Volkmar Falk - Academia.edu (original) (raw)
Papers by Volkmar Falk
Revista Española de Cardiología, 2018
Journal of the American College of Cardiology, 2016
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie, 2017
European Heart Journal, 2017
Authors/Task Force Members: Helmut Baumgartner* (ESC Chairperson) (Germany), Volkmar Falk* (EACTS... more Authors/Task Force Members: Helmut Baumgartner* (ESC Chairperson) (Germany), Volkmar Falk* (EACTS Chairperson) (Germany), Jeroen J. Bax (The Netherlands), Michele De Bonis (Italy), Christian Hamm (Germany), Per Johan Holm (Sweden), Bernard Iung (France), Patrizio Lancellotti (Belgium), Emmanuel Lansac (France), Daniel Rodriguez Mu~ noz (Spain), Raphael Rosenhek (Austria), Johan Sjögren (Sweden), Pilar Tornos Mas (Spain), Alec Vahanian (France), Thomas Walther (Germany), Olaf Wendler (UK), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain)
The Journal of Thoracic and Cardiovascular Surgery, 2020
Nature reviews. Cardiology, Jan 13, 2018
Annals of Biomedical Engineering, 2017
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Jan 6, 2017
This study evaluates reinterventions for degenerated stentless aortic xenografts. Between 2010 an... more This study evaluates reinterventions for degenerated stentless aortic xenografts. Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI). Valve implantation was successful in all surgical (24% root replacement) and in 24 transcatheter cases (93% trans-femoral, 56% balloon-expandable). Procedural complications were aortic dissection (n = 1) during reoperation and coronary obstruction (n = 4), device malpositioning (n = 3), deployment of >1 valve (n = 2) and vascular access site complications (n = 2) during ViV-TAVI....
European heart journal, Jan 22, 2017
RESPOND is a prospective, open-label, single-arm study evaluating the outcomes following transcat... more RESPOND is a prospective, open-label, single-arm study evaluating the outcomes following transcatheter aortic valve implantation (TAVI) with the repositionable and fully retrievable Lotus Valve used in routine clinical practice for the treatment of patients with aortic valve stenosis. RESPOND enrolled 1014 patients at sites across Europe, New Zealand, and Latin America; 996 patients received a Lotus Valve (mean age: 80.8 years; 50.8% female; Society of Thoracic Surgeons score: 6.0 ± 6.9). Repositioning was attempted in 29.2% of patients, with 99% success. The rate of all-cause mortality in the intent-to-treat population at 30 days (primary endpoint) was 2.6% (P < 0.001 vs. pre-specified performance goal). Thirty-day clinical follow-up was completed for 97.3% of patients. Among patients who received a Lotus Valve, the 30-day overall and disabling stroke rates were 3.0% and 2.2%, respectively. The 30-day permanent pacemaker implantation rate was 30.0% in all patients, and 34.6% in ...
Circulation, 2018
This article reviews the context and evidence of recent myocardial revascularization trials that ... more This article reviews the context and evidence of recent myocardial revascularization trials that compared percutaneous coronary intervention with coronary artery bypass grafting for the treatment of left main and multivessel coronary artery disease. We develop the rationale that some of the knowledge synthesis resulting from these trials, particularly with regard to the claimed noninferiority of percutaneous coronary intervention beyond nondiabetic patients with low anatomic complexity, may have been affected by trial design, patient selection based on suitability for percutaneous coronary intervention, and end point optimization favoring percutaneous coronary intervention over coronary artery bypass grafting. We provide recommendations that include holding a circumspect interpretation of the currently available evidence, as well as suggestions for the collaborative design and conduct of future clinical trials in this and other fields.
European Heart Journal, 2017
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2017
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcat... more The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-a...
International Journal of Computer Assisted Radiology and Surgery, 2022
Purpose For an in-depth analysis of the learning benefits that a stereoscopic view presents durin... more Purpose For an in-depth analysis of the learning benefits that a stereoscopic view presents during endoscopic training, surgeons required a custom surgical evaluation system enabling simulator independent evaluation of endoscopic skills. Automated surgical skill assessment is in dire need since supervised training sessions and video analysis of recorded endoscope data are very time-consuming. This paper presents a first step towards a multimodal training evaluation system, which is not restricted to certain training setups and fixed evaluation metrics. Methods With our system we performed data fusion of motion and muscle-action measurements during multiple endoscopic exercises. The exercises were performed by medical experts with different surgical skill levels, using either two or three-dimensional endoscopic imaging. Based on the multi-modal measurements, training features were calculated and their significance assessed by distance and variance analysis. Finally, the features were...
