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Faguer S, Piedrafita A, Sanz AB, Siwy J, Mina IK, Alves M, Bousquet P, Marcheix B, Casemayou A, Klein J, Minville V, Breuil B, Ortiz A, Schanstra JP. Performances of acute kidney injury biomarkers vary according to sex. Clin Kidney J 2024; 17:sfae091. [PMID: 38699482 PMCID: PMC11062024 DOI: 10.1093/ckj/sfae091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Indexed: 05/05/2024] Open
Abstract
Background Before implementing individualized strategies to treat acute kidney injury (AKI), identifying clusters of patients with divergent pathophysiological mechanisms, diagnosis criteria or outcomes is of the utmost importance. Here we studied sex-related molecular mechanisms in cardiac bypass (CBP) surgery patients developing AKI. Methods We compared the characteristics of 1170 patients referred for CBP surgery using multivariate logistic regression and propensity score-based analysis. Performances of the candidate urinary biomarkers at <4 h post-surgery, urinary neutrophil gelatinase-associated lipocalin (uNGAL), [IGFBP7]·[TIMP-2] product (NephroCheck) and a recently developed AKI signature of 204 urinary peptides (AKI204) to predict AKI were compared in both sexes. Results Incidence (∼25%) and severity of AKI were similar in men and women, even after adjustment for the usual risk factors of AKI, including baseline estimated glomerular filtration rate, age, diabetes mellitus, length of CBP and red blood cell transfusion. However, at the molecular level, performances of uNGAL, NephroCheck and AKI204 to predict AKI strongly diverged between men and women. In the full cohort, as well as in subgroups of men and women, the multimarker AKI204 signature outperformed uNGAL and NephroCheck and predicted the development of AKI significantly better in women than in men. Analysis of AKI204 at the single-peptide level suggested divergences of AKI mechanisms between sexes due to increased kidney inflammation in women (increased abundance of urinary fragments of osteopontin and uromodulin). Conclusions In patients referred for CBP surgery, significant clinical and biological differences between men and women as well as sexual dimorphism of AKI biomarker performances were identified. The urinary peptide signature points to sex-related molecular mechanisms underlying AKI.
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Affiliation(s)
- Stanislas Faguer
- Department of Nephrology and Organ Transplantation, French Intensive Care Renal Network, University Hospital of Toulouse, Toulouse, France
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Alexis Piedrafita
- Department of Nephrology and Organ Transplantation, French Intensive Care Renal Network, University Hospital of Toulouse, Toulouse, France
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Ana Belen Sanz
- IIS-Fundación Jiménez Díaz, School of Medicine, Autonomous University of Madrid, FRIAT and RICORS2040, Madrid, Spain
| | | | - Ioanna K Mina
- Mosaiques Diagnostics GmbH, Hannover, Germany
- Institute for Molecular Cardiovascular Research, RWTH Aachen University Hospital, Aachen, Germany
| | - Melinda Alves
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Paul Bousquet
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, Toulouse, France
| | - Bertrand Marcheix
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
- Department of Cardiac and Vascular Surgery, University Hospital of Toulouse, Toulouse, France
| | - Audrey Casemayou
- Department of Nephrology and Organ Transplantation, French Intensive Care Renal Network, University Hospital of Toulouse, Toulouse, France
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Julie Klein
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Vincent Minville
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, Toulouse, France
| | - Benjamin Breuil
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
| | - Alberto Ortiz
- IIS-Fundación Jiménez Díaz, School of Medicine, Autonomous University of Madrid, FRIAT and RICORS2040, Madrid, Spain
| | - Joost P Schanstra
- National Institute of Health and Medical Research, UMR 1297 (Institute of Metabolic and Cardiovascular Diseases), Toulouse, France
- Faculty of Health, University Paul Sabatier – Toulouse-III, Toulouse, France
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Labaste F, Cauquil P, Lestarquit M, Sanchez-Verlaan P, Aljuayli A, Marcheix B, Geeraerts T, Ferre F, Vardon-Bounes F, Minville V. Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery. Front Med (Lausanne) 2024; 11:1340119. [PMID: 38504912 PMCID: PMC10948405 DOI: 10.3389/fmed.2024.1340119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The COVID-19 pandemic prompted our team to develop new solutions for performing cardiac surgery without intravenous anesthetics due to a shortage of these drugs. We utilized an anesthetic conserving device (Sedaconda-ACD) to administer total inhaled anesthesia because specific vaporizers were unavailable for administering inhaled agents during cardiopulmonary bypass (CPB) in our center. We documented our experience and postoperative cardiovascular outcomes. The primary outcome was the peak level of troponin, with secondary outcomes encompassing other cardiovascular complications. Material and methods A single-center retrospective study was conducted. We performed a multivariate analysis with a propensity score. This investigation took place at a large university referral center. Participants Adult patients (age ≥ 18) who underwent elective cardiac surgery with CPB between June 2020 to March 2021. Intervention During the inclusion period, two anesthesia protocols for the maintenance of anesthesia coexisted-total inhaled anesthesia with Sedaconda-ACD and our classic protocol with intravenous drugs during and after CPB. Primary endpoint Troponin peak level recorded after surgery (highest level recorded within 48 h following the surgery). Results Out of the 654 included patients, 454 were analyzed after matching (intravenous group = 297 and inhaled group = 157). No significant difference was found between the groups in postoperative troponin peak levels (723 ng/l vs. 993 ng/l-p = 0.2). Total inhaled anesthesia was associated with a decreased requirement for inotropic medications (OR = 0.53, 95% CI 0.29-0.99, p = 0.04). Conclusion In our cohort, the Sedaconda-ACD device enabled us to achieve anesthesia without intravenous agents, and we did not observe any increase in postoperative complications. Total inhaled anesthesia with sevoflurane was not associated with a lower incidence of myocardial injury assessed by the postoperative troponin peak level. However, in our cohort, the use of inotropic drugs was lower.
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Affiliation(s)
- François Labaste
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
- RESTORE, UMR 1301 Inserm - 5070 CNRS - Université Paul Sabatier, Université de Toulouse, Toulouse, France
| | - Paul Cauquil
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Magda Lestarquit
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Pascale Sanchez-Verlaan
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Abdulrahman Aljuayli
- Department of Cardiac Surgery, Toulouse University Teaching Hospital, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiac Surgery, Toulouse University Teaching Hospital, Toulouse, France
| | - Thomas Geeraerts
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Fabrice Ferre
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Fanny Vardon-Bounes
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Vincent Minville
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
- RESTORE, UMR 1301 Inserm - 5070 CNRS - Université Paul Sabatier, Université de Toulouse, Toulouse, France
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Porterie J, Hostalrich A, Dagenais F, Marcheix B, Chaufour X, Ricco JB. Hybrid Treatment of Complex Diseases of the Aortic Arch and Descending Thoracic Aorta by Frozen Elephant Trunk Technique. J Clin Med 2023; 12:5693. [PMID: 37685761 PMCID: PMC10488597 DOI: 10.3390/jcm12175693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
The surgical management of acute and chronic complex diseases involving the aortic arch and the descending thoracic aorta remains challenging. Hybrid procedures associating total open arch replacement and stent-grafting of the proximal descending aorta were developed to allow a potential single-stage treatment, promote remodeling of the downstream aorta, and facilitate a potential second-stage thoracic endovascular aortic repair by providing an ideal landing zone. While these approaches initially used various homemade combinations of available conventional prostheses and stent-grafts, the so-called frozen elephant trunk technique emerged with the development of several custom-made hybrid prostheses. The aim of this study was to review the contemporary outcomes of this technique in the management of complex aortic diseases, with a special focus on procedural planning, organ protection and monitoring, refinements in surgical techniques, and long-term follow-up.
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Affiliation(s)
- Jean Porterie
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France;
| | - Aurélien Hostalrich
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (A.H.); (X.C.)
| | - François Dagenais
- Department of Cardiovascular Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC G1V 4G5, Canada;
| | - Bertrand Marcheix
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France;
| | - Xavier Chaufour
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (A.H.); (X.C.)
| | - Jean-Baptiste Ricco
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Poitiers, 86000 Poitiers, France;
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4
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Porterie J, Roux D, Marcheix B. Off-the-shelf bilateral antegrade cerebral perfusion: The "brain-bridge" technique. JTCVS Tech 2023; 19:12-15. [PMID: 37324342 PMCID: PMC10267808 DOI: 10.1016/j.xjtc.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/15/2023] [Accepted: 01/25/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Jean Porterie
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Daniel Roux
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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Hostalrich A, Porterie J, Boisroux T, Marcheix B, Ricco JB, Chaufour X. Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk. J Endovasc Ther 2023:15266028231169172. [PMID: 37125426 DOI: 10.1177/15266028231169172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the midterm outcomes of secondary extension of frozen elephant trunk (FET) by means of thoracic endovascular aortic repair (TEVAR). METHODS This single-center prospective study was conducted in a tertiary aortic center on consecutive patients having undergone TEVAR with an endograft covering most of the 10 cm FET module with 2 to 4 mm oversizing. All patients were monitored by computerized tomography angiography (CTA) at sixth month and yearly thereafter. RESULTS From January 2015 to July 2022, among 159 patients who received FET, 30 patients (18.8%) underwent a TEVAR procedure (13 for a thoracoabdominal aneurysm, 11 for a chronic aortic dissection and 6 for an emergency procedure). All connections were successfully achieved with 2 postoperative deaths (6.6%) and 1 paraplegia (3.3%). At a median follow-up of 21 months (interquartile range [IQR], 4.2-34.7), 5 patients (25%) required a fenestrated-branched endovascular aortic repair (F-BEVAR) extension followed by 4 patients with 5 reinterventions, 3 for a Type 3 endoleak due to disconnection between FET and TEVAR endograft, and 2 unrelated to the FET for a secondary Type 1C endoleak. All reinterventions were successful, without mortality or morbidity. CONCLUSIONS In this series, FET connection with a TEVAR endograft was effective with low postoperative morbidity but with a risk of aortic reintervention related to disconnection between the FET and TEVAR endograft. These results suggest the need for annual CTA monitoring with no time limit in patients following connection of the FET with a TEVAR endograft. CLINICAL IMPACT In this series of 30 patients, midterm outcomes of secondary extension of frozen elephant trunk (FET) by thoracic endovascular repair (TEVAR) showed 3 disconnections (10%) with a Type 3 endoleak between FET and TEVAR. These findings suggest the need for annual CTA monitoring with no time limit. But so far, only a few studies provide some information after one year while the risk of disconnection increases over time and becomes a concern after 3 years. This is the new message brought by our study.
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Affiliation(s)
- Aurélien Hostalrich
- Department of Vascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Jean Porterie
- Department of Cardiovascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Thibaut Boisroux
- Department of Vascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiovascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Jean Baptiste Ricco
- Department of Clinical Research, University Hospital of Poitiers, Poitiers, France
| | - Xavier Chaufour
- Department of Vascular Surgery, University Hospital Rangueil, Toulouse, France
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Piedrafita A, Siwy J, Klein J, Akkari A, Amaya-garrido A, Mebazaa A, Sanz AB, Breuil B, Montero Herrero L, Marcheix B, Depret F, Fernandez L, Tardif E, Minville V, Alves M, Metzger J, Grossac J, Mischak H, Ortiz A, Gazut S, Schanstra JP, Faguer S, Gazut S, Schanstra JP, Faguer S. Publisher Correction to: A universal predictive and mechanistic urinary peptide signature in acute kidney injury. Crit Care 2022; 26:406. [PMID: 36581955 PMCID: PMC9798650 DOI: 10.1186/s13054-022-04278-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Alexis Piedrafita
- grid.411175.70000 0001 1457 2980Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, 31000 Toulouse, France ,grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Justyna Siwy
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | - Julie Klein
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Amal Akkari
- grid.457331.7Université Paris-Saclay, CEA, List, 91120 Palaiseau, France
| | - Ana Amaya-garrido
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Alexandre Mebazaa
- Department of Anesthesiology, Critical Care and Burn Unit, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot-Paris 7, Sorbonne Paris Cité, UMR-S 942, INSERM, France, INI-CRCT, ParisNancy, France
| | - Anna Belen Sanz
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Benjamin Breuil
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Laura Montero Herrero
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Bertrand Marcheix
- grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France ,grid.411175.70000 0001 1457 2980Department of Cardiac and Vascular Surgery, University Hospital of Toulouse, 31000 Toulouse, France
| | - François Depret
- Department of Anesthesiology, Critical Care and Burn Unit, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot-Paris 7, Sorbonne Paris Cité, UMR-S 942, INSERM, France, INI-CRCT, ParisNancy, France
| | - Lucie Fernandez
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Elsa Tardif
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Vincent Minville
- grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France ,grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Melinda Alves
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Jochen Metzger
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | | | - Julia Grossac
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Harald Mischak
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | - Alberto Ortiz
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Stéphane Gazut
- grid.457331.7Université Paris-Saclay, CEA, List, 91120 Palaiseau, France
| | - Joost P. Schanstra
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Stanislas Faguer
- grid.411175.70000 0001 1457 2980Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, 31000 Toulouse, France ,grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
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Botea R, Lavie-Badie Y, Goicea A, Porterie J, Marcheix B. Early and midterm outcomes of a bentall operation using an all-biological valved BioConduit™. J Cardiothorac Surg 2022; 17:325. [PMID: 36536442 PMCID: PMC9761648 DOI: 10.1186/s13019-022-02073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To analyze the midterm results of aortic root replacement using the valved, all biological, No React®, BioConduit™. METHODS From 2017 to 2020, we prospectively followed 91 consecutive patients who underwent a Bentall procedure with a BioConduit™ valved graft in our institution. The primary outcomes were aortic bioprosthetic valve dysfunction and mortality according to Valve Academic Research Consortium 3 (VARC3). RESULTS Mean age was 70 ± 10 years and 67 patients (74%) were men. Ascending aortic aneurysm (72%), aortic valve regurgitation (51%) or stenosis (20%) and acute endocarditis (14%) were the main indications for surgery. Seventy-four patients (81.3%) were followed up at 1 year. The perioperative mortality was 8% (n = 8), the early, 1 year, mortality was 2% (n = 2) and the midterm mortality, at 4 years of follow up, was 4% (n = 3). Ten patients fulfilled the criteria for hemodynamic valve deterioration at 1 year (13%) and 14 for a bioprosthetic valve failure during the entire follow-up (17%). CONCLUSIONS We are reporting early and midterm results of Bentall procedures with the all-biological, valved, No-React® BioConduit™. To our knowledge, this is the first study reporting an early and midterm unexpectedly high rate of non-structural prosthetic hemodynamic deterioration. The rate of endocarditis and atrioventricular disconnections remain similar to previous studies.
