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Amedro P, Gavotto A, Huguet H, Souilla L, Huby AC, Matecki S, Cadene A, De La Villeon G, Vincenti M, Werner O, Bredy C, Lavastre K, Abassi H, Cohen S, Hascoet S, Dauphin C, Chalard A, Dulac Y, Souletie N, Bouvaist H, Douchin S, Lachaud M, Ovaert C, Soulatges C, Combes N, Thambo JB, Iriart X, Bajolle F, Bonnet D, Ansquer H, Delpey JG, Cohen L, Picot MC, Guillaumont S. Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial. Eur Heart J 2024; 45:1458-1473. [PMID: 38430485 PMCID: PMC11032713 DOI: 10.1093/eurheartj/ehae085] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND AND AIMS Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD. METHODS The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health. RESULTS The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P = .038; effect size 0.34], body mass index [mean difference -0.7 kg/m2 (95% CI -1.3; -0.1); P = .022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P = .044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P = .007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent. CONCLUSIONS This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease.
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Affiliation(s)
- Pascal Amedro
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Arthur Gavotto
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Helena Huguet
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
| | - Luc Souilla
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Anne-Cecile Huby
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Stefan Matecki
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Anne Cadene
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
| | - Gregoire De La Villeon
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Marie Vincenti
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Oscar Werner
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Charlene Bredy
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Fontfroide Cardiac Rehabilitation Center, 1800 rue de Saint-Priest, 34097 Montpellier, France
| | - Kathleen Lavastre
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Hamouda Abassi
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Sarah Cohen
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, Marie-Lannelongue Hospital, Le Plessis-Robinson, France
| | - Sebastien Hascoet
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, Marie-Lannelongue Hospital, Le Plessis-Robinson, France
| | - Claire Dauphin
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Aurelie Chalard
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Yves Dulac
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Toulouse University Hospital, Toulouse, France
| | - Nathalie Souletie
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Toulouse University Hospital, Toulouse, France
| | - Helene Bouvaist
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Stephanie Douchin
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Matthias Lachaud
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, APHM La Timone Hospital, Marseille, France
| | - Camille Soulatges
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, APHM La Timone Hospital, Marseille, France
| | - Nicolas Combes
- Pediatric and Congenital Cardiology Department, Pasteur Clinic, Toulouse, France
| | - Jean-Benoit Thambo
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Xavier Iriart
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
| | - Fanny Bajolle
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, APHP Necker Hospital, Paris, France
| | - Damien Bonnet
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, APHP Necker Hospital, Paris, France
| | - Helene Ansquer
- Pediatric and Congenital Cardiology Department, Brest University Hospital, Brest, France
| | - Jean-Guillaume Delpey
- Pediatric and Congenital Cardiology Department, Brest University Hospital, Brest, France
| | - Laurence Cohen
- Fetal, Pediatric and Congenital Private Practice, 8 rue du Conseil de l'Europe, 91300 Massy, France
| | - Marie-Christine Picot
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
- Clinical Investigation Centre, INSERM-CIC 1411, University of Montpellier, Montpellier, France
| | - Sophie Guillaumont
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
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Padovani P, Jalal Z, Fouilloux V, Benbrik N, Grunenwald C, Thambo JB, Aldebert P, Tagorti M, Roubertie F, Baron O, Ovaert C, Ly M, Baruteau AE. Risk of infective endocarditis after hybrid melody mitral valve replacement in infants: the French experience. Interdiscip Cardiovasc Thorac Surg 2024; 38:ivae046. [PMID: 38490258 DOI: 10.1093/icvts/ivae046] [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] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES Surgical management of mitral valve disease is challenging in infants <1 year old. We aimed at reviewing the French experience with Melody mitral valve replacement in critically ill infants. METHODS A retrospective cohort study reporting the French experience with Melody mitral valve replacement. RESULTS Seven symptomatic infants [complete atrioventricular septal defect (n = 4, Down syndrome: n = 3), hammock valve (n = 3)] underwent Melody mitral valve replacement [age: 3 months (28 days to 8 months), weight: 4.3 kg (3.2-6.4 kg)] because of severe mitral valve regurgitation (6) or mixed valve disease (1) and 14 mm (11-16 mm) mitral valve annulus. In 2 patients whose valve was felt irreparable, Melody mitral valve replacement was performed straightaway. The others underwent 2 (1-3) previous attempts of valve repair; 3 were on extracorporeal membrane oxygenation. Melody mitral valve replacement led to competent valve and low gradient [3 mmHg, (1-4 mmHg)]. One patient died 3 days post-implant from extracorporeal membrane oxygenation-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, 1 underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical mitral valve replacement at 2 years; another is currently planned for transcatheter Melody valve dilation. CONCLUSIONS Melody mitral valve replacement may be considered in selected infants with small mitral valve annulus as an alternative to mechanical mitral valve replacement. Our experience highlights a high-risk of late infective endocarditis that deserves further consideration.
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Affiliation(s)
- Paul Padovani
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Zakaria Jalal
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Virginie Fouilloux
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
| | - Nadir Benbrik
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Céline Grunenwald
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Jean-Benoit Thambo
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Philippe Aldebert
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
| | - Maha Tagorti
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - François Roubertie
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Olivier Baron
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
- Marseille Medical Genetics, INSERM U1251, Aix-Marseille Université, Marseille, France
| | - Mohamedou Ly
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Alban-Elouen Baruteau
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
- Nantes Université, INRAE, UMR 1280, PhAN, Nantes, France
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Hascoet S, Baruteau AE, Jalal Z, Demkow M, de Winter R, Gaio G, Clerc JM, Sabiniewicz R, Eberli F, Santoro G, Dauphin C, Schubert S, Smolka G, Lutz M, Moreno R, Pan M, Gutierrez-Larraya F, Godart F, Carminati M, Ovaert C, Batteux C, Guerin P, Thambo JB, Ewert P. Safety and efficacy of the Amplatzer™ Trevisio™ intravascular delivery system: Post-approval study results. Arch Cardiovasc Dis 2023; 116:580-589. [PMID: 37951755 DOI: 10.1016/j.acvd.2023.10.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The Amplatzer™ Trevisio™ Intravascular Delivery System (Trevisio DS; Abbott Laboratories, Chicago, IL, USA) facilitates the delivery of Amplatzer™ Occluders and features an ultraflexible tip, which improves assessment of occluder position before release. AIMS To assess the safety and efficacy of the Trevisio DS for transcatheter closure of patent foramen ovale and atrial septal defect. METHODS The Amplatzer™ Trevisio™ Intravascular Delivery System Post-Approval Study was a prospective, postmarket, single-arm, multicentre, observational study of the Trevisio DS. Enrolled patients were indicated for transcatheter closure of patent foramen ovale or atrial septal defect. In all procedures, the Trevisio DS was used to deliver Amplatzer™ Occluders. Technical success was defined as successful deployment and release of at least one occluder. Device- or procedure-related serious adverse events were tracked until discharge or day 7, whichever occurred earlier. RESULTS The study enrolled 144 patients with patent foramen ovale and 107 patients with atrial septal defect at 22 European sites; 53 patients with atrial septal defect (49.6%) were aged<18years. The rate of technical success was 98.4% (97.2% for atrial septal defect, 99.3% for patent foramen ovale). There was one serious adverse event (0.4%), an acute periprocedural device embolization that occurred after occluder release in a patient with atrial septal defect; the device was retrieved percutaneously. This was determined by the implanter to be unrelated to the performance of the Trevisio DS. CONCLUSIONS The Trevisio DS exhibited a high rate of technical success and an excellent safety profile during transcatheter closure of patent foramen ovale and atrial septal defect.
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Affiliation(s)
- Sebastien Hascoet
- Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), BME Lab, 92350 Le Plessis-Robinson, France.
| | - Alban-Elouen Baruteau
- Nantes Université, CHU de Nantes, Department of Paediatric Cardiology and Paediatric Cardiac Surgery, FHU PRECICARE, 44000 Nantes, France; Nantes Université, CHU de Nantes, Inserm, CIC FEA 1413, 44000 Nantes, France; Nantes Université, CHU de Nantes, CNRS, Inserm, l'Institut du Thorax, 44000 Nantes, France
| | - Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, CHU de Bordeaux, 33000 Bordeaux, France; Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), 92350 Le Plessis-Robinson, France; Electrophysiology and Heart Modelling Institute, IHU Liryc, Fondation Bordeaux Université, 33000 Bordeaux, France
| | - Marcin Demkow
- The Cardinal Stefan Wyszynski Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Robbert de Winter
- Amsterdam Academic Medical Centre (AMC), 1105 AZ Amsterdam, The Netherlands
| | | | | | | | | | | | | | - Stephan Schubert
- Deutsches Herzzentrum Berlin, 13353 Berlin, Germany; Herz-und Diabetes Zentrum NRW, University Clinic of Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | | | - Matthias Lutz
- Universitätsklinikum Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Raul Moreno
- Hospital Universitario de la Paz, 28046 Madrid, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia, 14004 Cordoba, Spain
| | | | | | | | | | - Clement Batteux
- Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), BME Lab, 92350 Le Plessis-Robinson, France
| | | | - Jean-Benoit Thambo
- Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), 92350 Le Plessis-Robinson, France; Electrophysiology and Heart Modelling Institute, IHU Liryc, Fondation Bordeaux Université, 33000 Bordeaux, France
| | - Peter Ewert
- Deutsches Herzzentrum München des Freistaates Bayern, 80636 München, Germany
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Wanert C, El Louali F, Al Dybiat S, Nguyen K, Zaffran S, Ovaert C. Genetic profile and genotype-phenotype correlations in childhood cardiomyopathy. Arch Cardiovasc Dis 2023; 116:309-315. [PMID: 37246080 DOI: 10.1016/j.acvd.2023.04.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Genetic cardiomyopathy is a rare disease in childhood. AIMS To analyse clinical and genetic aspects of a paediatric cardiomyopathy population, and to establish genotype-phenotype correlations. METHODS We performed a retrospective study of all patients with idiopathic cardiomyopathy aged<18years in Southeast France. Secondary causes of cardiomyopathy were excluded. All data (clinical, echocardiography, genetic testing) were collected retrospectively. Patients were classified into six groups: hypertrophic cardiomyopathy; dilated cardiomyopathy; restrictive cardiomyopathy; left ventricular non-compaction; arrhythmogenic right ventricular dysplasia; and mixed cardiomyopathy. Patients who did not have a complete genetic test according to current scientific developments had another deoxyribonucleic acid blood sample during the study time. Genetic tests were considered positive if the variant found was classified as pathogenic, likely pathogenic or a variant of uncertain significance. RESULTS Eighty-three patients were included between 2005 and 2019. Most patients had hypertrophic cardiomyopathy (39.8%) or dilated cardiomyopathy (27.7%). The median age at diagnosis was 1.28years (interquartile range: 0.27-10.48years). Heart transplantation was performed in 30.1% of patients, and 10.8% died during follow-up. Among 64 patients with a complete genetic analysis, 64.1% had genetic anomalies, mostly in MYH7 (34.2%) and MYBPC3 (12.2%) genes. There were no differences in the whole cohort between genotype-positive and genotype-negative patients. In the hypertrophic cardiomyopathy group, 63.6% had a positive genetic test. Patients with a positive genetic test more often had extracardiac impact (38.1% vs. 8.3%; P=0.009), and more often required an implantable cardiac defibrillator (23.8% vs. 0%; P=0.025) or a heart transplant (19.1% vs. 0%; P=0.047). CONCLUSIONS In our population, children with cardiomyopathy had a high positive genetic test rate. Hypertrophic cardiomyopathy with a positive genetic test is associated with a worse outcome.