Annals of Biomedical Engineering, 2020
Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist devic... more Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist device (VAD) support represent the only available lifelines for end stage disease. In the context of donor organ shortage, the future role of VAD as destination therapy is emerging. Yet, major drawbacks are connected to the long-term implantation of current devices. Poor VAD hemocompatibility exposes the patient to life-threatening events, including haemorrhagic syndromes and thrombosis. Here, we introduce a new concept of artificial support, the Hybrid Membrane VAD, as a first-of-its-kind pump prototype enabling physiological blood propulsion through the cyclic actuation of a hyperelastic membrane, enabling the protection from the thrombogenic interaction between blood and the implant materials. The centre of the luminal membrane surface displays a rationally-developed surface topography interfering with flow to support a living endothelium. The precast cell layer survives to a range of dyna...
Clinical research in cardiology : official journal of the German Cardiac Society, Jan 4, 2018
Unfortunately, an error occurred in the original article.
Clinical research in cardiology : official journal of the German Cardiac Society, Jan 12, 2018
We sought to investigate the procedural and hemodynamic outcome after valve-in-valve transcathete... more We sought to investigate the procedural and hemodynamic outcome after valve-in-valve transcatheter aortic valve replacement (VinV-TAVR) for different surgical (SBV) and transcatheter (TAVR) bioprosthetic valves. 223 patients (76 ± 11years, STS-Score 8.3 ± 10.1) suffering from SBV failure treated with VinV-TAVR were enrolled at 6 centers across Germany. At time of the intervention, the majority of patients were in NYHA-class ≥ III (88%, n = 180). Failure mode of the SBVs was either stenosis, regurgitation (AR) or a combination of both in 85 (38%), 76 (34%) and 62 (28%) patients, respectively. 138 (62%) patients were treated with first generation TAVR valves (Edwards Sapien XT or CoreValve). Second generation valves were implanted in 85 (38%) patients (Sapien 3, Medtronic CoreValve Evolut, SJM-Portico, JenaValve). VinV-TAVR was associated with high procedural success rate, conversion to surgery was necessary in 3 (2%) patients. After VinV-TAVR procedure, 4 (2%) patients suffered from ...
Expert review of cardiovascular therapy, 2018
Tricuspid valve regurgitation (TR) is frequently encountered and is most often functional (FTR) i... more Tricuspid valve regurgitation (TR) is frequently encountered and is most often functional (FTR) in nature. Surgical tricuspid valve (TV) treatment is well established in specialized centers. While transcatheter therapy for other valve disease is well established, interventional treatment of TV disease is still in its early stages. With the increasing adoption of catheter-based treatments, there is a growing interest in and need for interventional treatments for TR. An extensive literature search was methodologically performed aiming for an integrative review paper. Areas covered: This review will discuss the current surgical treatment modalities and emerging transcatheter interventions in the management of TR. Furthermore, this review will describe the pathophysiology of functional tricuspid regurgitation (FTR), and the new 2017 ESC/EACTS guidelines for the management of TR. Finally, a five-year view into the future will be stated. Expert commentary: At their center, the authors hav...
Interventional cardiology (London, England), 2018
Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment o... more Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment of mitral valve regurgitation, and indications have been expanded to include reoperations. Current European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines for the management of valvular heart disease recommended standards in terms of mitral valve disease differentiation, timing of intervention and surgical techniques to improve patient care. Numerous minimally invasive techniques to lessen the invasiveness have been described, such as the minimal-access J-sternotomy (ministernotomy), the parasternal incision, the port-access technique and the right minithoracotomy. Despite the development of catheter-based techniques, surgical repair remains the gold standard today for nearly all patients with degenerative valvular diseases and the majority of patients with other types of valvular diseases. Techniques include resection of the prolapsed segment, neo-chord...
