Publications of Mathieu LEMPEREUR
Bookmark and Share    
Full Text
See detailTraitement percutane des communications inter-auriculaires et des foramen ovales permeables.
LEMPEREUR, Mathieu ULiege; Lancellotti, Patrizio ULiege

in Revue medicale de Liege (2019), 74(S1), 87-96

Atria septal defect (ASD) is one of the most common congenital heart disease. ASD can be responsible for a volume overload of the right chambers associated with an increased morbi-mortality. In these ... [more ▼]

Atria septal defect (ASD) is one of the most common congenital heart disease. ASD can be responsible for a volume overload of the right chambers associated with an increased morbi-mortality. In these circumstances, percutaneous closure of ASD secundum-type is recommended as a first line therapy. The persistence of a patent foramen ovale (PFO) is found in approximately 25 % of adults. This anomaly can be responsible for paradoxical embolism, especially cryptogenic stroke. Recent studies have shown a clinical benefit to the percutaneous closure of FOP in cryptogenic stroke, with a modest, but significant, decrease in the risk of recurrence. In this article, we discuss the indications and procedure for percutaneous closure of ASD and PFO. [less ▲]

Detailed reference viewed: 69 (3 ULiège)
Full Text
See detailEvaluation physiologique invasive de la maladie coronarienne.
MARECHAL, Patrick ULiege; LEMPEREUR, Mathieu ULiege; GACH, Olivier ULiege et al

in Revue medicale de Liege (2019), 74(S1), 22-28

Percutaneous or surgical coronary revascularization must only be realized if myocardial ischemia is clearly demonstrated. In practice, this ischemia is most often seeked by non-invasive tests. These ones ... [more ▼]

Percutaneous or surgical coronary revascularization must only be realized if myocardial ischemia is clearly demonstrated. In practice, this ischemia is most often seeked by non-invasive tests. These ones are unfortunately not systematically realized or may bring equivocal results compared to angiographic images. Coronary angiography remains the test of choice for the evaluation of coronary disease, but visual analysis of coronary stenosis does not confirm their hemodynamic significance. The measurement of coronary flow reserve by FFR ("fractional flow reserve") or iFR (<<instantaneous wave-free ratio>>) is a simple method to invasively assess the hemodynamic impact of a coronary lesion. Spastic angina, when suspected by clinical history, can also be confirmed during coronary angiography by the provocative methylergonovine test. [less ▲]

Detailed reference viewed: 58 (2 ULiège)
Full Text
See detailAtherectomie rotationnelle (Rotablator(R)) : technique complémentaire dans la prise en charge des lésions coronaires indilatables.
GACH, Olivier ULiege; LEMPEREUR, Mathieu ULiege; MARECHAL, Patrick ULiege et al

in Revue medicale de Liege (2019), 74(S1), 39-43

In 40 years of existence, interventional cardiology has witnessed the introduction of numerous tools and techniques that have contributed to the important application's broadening of percutaneous ... [more ▼]

In 40 years of existence, interventional cardiology has witnessed the introduction of numerous tools and techniques that have contributed to the important application's broadening of percutaneous techniques, particulary in anatomical situations previously unfavourable, and which were, at that time, subject to surgical revascularization. Among these hostiles situations, one of the principal consists in failure to adequately dilate the lesions and/or to the inability to deliver and implant a stent appropriately, situations frequently associated with a high rate of procedural complications and poor long-term clinical outcomes. Thanks to the development of complementary dedicated techniques such atherectomy device, the treatment of most fibrotic and heavily calcified lesions has become feasible and safe. The present article describes the rotational atherectomy procedure, its indications and its clinical results. [less ▲]

Detailed reference viewed: 44 (3 ULiège)
Full Text
See detailFermeture percutanee de l'auricule gauche pour la prevention des complications thrombo-emboliques en cas de fibrillation auriculaire.
LEMPEREUR, Mathieu ULiege; DAVIN, Laurent ULiege; DULGHERU, Raluca Elena ULiege et al

in Revue medicale de Liege (2019), 74(S1), 97-103

Atrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from ... [more ▼]

Atrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from oral anticoagulation (OAC) are not treated. In case of contra-indications to long-term OAC, left atrial appendage (LAA) closure allows the exclusion of the LAA from the systemic circulation and significantly reduces the thromboembolism risk. Results from large randomized trials show that this technique is non-inferior in terms of efficacy compared to OAC and that it can significantly reduce the rate of haemorrhagic complications. Large-scale registries show promising results in patients with contra-indications to long-term OAC. Clinical trials are under way to define the role and spectrum of LAA occlusion and to optimize post-procedural treatment. [less ▲]

Detailed reference viewed: 77 (3 ULiège)
Full Text
See detailFermeture percutanee des fuites paravalvulaires.
Lancellotti, Patrizio ULiege; LEMPEREUR, Mathieu ULiege; MARCHETTA, Stella ULiege et al

in Revue medicale de Liege (2019), 74(S1), 82-86

Paravalvular leaks (PVL) are a serious complication after surgical or transcatheter aortic valve replacement. They are mostly small and unimportant. When they manifest clinically (1 to 5 % of PVL), they ... [more ▼]

Paravalvular leaks (PVL) are a serious complication after surgical or transcatheter aortic valve replacement. They are mostly small and unimportant. When they manifest clinically (1 to 5 % of PVL), they can become responsible for severe hemolytic anaemia or cause congestive heart failure. For years, surgical re-intervention has been considered the treatment of choice for symptomatic patients with PVL. However, surgical re-intervention is associated with a high risk of morbidity and mortality. Percutaneous PVL closure is a less invasive alternative to surgical re-intervention. The safety and feasibility of percutaneous PVL closure has been confirmed in several studies. In this article, we discuss the issue of PVL and their percutaneous management. [less ▲]

Detailed reference viewed: 35 (2 ULiège)
Full Text
See detailInterventions mitrales percutanees.
LEMPEREUR, Mathieu ULiege; DULGHERU, Raluca Elena ULiege; MARCHETTA, Stella ULiege et al

in Revue medicale de Liege (2019), 74(S1), 73-81

After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral ... [more ▼]

After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral regurgitation. In case of high or prohibitive surgical risk, new techniques are developed to allow percutaneous, less invasive management. In these circumstances, MitraClip(R) allows the treatment of mitral regurgitation in case of adequate valve morphology. Percutaneous balloon valvuloplasty is currently the first-line treatment of mitral stenosis related to rheumatic disease when anatomical features are favourable. Alongside the Inoue technique, which remains the classical procedure, other approaches are available with encouraging results. [less ▲]

Detailed reference viewed: 54 (2 ULiège)
Full Text
See detailCoronarographie diagnostique.
GACH, Olivier ULiege; DAVIN, Laurent ULiege; LEMPEREUR, Mathieu ULiege et al

in Revue medicale de Liege (2019), 74(S1), 17-21

Coronarography consists in selective angiography of the coronary arteries obtained invasively. It represents the gold standard for the anatomical exploration of the coronary arteries and establishes the ... [more ▼]

Coronarography consists in selective angiography of the coronary arteries obtained invasively. It represents the gold standard for the anatomical exploration of the coronary arteries and establishes the first step for the indication of possible percutaneous or surgical revascularisation. According to substantial progress, it represents an essential diagnostic tool frequently used with, despite its invasive characteristic, a very low complication's rate. The present article describes the patient's preparation for this procedure, technical modalities, major indications, contraindications and possible complications. [less ▲]

Detailed reference viewed: 134 (4 ULiège)
Full Text
See detailAngioplastie coronaire transluminale percutanée : de la révolution à l'évolution.
GACH, Olivier ULiege; DAVIN, Laurent ULiege; LEMPEREUR, Mathieu ULiege et al

in Revue medicale de Liege (2019), 74(S1), 34-38

In interventional cardiology, percutaneous transluminal coronary angioplasty (PTCA) definitely represents a revolution in the history of medicine, illustrating the medical community intention to replace ... [more ▼]