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Affiliation(s)
- Chloé Wanert
- Department of Paediatric Cardiology, Timone Infant Hospital, AP-HM, 13005 Marseille, France; Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, 13385 Marseille, France.
| | - Fedoua El Louali
- Department of Paediatric Cardiology, Timone Infant Hospital, AP-HM, 13005 Marseille, France
| | - Sarab Al Dybiat
- Department of Paediatric Cardiology, Timone Infant Hospital, AP-HM, 13005 Marseille, France
| | - Karine Nguyen
- Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, 13385 Marseille, France; Department of Specialized Cardiogenetics, Timone Infant Hospital, AP-HM, 13005 Marseille, France
| | - Stéphane Zaffran
- Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, 13385 Marseille, France
| | - Caroline Ovaert
- Department of Paediatric Cardiology, Timone Infant Hospital, AP-HM, 13005 Marseille, France; Department of Specialized Cardiogenetics, Timone Infant Hospital, AP-HM, 13005 Marseille, France
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5
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Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Damon C, Bouvaist H, Bouzguenda I, Cohen S, Dauphin C, Di Filippo S, Douchin S, Godart F, Guérin P, Helms P, Karsenty C, Lefort B, Mauran P, Ovaert C, Piéchaud JF, Thambo JB, Lee C, Little MP, Bonnet D, Bernier MO, Rage E. Lympho-hematopoietic malignancies risk after exposure to low dose ionizing radiation during cardiac catheterization in childhood. Eur J Epidemiol 2023:10.1007/s10654-023-01010-7. [PMID: 37191831 DOI: 10.1007/s10654-023-01010-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/16/2023] [Indexed: 05/17/2023]
Abstract
Pediatric patients with congenital heart disease (CHD) often undergo low dose ionizing radiation (LDIR) from cardiac catheterization (CC) for the diagnosis and/or treatment of their disease. Although radiation doses from a single CC are usually low, less is known about the long-term radiation associated cancer risks. We aimed to assess the risk of lympho-hematopoietic malignancies in pediatric CHD patients diagnosed or treated with CC. A French cohort of 17,104 children free of cancer who had undergone a first CC from 01/01/2000 to 31/12/2013, before the age of 16 was set up. The follow-up started at the date of the first recorded CC until the exit date, i.e., the date of death, the date of first cancer diagnosis, the date of the 18th birthday, or the 31/12/2015, whichever occurred first. Poisson regression was used to estimate the LDIR associated cancer risk. The median follow-up was 5.9 years, with 110,335 person-years. There were 22,227 CC procedures, yielding an individual active bone marrow (ABM) mean cumulative dose of 3.0 milligray (mGy). Thirty-eight incident lympho-hematopoietic malignancies were observed. When adjusting for attained age, gender and predisposing factors to cancer status, no increased risk was observed for lympho-hematopoietic malignancies RR/mGy = 1.00 (95% CI: 0.88; 1.10). In summary, the risk of lympho-hematopoietic malignancies and lymphoma was not associated to LDIR in pediatric patients with CHD who undergo CC. Further epidemiological studies with greater statistical power are needed to improve the assessment of the dose-risk relationship.
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Affiliation(s)
- Kossi D Abalo
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris Cité, Paris, France
| | - Sébastien Hascoët
- Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Serge Dreuil
- Institute for Radiological Protection and Nuclear Safety, (IRSN), PSE-SANTE/SER/UEM, BP 17, Fontenay-aux-Roses, 92262, France
| | | | - Cecilia Damon
- Institute for Radiological Protection and Nuclear Safety, (IRSN), DTR/D3NSI/SVDDA/CVD, BP 17, Fontenay-aux-Roses, 92262, France
| | - Hélène Bouvaist
- Cardiopédiatrie, hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, 38043, France
| | - Ivan Bouzguenda
- Pediatric and congenital cardiology, Interventional cardiology, INTERCARD Clinique La Louvière, Lille, France
| | - Sarah Cohen
- Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Claire Dauphin
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Sylvie Di Filippo
- Paediatric and Congential Cardiology Department, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphanie Douchin
- Cardiopédiatrie, hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, 38043, France
| | - François Godart
- Service de Cardiologie Infantile et Congénitale, Institut Coeur Poumon, Lille Cedex, 59037, France
| | - Patrice Guérin
- CHU Nantes, INSERM, Nantes Université, Clinique Cardiologique et des Maladies Vasculaires, Institut du Thorax, Nantes, 1413, CIC, France
| | - Pauline Helms
- Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France
| | - Clément Karsenty
- Pediatric and Congenital Cardiology, Institut des Maladies Métaboliques et Cardiovasculaires, Children's Hospital, INSERM U1048, Université de Toulouse, Toulouse, I2MC, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales, CHRU Tours, 49 boulevard Béranger, Tours, 37000, France
| | - Pierre Mauran
- Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, Reims Cedex, 51092, France
| | - Caroline Ovaert
- Cardiologie pédiatrique et congénitale, AP-HM et INSERM 1251, Aix-Marseille Université, Timone enfants, Marseille, France
| | | | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, 33600, France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Damien Bonnet
- M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris Cité, Paris, France
| | - Marie-Odile Bernier
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France
| | - Estelle Rage
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France.
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6
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El Louali F, Soler F, Fouilloux V, Evin M, Ovaert C. Morphological analysis of ventricular septal defect by echocardiography for prediction of aortic regurgitation in pediatric population. Sci Rep 2023; 13:6697. [PMID: 37095093 PMCID: PMC10125998 DOI: 10.1038/s41598-023-32940-7] [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] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/05/2023] [Indexed: 04/26/2023] Open
Abstract
Ventricular septal defects (VSD) are the most common congenital heart diseases in children. Among them, perimembranous VSD (pm-VSD) have a higher risk of complications, including aortic valve prolapse and aortic regurgitation (AR). The aim of our study was to assess echocardiographic criteria associated with AR during follow-up of pm-VSD. Forty children with restrictive pm-VSD, followed-up in our unit and who underwent a workable echocardiographic evaluation between 2015 and 2019 were included and retrospectively analyzed. The propensity score was used to match 15 patients with AR to 15 patients without AR. Median age was 2.2 year [1.4-5.7]. Median weight was 14 kg [9.9-20.3]. Aortic annulus z-score, Valsalva sinus z-score, sinotubular junction z-score, valve prolapse and commissure commitment were significantly different between the two groups (p = 0.047, p = 0.001, p = 0.010, p = 0.007, p < 0.001 respectively). Aortic root dilatation, aortic valve prolapse and commissure commitment to a perimembranous VSD are associated to aortic regurgitation.
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Affiliation(s)
- Fedoua El Louali
- Pediatric and Congenital Cardiology Department, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France.
- Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, Marseille, France.
| | - Floriane Soler
- Pediatric and Congenital Cardiology Department, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Virginie Fouilloux
- Pediatric and Congenital Cardiology Department, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
- Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, Marseille, France
| | - Morgane Evin
- Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, Marseille, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology Department, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
- Inserm U1251, Marseille Medical Genetics, Aix Marseille University, Marseille, France
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7
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Grynblat J, Malekzadeh-Milani SG, Meot M, Perros F, Szezepanski I, Morisset S, Ovaert C, Bonnet C, Maragnes P, Ranchoup J, Humbert M, Montani ID, Levy M, Bonnet D. Monitoring of Hemodynamics With Right Heart Catheterization in Children With Pulmonary Arterial Hypertension. J Am Heart Assoc 2023; 12:e029085. [PMID: 36974756 PMCID: PMC10122902 DOI: 10.1161/jaha.122.029085] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Background Right heart catheterization (RHC) is a high-risk procedure in children with pulmonary arterial hypertension without clear guidelines for the indications and targets of invasive reassessment. Our objectives are to define the aims of repeated RHC and evaluate the correlation between noninvasive criteria and hemodynamic parameters. Methods and Results Clinical and hemodynamic characteristics from 71 incident treatment-naïve children (median age 6.2 years) with pulmonary arterial hypertension who had a baseline and reevaluation RHC were analyzed. Correlations between noninvasive predictors and hemodynamic parameters were tested. Adverse outcomes were defined as death, lung transplantation, or Potts shunt. At baseline, pulmonary vascular resistance index (hazard ratio [HR] 1.07 per 1 WU·m2 increase [95% CI, 1.02-1.12], P=0.002), stroke volume index (HR 0.95 per 1 L·min-1·m-2 increase [95% CI, 0.91-0.99], P=0.012), pulmonary artery compliance index (HR 0.16 per 1 mL·mm Hg-1·m-2 increase [95% CI, 0.051-0.52], P=0.002), and right atrial pressure (HR, 1.31 per 1 mm Hg increase [95% CI, 1.01-1.71], P=0.043) were associated with adverse outcomes. Pulmonary vascular resistance index, pulmonary artery compliance index, and right atrial pressure were still associated with a worse outcome at second RHC. Noninvasive criteria accurately predicted hemodynamic evolution; however, 70% of the patients who had improved based on noninvasive criteria still presented at least 1 "at risk" hemodynamics at second RHC. Conclusions Pulmonary vascular resistance index, pulmonary artery compliance index, and right atrial pressure are solid predictors of adverse outcomes in pediatric pulmonary arterial hypertension and potential therapeutic targets. Noninvasive criteria accurately predict the evolution of hemodynamic parameters, but insufficiently. Repeated RHC are helpful to identify children with persistent higher risk after treatment introduction.
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Affiliation(s)
- Julien Grynblat
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
- Université Paris-Saclay, Faculty of Medicine Le Kremlin-Bicêtre France
- INSERM UMR_S 999, Hôpital Marie Lannelongue Le Plessis Robinson France
| | - Sophie-Guiti Malekzadeh-Milani
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
| | - Mathilde Meot
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
| | - Frédéric Perros
- Université Paris-Saclay, Faculty of Medicine Le Kremlin-Bicêtre France
- INSERM UMR_S 999, Hôpital Marie Lannelongue Le Plessis Robinson France
- Department of Respiratory and Intensive Care Medicine, AP-HP Hôpital Bicêtre Le Kremlin-Bicêtre France
| | - Isabelle Szezepanski
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
| | | | - Caroline Ovaert
- Department of Pediatric Cardiology La Timone Hospital, CHU Marseille France
| | | | - Pascale Maragnes
- Department of Cardiology Caen University, CHU de CAEN Caen France
| | | | - Marc Humbert
- Université Paris-Saclay, Faculty of Medicine Le Kremlin-Bicêtre France
- INSERM UMR_S 999, Hôpital Marie Lannelongue Le Plessis Robinson France
- Department of Respiratory and Intensive Care Medicine, AP-HP Hôpital Bicêtre Le Kremlin-Bicêtre France
| | - I David Montani
- Université Paris-Saclay, Faculty of Medicine Le Kremlin-Bicêtre France
- INSERM UMR_S 999, Hôpital Marie Lannelongue Le Plessis Robinson France
- Department of Respiratory and Intensive Care Medicine, AP-HP Hôpital Bicêtre Le Kremlin-Bicêtre France
| | - Marilyne Levy
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
| | - Damien Bonnet
- M3C-Necker, Hôpital Necker-Enfants malades, AP-HP Université de Paris Cité, Cardiologie Congénitale et Pédiatrique Paris France
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8
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Mignot M, Huguet H, Cambonie G, Guillaumont S, Vincenti M, Blanc J, Ovaert C, Picot MC, Karsenty C, Amedro P, Kollen L, Gavotto A. Risk factors for early occurrence of malnutrition in infants with severe congenital heart disease. Eur J Pediatr 2023; 182:1261-1269. [PMID: 36633658 DOI: 10.1007/s00431-023-04812-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
To identify the risk factors of early occurrence of malnutrition in infants with severe congenital heart disease (CHD) during their first year of life. Retrospective longitudinal multicenter study carried out from January 2014 to December 2020 in two tertiary care CHD centers. Four CHD hemodynamic groups were identified. Malnutrition was defined by a Waterlow score under 80% and/or underweight under -2 standard deviations. A total of 216 infants with a severe CHD, e.g., requiring cardiac surgery, cardiac catheterization, or hospitalization for heart failure during their first year of life, were included in the study. Malnutrition was observed among 43% of the cohort, with the highest prevalence in infants with increased pulmonary blood flow (71%) compared to the other hemodynamic groups (p < 0.001). In multivariate analysis, low birthweight (OR 0.62, 95% CI 0.44-0.89, p = 0.009), CHD with increased pulmonary blood flow (OR 4.80, 95% CI 1.42-16.20, p = 0.08), heart failure (OR 9.26, 95% CI 4.04-21.25, p < 0.001), and the number of hospitalizations (OR 1.35, 95% CI 1.08 l-1.69, p = 0.009) during the first year of life were associated with malnutrition (AUC 0.85, 95% CI 0.79-0.90). Conclusions: In infants with a severe CHD, early occurrence of malnutrition during the first year of life affected a high proportion of subjects. CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations were risk factors for malnutrition. Further studies are required to identify optimal nutritional support in this population. What is Known: • Malnutrition is a known morbidity and mortality factor in children with severe congenital heart disease. What is New: • Early occurrence of malnutrition during the first year of life in infant severe congenital heart disease (CHD) was high (43%). • CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations during the first year of life were risk factors for malnutrition.