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Affiliation(s)
- Roxana Botea
- grid.414295.f0000 0004 0638 3479Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France ,grid.414295.f0000 0004 0638 3479Department of Cardiology, Rangueil University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex, France
| | - Yoan Lavie-Badie
- grid.414295.f0000 0004 0638 3479Department of Cardiology, Rangueil University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex, France
| | - Alexandru Goicea
- grid.414295.f0000 0004 0638 3479Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France ,Department of Cardiovascular Surgery, Nicolae Stancioiu Heart Institute, Cluj-Napoca, Romania
| | - Jean Porterie
- grid.414295.f0000 0004 0638 3479Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- grid.414295.f0000 0004 0638 3479Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
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Treille de Grandsaigne H, Bouisset F, Porterie J, Biendel C, Marcheix B, Lairez O, Labaste F, Elbaz M, Galinier M, Delmas C. Incidence, management, and prognosis of post-ischaemic ventricular septal defect: Insights from a 12-year tertiary centre experience. Front Cardiovasc Med 2022; 9:1066308. [PMID: 36561773 PMCID: PMC9763320 DOI: 10.3389/fcvm.2022.1066308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Background Among mechanical complications of acute myocardial infarction, ventricular septal defect (VSD) is uncommon but still serious. The evolution of emergency coronary revascularisation paradoxically decreased our knowledge of this disease, making it even rarer. Aim To describe ischaemic VSD incidence, management, and associated in-hospital and 1-year outcomes over a 12-years period. Methods A retrospective single-centre register of patients managed for ischaemic VSD between January 2009 and December 2020. Results Ninety-seven patients were included representing 8 patients/ years and an incidence of 0.44% of ACS managed. The majority of the patients were 73-years-old males (n = 54, 56%) with STEMI presentation (n = 75, 79%) and already presented with Q necrosis on ECG (n = 70, 74%). Forty-nine (51%) patients underwent PCI, 60 (62%) inotrope/vasopressors infusion, and 70 (72%) acute mechanical circulatory support (IABP 62%, ECMO 13%, and Impella® 3%). VSD surgical repair was performed for 44 patients (45%) and 1 patient was transplanted. In-hospital mortality was 71%, and 86% at 1 year, without significant improvement over the decade. Surgery appears to be a protective factor [0.51 (0.28-0.94) p = 0.003], whereas age [1.06 (1.03-1.09), p < 0.001] and lactate [1.16 (1.09-1.23), p < 0.001] were linked to higher 1-year mortality. None of the patients that were managed medically survived 1 year. Conclusion Post-ischaemic VSD is a rare but serious complication still associated with high mortality. Corrective surgery is associated with better survival, however, timing, patient selection, and a place for mechanical circulatory support need to be defined.
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Affiliation(s)
- Henri Treille de Grandsaigne
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France,Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Frédéric Bouisset
- Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Jean Porterie
- Cardiovascular Surgery Department, Rangueil University Hospital, Toulouse, France
| | - Caroline Biendel
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France,Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Cardiovascular Surgery Department, Rangueil University Hospital, Toulouse, France
| | - Olivier Lairez
- Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - François Labaste
- Department of Anesthesiology, Intensive Care Medicine and Perioperative Medicine, Rangueil University Hospital, Toulouse, France
| | - Meyer Elbaz
- Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Michel Galinier
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France,Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Clément Delmas
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France,Cardiology Department, Rangueil University Hospital, Toulouse, France,*Correspondence: Clément Delmas
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Piedrafita A, Siwy J, Klein J, Akkari A, Amaya-garrido A, Mebazaa A, Sanz AB, Breuil B, Montero Herrero L, Marcheix B, Depret F, Fernandez L, Tardif E, Minville V, Alves M, Metzger J, Grossac J, Mischak H, Ortiz A, Gazut S, Schanstra JP, Faguer S, Mayeur N, Casemayou A, Labaste F, Mayeur N, Casemayou A, Labaste F. A universal predictive and mechanistic urinary peptide signature in acute kidney injury. Crit Care 2022; 26:344. [PMID: 36345008 PMCID: PMC9640896 DOI: 10.1186/s13054-022-04193-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The delayed diagnosis of acute kidney injury (AKI) episodes and the lack of specificity of current single AKI biomarkers hamper its management. Urinary peptidome analysis may help to identify early molecular changes in AKI and grasp its complexity to identify potential targetable molecular pathways. METHODS In derivation and validation cohorts totalizing 1170 major cardiac bypass surgery patients and in an external cohort of 1569 intensive care unit (ICU) patients, a peptide-based score predictive of AKI (7-day KDIGO classification) was developed, validated, and compared to the reference biomarker urinary NGAL and NephroCheck and clinical scores. RESULTS A set of 204 urinary peptides derived from 48 proteins related to hemolysis, inflammation, immune cells trafficking, innate immunity, and cell growth and survival was identified and validated for the early discrimination (< 4 h) of patients according to their risk to develop AKI (OR 6.13 [3.96-9.59], p < 0.001) outperforming reference biomarkers (urinary NGAL and [IGFBP7].[TIMP2] product) and clinical scores. In an external cohort of 1569 ICU patients, performances of the signature were similar (OR 5.92 [4.73-7.45], p < 0.001), and it was also associated with the in-hospital mortality (OR 2.62 [2.05-3.38], p < 0.001). CONCLUSIONS An overarching AKI physiopathology-driven urinary peptide signature shows significant promise for identifying, at an early stage, patients who will progress to AKI and thus to develop tailored treatments for this frequent and life-threatening condition. Performance of the urine peptide signature is as high as or higher than that of single biomarkers but adds mechanistic information that may help to discriminate sub-phenotypes of AKI offering new therapeutic avenues.
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Affiliation(s)
- Alexis Piedrafita
- grid.411175.70000 0001 1457 2980Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, 31000 Toulouse, France ,grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Justyna Siwy
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | - Julie Klein
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Amal Akkari
- grid.457331.7Université Paris-Saclay, CEA, List, 91120 Palaiseau, France
| | - Ana Amaya-garrido
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Alexandre Mebazaa
- Department of Anesthesiology, Critical Care and Burn Unit, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot-Paris 7, Sorbonne Paris Cité, UMR-S 942, INSERM, France, INI-CRCT, ParisNancy, France
| | - Anna Belen Sanz
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Benjamin Breuil
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Laura Montero Herrero
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Bertrand Marcheix
- grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France ,grid.411175.70000 0001 1457 2980Department of Cardiac and Vascular Surgery, University Hospital of Toulouse, 31000 Toulouse, France
| | - François Depret
- Department of Anesthesiology, Critical Care and Burn Unit, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot-Paris 7, Sorbonne Paris Cité, UMR-S 942, INSERM, France, INI-CRCT, ParisNancy, France
| | - Lucie Fernandez
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Elsa Tardif
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Vincent Minville
- grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France ,grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Melinda Alves
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France
| | - Jochen Metzger
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | | | - Julia Grossac
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Harald Mischak
- grid.421873.bMosaiques Diagnostics GmbH, Hannover, Germany
| | - Alberto Ortiz
- grid.5515.40000000119578126School of Medicine, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, FRIAT and REDINREN, Madrid, Spain
| | - Stéphane Gazut
- grid.457331.7Université Paris-Saclay, CEA, List, 91120 Palaiseau, France
| | - Joost P. Schanstra
- grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Stanislas Faguer
- grid.411175.70000 0001 1457 2980Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, and French Intensive Care Renal Network, 31000 Toulouse, France ,grid.7429.80000000121866389National Institute of Health and Medical Research (INSERM), UMR 1297, Institute of Cardiovascular and Metabolic Disease, 31000 Toulouse, France ,grid.15781.3a0000 0001 0723 035XUniversity Paul Sabatier, Toulouse-III, 31000 Toulouse, France
| | - Nicolas Mayeur
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
| | - Audrey Casemayou
- grid.7429.80000000121866389Institute for Metabolic and Cardiovascular Disease, National Institute of Health and Medical Research, Toulouse, France
| | - François Labaste
- grid.411175.70000 0001 1457 2980Department of Anesthesiology and Critical Care Medicine, University Hospital of Toulouse, 31000 Toulouse, France
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10
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Delmas C, Vallee L, Bouisset F, Porterie J, Biendel C, Lairez O, Crognier L, Marcheix B, Conil JM, Maury P, Minville V. Use of Percutaneous Atrioseptotosmy for Left Heart Decompression During Veno-Arterial Extracorporeal Membrane Oxygenation Support: An Observational Study. J Am Heart Assoc 2022; 11:e024642. [PMID: 36000436 PMCID: PMC9496417 DOI: 10.1161/jaha.121.024642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Left ventricular overload is frequent under veno‐arterial extracorporeal membrane oxygenation, which is associated with a worsening of the prognosis of these patients. Several left heart decompression (LHD) techniques exist. However, there is no consensus on their timing and type. We aimed to describe characteristics and outcomes of patients undergoing LHD and to compare percutaneous atrioseptostomy (PA) to other LHD techniques. Methods and Results Retrospective analysis was conducted of consecutive and prospectively collected patients supported by veno‐arterial extracorporeal membrane oxygenation for refractory cardiac arrest or cardiogenic shock between January 2015 and April 2018, with a 90‐day follow‐up in our tertiary center. Patients were divided according to the presence of LHD, and then according to its type (PA versus others). Thirty‐nine percent (n=63) of our patients (n=163) required an LHD. Patients with LHD had lower left ventricular ejection fraction, more ischemic cardiomyopathy, and no drug intoxication‐associated cardiogenic shock. PA was frequently used for LHD (41% of first‐line and 57% of second‐line LHD). PA appears safe and fast to realize (6.3 [interquartile range, 5.8–10] minutes) under fluoroscopic and echocardiographic guidance, with no acute complications. PA was associated with fewer neurological complications (12% versus 38%, P=0.02), no need to insert a second LHD (0% versus 19%, P=0.04), and higher 90‐day survival compared with other techniques (42% versus 19%, log‐rank test P=0.02), despite more sepsis (96% versus 73%, P=0.02) and blood transfusions (13.5% versus 7%, P=0.01). Multivariate analysis confirms the association between PA and 90‐day survival (hazard ratio, 2.53 [1.18–5.45], P=0.019). Conclusions LHD was frequently used for patients supported with veno‐arterial extracorporeal membrane oxygenation, especially in cases of ischemic cardiomyopathy and low left ventricular ejection fraction. PA seems to be a safe and efficient LHD technique associated with greater mid‐term survival justifying the pursuit of research on this topic.
