "Saint Andrews"State General HospitalPatrasAchaiaGreece

To the Editor:In the very interesting report published in the Chinese Medical Journal,[1] a 42-year-old Chinese male patient who had not any previous history of cardiovascular disease,but only bee stings without any s... 详细信息

关键词： cardiovascular Medical cycling

The role of echocardiography and CT angiography in transcatheter aortic valve implantation patients

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Journal of Geriatric Cardiology 2018年第1期15卷 86-94页

作者： Emmanouil Chourdakis Ioanna Koniari Nicholas G Kourlis Dimitrios Velissaris Nikolaos Koutsogiannis Grigorios Tsigkas Karl Eugen Hauptmann Bruno Sontag george hahalis Krankenhaus der Barmherzigen Briider Trier Germany Department of Cardiology University Hospital of Patras Rion Patras Greece Department of Internal Medicine University Hospital of Patras Rion Patras Greece

transcatheter 大动脉的阀门培植(TAVI ) 在于在有严重大动脉的狭窄的病人的其他的治疗。Multimodality 成像使用 transthoracic echocardiography (TTE ) 或 transesophageal echocardiography (脚趾) 和 multislice CT (MSCT ) 为外科手术前的管理组成奠基石技术，仙子程序的指导，列在后面在上面并且可能的 transcatheter 阀门的识别联系了复杂并发症。CT angiography 关于大动脉的体环直径和环绕的区域的全部的定义是更精确的。二维(2D ) echocardiography，与 3D 成像技术(MSCT， MRI 和 3D 脚趾) 相比低估大动脉的阀门体环直径。三维的脚趾成像提供类似于 MSCT 交付的那些的大动脉的阀门体环的大小。pre 程序的 MSCT 组成最小化 paravalvular 的存在的标准答案形式大动脉的流回，最经常的复杂并发症之一。TOE/TTE 和 MSCT 性能能预言心律调整器培植 procedural 以后的可能性。一位新短暂或坚持的先生的存在能被脚趾估计很好。TTE 和脚趾，开始在于为柱子 TAVI 评估的基本考试。在 transcatheter 心阀门失败的情况下， MSCT 能被用作另外的成像技术。

关键词：大动脉阀门 CT 培植成像技术外科手术标准答案子程序