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Affiliation(s)
- Margot Mignot
- Department of Pediatric Gastroenterology, Montpellier University Hospital, Montpellier, France
| | - Helena Huguet
- Epidemiology and Clinical Research Department, Montpellier University Hospital, Montpellier, France
- Epidemiology and Biostatistics, Clinical Investigation Centre, INSERM, University of Montpellier, Montpellier, France
| | - Gilles Cambonie
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Giraud, Montpellier, 34295, France
- Pathogenesis and Control of Chronic Infection, INSERM, UMR 1058, University of Montpellier, Montpellier, France
| | - Sophie Guillaumont
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Marie Vincenti
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Julie Blanc
- Pediatric and Congenital Cardiology Department, Timone Children Hospital, Aix-Marseille University, Marseille, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology Department, Timone Children Hospital, Aix-Marseille University, Marseille, France
| | - Marie-Christine Picot
- Epidemiology and Clinical Research Department, Montpellier University Hospital, Montpellier, France
- Epidemiology and Biostatistics, Clinical Investigation Centre, INSERM, University of Montpellier, Montpellier, France
| | - Clement Karsenty
- Pediatric Cardiology Unit, Children Hospital, Toulouse Hospital, Toulouse, France
- Institut Des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, INSERM U1048, I2MC, Toulouse, France
| | - Pascal Amedro
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM 1045, Bordeaux University Foundation, Pessac, France
| | - Laura Kollen
- Department of Pediatric Gastroenterology, Montpellier University Hospital, Montpellier, France
| | - Arthur Gavotto
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Giraud, Montpellier, 34295, France.
- PhyMedExp, CNRS, INSERM, University of Montpellier, Montpellier, France.
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9
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Jaouadi H, Jopling C, Bajolle F, Théron A, Faucherre A, Gerard H, Al Dybiat S, Ovaert C, Bonnet D, Avierinos JF, Zaffran S. Expanding the phenome and variome of the ROBO-SLIT pathway in congenital heart defects: toward improving the genetic testing yield of CHD. J Transl Med 2023; 21:160. [PMID: 36855159 PMCID: PMC9976407 DOI: 10.1186/s12967-023-03994-y] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Recent studies have shown the implication of the ROBO-SLIT pathway in heart development. Within this study, we aimed to further assess the implication of the ROBO and SLIT genes mainly in bicuspid aortic valve (BAV) and other human congenital heart defects (CHD). METHODS We have analyzed a cohort of singleton exome sequencing data comprising 40 adult BAV patients, 20 pediatric BAV patients generated by the Pediatric Cardiac Genomics Consortium, 10 pediatric cases with tetralogy of Fallot (ToF), and one case with coarctation of the aorta. A gene-centered analysis of data was performed. To further advance the interpretation of the variants, we intended to combine more than 5 prediction tools comprising the assessment of protein structure and stability. RESULTS A total of 24 variants were identified. Only 4 adult BAV patients (10%) had missense variants in the ROBO and SLIT genes. In contrast, 19 pediatric cases carried variants in ROBO or SLIT genes (61%). Three BAV patients with a severe phenotype were digenic. Segregation analysis was possible for two BAV patients. For the homozygous ROBO4: p.(Arg776Cys) variant, family segregation was consistent with an autosomal recessive pattern of inheritance. The ROBO4: c.3001 + 3G > A variant segregates with the affected family members. Interestingly, these variants were also found in two unrelated patients with ToF highlighting that the same variant in the ROBO4 gene may underlie different cardiac phenotypes affecting the outflow tract development. CONCLUSION Our results further reinforce the implication of the ROBO4 gene not only in BAV but also in ToF hence the importance of its inclusion in clinical genetic testing. The remaining ROBO and SLIT genes may be screened in patients with negative or inconclusive genetic tests.
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Affiliation(s)
- Hager Jaouadi
- Marseille Medical Genetics (MMG) U1251, Aix Marseille Université, INSERM, 13005, Marseille, France
| | - Chris Jopling
- Institute of Functional Genomics (IGF), University of Montpellier, CNRS, INSERM, LabEx ICST, Montpellier, France
| | - Fanny Bajolle
- Service de Cardiologie Congénitale Et Pédiatrique, Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Necker-Enfants Malades, APHP and Université Paris Cité, Paris, France
| | - Alexis Théron
- Marseille Medical Genetics (MMG) U1251, Aix Marseille Université, INSERM, 13005, Marseille, France
- Department of Cardiac Surgery, La Timone Hospital, AP-HM, Marseille, France
| | - Adèle Faucherre
- Institute of Functional Genomics (IGF), University of Montpellier, CNRS, INSERM, LabEx ICST, Montpellier, France
| | - Hilla Gerard
- Department of Cardiology, La Timone Hospital, AP-HM, Marseille, France
| | - Sarab Al Dybiat
- Department of Pediatric Cardiology, Timone Enfant Hospital, AP-HM, Marseille, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, Timone Enfant Hospital, AP-HM, Marseille, France
| | - Damien Bonnet
- Service de Cardiologie Congénitale Et Pédiatrique, Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Necker-Enfants Malades, APHP and Université Paris Cité, Paris, France
| | - Jean-François Avierinos
- Marseille Medical Genetics (MMG) U1251, Aix Marseille Université, INSERM, 13005, Marseille, France
- Department of Cardiology, La Timone Hospital, AP-HM, Marseille, France
| | - Stéphane Zaffran
- Marseille Medical Genetics (MMG) U1251, Aix Marseille Université, INSERM, 13005, Marseille, France.
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10
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Haddad RN, Hascoet S, Karsenty C, Houeijeh A, Baruteau AE, Ovaert C, Valdeolmillos E, Jalal Z, Bonnet D, Malekzadeh-Milani S. Multicentre experience with Optimus balloon-expandable cobalt-chromium stents in congenital heart disease interventions. Open Heart 2023; 10:openhrt-2022-002157. [PMID: 36631173 PMCID: PMC9835936 DOI: 10.1136/openhrt-2022-002157] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Received: 09/23/2022] [Accepted: 12/05/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To evaluate bare-metal Optimus and polytetrafluoroethylene (PTFE)-covered Optimus-CVS balloon-expandable, cobalt-chromium, hybrid cell-designed stents in congenital heart disease (CHD) interventions. METHODS Retrospective multicentre review of patients with CHD receiving Optimus stents. Stent mechanical behaviour, clinical indications and outcomes were assessed. RESULTS 183 stents (49.2% XXL/15-ZIG, 33.3% XL/12-ZIG, 17.5% L/9-ZIG) were implanted (98.9% success rate, 2.3% serious procedural complication rate) in 170 patients (57.6% men, 64.1% adults), median age 23.6 years (IQR, 15.2-39.2) and weight 63.5 kg (IQR, 47-75.7). Indications were right ventricular outflow tract stand-alone stenting or before revalvulation (62.4%), aortic coarctation treatment (15.3%), Fontan-circuit fenestration closure (12.4%) and miscellaneous (10%). 86/170 (50.6%) patients had PTFE-covered stenting (50% prophylactic). In 86/170 (50.6%) patients with stenotic lesions, median percentage of achieved stent expansion was 93.4% (IQR, 85.5%-97.7%), median gradient decreased from 28 mm Hg (IQR, 19-41) to 5 mm Hg (IQR, 1-9) (p<0.001), median vessel diameters increased from 13 mm (IQR, 7.9-17) to 18.9 mm (IQR, 15.2-22) (p<0.001) and percentage of vessel expansion was 45.2% (IQR, 19.8%-91.3%). In 30/36 (83.3%) patients with graft, median dilation of 2 mm (IQR, 2-5) above nominal diameter was achieved. Median stent shortening was 10.9% (IQR, 6.1-15.1) and was associated only with expansion diameter (OR: 0.66, 95% CI: 0.38 to 0.93). No clinically relevant fracture, stent embolisation or dysfunction occurred on a median follow-up of 9 (IQR, 4-14) months. CONCLUSIONS Optimus stents are effective tools for transcatheter treatment of simple and complex CHD. Optimus stents' reliable mechanical behaviour and particular covering design can promote widespread use.
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Affiliation(s)
- Raymond N Haddad
- Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker-Enfants malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France .,Department of Adult Congenital Heart Disease, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Sébastien Hascoet
- Department of Pediatric Cardiology and Congenital Heart Disease, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | - Clément Karsenty
- Department of Pediatric and Adult Congenital Cardiology, Toulouse University Hospital, Clinique Pasteur, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Ali Houeijeh
- Department of Pediatric Cardiology, Lille University Hospital, Lille, France
| | - Alban-Elouen Baruteau
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Nantes University Hospital, Nantes, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, Marseille University Hospital, Marseille, France
| | - Estibaliz Valdeolmillos
- Department of Pediatric Cardiology and Congenital Heart Disease, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | - Zakaria Jalal
- Department of Pediatric Cardiology, Bordeaux University Hospital, IHU Lyric, Bordeaux, France
| | - Damien Bonnet
- Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker-Enfants malades, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France,Department of Adult Congenital Heart Disease, Hôpital Européen Georges-Pompidou, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France,Université de Paris Cité, Paris, France
| | - Sophie Malekzadeh-Milani
- Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker-Enfants malades, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France,Department of Adult Congenital Heart Disease, Hôpital Européen Georges-Pompidou, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
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11
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Huang Q, El-Louali-Suzanne F, Soulatges C, Garaix F, Fouilloux V, Ovaert C. Exercise capacity in pediatric heart transplant recipient. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.285] [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: 12/31/2022]
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12
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Lenoir M, Beretti T, Testud B, Resseguier N, Gauthier K, Fouilloux V, Gran C, Paoli F, El-Louali F, Aldebert P, Blanc J, Soulatges C, Al-dybiat S, Carles G, Wanert C, Rozalen W, Lebel S, Arnaud S, Santelli D, Allary C, Peyre M, Grandvuillemin I, Desroberts C, Alaoui MB, Boubred F, Michel F, Ovaert C, Milh M, François C, Desnous B. Impact of cardiac surgical timing on the neurodevelopmental outcomes of newborns with Complex congenital heart disease (CHD). Front Pediatr 2023; 11:1003585. [PMID: 37033180 PMCID: PMC10077148 DOI: 10.3389/fped.2023.1003585] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/23/2023] [Indexed: 04/11/2023] Open
Abstract
Background More than half of infants with complex congenital heart disease (CHD) will have a neurodevelopmental disorder of multifactorial causes. The preoperative period represents a time-window during which neonates with complex CHD are in a state of hypoxia and hemodynamic instability, which fosters the emergence of brain injuries and, thus, affects early brain networks and neurodevelopmental outcomes. Currently, there is no consensus regarding the optimal age for cardiac surgery in terms of neurodevelopmental outcomes, and its definition is a real challenge. Our aim is to determine the relationship between cardiac surgical timing and long-term neurodevelopmental outcomes for various types of complex CHD. Methods We hypothesize that earlier surgical timing could represent a neuroprotective strategy that reduces perioperative white matter injuries (WMIs) and postoperative morbidity, leading to improved neurodevelopmental outcomes in infants with complex CHD. Firstly, our prospective study will allow us to determine the correlation between age at the time of surgery (days of life) and neurodevelopmental outcomes at 24 months. We will then analyze the correlation between age at surgery and (i) the incidence of WMIs (through pre- and postoperative MRIs), (ii) postoperative morbidity, and (iii) the duration of the hospital stay. Implications and Dissemination This research protocol was registered in the Clinical Trial Registry (National Clinical Trial: NCT04733378). This project aims to help launch the first Neurocardiac Investigation Clinic in Marseille - AP-HM - to propose an overall personalized monitoring and treatment program for patients operated on for complex CHD.