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Affiliation(s)
- Clément Delmas
- Intensive Cardiac Care Unit Cardiology Department Rangueil University Toulouse France.,Cardiology Department Rangueil University Hospital Toulouse France
| | - Luigi Vallee
- Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France
| | | | - Jean Porterie
- Cardiovascular Surgery Department Rangueil University Hospital Toulouse France
| | - Caroline Biendel
- Intensive Cardiac Care Unit Cardiology Department Rangueil University Toulouse France.,Cardiology Department Rangueil University Hospital Toulouse France
| | - Olivier Lairez
- Cardiology Department Rangueil University Hospital Toulouse France
| | - Laure Crognier
- Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France
| | - Bertrand Marcheix
- Cardiovascular Surgery Department Rangueil University Hospital Toulouse France
| | - Jean-Marie Conil
- Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France
| | - Philippe Maury
- Cardiology Department Rangueil University Hospital Toulouse France
| | - Vincent Minville
- Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France
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11
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Hostalrich A, Porterie J, Lebas B, Segal J, Bizos A, Marcheix B, Chaufour X, Ricco JB. Feasibility and results of secondary endovascular connections in hybrid prostheses of the aortic arch. Ann Vasc Surg 2022. [DOI: 10.1016/j.avsg.2022.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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12
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Delmas C, Porterie J, Jourdan G, Lezoualc'h F, Arnaud R, Brun S, Cavalerie H, Blanc G, Marcheix B, Lairez O, Verwaerde P, Mialet-Perez J. Effectiveness and Safety of a Prolonged Hemodynamic Support by the IVAC2L System in Healthy and Cardiogenic Shock Pigs. Front Cardiovasc Med 2022; 9:809143. [PMID: 35211526 PMCID: PMC8861279 DOI: 10.3389/fcvm.2022.809143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Mechanical circulatory supports are used in case of cardiogenic shock (CS) refractory to conventional therapy. Several devices can be employed, but are limited by their availability, benefit risk-ratio, and/or cost. Aims To investigate the feasibility, safety, and effectiveness of a long-term support by a new available device (IVAC2L) in pigs. Methods Experiments were carried out in male pigs, divided into healthy (n = 6) or ischemic CS (n = 4) groups for a median support time of 34 and 12 h, respectively. IVAC2L was implanted under fluoroscopic and TTE guidance under general anesthesia. CS was induced by surgical ligation of the left anterior descending artery. An ipsilateral lower limb reperfusion was created with the Solopath® system. Reperfusion was started after 1 h of support in healthy pigs and upon IVAC2L insertion in CS pigs. Hemodynamic and biological parameters were monitored before and during the whole period of support in each group. Results Occurrence of an ipsilateral lower limb ischemia was systematic in healthy and CS pigs in a few minutes after IVAC2L implantation, and could be reversed by the arterial reperfusion, as demonstrated by distal transcutaneous pressure in oxygen (TcPO2) and lactate normalization. IVAC2L support decreased pulmonary capillary wedge pressure (PCWP) (15.3 ± 0.3 vs. 7.5 ± 0.9 mmHg, p < 0.001), increased systolic blood pressure (SBP) (70 ± 4.5 vs. 101.3 ± 3.1 mmHg, p < 0.01), and cardiac output (CO) (4.0 ± 0.3 vs. 5.2 ± 0.6 l/min, p < 0.05) in CS pigs; at CS onset and after 12 h of support, without effects on heart rate or pulmonary artery pressure (PAP). Non-sustained ventricular arrhythmias were frequent at implantation (50%). A non-significant hemolysis was observed under support in CS pigs. Bleedings were frequent at the insertion and/or operating sites (30%). Conclusion Long-term support by IVAC2L is feasible and associated with a significant hemodynamic improvement in a porcine model. These preclinical data open the door for a study of IVAC2L in human ischemic CS, keeping in mind the need for systematic reperfusion of the lower limb and the associated risk of bleeding.
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Affiliation(s)
- Clément Delmas
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
- Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, Toulouse, France
- *Correspondence: Clément Delmas
| | - Jean Porterie
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
- Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Géraldine Jourdan
- Critical and Intensive Care Unit, Stromalab UMR 5273 CNRS/UPS-EFS-ENVT-INSERM U1031, Toulouse School of Veterinary Medicine, Toulouse, France
| | - Frank Lezoualc'h
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
| | - Romain Arnaud
- Department of Anesthesia, Intensive Care and Perioperative Care Medicine, University Hospital, Toulouse, France
| | - Stéphanie Brun
- Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Hugo Cavalerie
- Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Grégoire Blanc
- Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
- Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Olivier Lairez
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
- Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Patrick Verwaerde
- Critical and Intensive Care Unit, Stromalab UMR 5273 CNRS/UPS-EFS-ENVT-INSERM U1031, Toulouse School of Veterinary Medicine, Toulouse, France
- ENVA/UPEC/IMRB-Inserm U955, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Jeanne Mialet-Perez
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1297, National Institute of Health and Medical Research (INSERM), University of Toulouse, Toulouse, France
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13
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Pagezy A, Carrie D, Marcheix B, Inamo J, Fabre J, Labaste F, Bouisset F. Predictive factors for coronary angioplasty in early postoperative follow-up of heart surgery. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Piedrafita A, Balayssac S, Mayeur N, Gazut S, Grossac J, Buleon M, Alves M, Klein J, Minville V, Marcheix B, Schanstra JP, Faguer S. The tryptophan pathway and nicotinamide supplementation in ischaemic acute kidney injury. Clin Kidney J 2021; 14:2490-2496. [PMID: 34950461 PMCID: PMC8690092 DOI: 10.1093/ckj/sfab050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/11/2021] [Indexed: 01/19/2023] Open
Abstract
Background Down-regulation of the enzymes involved in tryptophan-derived nicotinamide (NAM) adenine dinucleotide (NAD+) production was identified after acute kidney injury (AKI), leading to the hypothesis that supplementation with NAM may increase the kidney NAD+ content, rescuing tryptophan pathways and subsequently improving kidney outcomes. Methods Urinary measurement of tryptophan and kynurenin using liquid chromatography–mass spectrometry metabolomics was used in a cohort of 167 cardiac bypass surgery patients along with tests for correlation to the development of postoperative AKI. A mouse model of ischaemic AKI using ischaemia–reperfusion injury (bilateral clamping of renal arteries for 25 min) was also used. Results We identified a significant decrease in urinary tryptophan and kynurenin in patients developing AKI, irrespective of the Kidney Disease: Improving Global Outcomes (KDIGO) stage. Although a significant difference was observed, tryptophan and kynurenin moderately discriminated for the development of all AKI KDIGO stages {area under the curve [AUC] 0.82 [95% confidence interval (CI) 0.75–0.88] and 0.75 [0.68–0.83], respectively} and severe KDIGO Stages 2–3 AKI [AUC 0.71 (95% CI 0.6–0.81) and 0.66 (0.55–0.77), respectively]. Sparked by this confirmation in humans, we aimed to confirm the potential preventive effect of NAM supplementation in wild-type male and female C57BL/6 mice subjected to ischaemic AKI. NAM supplementation had no effect on renal function (blood urea nitrogen at Day 1, sinistrin–fluorescein isothiocyanate glomerular filtration rate), architecture (periodic acid–Schiff staining) and injury or inflammation (kidney injury molecule 1 and IL18 messenger RNA expression). In addition, NAM supplementation did not increase post-AKI NAD+ kidney content. Conclusion Notwithstanding the potential role of NAM supplementation in the setting of basal NAD+ deficiency, our findings in mice and the reanalysis of published data do not confirm that NAM supplementation can actually improve renal outcomes after ischaemic AKI in unselected animals and probably patients.
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Affiliation(s)
- Alexis Piedrafita
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Stéphane Balayssac
- Groupe de RMN Biomédicale, Laboratoire SPCMIB (UMR CNRS 5068), Université Paul Sabatier-Toulouse 3, Toulouse, France
| | - Nicolas Mayeur
- Département d'Anesthésie et Réanimation, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | - Julia Grossac
- Département d'Anesthésie et Réanimation, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Marie Buleon
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Melinda Alves
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Julie Klein
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Vincent Minville
- Département d'Anesthésie et Réanimation, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Bertrand Marcheix
- RESTORE, UMR 1301 Inserm-5070 CNRS, Université Paul Sabatier, Université de Toulouse, Toulouse, France
| | - Joost P Schanstra
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Stanislas Faguer
- Institut National de la Santé et de la Recherche Médicale, UMR1297, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
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15
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Rouget A, Vardon-Bounes F, Lorber P, Vavasseur A, Marion O, Marcheix B, Lairez O, Balardy L, Fourcade O, Conil JM, Minville V. Prevalence of malnutrition in coronavirus disease 19: the NUTRICOV study. Br J Nutr 2021; 126:1296-1303. [PMID: 33342449 PMCID: PMC7853739 DOI: 10.1017/s0007114520005127] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/16/2020] [Accepted: 12/09/2020] [Indexed: 01/08/2023]
Abstract
Recent European Society of Parenteral and Enteral Nutrition guidelines highlighted the interest of prevention, diagnosis and treatment of malnutrition in the management of coronavirus disease 19 (COVID-19) patients. The aim of our study was to evaluate the prevalence of malnutrition in patients hospitalised for COVID-19. In a prospective observational cohort study malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) two-step approach. Patients were divided into two groups according to the diagnosis of malnutrition. Covariate selection for the multivariate analysis was based on P <0·2 in univariate analysis, with a logistic regression model and a backward elimination procedure. A partitioning of the population was realised. Eighty patients were prospectively enrolled. Thirty patients (37·5 %) had criteria for malnutrition. The need for intensive care unit admission (n 46, 57·5 %) was similar in the two groups. Three patients who died (3·75 %) were malnourished. Multivariate analysis exhibited that low BMI (OR 0·83, 95 % CI 0·73, 0·96, P = 0·0083), dyslipidaemia (OR 29·45, 95 % CI 3·12, 277·73, P = 0·0031), oral intake reduction <50 % (OR 3·169, 95 % CI 1·04, 9·64, P = 0·0422) and glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration; CKD-EPI) at admission (OR 0·979, 95 % CI 0·96, 0·998, P = 0·0297) were associated with the occurrence of malnutrition. We demonstrate the existence of a high prevalence of malnutrition in a general cohort of COVID-19 inpatients according to GLIM criteria. Nutritional support in COVID-19 care seems an essential element.
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Affiliation(s)
- Antoine Rouget
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Fanny Vardon-Bounes
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
- INSERM UMR 1048, Institut des maladies métaboliques et cardiovasculaires, CHU Toulouse, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Pierre Lorber
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Adrien Vavasseur
- Department of Radiology, CHU Toulouse Rangueil, 1 av du Pr J Poulhès, 31400Toulouse, France
| | - Olivier Marion
- Department of Nephrology and Organ Transplant, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiac Surgery, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Olivier Lairez
- INSERM UMR 1048, Institut des maladies métaboliques et cardiovasculaires, CHU Toulouse, 1 av du Pr Jean Poulhès, 31400Toulouse, France
- Department of Cardiology, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Laurent Balardy
- Department of Geriatric Medicine, CHU Toulouse Purpan, Place du Dr Baylac, 31000Toulouse, France
| | - Olivier Fourcade
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Jean-Marie Conil
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
| | - Vincent Minville
- Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France
- INSERM UMR 1048, Institut des maladies métaboliques et cardiovasculaires, CHU Toulouse, 1 av du Pr Jean Poulhès, 31400Toulouse, France
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16
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Chesneau B, Plancke A, Rolland G, Marcheix B, Dulac Y, Edouard T, Plaisancié J, Aubert-Mucca M, Julia S, Langeois M, Lavabre-Bertrand T, Khau Van Kien P. A +3 variant at a donor splice site leads to a skipping of the MYH11 exon 32, a recurrent RNA defect causing Heritable Thoracic Aortic Aneurysm and Dissection and/or Patent Ductus Arteriosus. Mol Genet Genomic Med 2021; 9:e1814. [PMID: 34672437 PMCID: PMC8606209 DOI: 10.1002/mgg3.1814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/11/2021] [Accepted: 09/03/2021] [Indexed: 12/29/2022] Open
Abstract
Background Pathogenic variants in MYH11 are associated with either heritable thoracic aortic aneurysm and dissection (HTAAD), patent ductus arteriosus (PDA) syndrome, or megacystis‐microcolon‐intestinal hypoperistalsis syndrome (MMIHS). Methods and Results We report a family referred for molecular diagnosis with HTAAD/PDA phenotype in which we found a variant at a non‐conserved position of the 5’ donor splice site of intron 32 of MYH11 potentially altering splicing (NM_002474.3:c.4578+3A>C). Although its cosegregation with disease was observed, it remained of unknown significance. Later, aortic surgery in the proband gave us the opportunity to perform a transcript analysis. This showed a skipping of the exon 32, an RNA defect previously reported to be translated to an in‐frame loss of 71 amino acids and a dominant‐negative effect in the smooth muscle myosin rod. This RNA defect is also reported in 3 other HTAAD/PDA pedigrees. Conclusion This report confirms that among rare variants in MYH11, skipping of exon 32 is recurrent. This finding is of particular interest to establish complex genotype–phenotype correlations where some alleles are associated with autosomal dominant HTAAD/PDA, while others result in recessive or dominant visceral myopathies.
