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8. Virtual downsizing for decision support in mitral valve repair

Author

Neugebauer, M., Tautz, L., Hüllebrand, M., Sündermann, S., Degener, F., Goubergrits, L., Kühne, T., Falk, V., Hennemuth, A., and Publica

Abstract

Purpose Various options are available for the treatment of mitral valve insufficiency, including reconstructive approaches such as annulus correction through ring implants. The correct choice of general therapy and implant is relevant for an optimal outcome. Additional to guidelines, decision support systems (DSS) can provide decision aid by means of virtual intervention planning and predictive simulations. Our approach on virtual downsizing is one of the virtual intervention tools that are part of the DSS workflow. It allows for emulating a ring implantation based on patient-specific lumen geometry and vendor-specific implants. Methods Our approach is fully automatic and relies on a lumen mask and an annulus contour as inputs. Both are acquired from previous DSS workflow steps. A virtual surface- and contour-based model of a vendor-specific ring design (26-40 mm) is generated. For each case, the ring geometry is positioned with respect to the original, patient-specific annulus and additional anatomical landmarks. The lumen mesh is parameterized to allow for a vertex-based deformation with respect to the user-defined annulus. Derived from post-interventional observations, specific deformation schemes are applied to atrium and ventricle and the lumen mesh is altered with respect to the ring location. Results For quantitative evaluation, the surface distance between the deformed lumen mesh and segmented post-operative echo lumen close to the annulus was computed for 11 datasets. The results indicate a good agreement. An arbitrary subset of six datasets was used for a qualitative evaluation of the complete lumen. Two domain experts compared the deformed lumen mesh with post-interventional echo images. All deformations were deemed plausible. Conclusion Our approach on virtual downsizing allows for an automatic creation of plausible lumen deformations. As it takes only a few seconds to generate results, it can be added to a virtual intervention toolset without unnecessarily increasing the pipeline complexity.

Published
2019

9. Prognostic Parameters for a Severe Disease Course in Pediatric Patients with Suspected Myocarditis: Data from the Prospective Multicenter Registry “MYKKE”

Author

Degener, F., additional, Opgen-Rhein, B., additional, Wagner, R., additional, Boehne, M., additional, Boecker, D., additional, Reineker, K., additional, Wiegand, G., additional, Racolta, A., additional, Müller, G., additional, Kiski, D., additional, Rentzsch, A., additional, Fischer, M., additional, Papakostas, K., additional, Ruf, B., additional, Hannes, T., additional, Khalil, M., additional, Kaestner, M., additional, Steinmetz, M., additional, ÖZcan, S., additional, Fischer, G., additional, Freudenthal, N., additional, Schweigmann, U., additional, Pickardt, T., additional, Huber, C., additional, Messroghli, D., additional, and Schubert, S., additional

Published
2020
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12. Impact of Endomyocardial Biopsy on Treatment and Outcome in Pediatric Myocarditis: Results from the German Multicenter Registry for Pediatric Myocarditis “MYKKE”

Author

Degener, F., additional, Opgen-Rhein, B., additional, Wagner, R., additional, Boehne, M., additional, Weigelt, A., additional, Reineker, K., additional, Racolta, A., additional, Müller, G., additional, Wiegand, G., additional, Kiski, D., additional, Rentzsch, A., additional, Papakostas, K., additional, Ruf, B., additional, Hannes, T., additional, Khalil, M., additional, Fischer, M., additional, Kaestner, M., additional, Steinmetz, M., additional, Freudenthal, N., additional, Fischer, G., additional, Panagiotou, E., additional, Schweigmann, U., additional, Pickardt, T., additional, Klingel, K., additional, Messroghli, D., additional, and Schubert, S., additional

Published
2019
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14. Survival and Outcome in Pediatric Myocarditis - 3 Year Data from the German Multi-center Prospective Myocarditis Registry: “MYKKE”

Author

Schubert, S., primary, Opgen-Rhein, B., additional, Böhne, M., additional, Weigelt, A., additional, Wagner, R., additional, Müller, G., additional, Rentzsch, A., additional, Racolta, A., additional, Papakostas, K., additional, Wiegand, G., additional, Ruf, B., additional, Hannes, T., additional, Reineker, K., additional, Kiski, D., additional, Khalil, M., additional, Steinmetz, M., additional, Fischer, G., additional, Pickardt, T., additional, Klingel, K., additional, Messroghli, D., additional, and Degener, F., additional

Published
2018
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15. Survival and Outcome in Pediatric Myocarditis-3 Year Data from the German Multi-center Prospective Myocarditis Registry: MYKKE

Author

Schubert, S., Opgen-Rhein, B., Boehne, M., Weigelt, A., Wagner, R., Mueller, G., Rentzsch, A., Racolta, A., Papakostas, K., Wiegand, G., Ruf, B., Hannes, T., Reineker, K., Kiski, D., Khalil, M., Steinmetz, M., Fischer, G., Pickardt, T., Klingel, K., Messroghli, D., Degener, F., Schubert, S., Opgen-Rhein, B., Boehne, M., Weigelt, A., Wagner, R., Mueller, G., Rentzsch, A., Racolta, A., Papakostas, K., Wiegand, G., Ruf, B., Hannes, T., Reineker, K., Kiski, D., Khalil, M., Steinmetz, M., Fischer, G., Pickardt, T., Klingel, K., Messroghli, D., and Degener, F.