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Affiliation(s)
- Marien Lenoir
- Division of Paediatric Cardiac Surgery, APHM La Timone, Marseille, France
| | - Thibault Beretti
- Département de Pédiatrie, Division de Neurologie, Hôpital de La Timone, Marseille, France
| | - Benoit Testud
- Department of Neuroradiology, APHM La Timone, Marseille, France
- CEMEREM, APHM La Timone, Marseille, France
| | - Noémie Resseguier
- Aix-Marseille University, Support Unit for Clinical Research and Economic Evaluation, AP - HM, Marseille, France
| | - Kim Gauthier
- Department of Paediatric Neurology, APHM La Timone, Marseille, France
| | - Virginie Fouilloux
- Division of Paediatric Cardiac Surgery, APHM La Timone, Marseille, France
| | - Célia Gran
- Division of Paediatric Cardiac Surgery, APHM La Timone, Marseille, France
| | - Florent Paoli
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Fedoua El-Louali
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Philippe Aldebert
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Julie Blanc
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Camille Soulatges
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Sarab Al-dybiat
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Guillaume Carles
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Chloe Wanert
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - William Rozalen
- Department of Paediatric Neurology, APHM La Timone, Marseille, France
| | - Stéphane Lebel
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Sophie Arnaud
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Dominique Santelli
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Chloé Allary
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Marianne Peyre
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | | | | | - Myriem Belghiti Alaoui
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Farid Boubred
- Department of Neonatology, APHM La Conception, Marseille, France
| | - Fabrice Michel
- Department of Paediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France
| | - Caroline Ovaert
- Department of Paediatric Cardiology, APHM La Timone, Marseille, France
| | - Mathieu Milh
- Department of Paediatric Neurology, APHM La Timone, Marseille, France
| | | | - Béatrice Desnous
- Département de Pédiatrie, Division de Neurologie, Hôpital de La Timone, Marseille, France
- INSERM U1106 Institut de Neurosciences des Systèmes, Marseille, France
- Correspondence: Béatrice Desnous
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Padovani P, Gewillig M, Butera G, Lucron H, Lefort B, Samion H, El Saiedi S, Ovaert C, Sirico D, Grunenwald Gronier C, Méot M, Benbrik N, Bonnet D, Malekzadeh-Milani S, Baruteau A. Transcatheter closure of persistent ductus arteriosus in 2 to 6 kg infants: Preliminary results from an international, retrospective study. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.059] [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: 10/14/2022]
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14
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Haddad R, Hascoet S, Karsenty C, Houeijeh A, Baruteau A, Valdeolmillos E, Jalal Z, Ovaert C, Bonnet D, Malekzadeh-Milani S. Multicentre experience with optimus balloon-expandable cobalt-chromium vascular stents in congenital heart disease interventions: Early outcomes and extended possibilities. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.019] [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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15
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Velly C, Quarello E, Bretelle F, Ovaert C. Postnatal diagnosis of congenital heart defects in Southeast of France: An audit of prenatal ultrasonographic practices and can we improve fetal screening by adding AI (artificial intelligence) solutions? Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.024] [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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16
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Louali FE, Huang H, Soulatges C, Garaix F, Fouilloux V, Ovaert C. Exercise capacity in pediatric heart transplant recipient. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.044] [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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17
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Ouldali N, Bagheri H, Salvo F, Antona D, Pariente A, Leblanc C, Tebacher M, Micallef J, Levy C, Cohen R, Javouhey E, Bader-Meunier B, Ovaert C, Renolleau S, Hentgen V, Kone-Paut I, Deschamps N, De Pontual L, Iriart X, Guen CGL, Angoulvant F, Belot A, Donzeau A, Aridi LE, Lety S, Leboucher B, Baur A, Jeusset L, Selegny M, Fedorczuk C, Lajus M, Bensaid P, Laoudi Y, Pons C, Robert AC, Beaucourt C, De Pontual L, Richard M, Goisque E, Iriart X, Brissaud O, Segretin P, Molimard J, Orecel MC, Benoit G, Bongiovanni L, Guerder M, Pouyau R, De Guillebon De Resnes JM, Mezgueldi E, Cour-Andlauer F, Horvat C, Poinsot P, Frachette C, Ouziel A, Gillet Y, Barrey C, Brouard J, Villedieu F, Ro V, Elanga N, Gajdos V, Basmaci R, Mutar H, Rouget S, Nattes E, Hau I, Biscardi S, Jurdi HE, Jung C, Semama D, Huet F, Zoccarato AM, Sarakbi M, Mortamet G, Bost-Bru C, Bassil J, Vinit C, Hentgen V, Leroux P, Bertrand V, Parrod C, Craiu I, Kone-Paut I, Durand P, Tissiere P, Claude C, Morelle G, Guiddir T, Borocco C, Delion F, Guillot C, Leteurtre S, Dubos F, Jouancastay M, Martinot A, Voeusler V, Languepin J, Garrec N, Demersay AC, Morand A, Bosdure E, Vanel N, Ughetto F, Michel F, Caujolle M, Blonde R, Nguyen J, Vignaud O, Masserot-Lureau C, Gouraud F, Araujo C, Ingrao T, Naji S, Sehaba M, Roche C, Carbasse A, Milesi C, Mazeghrane M, Haupt S, Schweitzer C, Romefort B, Launay E, Guen CGL, Ali A, Blot N, Tran A, Rancurel A, Afanetti M, Odorico S, Talmud D, Chosidow A, Romain AS, Grimprel E, Pouletty M, Gaschignard J, Corseri O, Faye A, Gaschignard J, Melki I, Ducrocq C, Benzoïd C, Lokmer J, Dauger S, Chomton M, Deho A, Lebourgeois F, Renolleau S, Lesage F, Moulin F, Dupic L, Pinhas Y, Debray A, Chalumeau M, Abadie V, Frange P, Cohen JF, Allali S, Curtis W, Belhadjer Z, Auriau J, Méot M, Houyel L, Bonnet D, Delacourt C, Meunier BB, Quartier P, Shaim Y, Baril L, Crommelynck S, Jacquot B, Blanc P, Maledon N, Robert B, Loeile C, Cazau C, Loron G, Gaga S, Vittot C, Nabhani LE, Buisson F, Prudent M, Flodrops H, Mokraoui F, Escoda S, Deschamps N, Bonnemains L, Mahi SL, Mertes C, Terzic J, Helms J, Idier C, Chenichene S, Ursulescu NM, Beaujour G, Hakim A, Miquel A, Rey A, Wiedermann A, Charbonneau A, Veauvy-Juven A, Ferry A, Mandelcwajg A, Rousseau A, Prenant A, Bourneuf AL, Filleron A, Robine A, Félix A, Parizel A, Labarre A, Cantais A, Ros B, Coulon B, Biot B, Dalichoux B, Fournier B, Cagnard B, Vanel B, Brossier D, Ménager B, Ozanne B, Marie-Jeanne C, Bergerot C, Chavy C, Guidon C, Fabre C, Galeotti C, Baker C, Ballot-Schmit C, Belleau C, Charasse C, Favel C, Toumi C, Ferrandiz C, Couturier C, Pouchoux C, Chomton-Cailliez M, Kevorkian-Verguet C, Brunet C, Manteau C, Mougey C, Santy C, Fitament C, Petriat C, Rebelle C, Charron C, Dartus M, Toulorge D, Guillou-Debuisson C, Bartebin D, Klein V, Broustal E, Desselas E, Marteau E, Bouvrot E, Delacroix E, Coinde E, Elnabhani L, Amouyal E, Chaillou E, Gabilly-Bernard E, Ruiz E, Thibault E, Robin E, Darrieux E, Blondel E, Socchi F, Cazassus F, Bajolle F, Lacin F, Madhi F, Zekre F, Guerin F, Boussicault G, Ginies H, Magloire G, Arnold G, Coulognon I, Sicard-Cras I, Kahn JE, Bordet J, Fausser JL, Baleine JF, Brice J, Gendras J, Pekin K, Norbert K, Karsenty C, Savary L, Martinat L, Lesniewski L, Charbonnier L, Alexandre L, Percheron L, Vincenti M, Selegny M, Lanzini M, Grisval M, Mercy M, Lampin ME, Desgranges M, Duperril M, Orcel MC, Audier M, Favier M, Carpentier M, Balcean M, Bonnet M, Jouret M, Delattre M, Levy M, Valensi M, Shum M, Dumortier M, Gelin M, Nemmouchi M, Williaume M, Sebaha M, Genetay-Stanescu N, Giroux N, Crassard N, Derridj N, Lachaume N, Werner O, Guilluy O, Richer O, Tirel O, Pauvert A, Casha P, Perez N, Gras P, Leger PL, Pinchou M, Mornand P, Largo P, Ibanez RC, Roulland C, Albarazi SH, Bichali S, Faton S, Schott A, Walser S, Guillaume S, Vincent S, Galene-Gromez S, Kozisek S, Maugard T, Blanc T, Navarro T, Lauvray T, Kovacs T, Launay V, Despert V, Lhostis V, Gall V, Micaelli X, Benadjaoud Y, Matoussi Z, Géniaux H, Facile A, Pietri T, Palassin P, Pinel S, Chouchana L, Callot D, Boulay C. Correction to “Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study”. Lancet Reg Health Eur 2022. [PMID: 35967266 PMCID: PMC9364716 DOI: 10.1016/j.lanepe.2022.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pommier V, Abassi H, Lavastre K, Calderon J, Guillaumont S, Dulac Y, Auriol F, Ovaert C, Blondelon A, Hascoet S, Lecerf F, Jore C, Avesani M, Thambo JB, Amedro P. Impact of COVID-19 disease on clinical research in pediatric and congenital cardiology. Arch Pediatr 2022; 29:347-353. [PMID: 35523633 PMCID: PMC9020482 DOI: 10.1016/j.arcped.2022.03.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/21/2022] [Accepted: 03/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND COVID-19 triggered an unprecedented crisis affecting society at every level. Research in pediatric and congenital cardiology is currently in full development and may have been disrupted. The aim of the study was to determine the impact of COVID-19 on pediatric and congenital cardiology clinical research and to analyze decision-making and adaptation processes, from a panel of ongoing academic and industry-sponsored research at the time of the pandemic. METHODS This observational study was carried out in April 2020, from a CHD clinical research network involving five tertiary care pediatric and congenital cardiology centers. Investigators and clinical research assistants from each participating research center completed an online survey questionnaire, and each principal investigator underwent a 1-h web-based videoconference interview. RESULTS A total of 34 study questionnaires were collected, reporting that 18 studies were totally suspended. Upon the investigator's decision, after discussion on ethical issues and with facilitating support from health authorities, 16 studies were resumed. The rate of study suspension in interventional research (53%) was similar to that in non-interventional research (56%). Logistical problems were predominantly reported in both continued and suspended trials. Research protocols were adapted, largely thanks to telemedicine, which in some cases even improved the course of the study. CONCLUSION The impact of the COVID-19 pandemic on clinical research in pediatric and congenital cardiology has been limited by a rapid adaptation of all research structures and an extensive use of telemedicine at all stages of the studies.