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Affiliation(s)
- Bertrand Chesneau
- UF de Génétique Médicale et Cytogénétique, Centre Hospitalier Régional Universitaire de Nîmes, Nîmes, France.,Centre de Référence du syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Aurélie Plancke
- UF de Génétique Médicale et Cytogénétique, Centre Hospitalier Régional Universitaire de Nîmes, Nîmes, France
| | - Guillaume Rolland
- UF de Génétique Médicale et Cytogénétique, Centre Hospitalier Régional Universitaire de Nîmes, Nîmes, France
| | - Bertrand Marcheix
- Département de Chirurgie Cardiaque, Hôpital Universitaire de Rangueil, Toulouse, France
| | - Yves Dulac
- Centre de Référence du syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Thomas Edouard
- Centre de Référence du syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Julie Plaisancié
- Service de Génétique Médicale, Hôpital Universitaire de Purpan, Toulouse, France
| | - Marion Aubert-Mucca
- Centre de Référence du syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.,Service de Génétique Médicale, Hôpital Universitaire de Purpan, Toulouse, France
| | - Sophie Julia
- Service de Génétique Médicale, Hôpital Universitaire de Purpan, Toulouse, France
| | - Maud Langeois
- Centre de Référence du syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.,Service de Génétique Médicale, Hôpital Universitaire de Purpan, Toulouse, France
| | - Thierry Lavabre-Bertrand
- UF de Génétique Médicale et Cytogénétique, Centre Hospitalier Régional Universitaire de Nîmes, Nîmes, France.,Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR5247, Université de Montpellier, Montpellier, France.,Faculté de Médecine Montpellier-Nîmes, Laboratoire d'Histologie-Embryologie-Cytogénétique, Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR5247, Nîmes, France
| | - Philippe Khau Van Kien
- UF de Génétique Médicale et Cytogénétique, Centre Hospitalier Régional Universitaire de Nîmes, Nîmes, France.,Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR5247, Université de Montpellier, Montpellier, France.,Faculté de Médecine Montpellier-Nîmes, Laboratoire d'Histologie-Embryologie-Cytogénétique, Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR5247, Nîmes, France
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Matta A, Bayard N, Revel-Mouroz P, Marcheix B, Bouisset F. Percutaneous Approach for Late Left Main Coronary Detachment Resulting in Aortic Pseudoaneurysm After Bentall Procedure. JACC Case Rep 2021; 3:1586-1588. [PMID: 34729506 PMCID: PMC8543132 DOI: 10.1016/j.jaccas.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 11/15/2022]
Abstract
We describe the case of 35-year-old patient with known Marfan syndrome, and previously treated by a Bentall procedure, who presented with an aortic pseudoaneurysm secondary to a partial proximal left main coronary artery detachment fixed by covered stent implantation. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Nathanael Bayard
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
| | - Paul Revel-Mouroz
- Department of Radiology, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
| | - Frédéric Bouisset
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Address for correspondence: Dr Frédéric Bouisset, Department of Cardiology, Toulouse University Hospital, 1, avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France.
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18
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Laudette M, Sainte-Marie Y, Cousin G, Bergonnier D, Belhabib I, Brun S, Formoso K, Laib L, Tortosa F, Bergoglio C, Marcheix B, Borén J, Lairez O, Fauconnier J, Lucas A, Mialet-Perez J, Moro C, Lezoualc'h F. Cyclic AMP-binding protein Epac1 acts as a metabolic sensor to promote cardiomyocyte lipotoxicity. Cell Death Dis 2021; 12:824. [PMID: 34471096 PMCID: PMC8410846 DOI: 10.1038/s41419-021-04113-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/28/2021] [Accepted: 08/16/2021] [Indexed: 01/21/2023]
Abstract
Cyclic adenosine monophosphate (cAMP) is a master regulator of mitochondrial metabolism but its precise mechanism of action yet remains unclear. Here, we found that a dietary saturated fatty acid (FA), palmitate increased intracellular cAMP synthesis through the palmitoylation of soluble adenylyl cyclase in cardiomyocytes. cAMP further induced exchange protein directly activated by cyclic AMP 1 (Epac1) activation, which was upregulated in the myocardium of obese patients. Epac1 enhanced the activity of a key enzyme regulating mitochondrial FA uptake, carnitine palmitoyltransferase 1. Consistently, pharmacological or genetic Epac1 inhibition prevented lipid overload, increased FA oxidation (FAO), and protected against mitochondrial dysfunction in cardiomyocytes. In addition, analysis of Epac1 phosphoproteome led us to identify two key mitochondrial enzymes of the the β-oxidation cycle as targets of Epac1, the long-chain FA acyl-CoA dehydrogenase (ACADL) and the 3-ketoacyl-CoA thiolase (3-KAT). Epac1 formed molecular complexes with the Ca2+/calmodulin-dependent protein kinase II (CaMKII), which phosphorylated ACADL and 3-KAT at specific amino acid residues to decrease lipid oxidation. The Epac1-CaMKII axis also interacted with the α subunit of ATP synthase, thereby further impairing mitochondrial energetics. Altogether, these findings indicate that Epac1 disrupts the balance between mitochondrial FA uptake and oxidation leading to lipid accumulation and mitochondrial dysfunction, and ultimately cardiomyocyte death.
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Affiliation(s)
- Marion Laudette
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yannis Sainte-Marie
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Grégoire Cousin
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse Rangueil, Toulouse, France
| | - Dorian Bergonnier
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Ismahane Belhabib
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Stéphanie Brun
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse Rangueil, Toulouse, France
| | - Karina Formoso
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Loubna Laib
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Florence Tortosa
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Camille Bergoglio
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Bertrand Marcheix
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse Rangueil, Toulouse, France
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olivier Lairez
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse Rangueil, Toulouse, France
| | - Jérémy Fauconnier
- PHYMEDEXP, Université de Montpellier, CNRS, INSERM, CHRU Montpellier, Montpellier, France
| | - Alexandre Lucas
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Jeanne Mialet-Perez
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Cédric Moro
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France
| | - Frank Lezoualc'h
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France.
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19
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Blanc A, Lairez O, Cariou E, Fournier P, Poenar AM, Marcheix B, Cron C, Grunenwald E, Porterie J, Labaste F, Elbaz M, Galinier M, Carrié D, Lavie-Badie Y. Participating in Sports After Mitral Valve Repair for Primary Mitral Regurgitation: A Retrospective Cohort Study. Clin J Sport Med 2021; 31:414-422. [PMID: 31809282 DOI: 10.1097/jsm.0000000000000769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/22/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Participating in either competitive or leisure sports is restrictive after surgical mitral valve repair (MVR). In this study, we examine the impact of sports on outcomes after MVR. DESIGN Retrospective cohort study. SETTING Patients aged 18 to 65 years who underwent a first-time MVR for primary mitral regurgitation (MR) in a tertiary care center. PATIENTS One hundred twenty-one consecutive patients were included in the study. The exclusion criteria were as follows: other concomitant procedures, early perioperative death or repeat intervention, noncardiac death or endocarditis during follow-up, and general contraindications for normal physical activity. ASSESSMENT OF RISK FACTORS Participation in sports was quantified by the number of hours per week during the past 6 months, classified according to the Mitchell classification and assessed with the International Physical Activity Questionnaire (IPAQ) short form. MAIN OUTCOME MEASURES The primary composite endpoint was MVR failure defined as MR grade ≥2 or mean transmitral gradient ≥8 mm Hg, signs and symptoms of heart failure, or late-onset postoperative AF (>3 months). RESULTS The mean age was 50 ± 11 years, and there were 85 (71%) men. The median follow-up was 34 months [interquartile range (IQR): 20-50]. Fifty-six (46%) patients participated in sports regularly (median of 3 h/wk; IQR: 2-5). Twenty (17%) patients reached the primary composite endpoint with no correlation with participation in sports (P = 0.537), IPAQ categories (P = 0.849), in any of the Mitchell classification subgroups and a high level of participation in sports ≥6 hours (P = 0.679). CONCLUSIONS Sports seem to be unrelated to the worst outcome after MVR.
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Affiliation(s)
- Adrien Blanc
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Ana Maria Poenar
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Bertrand Marcheix
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Christophe Cron
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Etienne Grunenwald
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Jean Porterie
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - François Labaste
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
- Department of Anesthesiology, University Hospital of Rangueil, Toulouse, France ; and
| | - Meyer Elbaz
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Purpan, Paul Sabatier University, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
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20
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Eyharts D, Lavie-Badie Y, Cazalbou S, Fournier P, Cariou E, Pascal P, Campelo-Parada F, Marcheix B, Galinier M, Berry I, Carrié D, Lairez O. Quantitative assessment of tricuspid regurgitation using right and left ventricular stroke volumes obtained from tomographic equilibrium radionuclide ventriculography. J Nucl Cardiol 2021; 28:864-872. [PMID: 31201690 DOI: 10.1007/s12350-019-01781-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Quantitative assessment of valve regurgitation using volumetric method by comparing right and left ventricular stroke volumes is still under investigations. AIMS To investigate the accuracy of tomographic equilibrium radionuclide ventriculography (t-ERV) for the quantification of tricuspid regurgitation (TR). METHODS AND RESULTS Sixty-one patients (44 men; mean age 59 ± 12 years) who underwent both t-ERV and transthoracic echocardiography (TTE) studies within 2 weeks for right ventricular systolic function assessment were eligible for inclusion. A sub-group of 22 patients underwent both t-ERV and CMR. Patients with mitral/aortic regurgitation by TTE were excluded of the study. TR regurgitant volume (RVol) was calculated using the proximal isovelocity surface area (PISA) method from TTE and the volumetric method (right ventricular stroke volume minus left ventricular stroke volume) from t-ERV. There was a significant correlation between RVol as assess by ERV and by TTE (R = 0.95, P < 0.0001). Intraclass correlation coefficient between TTE and ERV for TR quantification was 0.95 (P < 0.0001). Among patients who underwent CMR, the correlation between RVol obtained by TTE and by t-ERV and CMR were R = 0.81 and R = 0.75, respectively (all P < 0.0001). CONCLUSION TR assessment using the t-ERV correlates well with PISA from TTE in patients referred for right ventricular systolic function assessment.
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Affiliation(s)
- Damien Eyharts
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Stéphanie Cazalbou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Pierre Pascal
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
| | - Francisco Campelo-Parada
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Isabelle Berry
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Purpan, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France.
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France.
- Heart Valve Center, Toulouse University Hospital, Toulouse, France.
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21
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Labaste F, Porterie J, Bousquet P, Marcheix B, Sanchez-Verlaan P, Frances B, Valet P, Dray C, Minville V. Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study. Clin Interv Aging 2020; 15:2375-2381. [PMID: 33376313 PMCID: PMC7755370 DOI: 10.2147/cia.s265797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/04/2020] [Indexed: 01/19/2023] Open
Abstract
Background After cardiac surgery, postoperative delirium (POD) is common and is associated with long-term changes in cognitive function. Impact on health-related quality of life (QOL) and long-term dependence are not well known. This aim of this study is to evaluate the role of POD in poor evolution at three years after surgery including poor QOL and dependence and mortality. Patients and Methods We enrolled and followed 173 patients 60 years of age or older who were planning to undergo cardiac surgery with cardiopulmonary bypass. The primary composite outcome was death of any causes, or patients with either a loss of QOL (evaluated with of EuroQuol verbal 5D EQ5D less than 50), or a loss of two points on the instrumental activities of daily living occurring three years after surgery. POD was diagnosed with the use of Confusion Assessment Method. Multivariate logistic regression was performed. Results At three years, 74 patients (42.8%) had a poor evolution. Independent risk factors in poor patient evolution were sex (female gender; OR: 3.6; 95%CI: 1.45-8.7; p=0.006), metabolic status (diabetic patients; OR: 4; 95%CI: 1.6-10.2; p=0.002), Euroscore 2 (Euroscore 2 >1.5; OR: 5.2; 95%CI: 1.7-15.4; p=0.003) and POD (OR: 3.3; 95%CI 1.4-7.8; p=0.006). Coronary disease was protective (OR: 0.3; 95%CI: 0.14-0.71; p=0.006). Conclusion After cardiac surgery, POD significantly altered patient evolution and increased risk of dependence and loss of QOL.
