26
|
Vistarini N, Laliberté E, Beauchamp P, Bouhout I, Lamarche Y, Cartier R, Carrier M, Perrault L, Bouchard D, El-Hamamsy I, Pellerin M, Demers P. Del Nido cardioplegia in the setting of minimally invasive aortic valve surgery. Perfusion 2016; 32:112-117. [DOI: 10.1177/0267659116662701] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to report our experience with del Nido cardioplegia (DNC) in the setting of minimally invasive aortic valve surgery. Forty-six consecutive patients underwent minimally invasive aortic valve replacement (AVR) through a “J” ministernotomy: twenty-five patients received the DNC (Group 1) and 21 patients received standard blood cardioplegia (SBC) (Group 2). The rate of ventricular fibrillation at unclamping was significantly lower in the DNC group (12% vs 52%, p=0.004), as well as postoperative creatinine kinase-MB (CK-MB) values (11.4±5.2 vs 17.7±6.9 µg/L, p=0.004). There were no deaths, myocardial infarctions or major complications in either group. Less postoperative use of intravenous insulin (28% vs 81%, p<0.001) was registered in the DNC group. In conclusion, the DNC is easy to use and safe during minimally invasive AVR, providing a myocardial protection at least equivalent to our SBC, improved surgical efficiency, minimal cost and less blood glucose perturbations.
Collapse
|
27
|
Emmott A, Garcia J, Chung J, Lachapelle K, El-Hamamsy I, Mongrain R, Cartier R, Leask RL. Biomechanics of the Ascending Thoracic Aorta: A Clinical Perspective on Engineering Data. Can J Cardiol 2016; 32:35-47. [DOI: 10.1016/j.cjca.2015.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 10/17/2015] [Accepted: 10/18/2015] [Indexed: 12/14/2022] Open
|
28
|
Dionne P, Pagé P, Lamarche Y, Demers P, El-Hamamsy I, Jeanmart H. POST-OPERATIVE USE OF NEW ORAL ANTICOAGULANTS IN CARDIAC SURGERY, EXPERIENCE IN 51 PATIENTS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
29
|
Legris-Falardeau V, Noly P, Ibrahim R, Poirier N, El-Hamamsy I, Lamarche Y, Bouchard D, Cartier R, Dorval J, Demers P. CONTEMPORARY MANAGEMENT OF AORTIC COARCTATION IN ADULTS: MID-TERM RESULTS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
30
|
Vistarini N, Nguyen A, Perrault L, Bouchard D, Cartier R, Demers P, Pellerin M, Lamarche Y, El-Hamamsy I, Carrier M. LONG-TERM SURVIVAL AFTER CARDIAC TRANSPLANTATION: PAST, PRESENT AND FUTURE. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
31
|
Tarola C, Losenno K, Peterson M, El-Hamamsy I, Chu M. VALVE SPARING AORTIC ROOT RECONSTRUCTION: DOES GRAFT SIZING MATTER? Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
32
|
Bouhout I, Semplonius T, Cartier R, Poirier N, El-Hamamsy I. EARLY CHANGES IN AUTOGRAFT ROOT DIMENSIONS FOLLOWING THE ROSS PROCEDURE: ROLE OF SURGICAL ETIOLOGY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
33
|
Ghoneim A, Bouhout I, Fortin W, Mazine A, El-Hamamsy I, Jeanmart H, Pellerin M, Bouchard D. BEATING HEART MINIMALLY INVASIVE MITRAL VALVE SURGERY IN PATIENTS WITH PATENT CORONARY BYPASS GRAFTS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
34
|
Trapeaux J, Busseuil D, Shi Y, Nobari S, Shustik D, Mecteau M, El-Hamamsy I, Lebel M, Mongrain R, Rhéaume E, Tardif JC. Improvement of aortic valve stenosis by ApoA-I mimetic therapy is associated with decreased aortic root and valve remodelling in mice. Br J Pharmacol 2014; 169:1587-99. [PMID: 23638718 DOI: 10.1111/bph.12236] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 04/10/2013] [Accepted: 04/18/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND PURPOSE We have shown that infusions of apolipoprotein A-I (ApoA-I) mimetic peptide induced regression of aortic valve stenosis (AVS) in rabbits. This study aimed at determining the effects of ApoA-I mimetic therapy in mice with calcific or fibrotic AVS. EXPERIMENTAL APPROACH Apolipoprotein E-deficient (ApoE(-/-) ) mice and mice with Werner progeria gene deletion (Wrn(Δhel/Δhel) ) received high-fat diets for 20 weeks. After developing AVS, mice were randomized to receive saline (placebo group) or ApoA-I