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Affiliation(s)
- V. Pommier
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Clinical Investigation Centre, University Hospital, Montpellier, France
| | - H. Abassi
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Clinical Investigation Centre, University Hospital, Montpellier, France,PhyMedExp, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - K. Lavastre
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Clinical Investigation Centre, University Hospital, Montpellier, France
| | - J. Calderon
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Clinical Investigation Centre, University Hospital, Montpellier, France,PhyMedExp, CNRS, INSERM, University of Montpellier, Montpellier, France,Cardiac Neurodevelopmental Program, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - S. Guillaumont
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Clinical Investigation Centre, University Hospital, Montpellier, France,Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Y. Dulac
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Toulouse University Hospital, Toulouse CIC 1436, France
| | - F. Auriol
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Toulouse University Hospital, Toulouse CIC 1436, France
| | - C. Ovaert
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, APHM La Timone University Hospital, Marseille, France
| | - A. Blondelon
- Pediatric and Congenital Cardiology Department, M3C Regional Reference Centre, APHM La Timone University Hospital, Marseille, France
| | - S. Hascoet
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Centre Medico-Chirurgical Marie-Lannelongue, Le Plessis-Robinson, France
| | - F. Lecerf
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Centre Medico-Chirurgical Marie-Lannelongue, Le Plessis-Robinson, France
| | - C. Jore
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Avenue de Magellan, Bordeaux 33604, France
| | - M. Avesani
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Avenue de Magellan, Bordeaux 33604, France
| | - J.-B. Thambo
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Avenue de Magellan, Bordeaux 33604, France,IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM 1045, Bordeaux University Foundation, Pessac, France
| | - P. Amedro
- Pediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Avenue de Magellan, Bordeaux 33604, France,IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM 1045, Bordeaux University Foundation, Pessac, France,Corresponding author
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19
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Tortigue M, Nield LE, Karakachoff M, McLeod CJ, Belli E, Babu-Narayan SV, Prigent S, Boet A, Conway M, Elder RW, Ladouceur M, Khairy P, Kowalik E, Kalfa DM, Barron DJ, Mussa S, Hiippala A, Temple J, Abadir S, Le Gloan L, Lachaud M, Sanatani S, Thambo JB, Gronier CG, Amedro P, Vaksmann G, Charbonneau A, Koutbi L, Ovaert C, Houeijeh A, Combes N, Maury P, Duthoit G, Hiel B, Erickson CC, Bonnet C, Van Hare GF, Dina C, Karsenty C, Fournier E, Le Bloa M, Pass RH, Liberman L, Happonen JM, Perry JC, Romefort B, Benbrik N, Hauet Q, Fraisse A, Gatzoulis MA, Abrams DJ, Dubin AM, Ho SY, Redon R, Bacha EA, Schott JJ, Baruteau AE. Familial Recurrence Patterns in Congenitally Corrected Transposition of the Great Arteries: An International Study. Circ Genom Precis Med 2022; 15:e003464. [PMID: 35549293 DOI: 10.1161/circgen.121.003464] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Congenitally corrected transposition of the great arteries (ccTGA) is a rare disease of unknown cause. We aimed to better understand familial recurrence patterns. METHODS An international, multicentre, retrospective cohort study was conducted in 29 tertiary hospitals in 6 countries between 1990 and 2018, entailing investigation of 1043 unrelated ccTGA probands. RESULTS Laterality defects and atrioventricular block at diagnosis were observed in 29.9% and 9.3%, respectively. ccTGA was associated with primary ciliary dyskinesia in 11 patients. Parental consanguinity was noted in 3.4% cases. A congenital heart defect was diagnosed in 81 relatives from 69 families, 58% of them being first-degree relatives, including 28 siblings. The most prevalent defects in relatives were dextro-transposition of the great arteries (28.4%), laterality defects (13.6%), and ccTGA (11.1%); 36 new familial clusters were described, including 8 pedigrees with concordant familial aggregation of ccTGA, 19 pedigrees with familial co-segregation of ccTGA and dextro-transposition of the great arteries, and 9 familial co-segregation of ccTGA and laterality defects. In one family co-segregation of ccTGA, dextro-transposition of the great arteries and heterotaxy syndrome in 3 distinct relatives was found. In another family, twins both displayed ccTGA and primary ciliary dyskinesia. CONCLUSIONS ccTGA is not always a sporadic congenital heart defect. Familial clusters as well as evidence of an association between ccTGA, dextro-transposition of the great arteries, laterality defects and in some cases primary ciliary dyskinesia, strongly suggest a common pathogenetic pathway involving laterality genes in the pathophysiology of ccTGA.
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Affiliation(s)
- Marine Tortigue
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Lynne E Nield
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | | | | | - Emre Belli
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Sonya V Babu-Narayan
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Solène Prigent
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Angèle Boet
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Miriam Conway
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Robert W Elder
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT (R.W.E.)
| | - Magalie Ladouceur
- Department of Adult Congenital Heart Diseases, M3C Hôpital Européen Georges Pompidou, Paris, France (M.L.)
| | - Paul Khairy
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
| | - Ewa Kowalik
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland (E.K.)
| | - David M Kalfa
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - David J Barron
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | - Shafi Mussa
- Department of Congenital Cardiac Surgery, University Hospitals Bristol NHS Foundation Trust, United Kingdom (S.M.)
| | - Anita Hiippala
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - Joel Temple
- Department of Pediatrics, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE (J.T.)
| | - Sylvia Abadir
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
- Division of Cardiology, CHU Mère-Enfant Sainte-Justine, University of Montreal, Quebec, Canada (S.A.)
| | - Laurianne Le Gloan
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Department of Cardiology, CHU Nantes, Nantes, France (L.L.G.)
| | | | - Shubhayan Sanatani
- Division of Cardiology, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada (S.S.)
| | | | - Céline Grunenwald Gronier
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Pascal Amedro
- Department of Cardiology, CHU Bordeaux, France (J.-B.T., P.A.)
- PhyMedExp, CNRS, INSERM, University of Montpellier, France (P.A.)
| | - Guy Vaksmann
- Department of Pediatric Cardiology, Hôpital Privé de La Louvière, Lille, France (G.V.)
| | - Anne Charbonneau
- Department of Pediatric and Congenital Cardiology, American Memorial Hospital, CHU Reims, France (A.C.)
| | - Linda Koutbi
- Department of Cardiology (L.K.), La Timone Hospital, CHU Marseille, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology (C.O.), La Timone Hospital, CHU Marseille, France
- Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, France (C.O.)
| | - Ali Houeijeh
- Department of Pediatric Cardiology, CHRU Lille, France (A.H.)
| | - Nicolas Combes
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
- Department of Cardiology, Pasteur Clinic, Toulouse, France (N.C.)
| | | | - Guillaume Duthoit
- Department of Cardiology, Groupe Hospitalier Pitié Salpétrière, Sorbonne Université, Paris, France (G.D.)
| | - Bérengère Hiel
- Department of Pediatric Cardiology, CHU Amiens, France (B.H.)
| | - Christopher C Erickson
- UDivision of Pediatric Cardiology, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE (C.C.E.)
| | | | - George F Van Hare
- Division of Pediatric Cardiology, St Louis Children's Hospital, Washington University School of Medicine (G.F.V.H.)
| | - Christian Dina
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
| | - Clément Karsenty
- Department of Pediatric and Congenital Cardiology, Children's Hospital (C.K.), CHU Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR 1048, Université de Toulouse, France (C.K.)
| | - Emmanuelle Fournier
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Switzerland (M.L.B.)
| | - Robert H Pass
- Department of Pediatric Cardiology, Mount Sinai Kravis Children's Hospital, NY (R.H.P.)
| | - Leonardo Liberman
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Juha-Matti Happonen
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - James C Perry
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego (J.C.P.)
| | - Bénédicte Romefort
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Nadir Benbrik
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Quentin Hauet
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Alain Fraisse
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Michael A Gatzoulis
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Dominic J Abrams
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, MA (D.J.A.)
| | - Anne M Dubin
- Division of Pediatric Cardiology, Stanford University, Palo Alto, CA (A.M.D.)
| | - Siew Yen Ho
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Richard Redon
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Emile A Bacha
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Jean-Jacques Schott
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Alban-Elouen Baruteau
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
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Ouldali N, Bagheri H, Salvo F, Antona D, Pariente A, Leblanc C, Tebacher M, Micallef J, Levy C, Cohen R, Javouhey E, Bader-Meunier B, Ovaert C, Renolleau S, Hentgen V, Kone-Paut I, Deschamps N, De Pontual L, Iriart X, Guen CGL, Angoulvant F, Belot A. Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study. Lancet Reg Health Eur 2022; 17:100393. [PMID: 35505833 PMCID: PMC9051933 DOI: 10.1016/j.lanepe.2022.100393] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is the most severe clinical entity associated with pediatric SARS-CoV-2 infection with a putative role of the spike protein into the immune system activation. Whether COVID-19 mRNA vaccine can induce this complication in children is unknown. We aimed to assess the risk of hyper-inflammatory syndrome following COVID-19 mRNA vaccine in children. Methods We conducted a post-authorization national population-based surveillance using the French enhanced pharmacovigilance surveillance system for COVID-19 vaccines. All cases of suspected hyper-inflammatory syndrome following COVID-19 mRNA vaccine in 12–17-year-old children between June 15th, 2021 and January 1st, 2022, were reported. Cases were reviewed according to WHO criteria for MIS-C. The reporting rate of this syndrome was compared to the MIS-C rate per 1,000,000 12–17-year-old children infected by SARS-CoV-2. Findings Up to January 2022, 8,113,058 COVID-19 mRNA vaccine doses were administered to 4,079,234 12–17-year-old children. Among them, 12 presented a hyper-inflammatory syndrome with multisystemic involvement. Main clinical features included male predominance (10/12, 83%), cardiac involvement (10/12, 83%), digestive symptoms (10/12, 83%), coagulopathy (7/12, 58%), cytolytic hepatitis (6/12, 50%), and shock (5/12, 42%). 4/12 (33%) required intensive care unit transfer, and 3/12 (25%) hemodynamic support. All cases recovered. In eight cases, no evidence of previous SARS-CoV-2 infection was found. The reporting rate was 1.5 (95%CI [0.8; 2.6]) per 1,000,000 doses injected, i.e. 2.9 (95%CI [1.5; 5.1]) per 1,000,000 12–17-year-old vaccinated children. As a comparison, 113 MIS-C (95%CI [95; 135]) occurred per 1,000,000 12–17-year-old children infected by SARS-CoV-2. Interpretation Very few cases of hyper-inflammatory syndrome with multi-organ involvement occurred following COVID-19 mRNA vaccine in 12–17-year-old children. The low reporting rate of this syndrome, compared to the rate of post-SARS-CoV-2 MIS-C in the same age-group, largely supports the vaccination in a context of an important circulation of SARS-CoV-2. Funding ESPID Fellowship Award; Grandir–Fonds de Solidarité Pour L'enfance.
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Affiliation(s)
- Naïm Ouldali
- Assistance Publique-Hôpitaux de Paris, Department of general paediatrics, paediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France
- Infectious Diseases Division, CHU Sainte Justine - Montreal University, Montreal, Quebec, Canada
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Université de Paris, INSERM UMR 1123, ECEVE, Paris, France
- Corresponding author at: Assistance Publique-Hôpitaux de Paris, Department of general paediatrics, paediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France.
| | - Haleh Bagheri
- Department of Medical and Clinical Pharmacology, Regional Pharmacovigilance Center, CIC 1436, Toulouse University Hospital, France
| | - Francesco Salvo
- INSERM, BPH, U1219, Team Pharmacoepidemiology, Université de Bordeaux, 33000 Bordeaux, France
- Pole de Santé Publique, Service de Pharmacologie Médicale, Regional pharmacovigilance center of Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France
| | - Denise Antona
- Santé Publique France, Agence nationale de Santé publique, Saint-Maurice, France
| | - Antoine Pariente
- Team Pharmacoepidemiology, U1219 BPH Research Center, Bordeaux University, INSERM, Bordeaux, France
| | - Claire Leblanc
- Assistance Publique-Hôpitaux de Paris, Department of general paediatrics, paediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France
| | - Martine Tebacher
- Regional pharmacovigilance center of Strasbourg, HUS, Strasbourg, France
| | - Joëlle Micallef
- Marseille University hospital, Clinical pharmacology department Regional Pharmacovigilance Center of Marseille, France
- Aix-Marseille University, INSERM UMR 1106, Marseille, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Centre Hospitalier Intercommunal, Research Center, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Centre Hospitalier Intercommunal, Research Center, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Etienne Javouhey
- Hospices Civils de Lyon, Paediatric Intensive Care Unit, Hopital Femme, Mère Enfant, University of Lyon, Bron, France
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", University Claude Bernard Lyon 1, Hospices Civils of Lyon, Lyon, France
| | - Brigitte Bader-Meunier
- Department of Paediatric Hematology-Immunology and Rheumatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France
- Laboratory of Immunogenetics of Paediatric Autoimmunity, Imagine Institute, Paris University, Inserm U 1163, Paris, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, Hôpital Timone Enfant, AP-HM, Marseille, France
- Aix-Marseille University, MMG, INSERM, Marseille, France
| | - Sylvain Renolleau
- Pediatric Intensive Care Unit, Necker Hospital, AP-HP, Paris University, Paris, France
- Paris University, Paris EA7323, France
| | - Veronique Hentgen
- General Pediatrics department, Versailles Hospital, Paris, France
- CEREMAIA (French reference center for auto-inflammatory diseases and inflammatory amyloidosis), Paris, France
| | - Isabelle Kone-Paut
- CEREMAIA (French reference center for auto-inflammatory diseases and inflammatory amyloidosis), Paris, France
- Pediatric Rheumatology Department, Bicêtre Hospital, APHP, University of Paris Saclay, Kremlin Bicêtre, France
| | - Nina Deschamps
- General Pediatrics department, Saint-Malo Hospital, Saint-Malo, France
| | - Loïc De Pontual
- General Pediatrics and Pediatric emergency department, Jean Verdier Hospital, Bondy, France
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, Pessac, France
- Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, Pessac, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Christelle Gras-Le Guen
- Department of Pediatric Emergency Care, Nantes University Hospital, Nantes F-44000, France
- Obstetrical, Perinatal and Pediatric Epidemiology Research team, Center of Research in Epidemiology and Statistics, Université de Paris, INSERM, Paris F-75004, France
- Inserm CIC 1413, Nantes University Hospital, Nantes F-44000, France
| | - François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Department of general paediatrics, paediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Alexandre Belot
- Hospices Civils de Lyon, Paediatric Nephrology, Rheumatology, Dermatology, Hopital Femme, Mère Enfant and Centre International de Recherche en Infectiologie / INSERM U1111, Bron, France
- National Reference Center for Rheumatic and AutoImmune and Systemic Diseases in Children (RAISE), Lyon, France
- International Center of Research in Infectiology, Lyon University, INSERM U1111, CNRS UMR 5308, ENS, UCBL, 69007 Lyon, France
- Corresponding author at: Hospices Civils de Lyon, Paediatric Nephrology, Rheumatology, Dermatology, Hopital Femme, Mère Enfant and Centre International de Recherche en Infectiologie / INSERM U1111, Bron, France.
