Publications of Mathieu LEMPEREUR
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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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See detailContribution to the Study of Percutaneous Left Atrial Appendage Occlusion
LEMPEREUR, Mathieu ULiege

Doctoral thesis (2017)

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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

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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 ▲]

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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

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See detailImpact of gender difference in hospital outcomes following percutaneous coronary intervention. Results of the Belgian Working Group on Interventional Cardiology (BWGIC) registry
LEMPEREUR, Mathieu ULiege; Magne, Julien; Cornelis, Kristoff et al

in EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2014)

Aims: To determine whether there are gender-based differences in in-hospital outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods and results: We studied a large cohort ... [more ▼]

Aims: To determine whether there are gender-based differences in in-hospital outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods and results: We studied a large cohort using clinical data from a registry of 130,985 PCI procedures in Belgium, from January 2006 to February 2011. Compared to males, females were significantly older (70.3 vs. 64.8 years), and were more frequently diabetic or hypertensive. Men smoked more and more frequently had previous myocardial infarction (MI), previous PCI or previous coronary artery bypass graft (CABG) surgery. Coronary artery disease (CAD) was less severe in women, and PCI to the left anterior descending artery was more common in female patients. Unadjusted in-hospital mortality rates were higher in females versus males (2.5% for women and 1.6% for men, p<0.0001). After multivariable analysis, female gender remained an independent predictor of mortality (odds ratio 1.35, 95% CI: 1.22-1.49, p<0.0001). Conclusions: Gender-based differences in hospital mortality rates after PCI were observed in this large registry. Female sex remained an independent predictor of mortality after multivariable adjustment. [less ▲]

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See detailUnintentional "Ventriculo-Phlebo-Myo-Pericardiography"
GACH, Olivier ULiege; Lempereur, Mathieu ULiege; Eeckhout, Eric et al

in JACC. Cardiovascular Interventions (2014)

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See detailDeterminants of pulmonary artery hypertension at rest and during exercise in patients with heart failure
Tumminello, G.; LANCELLOTTI, Patrizio ULiege; Lempereur, Mathieu ULiege et al

in European Heart Journal (2007), 28(5), 569-574

Aims Pulmonary hypertension, a marker of poor prognosis in heart failure, may develop or increase during exercise. We sought to examine the determinants of pulmonary hypertension at rest and during ... [more ▼]

Aims Pulmonary hypertension, a marker of poor prognosis in heart failure, may develop or increase during exercise. We sought to examine the determinants of pulmonary hypertension at rest and during exercise in heart failure patients. Methods and results Forty-six patients with left ventricular (W) dysfunction (ejection fraction: 30 +/- 6%) underwent a semi-recumbent, incremental bicycle exercise Doppler echocardiography. LV systolic and diastolic function, pulmonary artery systolic pressure (PASP), functional mitral regurgitation (MR), and left atrial volume were quantified at rest and during exercise. Wide changes in PASP at exercise were unrelated to PASP at rest (r = 0.12). Independent predictors of PASP at rest were left atrial. volume (P = 0.006), E-wave velocity (P = 0.02), mitral tenting area (P = 0.005), and mitral effective regurgitant orifice (ERO) (P=0.02). The incidence of dyspnoea was similar in patients with and without moderately severe pulmonary hypertension at baseline. At peak exercise, LV ejection fraction (P = 0.03) and mitral ERO (P = 0.008) were independently associated with PASR Patients with a larger exercise increase in PASP (> 60 mmHg) interrupted frequently exercise for dyspnoea (70 vs. 27%; P = 0.04). A larger rise in mitral regurgitant volume during exercise emerged as the single determinant of exercise-induced increases in PASP. Conclusion In patients with HF, left atrial. volume, mitral deformation, and mitral regurgitant orifice correlated with pulmonary pressure at rest, whereas dynamic MR and limited contractile reserve correlated with pulmonary pressure at exercise. The magnitude of pulmonary pressure during exercise in these patients mainly depends on dynamic MR. [less ▲]

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