In interventional cardiology, percutaneous transluminal coronary angioplasty (PTCA) definitely represents a revolution in the history of medicine, illustrating the medical community intention to replace aggressive revascularization intervention by less invasive procedure. Rapidly adopted by physicians and patients, its utilization has grown exponentially and in parallel, numerous technical progresses have pushed forward the frontiers of its indications. This article summarizes the principal evolution of this revascularization technique from its beginning until its last innovations, describing some technical characteristics and emphasizing on some changes and extension of its indications. [less ▲]

Detailed reference viewed: 77 (4 ULiège)
Full Text
See detailLe "Heart Team" : definition et organisation. Point de Vue du Cardiologue.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; DAVIN, Laurent ULiege et al

in Revue medicale de Liege (2019), 74(S1), 5-9

The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the <<Heart Team>> or literally <<Equipe du coeur>> occupies a ... [more ▼]

The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the <<Heart Team>> or literally <<Equipe du coeur>> occupies a prominent place in the latest European and American recommendations, particularly in the management of complex coronary or valvular diseases and in heart failure patients. The concept of <<Heart Team>> is based on the need for a multidisciplinary holistic approach based on evidence (respect of the recommendations of the scientific societies), the patient as a whole (comorbidities, preferences), risks and long-term benefits of the treatment selected and performed, as well as on the level of local expertise. It aims to determine the best management strategy for the patient, and perhaps to guarantee a better result (prognosis). [less ▲]

Detailed reference viewed: 80 (9 ULiège)
Full Text
See detailReal-time fusion of echocardiography and fluoroscopy allowing successful implantation of a WATCHMAN device without contrast injection.
Aminian, Adel; LEMPEREUR, Mathieu ULiege; Ben Yedder, Mohammed et al

in EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2018), 14(2), 174-175

Detailed reference viewed: 32 (1 ULiège)
Full Text
See detailSuboptimal Device Implantation May Increase the Occurrence of Device Thrombosis After Left Atrial Appendage Occlusion.
Aminian, Adel; Lalmand, Jacques; Ben Yedder, Mohamed et al

in Journal of the American College of Cardiology (2018), 72(4), 473-474

Detailed reference viewed: 34 (2 ULiège)
Full Text
See detailTranscatheter left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: results from the Belgian registry.
Kefer, Joelle; Aminian, Adel; Vermeersch, Paul et al

in EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2018), 13(13), 1603-1611

AIMS: This study aimed to assess the safety and efficacy at midterm follow-up of left atrial appendage occlusion (LAAO) using different devices, in real life in Belgium. METHODS AND RESULTS: Between June ... [more ▼]

AIMS: This study aimed to assess the safety and efficacy at midterm follow-up of left atrial appendage occlusion (LAAO) using different devices, in real life in Belgium. METHODS AND RESULTS: Between June 2009 and November 2016, 457 consecutive patients (63% male, 75+/-12 yrs, CHA2DS2-VASc 4+/-0.6, HAS-BLED 3.5+/-0.7) undergoing LAAO were included. Technical success was 97.1%. There were 19 periprocedural major adverse events (4.1%) including three deaths (0.6%), nine tamponades (1.9%), four major bleedings (0.8%) and two device embolisations (0.4%). Among patients successfully implanted having a complete follow-up (672 patient-years, median follow-up 370 days), the actual annual stroke rate was 1.2%, lower than the expected stroke risk of 4% (70% reduction). The observed bleeding rate was 2%, while the calculated risk was 3.7% (46% reduction). Kaplan-Meier analysis showed a similar overall survival (93+/-2% and 87+/-3% versus 91+/-3% and 87+/-4%; p=0.35) and event-free survival (92+/-2% and 84+/-3% versus 88+/-3% and 80+/-5%; p=0.17) at one and two years, for the ACP/Amulet versus the WATCHMAN groups of patients, respectively. CONCLUSIONS: The data from the Belgian left atrial appendage occlusion registry suggest that the procedure is effective and relatively safe in a real-world setting, using either the WATCHMAN or the ACP/Amulet device. [less ▲]