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21
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Lucron H, Baruteau AE, Ovaert C, Houeijeh A, Brard M, Guerin P, Bourlon F, Dauphin C, Tuttle S, Tagorti M, Banydeen R, Godart F. Efficacy, Safety and Characteristics of the Amplatzer Vascular Plug II and IV Utilization for Various Percutaneous Occlusions in Children under 10 Years. CONGENIT HEART DIS 2022. [DOI: 10.32604/chd.2022.020835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Venet M, Jalal Z, Ly R, Malekzadeh-Milani S, Hascoët S, Fournier E, Ovaert C, Casalta AC, Karsenty C, Baruteau AE, Le Gloan L, Selegny M, Douchin S, Bouvaist H, Belaroussi Y, Camou F, Tlili G, Thambo JB. Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis. JACC Cardiovasc Imaging 2021; 15:299-308. [PMID: 34538632 DOI: 10.1016/j.jcmg.2021.07.015] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The aim of this study was to assess the diagnostic performances of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in congenital heart disease (CHD) patients with pulmonary prosthetic valve or conduit endocarditis (PPVE) suspicion. BACKGROUND PPVE is a major issue in the growing CHD population. Diagnosis is challenging, and usual imaging tools are not always efficient or validated in this specific population. Particularly, the diagnostic yield of 18F-FDG PET/CT remains poorly studied in PPVE. METHODS A retrospective multicenter study was conducted in 8 French tertiary centers. Children and adult CHD patients who underwent 18F-FDG PET/CT in the setting of PPVE suspicion between January 2010 and May 2020 were included. The cases were initially classified as definite, possible, or rejected PPVE regarding the modified Duke criteria and finally by the Endocarditis Team consensus. The result of 18F-FDG PET/CT had been compared with final diagnosis consensus used as gold-standard in our study. RESULTS A total of 66 cases of PPVE suspicion involving 59 patients (median age 23 years, 73% men) were included. Sensitivity, specificity, positive predictive value, and negative predictive value of 18F-FDG PET/CT in PPVE suspicion were respectively: 79.1% (95% CI: 68.4%-91.4%), 72.7% (95% CI: 60.4%-85.0%), 91.9% (95% CI: 79.6%-100.0%), and 47.1% (95% CI: 34.8%-59.4%). 18F-FDG PET/CT findings would help to correctly reclassify 57% (4 of 7) of possible PPVE to definite PPVE. CONCLUSIONS Using 18F-FDG PET/CT improves the diagnostic accuracy of the Duke criteria in CHD patients with suspected PPVE. Its high positive predictive value could be helpful in routine to shorten diagnosis and treatment delays and improve clinical outcomes.
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Affiliation(s)
- Maëlys Venet
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France.
| | - Zakaria Jalal
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
| | - Reaksmei Ly
- Congenital Heart Diseases Unit, Hôpital Européen Georges-Pompidou, Paris, France
| | | | - Sebastien Hascoët
- Paris-Sud Faculty of Medicine, Marie-Lannelongue Hospital, Paris, Saclay, Le Plessis-Robinson, France
| | - Emmanuelle Fournier
- Paris-Sud Faculty of Medicine, Marie-Lannelongue Hospital, Paris, Saclay, Le Plessis-Robinson, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology Department, La Timone University Hospital, Marseille, France
| | - Anne Claire Casalta
- Pediatric and Congenital Cardiology Department, La Timone University Hospital, Marseille, France
| | - Clément Karsenty
- Pediatric Cardiology Unit, Children's Hospital, CHU Toulouse, France
| | - Alban Elouen Baruteau
- L'institut du thorax, Congenital and Pediatric Cardiology Unit, CHU de Nantes, Nantes, France; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Children's Hospital, CHU Nantes, Nantes, France, (j)Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France
| | - Laurianne Le Gloan
- L'institut du thorax, Congenital and Pediatric Cardiology Unit, CHU de Nantes, Nantes, France; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Children's Hospital, CHU Nantes, Nantes, France, (j)Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France
| | - Maëlle Selegny
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Children's Hospital, CHU Nantes, Nantes, France, (j)Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France
| | | | | | - Yaniss Belaroussi
- INSERM, Bordeaux Population Health Research Center, ISPED, University of Bordeaux, Bordeaux, France, (n)INSERM CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Bordeaux, France; Cardiology Department, CHU Grenoble, Grenoble, France; Department of Thoracic Surgery, Haut-Leveque Hospital, Bordeaux University, Bordeaux, France
| | - Fabrice Camou
- Medical Intensive Care Unit, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France
| | - Ghoufrane Tlili
- Nuclear Medicine Department, Hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, Pessac, France
| | - Jean-Benoît Thambo
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
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La Fay C, Le Moine P, Blanc L, Abouchahla W, Hoang NP, Vial-Cholley E, Cojean N, Suc A, Aries E, Ovaert C, Revon-Rivière G. Pediatric Cardiology Teams interact with Pediatric Palliative Care (PPC) Teams for children's and family's best interest: Results from a multicentric study in France. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.033] [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: 10/20/2022]
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Wilkin M, Aries E, Ovaert C. Late myocardial infarct in pulmonary atresia and intact ventricular septum: A must-know complication! Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.056] [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: 10/20/2022]
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25
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Carles G, Lenoir M, Aries E, El Louali F, Raisky O, Ovaert C. Balloon dilation versus surgery for severe neonatal aortic valve stenosis: A matched comparison. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.094] [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: 10/20/2022]
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Rique A, Cautela J, Thuny F, Michel G, Ovaert C, El Louali F. Physical activity reduces longitudinal strain alteration in children treated by anthracyclins. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.041] [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: 10/20/2022]
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Porcher R, Desguerre I, Amthor H, Chabrol B, Audic F, Rivier F, Isapof A, Tiffreau V, Campana-Salort E, Leturcq F, Tuffery-Giraud S, Yaou RB, Annane D, Amédro P, Barnerias C, Bécane HM, Béhin A, Bonnet D, Bassez G, Cossée M, de La Villéon G, Delcourte C, Fayssoil A, Fontaine B, Godart F, Guillaumont S, Jaillette E, Laforêt P, Leonard-Louis S, Lofaso F, Mayer M, Morales RJ, Meune C, Orlikowski D, Ovaert C, Prigent H, Saadi M, Sochala M, Tard C, Vaksmann G, Walther-Louvier U, Eymard B, Stojkovic T, Ravaud P, Duboc D, Wahbi K. Association between prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy-analysis of registry data. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.039] [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: 11/25/2022]
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Wanert C, El Louali F, Ovaert C, Schouvey S, Lenoir M, Fouilloux V, Tsimaratos M, Rousset-Rouvière C, Garaix F. Evaluation of a cardiac transplanted children cohort: long term pediatric follow-up and transiant to adulthood. Twenty years of monocentric experience. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.012] [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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El Louali F, Ovaert C, Paoli F, Chabrol B, Cuisset T. Expanding the limits of TAVI: First in man report of valve implantation in a 25-year-old patient with mucolipidosis. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.092] [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: 10/20/2022]
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Malekzadeh-Milani S, Jalal Z, Karsenty C, El Louali F, Aldebert P, Baruteau A, Godart F, Dauphin C, Douchin S, Lucron H, Bouvaist H, Hascoet S, Bard M, Houjejeh A, Bonnet D, Thambo JB, Ovaert C. Endovascular treatment for native coarctation in children in France. A multicentric, retrospective long-term analysis. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.019] [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: 11/15/2022]
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31
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Lucron H, Baruteau AE, Ovaert C, Guerin P, Bourlon F, Houeijeh A, Dauphin C, Tuttle S, Tagorti M, Banydeen R, Brard M, Godart F. Efficacy, safety, and characteristics of the utilization of the Amplatzer Vascular Plug (AVP) II and IV for various percutaneous occlusions in children under 10 years. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.079] [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: 11/25/2022]
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Duvant P, Fillat M, Garaix F, Roquelaure B, Ovaert C, Fouilloux V, Tsimaratos M, Auquier P, Fabre A, Baumstarck K. Quality of life of transplanted children and their parents: a cross-sectional study. Orphanet J Rare Dis 2021; 16:364. [PMID: 34404428 PMCID: PMC8369793 DOI: 10.1186/s13023-021-01987-y] [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: 01/28/2020] [Accepted: 07/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transplantation is a saving therapeutic that has heavy consequences. The quality of life (QoL) of transplanted children and their parents has been little studied and should help physicians better manage these patients. The objectives of the study were to assess: (1) the QoL of transplanted children and parents and compare it with that of children with other chronic conditions associated with long-term consequences, and (2) potential variables modulating the QoL. METHODS This cross-sectional study was performed in a multidisciplinary paediatric unit (Timone Hospital, Marseille, France). Children were less than 18 years old; had a liver, kidney or heart transplant; and had a time since transplantation of 1-10 years. Socio-demographics and clinical data were recorded from medical forms. The QoL was assessed using the VSP-A (Vécu et Santé Perçue de l'Adolescent et de l'Enfant) and the WhoQoL self-reported questionnaires. RESULTS Forty-five families were included (response rate: 76%). The transplanted organs were the liver for 20 children, the kidney for 15 children, and the heart for 10 children. The QoL of transplanted children reported by their parents was better than that of children with inborn errors of metabolism and similar to that of childhood leukaemia survivors. The QoL of parents of transplanted children was better than that of parents of children with inborn errors of metabolism and did not differ from French norms. The QoL did not differ according to the nature of the transplanted organ, sex or the main sociodemographic data. The main modulators decreasing QoL were residual treatment level, medications switch and the presence of another regular treatment. CONCLUSION Transplanted children and their families reported a fairly preserved QoL compared to children with other chronic health conditions. Special attention should be given to QoL modulators related to therapeutic management (medication switches, regular treatments) that might be amenable to improve the QoL. Trial registration Ethics committee of Aix-Marseille University, France (reference number: 2014-08-04-03, 24/4/2015; https://www.univ-amu.fr/fr/public/comite-dethique ).
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Affiliation(s)
- Pauline Duvant
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Magali Fillat
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Florentine Garaix
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Bertrand Roquelaure
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Caroline Ovaert
- Service médico-chirurgical de cardiologie pédiatrique et congénitale, Hôpital de la Timone, Marseille, France
| | - Virginie Fouilloux
- Service médico-chirurgical de cardiologie pédiatrique et congénitale, Hôpital de la Timone, Marseille, France
| | - Michel Tsimaratos
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Pascal Auquier
- EA 3279 CEReSS - Health Service Research and Quality of Life Center, Aix-Marseille Univ, 27 bd Jean Moulin, 13385, Marseille Cedex 05, France
| | - Alexandre Fabre
- Service de pédiatrie multidisciplinaire, Hôpital de la Timone, Marseille, France
| | - Karine Baumstarck
- EA 3279 CEReSS - Health Service Research and Quality of Life Center, Aix-Marseille Univ, 27 bd Jean Moulin, 13385, Marseille Cedex 05, France.