mimetic peptide infusions (ApoA-I treated groups, 100 mg·kg(-1) for ApoE(-/-) mice; 50 mg·kg(-1) for Wrn mice), three times per week for 4 weeks. We evaluated effects on AVS using serial echocardiograms and valve histology. KEY RESULTS Aortic valve area (AVA) increased in both ApoE(-/-) and Wrn mice treated with the ApoA-I mimetic compared with placebo. Maximal sinus wall thickness was lower in ApoA-I treated ApoE(-/-) mice. The type I/III collagen ratio was lower in the sinus wall of ApoA-I treated ApoE(-/-) mice compared with placebo. Total collagen content was reduced in aortic valves of ApoA-I treated Wrn mice. Our 3D computer model and numerical simulations confirmed that the reduction in aortic root wall thickness resulted in improved AVA. CONCLUSIONS AND IMPLICATIONS ApoA-I mimetic treatment reduced AVS by decreasing remodelling and fibrosis of the aortic root and valve in mice.
Collapse
|
35
|
Dionne P, Poirier N, Cartier R, Mongeon F, Dore A, Deschamps A, El-Hamamsy I. EARLY OUTCOMES FOLLOWING THE FIRST 100 ROSS PROCEDURES IN A STARTING PROGRAM: WHAT IS THE LEARNING CURVE? Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
36
|
Forcillo J, Poirier N, El-Hamamsy I. A NOVEL APPROACH FOR THE SURGICAL MANAGEMENT OF UNICUSPID AORTIC VALVES: TECHNICAL FEASIBILITY AND EARLY ECHOCARDIOGRAPHIC Results. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
37
|
Saydy N, Mazine A, Stevens L, Jeanmart H, Demers P, Pagé P, Lamarche Y, El-Hamamsy I. PREDICTORS OF POSTOPERATIVE ACUTE KIDNEY INJURY IN YOUNG ADULTS UNDERGOING CARDIAC SURGERY. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
38
|
Dionne P, Wener E, Leask R, Mongrain R, Cartier R, Poirier N, El-Hamamsy I. BIOMECHANICAL PROPERTIES OF PATIENT-SPECIFIC AORTAS AND PULMONARY ARTERIES ACCORDING TO AORTIC VALVE PHENOTYPE: RELEVANCE TO THE ROSS PROCEDURE. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
39
|
Badrudin D, Moss E, Bouchard D, Carrier M, Cartier R, El-Hamamsy I, Lamarche Y, Pellerin M, Perrault L, Demers P. 160 Surgery For Type A Aortic Dissection: Results Over 15 Years. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
40
|
Bouhout I, Poirier N, Mercier L, Dore A, Leduc L, El-Hamamsy I. 795 Pregnancy Following Aortic Valve Replacement - Cardiac, Maternal and Fetal Outcomes. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
41
|
Bouhout I, Stevens L, Cartier R, Carrier M, Pellerin M, Perrault L, Bouchard D, Demers P, Poirier N, El-Hamamsy I. 141 Long-Term Outcomes Following Isolated Mechanical Aortic Valve Replacement In Young Adults. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
42
|
Lamarche Y, Pagé M, Laflamme M, El-Hamamsy I, Bouchard D, Bernatchez J, Noel L, Laflamme J, Cartier R. 699 Cardiac Arrest After Cardiac Surgery : Role of Simulation for the Intensive Care Team Performance. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
43
|
Pagé M, Mongeon F, Stevens L, Dore A, Mercier L, Khairy P, Garceau P, Marcotte F, El-Hamamsy I. 797 Cusp Fusion Phenotype is a Determinant of Ascending Aorta Dilation Rate and Pattern Among Patients With Isolated Bicuspid Aortic Valve. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
44
|
Bertazzo S, Cloyd K, Gentleman E, El-Hamamsy I, Chester A, Yacoub M, Stevens M. 285 NANO- AND MICRO-STRUCTURE OF CALCIFICATION IN HUMAN AORTIC VALVE, AORTA AND CORONARY WALL. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
45
|
Vanden Eynden F, Bouchard D, El-Hamamsy I, Butnaru A, Demers P, Carrier M, Perrault LP, Tardif JC, Pellerin M. Effect of Aortic Valve Replacement for Aortic Stenosis on Severity of Mitral Regurgitation. Ann Thorac Surg 2007; 83:1279-84. [PMID: 17383327 DOI: 10.1016/j.athoracsur.2006.12.076] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 12/22/2006] [Accepted: 12/27/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgically addressing moderate mitral regurgitation (MR) at the time of aortic valve replacement (AVR) for aortic stenosis remains uncertain. The purpose of this study was to examine the change in moderate (2+) or