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Affiliation(s)
- François Labaste
- Anesthesiology and Intensive Care Department, CHU Toulouse, Toulouse, France.,Institut des Maladies Métaboliques et Cardiovasculaires, INSERM U1048, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Jean Porterie
- Cardiac Surgery Department, CHU Toulouse, Toulouse, France
| | - Paul Bousquet
- Anesthesiology and Intensive Care Department, CHU Toulouse, Toulouse, France
| | | | | | - Bernard Frances
- Research Center on Animal Cognition, Center for Integrative Biology, Toulouse University, CNRS, UPS, Toulouse, France
| | - Philippe Valet
- Institut des Maladies Métaboliques et Cardiovasculaires, INSERM U1048, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Cedric Dray
- Institut des Maladies Métaboliques et Cardiovasculaires, INSERM U1048, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Vincent Minville
- Anesthesiology and Intensive Care Department, CHU Toulouse, Toulouse, France.,Institut des Maladies Métaboliques et Cardiovasculaires, INSERM U1048, Université de Toulouse, Université Paul Sabatier, Toulouse, France
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22
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Chabry Y, Porterie J, Gautier CH, Nader J, Chaufour X, Alsac JM, Reix T, Marcheix B, Koskas F, Ruggieri VG, Achouh P, Caus T. The frozen elephant trunk technique in an emergency: THORAFLEX French National Registry offers new insights. Eur J Cardiothorac Surg 2020; 59:ezaa325. [PMID: 33141214 DOI: 10.1093/ejcts/ezaa325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/04/2020] [Accepted: 07/18/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Our goal was to study the immediate outcome after an emergency frozen elephant trunk procedure with a Thoraflex™ Hybrid prosthesis (THP) in patients included in the EPI-Flex national registry and operated on in 21 French centres. METHODS All patients operated on in France between April 2016 and April 2019 for acute aortic syndromes and who had an frozen elephant trunk procedure with a THP were included in the study. The main end point was in-hospital mortality. The secondary end point was neuromorbidity, including paraplegia. The evolution of the main end point was monitored using a variable life-adjusted display graph with cumulative sum derivatives in order to stop inclusions in case the observed mortality became out of range compared to an expected mortality between 15% and 20%. RESULTS Enrolment ended on the scheduled date and included 109 patients. Most cases (54%) were performed at 3 centres, where more than 10 THP each were implanted (10-26). The observed mortality in the large-volume centres (22%) was comparable to that observed in the low-volume centres (20%). The individually risk-adjusted cumulative sum revealed that observed in-hospital mortality was statistically in line with that predicted by the log EuroSCORE. Analysis of the secondary end point revealed 8% cases of paraplegia, all of which appeared after treatment of the thoracic type A aortic dissection. CONCLUSIONS In France, THP for emergency frozen elephant trunk surgery outside high-volume centres did not result in excessive in-hospital deaths. However, a word of caution must be expressed regarding the prevention of medullar ischaemia even in emergency aortic surgery.
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Affiliation(s)
- Yuthiline Chabry
- Federation of Heart, Lung and Vessels, University Hospital Amiens-Picardie, Amiens, France
| | - Jean Porterie
- Department of Cardiac and Vascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Charles-Henri Gautier
- Department of Cardiac and Vascular Surgery, University Hospital European Hospital Georges-Pompidou, Paris, France
| | - Joseph Nader
- Federation of Heart, Lung and Vessels, University Hospital Amiens-Picardie, Amiens, France
| | - Xavier Chaufour
- Department of Cardiac and Vascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Jean Marc Alsac
- Department of Cardiac and Vascular Surgery, University Hospital European Hospital Georges-Pompidou, Paris, France
| | - Thierry Reix
- Federation of Heart, Lung and Vessels, University Hospital Amiens-Picardie, Amiens, France
| | - Bertrand Marcheix
- Department of Cardiac and Vascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Fabien Koskas
- Department of Vascular Surgery, University Hospital Pitié-Salpétrière, APHP, Paris, France
| | - Vito Giovanni Ruggieri
- Department of Thoracic and Cardiovascular Surgery, Robert Debré University Hospital, Reims, France
| | - Paul Achouh
- Department of Cardiac and Vascular Surgery, University Hospital European Hospital Georges-Pompidou, Paris, France
| | - Thierry Caus
- Federation of Heart, Lung and Vessels, University Hospital Amiens-Picardie, Amiens, France
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23
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Labaste F, Rey V, Gonzalez H, Marcheix B, Fourcade O, Minville V. AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Corona Virus Disease 2019 Pandemic. J Cardiothorac Vasc Anesth 2020; 35:1267-1268. [PMID: 33082095 DOI: 10.1053/j.jvca.2020.09.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
Affiliation(s)
- François Labaste
- Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse; Inserm U1048, I2MC, Université Paul Sabatier
| | - Valentin Rey
- Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse
| | - Hélène Gonzalez
- Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse
| | - Bertrand Marcheix
- Chirurgie Cardiaque, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Olivier Fourcade
- Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse
| | - Vincent Minville
- Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse; Inserm U1048, I2MC, Université Paul Sabatier
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24
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Lapébie FX, Robin G, Adoue D, Bura-Rivière A, Marcheix B. Left ventricular pseudoaneurysm revealing a Behçet's disease: a case report. Clin Exp Rheumatol 2020; 38 Suppl 127:127-128. [PMID: 33331266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/08/2020] [Indexed: 06/12/2023]
Affiliation(s)
| | - Guillaume Robin
- Cardiology Department, Toulouse University Hospital, Toulouse, France
| | - Daniel Adoue
- Internal Medicine Department, Toulouse University Cancer Institute, Toulouse, France
| | | | - Bertrand Marcheix
- Cardiovascular Surgery Department, Toulouse University Hospital, Toulouse, France
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25
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Bousquet P, Labaste F, Gobin J, Marcheix B, Minville V. Bilateral Parasternal Block and Bilateral Erector Spinae Plane Block Reduce Opioid Consumption in During Cardiac Surgery. J Cardiothorac Vasc Anesth 2020; 35:1249-1250. [PMID: 32843270 DOI: 10.1053/j.jvca.2020.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Paul Bousquet
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - François Labaste
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France; Université Paul Sabatier, Toulouse, France
| | - Julie Gobin
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiac Surgery, Toulouse University Teaching Hospital, Toulouse, France
| | - Vincent Minville
- Anesthesiology and Critical Care Unit, Toulouse University Teaching Hospital, Toulouse, France; Université Paul Sabatier, Toulouse, France.
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26
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Mané C, Delmas C, Porterie J, Jourdan G, Verwaerde P, Marcheix B, Concordet D, Georges B, Ruiz S, Gandia P. Influence of extracorporeal membrane oxygenation on the pharmacokinetics of ceftolozane/tazobactam: an ex vivo and in vivo study. J Transl Med 2020; 18:213. [PMID: 32460856 PMCID: PMC7251674 DOI: 10.1186/s12967-020-02381-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/16/2020] [Indexed: 02/07/2023] Open
Abstract
Background Extracorporeal membrane oxygenation (ECMO) is increasingly used in intensive care units and can modify drug pharmacokinetics and lead to under-exposure associated with treatment failure. Ceftolozane/tazobactam is an antibiotic combination used for complicated infections in critically ill patients. Launched in 2015, sparse data are available on the influence of ECMO on the pharmacokinetics of ceftolozane/tazobactam. The aim of the present study was to determine the influence of ECMO on the pharmacokinetics of ceftolozane-tazobactam. Methods An ex vivo model (closed-loop ECMO circuits primed with human whole blood) was used to study adsorption during 8-h inter-dose intervals over a 24-h period (for all three ceftolozane/tazobactam injections) with eight samples per inter-dose interval. Two different dosages of ceftolozane/tazobactam injection were studied and a control (whole blood spiked with ceftolozane/tazobactam in a glass tube) was performed. An in vivo porcine model was developed with a 1-h infusion of ceftolozane–tazobactam and concentration monitoring for 11 h. Pigs undergoing ECMO were compared with a control group. Pharmacokinetic analysis of in vivo data (non-compartmental analysis and non-linear mixed effects modelling) was performed to determine the influence of ECMO. Results With the ex vivo model, variations in concentration ranged from − 5.73 to 1.26% and from − 12.95 to − 2.89% respectively for ceftolozane (concentrations ranging from 20 to 180 mg/l) and tazobactam (concentrations ranging from 10 to 75 mg/l) after 8 h. In vivo pharmacokinetic exploration showed that ECMO induces a significant decrease of 37% for tazobactam clearance without significant modification in the pharmacokinetics of ceftolozane, probably due to a small cohort size. Conclusions Considering that the influence of ECMO on the pharmacokinetics of ceftolozane/tazobactam is not clinically significant, normal ceftolozane and tazobactam dosing in critically ill patients should be effective for patients undergoing ECMO.
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Affiliation(s)
- Camille Mané
- Pharmacokinetics and Toxicology Laboratory, Toulouse University Hospital, Toulouse, France.,INTHERES, INRAE, ENVT, Université de Toulouse, Toulouse, France
| | - Clément Delmas
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France.,Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR-1048, National Institute of Health and Medical Research (INSERM), Toulouse, France
| | - Jean Porterie
- Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR-1048, National Institute of Health and Medical Research (INSERM), Toulouse, France.,Cardiovascular Surgery Unit, Rangueil University Hospital, Toulouse, France
| | - Géraldine Jourdan
- Critical and Intensive Care Unit, Stomalab UMR 5273 CNRS/UPS-EFS-ENVT-INSERM U1031, Toulouse School of Veterinary Medicine, Toulouse, France
| | - Patrick Verwaerde
- Anesthesia-Emergency-Intensive Care Department, UPEC/IMRB-Inserm U955, Alfort School of Veterinary Medicine, Maisons-Alfort, France
| | - Bertrand Marcheix
- Cardiovascular Surgery Unit, Rangueil University Hospital, Toulouse, France
| | | | - Bernard Georges
- Anesthesia-General Intensive Care Division, Rangueil General Intensive Care Department, Toulouse University Hospital, Toulouse, France
| | - Stéphanie Ruiz
- Anesthesia-General Intensive Care Division, Rangueil General Intensive Care Department, Toulouse University Hospital, Toulouse, France
| | - Peggy Gandia
- Pharmacokinetics and Toxicology Laboratory, Toulouse University Hospital, Toulouse, France. .,INTHERES, INRAE, ENVT, Université de Toulouse, Toulouse, France.
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27
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Botea R, Porterie J, Marcheix B, Breleur FO, Lavie-Badie Y. Infective Endocarditis in a Third Trimester Pregnant Woman: Team Work Is the Best Option. JACC Case Rep 2020; 2:521-525. [PMID: 34317284 PMCID: PMC8298775 DOI: 10.1016/j.jaccas.2020.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/13/2022]
Abstract
Infective endocarditis in pregnancy may have a misleading presentation and carries a high-risk of complications for both the mother and her infant. When urgent valve surgery is required, the fetal risk relative to cardiopulmonary bypass is challenging requiring a multidisciplinary management. We report the case of a pregnant woman with infective endocarditis on a bicuspid aortic valve who was successfully treated by a 2-step strategy including cardiac surgery. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Roxana Botea
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Jean Porterie
- Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiovascular Surgery, Rangueil University Hospital, Toulouse, France
| | | | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
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28
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Rollin A, Mandel F, Grunenwald E, Mondoly P, Monteil B, Marcheix B, Maury P. Hybrid surgical ablation for persistent or long standing persistent atrial fibrillation: A French single centre experience. Ann Cardiol Angeiol (Paris) 2020; 69:86-92. [PMID: 32241522 DOI: 10.1016/j.ancard.2020.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hybrid ablation for the treatment of atrial fibrillation is a single combined procedure consisting in a minimally thoracoscopic surgical ablation followed by a catheter ablation. This promising technique is recommended in persistent atrial fibrillation according to the current guidelines but is not routinely performed in France, mainly due to the absence of reimbursement by the French National Health Insurance. AIMS The aim of this prospective and single-centre study was to analyse, for the first time in France, the feasibility, efficacy and complication rates of hybrid ablation in patients with persistent atrial fibrillation. METHODS Hybrid ablation was performed in 15 consecutive patients (13 men, mean age 61±6 years) with persistent (7 patients) or long standing persistent (8 patients) atrial fibrillation. RESULTS Hybrid ablation was completed in 14/15 patients. Eleven patients returned in sinus rhythm during the procedure. Two patients (13%) had major per-procedural complications and 2 had minor complications. During an average follow-up of 25±6 months, 6 patients (40%) underwent a redo catheter ablation because of atrial tachycardia, mainly peri-mitral atrial flutter. At 1 year follow up, 14/15 patients were in sinus rhythm, including 11 free of antiarrhythmic drugs.