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Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Cohen S, Dauphin C, Filippo SD, Douchin S, Godart F, Guérin P, Helms P, Karsenty C, Lefort B, Mauran P, Ovaert C, Piéchaud JF, Thambo JB, Leuraud K, Bonnet D, Bernier MO, Rage E. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile. BMJ Open 2021; 11:e048576. [PMID: 34344681 PMCID: PMC8336117 DOI: 10.1136/bmjopen-2020-048576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The COCCINELLE study is a nationwide retrospective French cohort set up to evaluate the risk of cancer in patients who undergone cardiac catheterisation (CC) procedures for diagnosis or treatment of congenital heart disease during childhood. PARTICIPANTS Children who undergone CC procedures from 1 January 2000 to 31 December 2013, before the age of 16 in one of the 15 paediatric cardiology departments which perform paediatric CC in mainland France were included. The follow-up started at the date of the first recorded CC procedure until the exit date, that is, the date of death, the date of first cancer diagnosis, the date of the 18th birthday or the 31 December 2015, whichever occurred first. The cohort was linked to the National Childhood Cancer Registry to identify patients diagnosed with cancer and with the French National Directory for the Identification of Natural Persons to retrieve the patients' vital status. FINDINGS TO DATE A total of 17 104 children were included in the cohort and followed for 110 335 person-years, with 22 227 CC procedures collected. Among the patients, 81.6% received only one procedure. Fifty-nine cancer cases were observed in the cohort. Standardised incidence ratios (SIRs) were increased for all-cancer (SIR=3.8, 95% CI: 2.9 to 4.9), leukaemia (SIR=3.3, 95% CI: 2.0 to 5.4), lymphoma (SIR=14.9, 95% CI: 9.9 to 22.5) and solid cancers excluding central nervous system (CNS) tumours (SIR=3.3, 95% CI: 2.0 to 5.5) compared with the general population. FUTURE PLANS Dose reconstruction is currently underway to estimate individual cumulative doses absorbed to relevant organs, including red bone marrow and brain for respectively haematologic disorders and CNS tumours risk estimation. A dose-response analysis will be conducted with consideration to confounding factors such as age at exposure, gender, predisposing factors to cancer and other sources of medical diagnostic low-dose ionising radiation.
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Affiliation(s)
- Kossi Dovene Abalo
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Sébastien Hascoët
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Serge Dreuil
- PSE-SANTE/SER/UEM, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | | | - Sarah Cohen
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Claire Dauphin
- Cardiology and Vascular Department, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | - Sylvie Di Filippo
- Paediatric and Congential Cardiology Department, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphanie Douchin
- Cardiopédiatrie, Hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, France, Grenoble, France
| | - François Godart
- Service de Cardiologie Infantile et Congénitale, Institut Cœur Poumon, Lille Cedex, Lille, France
| | - Patrice Guérin
- Clinique Cardiologique et des Maladies Vasculaires, CIC 1413, Institut du Thorax, Cardiopédiatrie, CHU Nantes, INSERM, Nantes Université, Nantes, France
| | - Pauline Helms
- Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France
| | - Clement Karsenty
- Pediatric and Congenital Cardiology, Children's Hospital and INSERM U1048, I2MC, Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Toulouse, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales, CHRU Tours, Tours, France
| | - Pierre Mauran
- Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, Reims Cedex, Reims, France
| | - Caroline Ovaert
- Cardiologie pédiatrique et congénitale, Timone enfants, AP-HM et INSERM 1251, Aix-Marseille Université, Marseille, France
| | - Jean-François Piéchaud
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques-Cartier, Massy, France
| | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Klervi Leuraud
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Damien Bonnet
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Marie-Odile Bernier
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Estelle Rage
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
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Quennelle S, Ovaert C, Cailliez M, Garaix F, Tsimaratos M, El Louali F. Dilatation of the aorta in children with advanced chronic kidney disease. Pediatr Nephrol 2021; 36:1825-1831. [PMID: 33459933 DOI: 10.1007/s00467-020-04887-8] [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: 03/30/2020] [Revised: 10/27/2020] [Accepted: 12/01/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND The peculiarity of the cardiovascular risk profile with increased arterial vulnerability is well known in adults with chronic kidney disease (CKD). It is explained by an increased incidence of traditional cardiovascular risk factors together with other comorbidities related to the uremic condition and cardiorenal syndrome (CRS). The present study aimed to determine the cardiovascular impact of the uremic condition in a pediatric population with advanced CKD. METHODS From 2016 to 2018, 39 consecutive patients with advanced CKD who underwent echocardiographic evaluation were included. All echocardiographic examinations were performed by the same operator (FE). Demographic, clinical, biological, and echocardiographic data were collected. RESULTS The mean age at echocardiographic exam was 9.7 ± 4.6 years. Twenty-four (61.5%) patients were on hemodialysis; 17 (43.6%) patients were in a peritoneal dialysis program of whom 11 switched at a later stage to hemodialysis. Eight (20.5%) patients had an arteriovenous fistula (AVF). Hypertension was present in 30 (76.9%) patients while left ventricular hypertrophy (LVH) was described in 13 (33.3%) patients. Dilatation of the ascending aorta (Z-score > 2) was found in 15 (38.4%) patients and was statistically (in univariate analysis) related to gender, hypertension, the presence of an AVF, and the use of hemodialysis after peritoneal dialysis (p = 0.024, p = 0.016, p = 0.006, p = 0.009, respectively). CONCLUSION In addition to classical and predictable abnormalities related to CKD, we found a high prevalence of dilatation of the ascending aorta in children with advanced CKD. Hypertension, AVF, and hemodialysis were associated factors.
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Affiliation(s)
- Sophie Quennelle
- Paediatric Cardiology Department, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - Caroline Ovaert
- Paediatric Cardiology Department, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - Mathilde Cailliez
- Nephrology Unit, Pédiatrie Multidisciplinaire Timone, la Timone Hospital, Aix-Marseille University, Marseille, France
| | - Florentine Garaix
- Nephrology Unit, Pédiatrie Multidisciplinaire Timone, la Timone Hospital, Aix-Marseille University, Marseille, France
| | - Michel Tsimaratos
- Nephrology Unit, Pédiatrie Multidisciplinaire Timone, la Timone Hospital, Aix-Marseille University, Marseille, France
| | - Fedoua El Louali
- Paediatric Cardiology Department, La Timone Hospital, Aix-Marseille University, Marseille, France.
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Porcher R, Desguerre I, Amthor H, Chabrol B, Audic F, Rivier F, Isapof A, Tiffreau V, Campana-Salort E, Leturcq F, Tuffery-Giraud S, Ben Yaou R, Annane D, Amédro P, Barnerias C, Bécane HM, Béhin A, Bonnet D, Bassez G, Cossée M, de La Villéon G, Delcourte C, Fayssoil A, Fontaine B, Godart F, Guillaumont S, Jaillette E, Laforêt P, Leonard-Louis S, Lofaso F, Mayer M, Morales RJ, Meune C, Orlikowski D, Ovaert C, Prigent H, Saadi M, Sochala M, Tard C, Vaksmann G, Walther-Louvier U, Eymard B, Stojkovic T, Ravaud P, Duboc D, Wahbi K. Association between prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy-analysis of registry data. Eur Heart J 2021; 42:1976-1984. [PMID: 33748842 DOI: 10.1093/eurheartj/ehab054] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 10/07/2020] [Revised: 01/03/2021] [Accepted: 01/24/2021] [Indexed: 01/16/2023] Open
Abstract
AIMS To estimate the effect of prophylactic angiotensin-converting enzyme inhibitors (ACEi) on survival in Duchenne muscular dystrophy (DMD). METHODS AND RESULTS We analysed the data from the French multicentre DMD Heart Registry (ClinicalTrials.gov: NCT03443115). We estimated the association between the prophylactic prescription of ACEi and event-free survival in 668 patients aged 8 to 13 years, with normal left ventricular function, using (i) a Cox model with intervention as a time-dependent covariate, (ii) a propensity-based analysis comparing ACEi treatment vs. no treatment, and (iii) a set of sensitivity analyses. The study outcomes were overall survival and hospitalizations for heart failure (HF) or acute respiratory failure. Among the 668 patients included in the DMD Heart Registry, 576 (mean age 6.1 ± 2.8 years) were eligible for this study, of whom 390 were treated with ACEi prophylactically. Death occurred in 53 patients (13.5%) who were and 60 patients (32.3%) who were not treated prophylactically with ACEi, respectively. In a Cox model with intervention as a time-dependent variable, the hazard ratio (HR) associated with ACEi treatment was 0.49 [95% confidence interval (CI) 0.34-0.72] and 0.47 (95% CI 0.31-0.17) for overall mortality after adjustment for baseline variables. In the propensity-based analysis, 278 patients were included in the treatment group and 834 in the control group, with 18.5% and 30.4% 12-year estimated probability of death, respectively. ACEi were associated with a lower risk of death (HR 0.39; 95% CI 0.17-0.92) and hospitalization for HF (HR 0.16; 95% CI 0.04-0.62). All other sensitivity analyses yielded similar results. CONCLUSION Prophylactic ACEi treatment in DMD was associated with a significantly higher overall survival and lower rates of hospitalization for HF.