Published
2018

22. Four-Year Experience of the German Multicenter Registry for Pediatric Patients with Suspected Myocarditis: MYKKE

Author

Degener, F., additional, Opgen-Rhein, B., additional, Böhne, M., additional, Weigelt, A., additional, Wagner, R., additional, Müller, G., additional, Racolta, A., additional, Rentzsch, A., additional, Papakostas, K., additional, Reineker, K., additional, Kiski, D., additional, Ruf, B., additional, Wiegand, G., additional, Hannes, T., additional, Khalil, M., additional, Fischer, M., additional, Kaestner, M., additional, Steinmetz, M., additional, Fischer, G., additional, Freudenthal, N., additional, Pickardt, T., additional, Messroghli, D., additional, and Schubert, S., additional

Published
2018
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25. Assist Device Therapy for Myocarditis - Analysis from the German Multi-Centre Prospective Myocarditis Registry in Pediatric Patients: “Mykke”

Author

Schubert, S., primary, Degener, F., additional, Opgen-Rhein, B., additional, Schmidt, F., additional, Weigelt, A., additional, Wagner, R., additional, Mir, T., additional, Rentzsch, A., additional, Knyphausen, E.z., additional, Papkostas, K., additional, Wiegand, G., additional, Ruf, B., additional, Hannes, T., additional, Reineker, K., additional, Kiski, D., additional, Khalil, M., additional, Steinmetz, M., additional, Fischer, G., additional, Pickardt, T., additional, Messroghli, D., additional, and MYKKE Consortium, O.O., additional

Published
2017
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26. Assist Device Therapy for Myocarditis - Analysis from the German Multi-Centre Prospective Myocarditis Registry in Pediatric Patients: Mykke

Author

Schubert, S., Degener, F., Opgen-Rhein, B., Schmidt, F., Weigelt, A., Wagner, R., Mir, T., Rentzsch, A., Knyphausen, E. Z., Papkostas, K., Wiegand, G., Ruf, B., Hannes, T., Reineker, K., Kiski, D., Khalil, M., Steinmetz, M., Fischer, G., Pickardt, T., Messroghli, D., Schubert, S., Degener, F., Opgen-Rhein, B., Schmidt, F., Weigelt, A., Wagner, R., Mir, T., Rentzsch, A., Knyphausen, E. Z., Papkostas, K., Wiegand, G., Ruf, B., Hannes, T., Reineker, K., Kiski, D., Khalil, M., Steinmetz, M., Fischer, G., Pickardt, T., and Messroghli, D.

Published
2017

27. Update on Baseline Data and First 1-Year Follow-up of the German Multicenter Myocarditis Registry for Pediatric Patients: “MYKKE”

Author

Degener, F., additional, Opgen-Rhein, B., additional, Schmidt, F., additional, Weigelt, A., additional, Wagner, R., additional, Müller, G., additional, Rentzsch, A., additional, Racolta, A., additional, Papakostas, K., additional, Wiegand, G., additional, Ruf, B., additional, Hannes, T., additional, Reineker, K., additional, Kiski, D., additional, Khalil, M., additional, Steinmetz, M., additional, Fischer, G., additional, Pickardt, T., additional, Messroghli, D., additional, and Schubert, S., additional

Published
2017
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33. Cold-induced urticaria and angioedema. Classification, diagnosis and therapy [Kälteinduzierte quaddeln und angioödeme. Klassifikation, diagnostik und therapie]

Author

Krause, K. Degener, F. Altrichter, S. Ardelean, E. Kalogeromitros, D. Magerl, M. Metz, M. Siebenhaar, F. Weller, K. Maurer, M.

Subjects
immune system diseases, skin and connective tissue diseases
Abstract

The onset of wheals and/or angioedema following the exposure to cold may be associated with a number of different diseases. Most frequently this occurs in cold contact urticaria, a type of physical urticaria, which is characterized by a positive cold stimulation test. The clinical symptoms are based on cold-dependent mast cell activation with subsequent release of proinflammatory mediators. In cases of negative or atypical reaction to cold stimulation testing rare acquired atypical or familiar cold urticaria forms may be suspected. Strict avoidance of cold should be recommended as far as possible. As the underlying causes of cold contact urticaria are widely unknown, the symptomatic use of non-sedating antihistamines is the treatment of first choice. The very rare familiar cold auto-inflammatory syndrome (FCAS) is based on CIAS1/NLRP3 mutations and may be treated effectively by neutralization of pathogenic interleukin 1β. © 2010 Springer-Verlag.