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Affiliation(s)
- A Rollin
- Hôpital Rangueil, CHU Toulouse, Toulouse, France.
| | - F Mandel
- Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - E Grunenwald
- Service de chirurgie cardiaque, hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - P Mondoly
- Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - B Monteil
- Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - B Marcheix
- Service de chirurgie cardiaque, hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - P Maury
- Hôpital Rangueil, CHU Toulouse, Toulouse, France
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29
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Laperche C, Lairez O, Ferrieres J, Robin G, Gautier M, Lavie Badie Y, Lhermusier T, Boudou N, Campelo-Parada F, Roncalli J, Marcheix B, Galinier M, Elbaz M, Carrié D, Bouisset F. Coronary angiography in the setting of acute infective endocarditis requiring surgical treatment. Arch Cardiovasc Dis 2020; 113:50-58. [DOI: 10.1016/j.acvd.2019.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/02/2019] [Accepted: 09/30/2019] [Indexed: 02/08/2023]
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30
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Servoz C, Bouisset F, Marcheix B, Grunenwald E, Carrié D, Boudou N, Campelo-Parada F, Chollet T, Lhermusier T. Infective endocarditis after transcatheter aortic-valve implantation: Incidence, impact and treatment in a French university hospital. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Servoz C, Chollet T, Bouisset F, Carrié D, Boudou N, Campelo-Parada F, Marcheix B, Grunenwald E, Lhermusier T. Impact of lung diseases in patients undergoing on transaortic compared with transfemoral TAVI. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Delon C, Biendel C, Carrié D, Galinier M, Marcheix B, Robin G, Lairez O, Grunenwald E, Delmas C. Percutaneous versus surgical drainage of non-iatrogenic pericardial effusion. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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33
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Laperche C, Lairez O, Elbaz M, Carrie D, Galinier M, Marcheix B, Gautier M, Robin G, Bouisset F. P859Infective endocarditis requiring surgical intervention: safety and therapeutic impact of preoperative coronary angiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Preoperative coronary angiography (CA) cannot be performed systematically in patients with infective endocarditis requiring surgical treatment due to a high risk of embolization, in cases of aortic endocarditis, or when abscesses or vegetations are present.
Purpose
The aim of this study is to assess the safety and the therapeutic impact of preoperative coronary angiography in infective endocarditis requiring surgery.
Methods
This monocentric, observational study included patients with infective endocarditis requiring surgical treatment who were hospitalized between March 2013 and December 2016 in our Hospital. The outcome were i) the occurence of post-CA complications, such as neurological embolization, acute kidney failure requiring post-operative dialysis, or ii) necessity for surgical myocardial revascularization, and the mortality at 28 days and one year.
Results
193 patients were included among which 178 were effectively operated on. 119 patients had an aortic endocarditis with an aortic vegetation for 74 patients. Invasive coronary angiography was performed in 142 patients (91.6% by radial approach), and 14 patients were evaluated by coronary tomodensitometry (one patient had exploration with both techniques).
CA was carried out regardless of the location of the endocarditis, whether it was aortic or not (p=0,39), and regardless of the existence of abscesses and/ or adenoids (p=0,09), even in case of emergency surgery (p=0,79). Among the 178 patients operated on, 35 had significant coronary lesion(s) and 25 underwent an associated artery bypass graft.
Neurological embolization occurred after angiography in only 2 patients with mitral endocarditis, and none was observed in patients with aortic endocarditis. Acute renal failure after CA was observed in 15 (10.6%)
Surgery was performed in 173 patients, and 25 of them had a myocardial revascularization. No increase in post-operative dialysis rate was observed (p=0,43) and there were no differences in the mortality rates, neither at 28 days (p=0,77) nor at 12 months following surgery (p=0,59).
Conclusion
Preoperative CA was not associated with a higher occurence of complications, such as embolizaton or post-operative acute kidney failure, and did not decrease post-operative mortality in infective endocarditis (aortic or not) requiring surgery.
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Affiliation(s)
- C Laperche
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - O Lairez
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - M Elbaz
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - D Carrie
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - M Galinier
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - B Marcheix
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - M Gautier
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - G Robin
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - F Bouisset
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
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34
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Bouisset F, Marcheix B, Grunenwald E, Lhermusier T. Late Right Coronary Obstruction Following TAVR in a Degenerated Surgical Aortic Bioprosthetic Valve. JACC Case Rep 2019; 1:419-420. [PMID: 34316842 PMCID: PMC8288631 DOI: 10.1016/j.jaccas.2019.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 06/13/2023]
Abstract
We present a case of an 80-year-old woman with severe aortic insufficiency due to a degenerated 21-mm biological prosthetic aortic valve implanted 9 years earlier, treated by using a transcatheter aortic valve replacement valve-in-valve procedure and who experienced a delayed right coronary obstruction. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Frederic Bouisset
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
| | - Etienne Grunenwald
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
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35
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Eyharts D, Lavie-Badie Y, Cazalbou S, Fournier P, Cariou E, Pascal P, Campelo F, Marcheix B, Galinier M, Berry I, Carrie D, Lairez O. P3360Quantitative assessment of tricuspid regurgitation using right and left ventricular stroke volumes obtained from tomographic equilibrium radionuclide ventriculography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Quantitative assessment of valve regurgitation using volumetric method by comparing right and left ventricular stroke volumes is still under investigations.
Aims
To investigate the accuracy of tomographic equilibrium radionuclide ventriculography (t-ERV) for the quantification of tricuspid regurgitation (TR).
Methods and results
Sixty-one patients (44 men; mean age 59±12 years) who underwent both t-ERV and transthoracic echocardiography (TTE) studies within 2 weeks for right ventricular systolic function assessment were eligible for inclusion. A sub-group of 22 patients underwent both t-ERV and CMR. Patients with mitral/aortic regurgitation by TTE were excluded of the study. TR regurgitant volume (RVol) was calculated using the proximal isovelocity surface area (PISA) method from TTE and the volumetric method (right ventricular stroke volume minus left ventricular stroke volume) from t-ERV. RVol tended to be higher using the ERV volumetric method as compared to PISA method (43±35 and 35±33 ml, respectively; P<0.0001). There was a significant correlation between RVol as assess by ERV and by TTE (R=0.95, P<0.0001). Intraclass correlation coefficient between TTE and ERV for TR quantification was 0.95 (P<0.0001). Among patients who underwent CMR, the correlation between RVol obtained by TTE and by t-ERV and CMR were R=0.81 and R=0.75, respectively (all P<0.0001), without difference between the two correlations (P=0.263).
Linear regression (left) and Bland-Altma
Conclusion
TR assessment using the t-ERV correlates well with PISA from TTE in patients referred for right ventricular systolic function assessment.
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Affiliation(s)
- D Eyharts
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - Y Lavie-Badie
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - S Cazalbou
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - P Fournier
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - E Cariou
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - P Pascal
- Toulouse Rangueil University Hospital (CHU), Department of Nuclear Medicine, Toulouse, France
| | - F Campelo
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - B Marcheix
- University Hospital of Toulouse, Department of Cardiac Surgery, Toulouse, France
| | - M Galinier
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - I Berry
- Toulouse Rangueil University Hospital (CHU), Department of Nuclear Medicine, Toulouse, France
| | - D Carrie
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
| | - O Lairez
- Toulouse Rangueil University Hospital (CHU), Department of Cardiology, Toulouse, France
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36
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Larroche J, Panh L, Lhermusier T, Lairez O, Bataille V, Marachet MA, Chollet T, Petermann A, Bouisset F, Boudou N, Marcheix B, Rousseau H, Galinier MA, Carrie D, Lavie-Badie Y. P906Impact of aortic valve calcification severity on device success after trans catheter aortic valve replacement. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The aim of this study was to determine whether CS, measured on the preoperative contrast enhanced multislice computed tomography (MSCT), is associated with Device Success (DS), Major Adverse Cardiac Events (MACE) and paravalvular leaks (PVL) after TAVR.
Methods
We included 352 consecutive patients who underwent TAVR with a preoperative standardized contrast enhanced MSCT. Valvular calcifications detection was defined by adding +100 Hounsfield Unit (HU) to mean HU determined by a Region Of Interest placed in the contrast enhanced ascending aorta. CS was then indexed to the aortic annulus surface (CSi). Endpoints were DS and 30-days MACE according to Valve Academic Research Consortium-2 consensus document, and PVL greater than or equal to grade 2.
Results
DS was obtained for 305 patients. In multivariate analysis, CS and CSi were negatively and independently associated with DS: OR=0.88, 95% CI 0.81–0.96, p=0.004; and OR=0.94, 95% CI 0.91–0.98, p=0.002 respectively. There was no association between MACE and CS (p=0,953) and CSi (p=0,757). PVL was positively associated with CS (p<0.001) and CSi (p<0.001).
Multivariate analysis for device success Multivariate analysis for device success procedure Initial Model Final Model OR (95% CI) p OR (95% CI) p Age (years) 1.06 (1–1.12) 0.058 Size (cm) 1.02 (0.98–1.07) 0.26 Hypertension 0.35 (0.13–0.92) 0.033 0.34 (0.13–0.87) 0.024 Diabete mellitus 1.72 (0.68–4.34) 0.249 Mean gradient 0.99 (0.97–1.02) 0.517 Mitral regurgitation 0.6 (0.28–1.27) 0.18 Valve size ≤23 1 (REF) 26 1.85 (0.8–4.27) 0.152 29 4.08 (1.32–12.59) 0.015 4.72 (1.62–13.78) 0.004 31 1.42 (0.32–6.38) 0.647 CS (for an increase of 1000 pts) 0.89 (0.81–0.98) 0.017 0.88 (0.81–0.96) 0.004 CSi (for an increase of 100 pts) 0.94 (0.9–0.99) 0.013 0.96 (0.91–0.98) 0.002
Example of CS measurement
Conclusion
In TAVR, the aortic valvular CS, measured on preoperative contrast enhanced MSCT, is significantly associated with DS and PVL, but not with 30-days MACE. Its routine use could be relevant to appreciate success chances of TAVR.
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Affiliation(s)
- J Larroche
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - L Panh
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - T Lhermusier
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - O Lairez
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - V Bataille
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - M.-A Marachet
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - T Chollet
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - A Petermann
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - F Bouisset
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - N Boudou
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - B Marcheix
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - H Rousseau
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - M.-A Galinier
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - D Carrie
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - Y Lavie-Badie
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
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Chollet T, Marcheix B, Boudou N, Elbaz M, Campelo-Parada F, Bataille V, Bouisset F, Lairez O, Porterie J, Galinier M, Carrie D, Lhermusier T. Propensity-matched comparison of clinical outcomes after transaortic versus transfemoral aortic valve replacement. EUROINTERVENTION 2019; 14:750-757. [PMID: 29969427 DOI: 10.4244/eij-d-18-00168] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS We aimed to compare the long-term outcomes of transaortic (TAo-AVR) and transfemoral (TF-AVR) transcatheter aortic valve replacement. METHODS AND RESULTS Between January 2012 and December 2015, consecutive TAo-AVR and TF-AVR cases were compared using a propensity score-matching analysis. Primary endpoints were 30-day and one-year mortality; 644 TAVR patients were included (163 TAo-AVR and 481 TF-AVR). Peripheral artery disease (31.9% vs. 5%, p<0.001) and coronary artery disease (50.0% vs. 39.3%, p=0.009) were more frequent in TAo-AVR patients. The Society of Thoracic Surgeons scores were not different (6.9% vs. 6.5%, p=0.243). Propensity matching identified 124 well-matched patient pairs. Thirty-day and one-year mortality rates were similar in the overall population of TAo-AVR and TF-AVR patients (7.3% vs 7.6%, p=0.8 and 18.4% vs. 15.8%, p=0.6, respectively), and in the matched cohort (7.3% vs. 6.5%, p=0.8 and 15.3% vs. 16.1%, p=0.8, respectively). Transaortic access was associated with higher risk of new onset of atrial fibrillation (NOAF) (24.4% vs. 9.6%, p=0.012), life-threatening bleedings (6.5% vs. 0.8%, p=0.036) and transfusion (41% vs. 16.7%, p<0.001). CONCLUSIONS No significant differences were observed between the respective 30-day and one-year mortality rates of TAo-AVR and TF-AVR patients. The transaortic approach thus constitutes a valid alternative to TF-AVR, but is associated with higher rates of NOAF, bleedings, and transfusion.
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Affiliation(s)
- Thomas Chollet
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
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Dumonteil N, Levade M, Garcia C, Lhermusier T, Series J, Le Faouder P, Marcheix B, Payrastre B, Carrié D, Sié P. Platelet Activation Is Limited during Transcatheter Aortic Valve Implantation in Patients on Aspirin Monotherapy and without per Procedural Clinical Complications. TH Open 2019; 3:e146-e152. [PMID: 31259296 PMCID: PMC6598084 DOI: 10.1055/s-0039-1692142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/18/2019] [Indexed: 11/25/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment option for symptomatic patients with severe aortic valve stenosis (AS). During and early after the procedure, both ischemic events (predominantly stroke) and bleedings remain prevalent. The optimal antithrombotic regimen is still debated. Single- versus dual-antiplatelet therapy is associated with a lower rate of severe bleeding, without difference in thrombotic complications. Although platelets have been empirically targeted, little is known on their contribution to these events primarily related to embolization of thrombotic material and tissue-derived debris from the wounded aortic valve and large vessels. The objective of this study was to assess local platelet activation in blood sampled in the ascending aorta immediately before and within minutes postimplantation. A series of 18 patients with AS on monotherapy with aspirin successfully underwent TAVI with the self-expandable Medtronic CoreValve by transfemoral route. No clinical thrombotic complication occurred at 30-day follow-up. Compared with patients with stable coronary artery disease unscathed of AS and similarly treated by low-dose aspirin, AS patients displayed a chronic state of platelet activation before TAVI, assessed in venous blood using various biomarkers. However, per procedure, in aortic blood, no change occurred between the two time points in the plasma levels of serotonin or 12-lipoxgenase products, or membrane exposure of granule markers CD62-P and CD63. Our results suggest that local acute platelet activation is limited during TAVI on monotherapy with aspirin.