Detailed reference viewed: 25 (4 ULiège)
Full Text
See detailContribution to the Study of Percutaneous Left Atrial Appendage Occlusion
LEMPEREUR, Mathieu ULiege

Doctoral thesis (2017)

Detailed reference viewed: 35 (4 ULiège)
Full Text
See detailROLE OF IMAGING IN LEFT ATRIAL APPENDAGE OCCLUSION
LEMPEREUR, Mathieu ULiege; AMINIAN, Adel; DULGHERU, Raluca Elena ULiege et al

in International Journal of Cardiovascular Practice (2017), 2(2), 33-43

Detailed reference viewed: 62 (6 ULiège)
Full Text
See detailPourquoi traiter une occlusion coronaire totale chronique ?
MARECHAL, Patrick ULiege; GACH, Olivier ULiege; DAVIN, Laurent ULiege et al

in Revue Médicale Suisse (2017), 13(571), 1406-1409

Despite an incidence of about 15% of the patients undergoing coronary angiography, total chronic occlusions (CTO) are rarely revascularized by percutaneous angioplasty (PCI). Nevertheless, current ... [more ▼]

Despite an incidence of about 15% of the patients undergoing coronary angiography, total chronic occlusions (CTO) are rarely revascularized by percutaneous angioplasty (PCI). Nevertheless, current evidence suggest that successful CTO-PCI improve symptoms, quality of live and long-term survival. During the last years, improvement of specific techniques for these complexes procedures and increasing experience of operators allow actually to obtain success and complications rates almost equivalent to non-CTO lesions angioplasty. This review focus on the clinical benefits of CTO revascularization and on appropriate patient selection. [less ▲]

Detailed reference viewed: 174 (5 ULiège)
Full Text
See detailDevice-associated thrombus formation after left atrial appendage occlusion: A systematic review of events reported with the Watchman, the Amplatzer Cardiac Plug and the Amulet.
LEMPEREUR, Mathieu ULiege; Aminian, Adel; Freixa, Xavier et al

in Catheterization and Cardiovascular Interventions (2017), 90(5), 111-121

OBJECTIVES: This study aimed to provide a systematic review of device-associated thrombosis (DAT) after left atrial appendage occlusion (LAAO) with the Watchman, Amplatzer Cardiac Plug, and Amulet devices ... [more ▼]

OBJECTIVES: This study aimed to provide a systematic review of device-associated thrombosis (DAT) after left atrial appendage occlusion (LAAO) with the Watchman, Amplatzer Cardiac Plug, and Amulet devices. BACKGROUND: DAT is known as a complication of LAAO but data about its clinical impact is scarce. METHODS: A systematic review of studies evaluating the incidence, treatment and clinical implications of DAT from January 2008 to September 2015 was conducted. RESULTS: A total of 30 studies describing DAT events were included in the analysis. The overall incidence of DAT was 3.9% (82 DAT for 2118 implanted devices). The median time from procedure to diagnosis of DAT was 1.5 months (IQR: 0-2.9). Most cases were diagnosed with transesophageal echocardiogram (TEE). The treatment consisted of low molecular weight heparin (LMWH) in 45.5% of cases, and oral anticoagulation (OAC) or other treatment modalities in 54.5%. Complete thrombus resolution was achieved in 95.0% of cases (100% with LMWH and 89.5% with OAC). Treatment duration varied greatly with a median treatment duration of 45 days (IQR: 14-135). Clinical events related to DAT consisted of neurologic events namely two transient ischemic attacks (2.4%) and four ischemic strokes (4.9%). CONCLUSIONS: DAT is an infrequent complication of percutaneous LAAO. It occurs mainly early after the procedure and is associated with a low rate of neurological complications. In the majority of cases, diagnosis is made during follow-up imaging with TEE. Anticoagulation treatment seems to be safe and highly effective. Further studies are needed to evaluate the optimal management of DAT. (c) 2017 Wiley Periodicals, Inc. [less ▲]