moderate-severe (3+) MR after isolated AVR for aortic stenosis to determine preoperative factors predictive of improvement in MR. METHODS Using an institutional databank of prospectively collected data, all patients undergoing isolated AVR for aortic stenosis with moderate (2+) to moderate-severe (3+) MR between 1994 and 1996 at the Montreal Heart Institute were evaluated. RESULTS Eighty patients with preoperative and postoperative transthoracic echocardiographic follow-up were identified. Preoperative MR was moderate (2+) in 78 patients (97.5%) and moderate-severe (3+) in 2 patients (2.5%). Mitral regurgitation was classified as rheumatic (32%), ischemic (32%), functional (21%), and myxomatous (15%). At 1-year follow-up transthoracic echocardiography, MR improved by 1 or 2 grades in 29 patients (35%), was unchanged in 44 (55%), and worsened in 7 (10%). On multivariate analysis, isolated ischemic and functional MR were the only preoperative factors predictive of MR improvement after AVR (p = 0.01): 54% of ischemic and 44% of functional MR patients showed improvement in MR after AVR compared with 23% of rheumatic and 17% of myxomatous MR patients. CONCLUSIONS Etiology of MR was a significant prognostic factor for improvement in MR grade. Since there was little improvement in the rheumatoid and myxomatous group, replacement or repair should strongly be considered. For functional and ischemic mitral regurgitation, a surgical correction should be performed on an individual basis.
Collapse
|
46
|
El-Hamamsy I, White M, Pellerin M, Demers P, Bouchard D, Leung TK, Perrault LP, Carrier M. Successful explantation of a left ventricular assist device following acute fulminant myocarditis. Can J Cardiol 2006; 22:507-8. [PMID: 16685316 PMCID: PMC2560553 DOI: 10.1016/s0828-282x(06)70269-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
A left ventricular (LV) assist device was implanted in a 53-year-old woman in cardiogenic shock secondary to fulminant myocarditis. LV function recovered to normal after one week of support from an LV assist device. The device was explanted and the patient is showing a good outcome with a normalized LV function.
Collapse
|
47
|
El-Hamamsy I, Stevens L, White M, Perrault L, Pellerin M, Carrier M. 221. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
48
|
El-Hamamsy I, Stevens LM, Carrier M, Pelletier G, White M, Tremblay F, Perrault LP. Incidence and prognosis of cancer following heart transplantation using RATG induction therapy. Transpl Int 2005; 18:1280-5. [PMID: 16221159 DOI: 10.1111/j.1432-2277.2005.00203.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cancer limits survival following heart transplantation. The study's objectives were to evaluate the incidence and risk factors for cancers after heart transplantation and to assess the association between i.v. thymoglobuline induction therapy [rabbit antithymocyte immunoglobulin, (RATG)] and neoplasia. From 1982 to 2002, prospective data were gathered for 207 heart transplant recipients. Except from 1982 to 1987, all patients received a 3-day course of i.v. RATG following transplantation. Forty-three malignant neoplasms (21%) were diagnosed. The most common were: skin (42%), lung (12%), prostate (9%), genitourinary (9%) and lymphoma (5%). Mean length of follow-up after transplantation was 99 +/- 57 months. Mean survival after diagnosis was 52 +/- 44 months. Multivariate analysis showed no significant increase in the incidence of cancer with recipient age, sex, number of rejection episodes, the type of immunosuppression or the use of RATG. Patients receiving RATG developed their malignancies significantly earlier after transplantation (P =0.007) and succumbed faster after the diagnosis (P = 0.06). Cancer is a limiting event for long-term survival after heart transplantation. No individual risk factors allow predicting its development. In the present cohort, RATG does not have carcinogenic effects following transplantation, but is associated with a more precocious development of malignancies.