Published
2010

34. (36) - Assist Device Therapy for Myocarditis - Analysis from the German Multi-Centre Prospective Myocarditis Registry in Pediatric Patients: “Mykke”

Author

Schubert, S., Degener, F., Opgen-Rhein, B., Schmidt, F., Weigelt, A., Wagner, R., Mir, T., Rentzsch, A., Knyphausen, E.z., Papkostas, K., Wiegand, G., Ruf, B., Hannes, T., Reineker, K., Kiski, D., Khalil, M., Steinmetz, M., Fischer, G., Pickardt, T., Messroghli, D., and MYKKE Consortium, O.O.

Published
2017
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36. Four-Year Experience of the German Multicenter Registry for Pediatric Patients with Suspected Myocarditis: MYKKE.

Author

Degener, F., Opgen-Rhein, B., Böhne, M., Weigelt, A., Wagner, R., Müller, G., Racolta, A., Rentzsch, A., Papakostas, K., Reineker, K., Kiski, D., Ruf, B., Wiegand, G., Hannes, T., Khalil, M., Fischer, M., Kaestner, M., Steinmetz, M., Fischer, G., and Freudenthal, N.

Subjects
*MYOCARDITIS, *HEART failure in children, *AGE factors in disease, *CARDIOMYOPATHIES, *SYMPTOMS, *GENETICS, *DISEASE risk factors
Published
2018
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44. Euphorbia hillebrandii var. wainianoana

Author

O. Degener, F. Salucop & E.Y. Hosaka, O. Degener, F. Salucop & E.Y. Hosaka, O. Degener, F. Salucop & E.Y. Hosaka, and O. Degener, F. Salucop & E.Y. Hosaka

Abstract

Angiosperms, http://name.umdl.umich.edu/IC-HERB00IC-X-1303381%5DMICH-V-1303381, https://quod.lib.umich.edu/cgi/i/image/api/thumb/herb00ic/1303381/MICH-V-1303381/!250,250, The University of Michigan Library provides access to these materials for educational and research purposes. Some materials may be protected by copyright. If you decide to use any of these materials, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about the collection, please contact the Herbarium professional staff: herb-dlps-help@umich.edu. If you have concerns about the inclusion of an item in this collection, please contact Library Information Technology: libraryit-info@umich.edu., https://www.lib.umich.edu/about-us/policies/copyright-policy

Published
1938

50. Ticagrelor Removal by CytoSorb ® in Patients Requiring Emergent or Urgent Cardiac Surgery: A UK-Based Cost-Utility Analysis.

Author

Javanbakht M, Trevor M, Rezaei Hemami M, Rahimi K, Branagan-Harris M, Degener F, Adam D, Preissing F, Scheier J, Cook SF, and Mortensen E

Abstract

Background: Acute coronary syndrome patients receiving dual antiplatelet therapy who need emergent or urgent cardiac surgery are at high risk of major bleeding, which can impair postoperative outcomes. CytoSorb ® , a blood purification technology based on adsorbent polymer, has been demonstrated to remove ticagrelor from blood during on-pump cardiac surgery., Objective: The aim of this study was to evaluate the cost utility of intraoperative removal of ticagrelor using CytoSorb versus usual care among patients requiring emergent or urgent cardiac surgery in the UK., Methods: A de novo decision analytic model, based on current treatment pathways, was developed to estimate the short- and long-term costs and outcomes. Results from randomised clinical trials and national standard sources such as National Health Service (NHS) reference costs were used to inform the model. Costs were estimated from the NHS and Personal Social Services perspective. Deterministic and probabilistic sensitivity analyses (PSAs) explored the uncertainty surrounding the input parameters., Results: In emergent cardiac surgery, intraoperative removal of ticagrelor using CytoSorb was less costly (£12,933 vs. £16,874) and more effective (0.06201vs. 0.06091 quality-adjusted life-years) than cardiac surgery without physiologic clearance of ticagrelor over a 30-day time horizon. For urgent cardiac surgery, the use of CytoSorb was less costly than any of the three comparators-delaying surgery for natural washout without adjunctive therapy, adjunctive therapy with short-acting antiplatelet agents, or adjunctive therapy with low-molecular-weight heparin. Results from the PSAs showed that CytoSorb has a high probability of being cost saving (99% in emergent cardiac surgery and 53-77% in urgent cardiac surgery, depending on the comparators). Cost savings derive from fewer transfusions of blood products and re-thoracotomies, and shorter stay in the hospital/intensive care unit., Conclusions: The implementation of CytoSorb as an intraoperative intervention for patients receiving ticagrelor undergoing emergent or urgent cardiac surgery is a cost-saving strategy, yielding improvement in perioperative and postoperative outcomes and decreased health resource use.

Published
2020
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