Revista Española de Cardiología, 2018
Journal of the American College of Cardiology, 2016
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie, 2017
European Heart Journal, 2017
Authors/Task Force Members: Helmut Baumgartner* (ESC Chairperson) (Germany), Volkmar Falk* (EACTS... more Authors/Task Force Members: Helmut Baumgartner* (ESC Chairperson) (Germany), Volkmar Falk* (EACTS Chairperson) (Germany), Jeroen J. Bax (The Netherlands), Michele De Bonis (Italy), Christian Hamm (Germany), Per Johan Holm (Sweden), Bernard Iung (France), Patrizio Lancellotti (Belgium), Emmanuel Lansac (France), Daniel Rodriguez Mu~ noz (Spain), Raphael Rosenhek (Austria), Johan Sjögren (Sweden), Pilar Tornos Mas (Spain), Alec Vahanian (France), Thomas Walther (Germany), Olaf Wendler (UK), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain)
The Journal of Thoracic and Cardiovascular Surgery, 2020
Nature reviews. Cardiology, Jan 13, 2018
Annals of Biomedical Engineering, 2017
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Jan 6, 2017
This study evaluates reinterventions for degenerated stentless aortic xenografts. Between 2010 an... more This study evaluates reinterventions for degenerated stentless aortic xenografts. Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI). Valve implantation was successful in all surgical (24% root replacement) and in 24 transcatheter cases (93% trans-femoral, 56% balloon-expandable). Procedural complications were aortic dissection (n = 1) during reoperation and coronary obstruction (n = 4), device malpositioning (n = 3), deployment of >1 valve (n = 2) and vascular access site complications (n = 2) during ViV-TAVI....
European heart journal, Jan 22, 2017
RESPOND is a prospective, open-label, single-arm study evaluating the outcomes following transcat... more RESPOND is a prospective, open-label, single-arm study evaluating the outcomes following transcatheter aortic valve implantation (TAVI) with the repositionable and fully retrievable Lotus Valve used in routine clinical practice for the treatment of patients with aortic valve stenosis. RESPOND enrolled 1014 patients at sites across Europe, New Zealand, and Latin America; 996 patients received a Lotus Valve (mean age: 80.8 years; 50.8% female; Society of Thoracic Surgeons score: 6.0 ± 6.9). Repositioning was attempted in 29.2% of patients, with 99% success. The rate of all-cause mortality in the intent-to-treat population at 30 days (primary endpoint) was 2.6% (P < 0.001 vs. pre-specified performance goal). Thirty-day clinical follow-up was completed for 97.3% of patients. Among patients who received a Lotus Valve, the 30-day overall and disabling stroke rates were 3.0% and 2.2%, respectively. The 30-day permanent pacemaker implantation rate was 30.0% in all patients, and 34.6% in ...
Circulation, 2018
This article reviews the context and evidence of recent myocardial revascularization trials that ... more This article reviews the context and evidence of recent myocardial revascularization trials that compared percutaneous coronary intervention with coronary artery bypass grafting for the treatment of left main and multivessel coronary artery disease. We develop the rationale that some of the knowledge synthesis resulting from these trials, particularly with regard to the claimed noninferiority of percutaneous coronary intervention beyond nondiabetic patients with low anatomic complexity, may have been affected by trial design, patient selection based on suitability for percutaneous coronary intervention, and end point optimization favoring percutaneous coronary intervention over coronary artery bypass grafting. We provide recommendations that include holding a circumspect interpretation of the currently available evidence, as well as suggestions for the collaborative design and conduct of future clinical trials in this and other fields.
European Heart Journal, 2017
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2017
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcat... more The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-a...
International Journal of Computer Assisted Radiology and Surgery, 2022
Purpose For an in-depth analysis of the learning benefits that a stereoscopic view presents durin... more Purpose For an in-depth analysis of the learning benefits that a stereoscopic view presents during endoscopic training, surgeons required a custom surgical evaluation system enabling simulator independent evaluation of endoscopic skills. Automated surgical skill assessment is in dire need since supervised training sessions and video analysis of recorded endoscope data are very time-consuming. This paper presents a first step towards a multimodal training evaluation system, which is not restricted to certain training setups and fixed evaluation metrics. Methods With our system we performed data fusion of motion and muscle-action measurements during multiple endoscopic exercises. The exercises were performed by medical experts with different surgical skill levels, using either two or three-dimensional endoscopic imaging. Based on the multi-modal measurements, training features were calculated and their significance assessed by distance and variance analysis. Finally, the features were...