Collapse
|
49
|
El-Hamamsy I, Dürrleman N, Stevens LM, Perrault LP, Carrier M. Aspergillus Endocarditis After Cardiac Surgery. Ann Thorac Surg 2005; 80:359-64. [PMID: 15975413 DOI: 10.1016/j.athoracsur.2004.08.070] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2004] [Revised: 08/28/2004] [Accepted: 08/30/2004] [Indexed: 10/25/2022]
Abstract
Aspergillus species infections are an increasingly common occurrence in hospital wards. Aspergillus endocarditis constitutes one of the manifestations of the disease, which bears a poor prognosis in cardiac surgery patients. A review of the literature on fungal and Aspergillus endocarditis was undertaken. Valvular risk factors, indwelling intravenous catheters, prolonged antibiotics, malignancy, and intravenous drug use increase the risk. Clinical presentation is insidious, with embolic complications often representing the first manifestation of the disease. Blood cultures are typically negative. The mortality rate is almost 100%. Amphotericin B represents the mainstay of medical therapy with several possible adjuncts. Surgery is an essential part of therapy in Aspergillus endocarditis after cardiac surgery and should be undertaken as soon as the diagnosis is made. Aspergillus endocarditis is an ominous complication after cardiac surgery. A high suspicion index, early administration of appropriate antibiotics, and prompt surgical intervention should improve the prognosis, which remains dismal.
Collapse
|
50
|
Perrault LP, El-Hamamsy I, Dumont E, Malo O, Carrier M. Effects of Crystalloid, Blood and Celsior Solutions on Porcine Coronary Endothelial Function After Heart Transplantation. J Heart Lung Transplant 2005; 24:912-20. [PMID: 15982622 DOI: 10.1016/j.healun.2004.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2004] [Revised: 04/26/2004] [Accepted: 05/09/2004] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Coronary endothelial dysfunction occurs early after heart transplantation and predicts the development of cardiac allograft vasculopathy. Cardioplegic solutions may cause endothelial injury. The present study aimed to assess the effects of cardioplegic solutions (crystalloid, blood and Celsior) used at the time of graft harvesting on endothelial function and intimal hyperplasia 1 month after heart transplantation. METHODS A porcine heterotopic heart transplantation model was used. Three experimental groups were studied: crystalloid, blood and Celsior solutions were used for induction of cardiac arrest. Epicardial coronary arteries of native and allograft hearts were studied 1 month after transplantation in organ chambers. Endothelium-dependent relaxations to serotonin, bradykinin and calcium ionophore were assessed. Coronary neointimal proliferation was evaluated using histomorphometric studies. RESULTS Endothelium-dependent relaxations to serotonin and to calcium ionophore were significantly decreased in all 3 experimental groups vs controls (p<0.05). Endothelium-dependent relaxations to bradykinin were significantly reduced in the crystalloid group compared with the Celsior and blood groups and controls (p<0.05). There was a significantly lower rate of severe intimal hyperplasia in the Celsior group compared to the crystalloid and blood groups (p<0.05). CONCLUSION Celsior cardioplegic solution represents the solution of choice in terms of preservation of endothelial function and lower incidence of severe coronary intimal hyperplasia following transplantation compared with crystalloid and blood cardioplegia solutions. These early results could translate into a reduction of the long-term incidence of cardiac allograft vasculopathy and improve graft survival.
Collapse
|