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Affiliation(s)
- Nicolas Dumonteil
- Pôle Cardiovasculaire et Métabolique, Hôpital Rangueil, Toulouse, France
| | - Marie Levade
- INSERM, U1048 and Université Toulouse 3, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Cédric Garcia
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Thibault Lhermusier
- Pôle Cardiovasculaire et Métabolique, Hôpital Rangueil, Toulouse, France
- INSERM, U1048 and Université Toulouse 3, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Jennifer Series
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pauline Le Faouder
- MetaToul-Lipidomique, INSERM U1048 and Université Paul Sabatier Toulouse 3, Toulouse, France
| | - Bertrand Marcheix
- Pôle Cardiovasculaire et Métabolique, Hôpital Rangueil, Toulouse, France
| | - Bernard Payrastre
- INSERM, U1048 and Université Toulouse 3, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Didier Carrié
- Pôle Cardiovasculaire et Métabolique, Hôpital Rangueil, Toulouse, France
- INSERM, U1048 and Université Toulouse 3, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Pierre Sié
- INSERM, U1048 and Université Toulouse 3, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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Porterie J, Mayeur N, Lhermusier T, Dumonteil N, Chollet T, Lairez O, Marcheix B. Aortic and innominate routes for transcatheter aortic valve implantation. J Thorac Cardiovasc Surg 2019; 157:1393-1401.e7. [DOI: 10.1016/j.jtcvs.2018.07.098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 06/25/2018] [Accepted: 07/08/2018] [Indexed: 11/29/2022]
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Hernández-Enríquez M, Chollet T, Bataille V, Campelo-Parada F, Boudou N, Bouisset F, Grunenwald E, Porterie J, Freixa X, Regueiro A, Sabaté M, Carrié D, Marcheix B, Lhermusier T. Comparison of the Frequency of Thrombocytopenia After Transfemoral Transcatheter Aortic Valve Implantation Between Balloon-Expandable and Self-Expanding Valves. Am J Cardiol 2019; 123:1120-1126. [PMID: 30709598 DOI: 10.1016/j.amjcard.2018.12.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/21/2018] [Accepted: 12/27/2018] [Indexed: 12/20/2022]
Abstract
Thrombocytopenia after transcatheter aortic valve implantation (TAVI) is common and has been related to worse clinical outcomes. Comparison of platelet kinetics among different types of valves is limited. Our objectives were to analyze the differences in drop platelet count (DPC) between balloon-expandable valves (BEVs) and self-expanding valves and their prognostic implications after TAVI. Patients who underwent transfemoral TAVI from 2008 to 2016 were included. Exclusion criteria were severe baseline thrombocytopenia and periprocedural death. Postprocedural platelet counts were collected. Two groups were created: DPC ≤30 and DPC >30%. Valve Academic Research Consortium-2 criteria were used to define outcomes. Study population included 609 patients (age 84.7 ± 6.0, 46.6% males). The mean DPC was 32.5 ± 13.9%. The DPC was higher in the BEV arm (33.9 ± 14.2 vs 30.7 ± 13.4%, p = 0.006), and the nadir was reached later in comparison to the self-expanding valve arm (3.0 ± 1.3 vs 2.5 ± 1.1 days, p <0.001). After multivariable analysis, the use of BEV, known coronary artery disease, and left ventricle ejection fraction were the factors associated with a higher rate of DPC >30%. At 30 days, the DPC >30% was related with a higher rate of life-threatening and/or major bleeding (6.8 vs 2.1%, p = 0.009) and death (3.5 vs 0.8%, p = 0.036). At 1 year, the difference in mortality disappeared. In conclusion, in this cohort of patients, the use of BEV seems to be associated with a higher risk of DPC after TAVI. A DPC ≥30% was related with increased risk of life-threatening and/or major bleeding and death at 30 days. Larger and prospective studies are needed to understand this phenomenon.
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Charbonnier G, Lavie-Badie Y, Robin G, Labaste F, Eyharts D, Fournier P, Cariou E, Porte L, Marcheix B, Porterie J, Grunenwald E, Cron C, Galinier M, Lairez O. Cardiac surgery in infective endocarditis with neurological complications: Identifying prognosis risk factors in mortality and handicap at 6 months. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Faguer S, Tardif E, Mayeur N, Labaste F, Grunenwald E, Minville V, Marcheix B, Schanstra J. Incidence et facteurs prédictifs d’insuffisance rénale aiguë après chirurgie cardiaque sous circulation extracorporelle : cohorte prospective monocentrique de 509 patients. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
It is well known that a heavily calcified mitral valve significantly increases the perioperative and postoperative risks of mitral valve surgery. A 71-year-old woman was referred to our department with severe mitral valve disease. Cardiac imaging revealed extremely severe calcification of the entire left heart. Surgery was performed through a median sternotomy with standard cardiopulmonary bypass. After dilating the mitral orifice with a balloon, we replaced the valve with a transcatheter Edwards Sapiens 3 aortic valve under direct vision. Seven months after the procedure, the patient was doing well and no longer suffered from dyspnea.
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Affiliation(s)
- Elise Lupon
- 1 Department of Cardiac Surgery, Paul Sabatier University, Toulouse, France
| | - Anais Lemaire
- 2 Department of Cardiac Surgery, University Hospital Rangueil, Toulouse, France
| | - Christophe Cron
- 2 Department of Cardiac Surgery, University Hospital Rangueil, Toulouse, France
| | - Bertrand Marcheix
- 1 Department of Cardiac Surgery, Paul Sabatier University, Toulouse, France
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Delmas C, Jacquemin A, Vardon-Bounes F, Georges B, Guerrero F, Hernandez N, Marcheix B, Seguin T, Minville V, Conil JM, Silva S. Anticoagulation Monitoring Under ECMO Support: A Comparative Study Between the Activated Coagulation Time and the Anti-Xa Activity Assay. J Intensive Care Med 2018; 35:679-686. [DOI: 10.1177/0885066618776937] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Purpose: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)—a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population. Methods: All patients treated by venoarterial or venovenous ECMO in our intensive care unit between January 2014 and December 2015 were prospectively included. A concomitant measurement of the anti-Xa activity and ACT was performed on the same sample collected twice a day (morning–evening) for unfractionated heparin adaptation with an ACT target range of 180 to 220 seconds. Results: One hundred and nine patients (men 69.7%, median age 54 years) treated with ECMO (70.6% venoarterial) were included. Spearman analysis found no correlation between anti-Xa and ACT (ρ < 0.4) from day 1 and worsened over time. Kappa analysis showed no agreement between the respective target ranges of ACT and anti-Xa. Conclusions: We demonstrate that concomitant measurement of ACT and anti-Xa activity is irrelevant in ECMO patients. Since ACT is poorly correlated with heparin dosage, anti-Xa activity appears to be a more suitable assay for anticoagulation monitoring.
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Affiliation(s)
- Clément Delmas
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
- Intensive Cardiac Care, Cardiology Department, Rangueil University Hospital, Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Rangueil, Toulouse, France
| | - Aemilia Jacquemin
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Fanny Vardon-Bounes
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Bernard Georges
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Felipe Guerrero
- Hematology Laboratory, Rangueil University Hospital, Toulouse, France
| | - Nicolas Hernandez
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Cardiac Surgery Department, Rangueil University Hospital, Toulouse, France
| | - Thierry Seguin
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Vincent Minville
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Rangueil, Toulouse, France
| | - Jean-Marie Conil
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
| | - Stein Silva
- Intensive Care Unit, Anesthesia and Critical Care Department, Rangueil University Hospital, Toulouse, France
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Delmas C, Elbaz M, Bonello L, Biendel C, Bouisset F, Lairez O, Silva S, Marcheix B, Galinier M. Place de l’assistance circulatoire dans le choc cardiogénique en France en 2018 : revue de la littérature et perspectives. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Le choc cardiogénique reste de nos jours une entité mal définie, assez fréquente en pratique clinique (60 000–70 000 cas/an en Europe), dont le pronostic est sombre, avec une mortalité souvent supérieure à 40 % à 30 jours. À travers cette revue de la littérature, nous essaierons de définir cette entité et ses étiologies, avant de parler de son incidence et de son pronostic. L’approche physiopathologique du choc cardiogénique nous permettra par la suite d’approcher sa prise en charge thérapeutique classique (gestion de la volémie, amines inotropes et vasoconstrictives, ventilation) et les limites de cette dernière. Ainsi, nous aborderons les assistances circulatoires et cardiocirculatoires disponibles en France, afin de les envisager au sein d’une stratégie globale de prise en charge du patient en choc cardiogénique. Nous discuterons plus spécifiquement leurs indications ainsi que l’importance du moment d’implantation afin d’optimiser leur efficacité. Enfin, nous évoquerons les assistances actuellement en développement, mais également les nouvelles stratégies thérapeutiques qui pourraient arriver dans les prochaines années.
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Lairez O, Delmas C, Fournier P, Cassol E, Méjean S, Pascal P, Petermann A, Dambrin C, Minville V, Carrié D, Rousseau H, Galinier M, Roncalli J, Marcheix B, Berry I. Feasibility and accuracy of gated blood pool SPECT equilibrium radionuclide ventriculography for the assessment of left and right ventricular volumes and function in patients with left ventricular assist devices. J Nucl Cardiol 2018; 25:625-634. [PMID: 27905008 DOI: 10.1007/s12350-016-0670-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Left ventricular assist devices (LVADs) require serial assessment of right and left ventricular (RV & LV) volumes and function. Because the RV is not assisted, its function is a critical determinant of the hemodynamic and contributes significantly to postoperative morbidity and mortality. We evaluated the feasibility and the accuracy of tomographic-equilibrium radionuclide ventriculography (t-ERV) for the assessment of patients with LVADs. METHODS Twenty-four patients with LVAD underwent t-ERV. Because of the limited acoustic window, transthoracic echocardiography (TTE) was only feasible in 19 patients. Functional evaluation including six-minute walk test (6MWT) and peak oxygen consumption (POC) was performed in 18 patients. Nine patients underwent a cardiac multidetector computed tomography (MDCT). Eight patients underwent a second evaluation by ERV 4.3 ± 1.4 months later. RESULTS Reliability between t-ERV and MDCT for LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, RV end-diastolic volume, RV end-systolic volume, and RV ejection fraction (RVEF) was 0.900 (P = .001), 0.911 (P = .001), 0.765 (P = .021), 0.728 (P = .042), 0.875 (P = .004), and 0.781 (P = .023), respectively. There was no correlation between t-ERV and RV systolic parameters assessed by TTE. RVEF was correlated with POC (R = 0.521; P = .027). A cut-off value of 40% for RVEF measured by t-ERV could discriminate patients with poor functional status (P = .048 for NYHA stage; P = .016 for 6MWT and P = .007 for POC). CONCLUSION t-ERV is a simple, reproducible, and an accurate technique for the assessment of RV function in patients with LVADs and warrants consideration in the evaluation and monitoring of symptomatic patients.
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Affiliation(s)
- Olivier Lairez
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France.
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France.