Detailed reference viewed: 14 (1 ULiège)
Full Text
See detailLeft Atrial Appendage Occlusion in Patients With Atrial Fibrillation and Previous Major Gastrointestinal Bleeding (from the Amplatzer Cardiac Plug Multicenter Registry).
LEMPEREUR, Mathieu ULiege; Aminian, Adel; Freixa, Xavier et al

in American Journal of Cardiology (2017), 120(3), 414-420

History of major gastrointestinal (GI) bleeding may represent a frequent clinical indication for left atrial appendage occlusion (LAAO) in patients with non-valvular atrial fibrillation (AF). This study ... [more ▼]

History of major gastrointestinal (GI) bleeding may represent a frequent clinical indication for left atrial appendage occlusion (LAAO) in patients with non-valvular atrial fibrillation (AF). This study aims to investigate the procedural safety and long-term outcome of patients with previous major GI bleeding (MGIB) who underwent LAAO. Data from the Amplatzer Cardiac Plug multicenter registry on 1,047 patients were analyzed. Patients with previous MGIB as indication for LAAO were compared with patients without previous MGIB. A total of 151 patients (14.4%) with previous MGIB were identified. Periprocedural major bleeding events were more frequent in patients with previous MGIB (4.0% vs 0.8%, p = 0.001). With an average follow-up of 1.3 years, the observed annual rate of stroke/transient ischemic attack and major bleeding for patients with previous MGIB were 2.1% (61.4% relative reduction according to the Congestive Heart failure, Hypertension, Age >/=75 (doubled), Diabetes, Stroke (doubled), Vascular disease, Age 65-74, and Sex (female) [CHA2DS2-VASc] score) and 4.6% (20.1% relative reduction according to the expected rate based on the Hypertension, Abnormal renal/liver function (1 point each), Stroke, Bleeding history or predisposition, Labile INR, Elderly (>65 years), Drugs/alcohol concomitantly (1 point each) [HAS-BLED] score), respectively. In conclusion, in patients with non-valvular atrial fibrillation and previous MGIB, LAAO was associated with a low annual rate of stroke/transient ischemic attack. Periprocedural major bleeding events were more frequent in this specific population although the annual major bleeding rate showed a 20.1% relative risk reduction according to the HAS-BLED score. [less ▲]

Detailed reference viewed: 27 (3 ULiège)
Full Text
See detailL'IMAGE DU MOIS. Une fistule coronaro-ventriculaire gauche.
MARCHETTA, Stella ULiege; LEMPEREUR, Mathieu ULiege; Gach, Olivier ULiege

in Revue Médicale de Liège (2016), 71(1), 4-5

Detailed reference viewed: 90 (7 ULiège)
Full Text
See detailA 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis.
Bogale, Nigussie; LEMPEREUR, Mathieu ULiege; Fung, Anthony Y.

in Cardiovascular Revascularization Medicine: including Molecular Interventions (2016), 17(5), 346-52

UNLABELLED: Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with ... [more ▼]

UNLABELLED: Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with minimal mechanical intervention followed by delayed PCI 1-2days later guided by Optical Coherence Tomography (OCT). From October 2011 to December 2013, we treated 5 patients with this approach. Time from early recanalization to the delayed definitive PCI was 1day (median, range 1-3days). All the OCT images were diagnostic with a clear view of the underlying structures. SUMMARY: A 2-step approach to treat stent thrombosis appears beneficial with low incidence of peri-procedural thrombosis or no-reflow phenomena during the second step, and superb OCT imaging. [less ▲]

Detailed reference viewed: 29 (4 ULiège)