Annals of Biomedical Engineering, 2020
Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist devic... more Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist device (VAD) support represent the only available lifelines for end stage disease. In the context of donor organ shortage, the future role of VAD as destination therapy is emerging. Yet, major drawbacks are connected to the long-term implantation of current devices. Poor VAD hemocompatibility exposes the patient to life-threatening events, including haemorrhagic syndromes and thrombosis. Here, we introduce a new concept of artificial support, the Hybrid Membrane VAD, as a first-of-its-kind pump prototype enabling physiological blood propulsion through the cyclic actuation of a hyperelastic membrane, enabling the protection from the thrombogenic interaction between blood and the implant materials. The centre of the luminal membrane surface displays a rationally-developed surface topography interfering with flow to support a living endothelium. The precast cell layer survives to a range of dyna...
Clinical research in cardiology : official journal of the German Cardiac Society, Jan 4, 2018
Unfortunately, an error occurred in the original article.
Clinical research in cardiology : official journal of the German Cardiac Society, Jan 12, 2018
We sought to investigate the procedural and hemodynamic outcome after valve-in-valve transcathete... more We sought to investigate the procedural and hemodynamic outcome after valve-in-valve transcatheter aortic valve replacement (VinV-TAVR) for different surgical (SBV) and transcatheter (TAVR) bioprosthetic valves. 223 patients (76 ± 11years, STS-Score 8.3 ± 10.1) suffering from SBV failure treated with VinV-TAVR were enrolled at 6 centers across Germany. At time of the intervention, the majority of patients were in NYHA-class ≥ III (88%, n = 180). Failure mode of the SBVs was either stenosis, regurgitation (AR) or a combination of both in 85 (38%), 76 (34%) and 62 (28%) patients, respectively. 138 (62%) patients were treated with first generation TAVR valves (Edwards Sapien XT or CoreValve). Second generation valves were implanted in 85 (38%) patients (Sapien 3, Medtronic CoreValve Evolut, SJM-Portico, JenaValve). VinV-TAVR was associated with high procedural success rate, conversion to surgery was necessary in 3 (2%) patients. After VinV-TAVR procedure, 4 (2%) patients suffered from ...
Expert review of cardiovascular therapy, 2018
Tricuspid valve regurgitation (TR) is frequently encountered and is most often functional (FTR) i... more Tricuspid valve regurgitation (TR) is frequently encountered and is most often functional (FTR) in nature. Surgical tricuspid valve (TV) treatment is well established in specialized centers. While transcatheter therapy for other valve disease is well established, interventional treatment of TV disease is still in its early stages. With the increasing adoption of catheter-based treatments, there is a growing interest in and need for interventional treatments for TR. An extensive literature search was methodologically performed aiming for an integrative review paper. Areas covered: This review will discuss the current surgical treatment modalities and emerging transcatheter interventions in the management of TR. Furthermore, this review will describe the pathophysiology of functional tricuspid regurgitation (FTR), and the new 2017 ESC/EACTS guidelines for the management of TR. Finally, a five-year view into the future will be stated. Expert commentary: At their center, the authors hav...
Interventional cardiology (London, England), 2018
Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment o... more Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment of mitral valve regurgitation, and indications have been expanded to include reoperations. Current European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines for the management of valvular heart disease recommended standards in terms of mitral valve disease differentiation, timing of intervention and surgical techniques to improve patient care. Numerous minimally invasive techniques to lessen the invasiveness have been described, such as the minimal-access J-sternotomy (ministernotomy), the parasternal incision, the port-access technique and the right minithoracotomy. Despite the development of catheter-based techniques, surgical repair remains the gold standard today for nearly all patients with degenerative valvular diseases and the majority of patients with other types of valvular diseases. Techniques include resection of the prolapsed segment, neo-chord...