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France.
| | - Clément Delmas
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Emmanuelle Cassol
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Simon Méjean
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Pierre Pascal
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Antoine Petermann
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Radiology, Toulouse University Hospital, Toulouse, France
| | - Camille Dambrin
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Cardiac Surgery, Toulouse University Hospital, Toulouse, France
| | - Vincent Minville
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Anesthesiology, Toulouse University Hospital, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Purpan, University Paul Sabatier, Toulouse, France
| | - Hervé Rousseau
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Radiology, Toulouse University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Jérôme Roncalli
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Purpan, University Paul Sabatier, Toulouse, France
| | - Bertrand Marcheix
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Cardiac Surgery, Toulouse University Hospital, Toulouse, France
| | - Isabelle Berry
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
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Perrin C, Conil J, Georges B, Bounes F, Marcheix B, Brouchet L, Fourcade O, Delmas C. Bloodstream infections in adults undergoing extracorporeal membrane oxygenation: Epidemiology and risk factors. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Auffret V, Lefevre T, Van Belle E, Eltchaninoff H, Iung B, Koning R, Motreff P, Leprince P, Verhoye JP, Manigold T, Souteyrand G, Boulmier D, Joly P, Pinaud F, Himbert D, Collet JP, Rioufol G, Ghostine S, Bar O, Dibie A, Champagnac D, Leroux L, Collet F, Teiger E, Darremont O, Folliguet T, Leclercq F, Lhermusier T, Olhmann P, Huret B, Lorgis L, Drogoul L, Bertrand B, Spaulding C, Quilliet L, Cuisset T, Delomez M, Beygui F, Claudel JP, Hepp A, Jegou A, Gommeaux A, Mirode A, Christiaens L, Christophe C, Cassat C, Metz D, Mangin L, Isaaz K, Jacquemin L, Guyon P, Pouillot C, Makowski S, Bataille V, Rodés-Cabau J, Gilard M, Le Breton H, Le Breton H, Eltchaninoff H, Gilard M, Iung B, Le Breton H, Lefevre T, Van Belle E, Laskar M, Leprince P, Iung B, Bataille V, Chevalier B, Garot P, Hovasse T, Lefevre T, Donzeau Gouge P, Farge A, Romano M, Cormier B, Bouvier E, Bauchart JJ, Bodart JC, Delhaye C, Houpe D, Lallemant R, Leroy F, Sudre A, Van Belle E, Juthier F, Koussa M, Modine T, Rousse N, Auffray JL, Richardson M, Berland J, Eltchaninoff H, Godin M, Koning R, Bessou JP, Letocart V, Manigold T, Roussel JC, Jaafar P, Combaret N, Souteyrand G, D’Ostrevy N, Innorta A, Clerfond G, Vorilhon C, Auffret V, Bedossa M, Boulmier D, Le Breton H, Leurent G, Anselmi A, Harmouche M, Verhoye JP, Donal E, Bille J, Joly P, Houel R, Vilette B, Abi Khalil W, Delepine S, Fouquet O, Pinaud F, Rouleau F, Abtan J, Himbert D, Urena M, Alkhoder S, Ghodbane W, Arangalage D, Brochet E, Goublaire C, Barthelemy O, Choussat R, Collet JP, Lebreton G, Leprince P, Mastrioanni C, Isnard R, Dauphin R, Dubreuil O, Durand De Gevigney G, Finet G, Harbaoui B, Ranc S, Rioufol G, Farhat F, Jegaden O, Obadia JF, Pozzi M, Ghostine S, Brenot P, Fradi S, Azmoun A, Deleuze P, Kloeckner M, Bar O, Blanchard D, Barbey C, Chassaing S, Chatel D, Le Page O, Tauran A, Bruere D, Bodson L, Meurisse Y, Seemann A, Amabile N, Caussin C, Dibie A, Elhaddad S, Drieu L, Ohanessian A, Philippe F, Veugeois A, Debauchez M, Zannis K, Czitrom D, Diakov C, Raoux F, Champagnac D, Lienhart Y, Staat P, Zouaghi O, Doisy V, Frieh JP, Wautot F, Dementhon J, Garrier O, Jamal F, Leroux PY, Casassus F, Leroux L, Seguy B, Barandon L, Labrousse L, Peltan J, Cornolle C, Dijos M, Lafitte S, Bayet G, Charmasson C, Collet F, Vaillant A, Vicat J, Giacomoni MP, Teiger E, Bergoend E, Zerbib C, Darremont O, Louis Leymarie J, Clerc P, Choukroun E, Elia N, Grimaud JP, Guibaud JP, Wroblewski S, Abergel E, Bogino E, Chauvel C, Dehant P, Simon M, Angioi M, Lemoine J, Lemoine S, Popovic B, Folliguet T, Maureira P, Huttin O, Selton Suty C, Cayla G, Delseny D, Leclercq F, Levy G, Macia JC, Maupas E, Piot C, Rivalland F, Robert G, Schmutz L, Targosz F, Albat B, Dubar A, Durrleman N, Gandet T, Munos E, Cade S, Cransac F, Bouisset F, Lhermusier T, Grunenwald E, Marcheix B, Fournier P, Morel O, Ohlmann P, Kindo M, Hoang MT, Petit H, Samet H, Trinh A, Huret B, Lecoq G, Morelle JF, Richard P, Derieux T, Monier E, Joret C, Lorgis L, Bouchot O, Eicher JC, Drogoul L, Meyer P, Lopez S, Tapia M, Teboul J, Elbeze JP, Mihoubi A, Bertrand B, Vanzetto G, Wittenberg O, Bach V, Martin C, Sauier C, Casset C, Castellant P, Gilard M, Bezon E, Choplain JN, Kallifa A, Nasr B, Jobic Y, Blanchard D, Lafont A, Pagny JY, Spaulding C, Abi Akar R, Fabiani JN, Zegdi R, Berrebi A, Puscas T, Desveaux B, Ivanes F, Quilliet L, Saint Etienne C, Bourguignon T, Aupy B, Perault R, Bonnet JL, Cuisset T, Lambert M, Grisoli D, Jaussaud N, Salaun E, Delomez M, Laghzaoui A, Savoye C, Beygui F, Bignon M, Roule V, Sabatier R, Ivascau C, Saplacan V, Saloux E, Bouchayer D, Claudel JP, Tremeau G, Diab C, Lapeze J, Pelissier F, Sassard T, Matz C, Monsarrat N, Carel I, Hepp A, Sibellas F, Curtil A, Dambrin G, Favereau X, Jegou A, Ghorayeb G, Guesnier L, Khoury W, Kucharski C, Pouzet B, Vaislic C, Cheikh-Khelifa R, Hilpert L, Maribas P, Gommeaux A, Hannebicque G, Hochart P, Paris M, Pecheux M, Fabre O, Guesnier L, Leborgne L, Mirode A, Peltier M, Trojette F, Carmi D, Tribouilloy C, Christiaens L, Mergy J, Corbi P, Raud Raynier P, Carillo S, Christophe C, Hueber A, Moulin F, Pinelli G, Cassat C, Darodes N, Pesteil F, Metz D, Aludaat C, Torossian F, Belle L, Mangin L, Chavanis N, Akret C, Cerisier A, Isaaz K, Favre JP, Fuzellier JF, Pierrard R, Jacquemin L, Roth O, Wiedemann JY, Bischoff N, Gavra G, Bourrely N, Digne F, Guyon P, Najjari M, Stratiev V, Bonnet N, Mesnildrey P, Attias D, Dreyfus J, Karila Cohen D, Laperche T, Nahum J, Scheuble A, Pouillot C, Rambaud G, Brauberger E, Ah Hot M, Allouch P, Beverelli F, Makowski S, Rosencher J, Aubert S, Grinda JM, Waldman T. Temporal Trends in Transcatheter Aortic Valve Replacement in France. J Am Coll Cardiol 2017; 70:42-55. [DOI: 10.1016/j.jacc.2017.04.053] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 04/05/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
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Kamilia C, Regaieg K, Baccouch N, Chelly H, Bahloul M, Bouaziz M, Jendoubi A, Abbes A, Belhaouane H, Nasri O, Jenzri L, Ghedira S, Houissa M, Belkadi K, Harti Y, Nsiri A, Khaleq K, Hamoudi D, Harrar R, Thieffry C, Wallet F, Parmentier-Decrucq E, Favory R, Mathieu D, Poissy J, Lafon T, Vignon P, Begot E, Appert A, Hadj M, Claverie P, Matt M, Barraud O, François B, Jamoussi A, Jazia AB, Marhbène T, Lakhdhar D, Khelil JB, Besbes M, Goutay J, Blazejewski C, Joly-Durand I, Pirlet I, Weillaert MP, Beague S, Aziz S, Hafiane R, Hattabi K, Bouhouri MA, Hammoudi D, Fadil A, Harrar RA, Zerouali K, Medhioub FK, Allela R, Algia NB, Cherif S, Slaoui MT, Boubia S, Hafiani Y, Khaoudi A, Cherkab R, Elallam W, Elkettani C, Barrou L, Ridaii M, Mehdi RE, Schimpf C, Mizrahi A, Pilmis B, Le Monnier A, Tiercelet K, Cherin M, Bruel C, Philippart F, Bailly S, Lucet J, Lepape A, L’hériteau F, Aupée M, Bervas C, Boussat S, Berger-Carbonne A, Machut A, Savey A, Timsit JF, Razazi K, Rosman J, de Prost N, Carteaux 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Gainnier M, Papazian L, Guervilly C, Garnero A, Arnal JM, Roze H, Richard JC, Repusseau B, Dewitte A, Joannes-Boyau O, Ouattara A, Harbouze N, Amine AM, Olandzobo AG, Herbland A, Richard M, Girard N, Lambron L, Lesieur O, Wainschtein S, Hubert S, Hugues A, Tran M, Bouillard P, Loteanu V, Leloup M, Laurent A, Lheureux F, Prestifilippo A, Cruz MDM, Romain R, Antonelli M, Blanch TL, Bonnetain F, Grazzia-Bocci M, Mancebo J, Samain E, Paul H, Capellier G, Zavgorodniaia T, Soichot M, Malissin I, Voicu S, Garçon P, Goury A, Kerdjana L, Deye N, Bourgogne E, Megarbane B, Mejri O, Hmida MB, Tannous S, Chevillard L, Labat L, Risede P, Fredj H, Léger M, Brunet M, Le Roux G, Boels D, Lerolle N, Farah S, Amiel-Niemann H, Kubis N, Declèves X, Peyraux N, Baud F, Serafini M, Alvarez JC, Heinzelman A, Jozwiak M, Millasseau S, Teboul JL, Alphonsine JE, Depret F, Richard N, Attal P, Richard C, Monnet X, Chemla D, Jerbi S, Khedhiri W, Necib H, Scarfo P, Chevalier C, Piagnerelli M, Lafont A, Galy A, Mancia 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Ait-Ammar N, Bonnal C, Merle JC, Botterel F, Levesque E, Riad Z, Mezidi M, Yonis H, Aublanc M, Perinel-Ragey S, Lissonde F, Louf-Durier A, Tapponnier R, Louis B, Forel JM, Bisbal M, Lehingue S, Rambaud R, Adda M, Hraiech S, Marchi E, Roch A, Guerin V, Rozencwajg S, Schmidt M, Hekimian G, Bréchot N, Trouillet JL, Besset S, Franchineau G, Nieszkowska A, Pascal L, Loiselle M, Sarah C, Laurence D, Guillemette T, Jacquens A, Kerever S, Guidet B, Aegerter P, Das V, Fartoukh M, Hayon J, Desmard M, Fulgencio JP, Zuber B, Soufi A, Khaleq K, Hamoudi D, Garret C, Peron M, Coron E, Bretonnière C, Audureau E, Audrey W, Christophe D, Christian J, Daniel A, Cyrille F, Aissaoui W, Rghioui K, Haddad W, Barrou H, Carteaux-Taeib A, Lupinacci R, Manceau G, Jeune F, Tresallet C, Habacha S, Fathallah I, Zoubli A, Aloui R, Kouraichi N, Jouet E, Badin J, Fermier B, Feller M, Serie M, Pillot J, Marie W, Gisbert-Mora C, Vinclair C, Lesbordes P, Mathieu P, De Brabant F, Muller E, Robaux MA, Giabicani M, Marchalot A, Gelinotte S, Declercq PL, Eraldi JP, Bougerol F, Meunier-Beillard N, Devilliers H, Rigaud JP, Verrière C, Ardisson F, Kentish-Barnes N, Jacq G, Chermak A, Lautrette A, Legrand M, Soummer A, Thiery G, Cottereau A, Canet E, Caujolle M, Allyn J, Valance D, Brulliard C, Martinet O, Jabot J, Gallas T, Vandroux D, Allou N, Durand A, Nevière R, Delguste F, Boulanger E, Preau S, Martin R, Cochet H, Ponthus JP, Amilien V, Tchir M, Barsam E, Ayoub M, Georger JF, Guillame I, Assaraf J, Tripon S, Mallet M, Barbara G, Louis G, Gaudry S, Barbarot N, Jamet A, Outin H, Gibot S, Bollaert PE, Holleville M, Legriel S, Chateauneuf AL, Cavelot S, Moyer JD, Bedos JP, Merle P, Laine A, Natalie DS, Cornuault M, Libot J, Asehnoune K, Rozec B, Dantal J, Videcoq M, Degroote T, Jaillette E, Zerimech F, Malika B, Llitjos JF, Amara M, Lacave G, Pangon B, Mavinga J, Makunza JN, Mafuta ME, Yanga Y, Eric A, Ilunga J, Kilembe M, Alby-Laurent F, Toubiana J, Mokline A, Laajili A, Amri H, Rahmani I, Mensi N, Gharsallah L, Tlaili S, Gasri B, Hammouda R, Messadi AA, Allain PA, Gault N, Paugam-Burtz C, Foucrier A, Chatbri B, Bourbiaa Y, Thabet L, Neuschwander A, Vincent L, Beck J, Vibol C, Amelie Y, Resche-Rigon M, Pirracchio JM, Bureau C, Decavèle M, Campion S, Ainsouya R, Niérat MC, Prodanovic H, Raux M, Similowski T, Dubé BP, Demiri S, Dres M, May F, Quintard H, Kounis I, Saliba F, André S. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress. Ann Intensive Care 2017. [PMCID: PMC5225389 DOI: 10.1186/s13613-016-0224-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rollin A, Marcheix B, Mondoly P, Duparc A, Cardin C, Maury P, Grunenwald E. Hybrid treatment of persistent atrial fibrillation: combined epicardial and endocardial ablation. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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