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Affiliation(s)
- Raphaël Porcher
- Université de Paris, CRESS UMR1153, INSERM, INRA, F-75004, Paris, France; Centre d'Epidémiologie Clinique, AP-HP, Hôtel-Dieu, F-75004 Paris, France
| | - Isabelle Desguerre
- AP-HP, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neurologie Pédiatrique, Hôpital Necker, GH Necker-Enfants Malades, Paris, France
| | - Helge Amthor
- Versailles Saint-Quentin-en-Yvelines University, INSERM U1179, LIA BAHN CSM, Montigny-le-Bretonneux, 78180, Neuromuscular Reference Centre, Paediatric Department, University Hospital Raymond Poincaré, Garches, 92380, France
| | | | - Frédérique Audic
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Roger Salengro, CHRU Lille, Lille, France
| | - François Rivier
- Department of Paediatric Neurology & Reference Centre for Neuromuscular Diseases AOC, CHU Montpellier, France.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Arnaud Isapof
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Trousseau, Paris, France
| | - Vincent Tiffreau
- Physical and Rehabilitation Medicine Unit, University Hospital, Lille, France, URePSSS (Pluridisciplinary Research Unit: Sports, Health, Society) EA, 7369, Lille University
| | - Emmanuelle Campana-Salort
- APHM, Department of Neurology, Neuromuscular and ALS Reference Centre, La Timone University Hospital, Marseille, FranceAix Marseille Université, INSERM, GMGF, Marseille, France
| | - France Leturcq
- Laboratoire de Biochimie et Génétique Moléculaire, Hôpital Cochin et Institut de Myologie, Groupe Hospitalier La Pitié Salpétrière, APHP, France
| | - Sylvie Tuffery-Giraud
- Laboratory of Genetics of Rare Diseases (LGMR), University of Montpellier, Montpellier, France
| | - Rabah Ben Yaou
- Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Centre for Research in Myology, Institut de Myologie, Pitié-Salpêtrière University Hospital, Paris, France.,APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Djillali Annane
- General Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), Lab Inflammation & Infection, U1173 University Paris Saclay-UVSQ/INSERM, Garches, France
| | - Pascal Amédro
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Paediatric Cardiology, CHU Montpellier, France
| | - Christine Barnerias
- AP-HP, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neurologie Pédiatrique, Hôpital Necker, GH Necker-Enfants Malades, Paris, France
| | - Henri Marc Bécane
- APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Anthony Béhin
- APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Damien Bonnet
- AP-HP, Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris-Cité, Paris, France
| | - Guillaume Bassez
- APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Mireille Cossée
- Laboratory of Genetics of Rare Diseases (LGMR), University of Montpellier, Montpellier, France
| | | | - Claire Delcourte
- Critical Care Centre, University Hospital of Lille, Lille Cedex, France
| | - Abdallah Fayssoil
- APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France.,APHP, Hôpital Raymond Poincaré, Centre de Référence des Maladies Neuromusculaires Nord-Est-Île de France, Garches, France
| | - Bertand Fontaine
- Department of Neurology & Reference Centre for Neuromuscular Diseases AOC, CHU Montpellier, France
| | - François Godart
- Pediatric Cardiology Department, Lille University Hospital, University Nord de France, Lille, France
| | | | | | - Pascal Laforêt
- APHP, Hôpital Raymond Poincaré, Centre de Référence des Maladies Neuromusculaires Nord-Est-Île de France, Garches, France
| | - Sarah Leonard-Louis
- APHP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Frederic Lofaso
- Service d'Explorations Fonctionnelles, Hôpital Raymond Poincaré, Garches, FranceINSERM Université de Versailles Saint Quentin en Yvelines, France
| | - Michele Mayer
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Trousseau, Paris, France
| | - Raul Juntas Morales
- Department of Neurology & Reference Centre for Neuromuscular Diseases AOC, CHU Montpellier, France
| | - Christophe Meune
- APHP, Department of Cardiology, Bobigny Hospital, Paris, XIII University, INSERM UMR S-942, Paris, France
| | - David Orlikowski
- Réanimation Adultes, APHP, Hôpitaux Universitaires Paris Ile de France Ouest, site R. Poincaré, Garches, France; CIC1429 INSERM AP-HP, Hôpitaux Universitaires Paris Ile de France Ouest, site R. Poincaré, Garches, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille Medical Genetics, INSERM UMR 1251, Aix Marseille University, Marseille, France
| | - Hélène Prigent
- Réanimation adultes, APHP, Hôpitaux Universitaires Paris Ile de France Ouest, site R. Poincaré, Garches, France
| | - Malika Saadi
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Paris-Descartes, Sorbonne Paris Cité University, Paris, France
| | - Maximilien Sochala
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Paris-Descartes, Sorbonne Paris Cité University, Paris, France
| | - Celine Tard
- Unité de Cardiologie Congénitale, Hôpital Privé de La Louvière, Lille, France
| | - Guy Vaksmann
- Unité de Cardiologie Congénitale, Hôpital Privé de La Louvière, Lille, France
| | - Ulrike Walther-Louvier
- Department of Paediatric Neurology & Reference Centre for Neuromuscular Diseases AOC, CHU Montpellier, France
| | - Bruno Eymard
- Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Centre for Research in Myology, Institut de Myologie, Pitié-Salpêtrière University Hospital, Paris, France
| | - Tanya Stojkovic
- Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Centre for Research in Myology, Institut de Myologie, Pitié-Salpêtrière University Hospital, Paris, France
| | - Philippe Ravaud
- Université de Paris, CRESS UMR1153, INSERM, INRA, F-75004, Paris, France; Centre d'Epidémiologie Clinique, AP-HP, Hôtel-Dieu, F-75004 Paris, France
| | - Denis Duboc
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Paris-Descartes, Sorbonne Paris Cité University, Paris, France
| | - Karim Wahbi
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Paris-Descartes, Sorbonne Paris Cité University, Paris, France.,INSERM Unit 970, Paris Cardiovascular Research Centre (PARCC), Paris, France
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Jalal Z, Valdeolmillos E, Malekzadeh-Milani S, Eicken A, Georgiev S, Hofbeck M, Sieverding L, Gewillig M, Ovaert C, Bouvaist H, Pillois X, Thambo JB, Boudjemline Y. Mid-Term Outcomes Following Percutaneous Pulmonary Valve Implantation Using the "Folded Melody Valve" Technique. Circ Cardiovasc Interv 2021; 14:e009707. [PMID: 33726503 PMCID: PMC8055198 DOI: 10.1161/circinterventions.120.009707] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The folded valve is a manual shortening of the Melody device, which has been validated as a valuable therapeutic option for the management of dysfunctional right ventricular outflow tracts needing a short valved stent. In this article, we aimed to evaluate, in a multicenter cohort, the mid-term outcomes of patients in whom a percutaneous pulmonary valve implantation was performed using the folded valve technique. Methods: A 2012 to 2018 retrospective multicenter study was performed in 7 European institutions. All patients who benefit from percutaneous pulmonary valve implantation with a folded Melody valve were included. Results: A total of 49 patients (median age, 19 years [range 4–56], 63% male) were included. The primary percutaneous pulmonary valve implantation indication was right ventricular outflow tract stenosis (n=19; 39%), patched native right ventricular outflow tracts were the most common substrate (n=15; 31%). The folded technique was mostly used in short right ventricular outflow tracts (n=28; 57%). Procedural success was 100%. After a median follow-up of 28 months (range, 4–80), folded Melody valve function was comparable to the immediate postimplantation period (mean transvalvular peak velocity=2.6±0.6 versus 2.4±0.6 m/s, P>0.1; only 2 patients had mild pulmonary regurgitation). Incidence rate of valve-related reinterventions was 2.1% per person per year (95% CI, 0.1%–3.9%). The probability of survival without valve-related reinterventions at 36 months was 90% (95% CI, 76%–100%). Conclusions: The folded Melody valve is a safe technique with favorable mid-term outcomes up to 6.5 years after implantation, comparable with the usual Melody valve implantation procedure. Complications and reinterventions rates were low, making this technique relevant in selected patients.
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Affiliation(s)
- Zakaria Jalal
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Estíbaliz Valdeolmillos
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, Pediatric Cardiology, France (S.M.-M.)
| | - Andreas Eicken
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the TU Munich, Germany (A.E., S.G.)
| | - Stanimir Georgiev
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the TU Munich, Germany (A.E., S.G.)
| | - Michael Hofbeck
- Department of Pediatric Cardiology, University Children's Hospital, Tuebingen, Germany (M.H., L.S.)
| | - Ludger Sieverding
- Department of Pediatric Cardiology, University Children's Hospital, Tuebingen, Germany (M.H., L.S.)
| | - Marc Gewillig
- Department of Pediatric Cardiology, University Hospitals Leuven, Belgium (M.G.)
| | - Caroline Ovaert
- Department of Pediatric Cardiology and Congenital Heart Disease, AP-HM, Timone enfants, Hopital de la Timone, Provence-Alpes-Côte d'Azur, France (C.O.)
| | | | - Xavier Pillois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Jean-Benoit Thambo
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Younes Boudjemline
- Cardiac Catheterization Laboratories, Sidra Heart Center, Sidra Medicine, Doha, Qatar (Y.B.)
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Ouldali N, Toubiana J, Antona D, Javouhey E, Madhi F, Lorrot M, Léger PL, Galeotti C, Claude C, Wiedemann A, Lachaume N, Ovaert C, Dumortier M, Kahn JE, Mandelcwajg A, Percheron L, Biot B, Bordet J, Girardin ML, Yang DD, Grimaud M, Oualha M, Allali S, Bajolle F, Beyler C, Meinzer U, Levy M, Paulet AM, Levy C, Cohen R, Belot A, Angoulvant F. Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children. JAMA 2021; 325:855-864. [PMID: 33523115 PMCID: PMC7851757 DOI: 10.1001/jama.2021.0694] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [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] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Multisystem inflammatory syndrome in children (MIS-C) is the most severe pediatric disease associated with severe acute respiratory syndrome coronavirus 2 infection, potentially life-threatening, but the optimal therapeutic strategy remains unknown. OBJECTIVE To compare intravenous immunoglobulins (IVIG) plus methylprednisolone vs IVIG alone as initial therapy in MIS-C. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study drawn from a national surveillance system with propensity score-matched analysis. All cases with suspected MIS-C were reported to the French National Public Health Agency. Confirmed MIS-C cases fulfilling the World Health Organization definition were included. The study started on April 1, 2020, and follow-up ended on January 6, 2021. EXPOSURES IVIG and methylprednisolone vs IVIG alone. MAIN OUTCOMES AND MEASURES The primary outcome was persistence of fever 2 days after the introduction of initial therapy or recrudescence of fever within 7 days, which defined treatment failure. Secondary outcomes included a second-line therapy, hemodynamic support, acute left ventricular dysfunction after first-line therapy, and length of stay in the pediatric intensive care unit. The primary analysis involved propensity score matching with a minimum caliper of 0.1. RESULTS Among 181 children with suspected MIS-C, 111 fulfilled the World Health Organization definition (58 females [52%]; median age, 8.6 years [interquartile range, 4.7 to 12.1]). Five children did not receive either treatment. Overall, 3 of 34 children (9%) in the IVIG and methylprednisolone group and 37 of 72 (51%) in the IVIG alone group did not respond to treatment. Treatment with IVIG and methylprednisolone vs IVIG alone was associated with lower risk of treatment failure (absolute risk difference, -0.28 [95% CI, -0.48 to -0.08]; odds ratio [OR], 0.25 [95% CI, 0.09 to 0.70]; P = .008). IVIG and methylprednisolone therapy vs IVIG alone was also significantly associated with lower risk of use of second-line therapy (absolute risk difference, -0.22 [95% CI, -0.40 to -0.04]; OR, 0.19 [95% CI, 0.06 to 0.61]; P = .004), hemodynamic support (absolute risk difference, -0.17 [95% CI, -0.34 to -0.004]; OR, 0.21 [95% CI, 0.06 to 0.76]), acute left ventricular dysfunction occurring after initial therapy (absolute risk difference, -0.18 [95% CI, -0.35 to -0.01]; OR, 0.20 [95% CI, 0.06 to 0.66]), and duration of stay in the pediatric intensive care unit (median, 4 vs 6 days; difference in days, -2.4 [95% CI, -4.0 to -0.7]). CONCLUSIONS AND RELEVANCE Among children with MIS-C, treatment with IVIG and methylprednisolone vs IVIG alone was associated with a more favorable fever course. Study interpretation is limited by the observational design.
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Affiliation(s)
- Naïm Ouldali
- Assistance Publique–Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Université de Paris, INSERM UMR 1123, ECEVE, Paris, France
| | - Julie Toubiana
- Assistance Publique–Hôpitaux de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, Université de Paris, Paris, France
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Denise Antona
- Santé Publique France, Agence Nationale de Santé Publique, Saint-Maurice, France
| | - Etienne Javouhey
- Hospices Civils de Lyon, Paediatric Intensive Care Unit, Hopital Femme, Mère Enfant, University of Lyon, Bron, France
- EA 7426 Pathophysiology of Injury-Induced Immunosuppression, University Claude Bernard Lyon 1, Hospices Civils of Lyon, Lyon, France
| | - Fouad Madhi
- Centre Hospitalier Intercommunal, Paediatric Department, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Mathie Lorrot
- Assistance Publique–Hôpitaux de Paris, Department of General Paediatric, Armand Trousseau University Hospital, Sorbonne Université, Paris, France
| | - Pierre-Louis Léger
- Assistance Publique–Hôpitaux de Paris, Paediatric Intensive Care Unit, Armand Trousseau University Hospital, Sorbonne Université, Paris, France
| | - Caroline Galeotti
- Assistance Publique–Hôpitaux de Paris, Department of Paediatric Rheumatology, Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), Bicêtre University Hospital, Université de Paris Saclay, Le Kremlin-Bicêtre, France
| | - Caroline Claude
- Assistance Publique–Hôpitaux de Paris, Paediatric Intensive Care Unit, Bicêtre University Hospital, Université de Paris Saclay, Le Kremlin-Bicêtre, France
| | - Arnaud Wiedemann
- Children’s Hospital, University Hospital of Nancy, Paediatric Department, Université de Lorraine, Vandoeuvre les Nancy, France
- INSERM UMRS 1256 NGERE, Nutrition, Genetics, and Environmental Risk Exposure, National Center of Inborn Errors of Metabolism, Université de Lorraine, Vandoeuvre les Nancy, France
| | - Noémie Lachaume
- Assistance Publique–Hôpitaux de Paris, Paediatric Emergency Departement, Louis Mourier University Hospital, Colombes, France
| | - Caroline Ovaert
- Assistance Publique–Hôpitaux de Marseille, Paediatric and Congenital Cardiology, Timone Hospital Marseille, University Hospital, Marseille, France
- INSERM, Marseille Medical Genetics, UMR 1251, Aix Marseille Université, Marseille, France
| | - Morgane Dumortier
- Hôpital Femme Enfant Adolescent, Department of Paediatrics and Paediatric Emergency, University Hospital, Nantes, France
| | - Jean-Emmanuel Kahn
- Assistance Publique–Hôpitaux de Paris, Internal Medicine Department, Ambroise Paré University Hospital, Université Versailles-Saint Quentin-en-Yvelines, Boulogne-Billancourt, France
| | | | - Lucas Percheron
- Hôpital des Enfants, Paediatric Nephrology Department, Purpan University Hospital, Toulouse, France
| | - Blandine Biot
- Paediatric Department, Hôpital de Valence, Valence, France
| | - Jeanne Bordet
- Strasbourg University Hospital, Paediatric Cardiology Department, Hautepierre University Hospital, Strasbourg, France
| | - Marie-Laure Girardin
- Paediatric Intensive Care Unit, Strasbourg University Hospital, Hautepierre University Hospital, Strasbourg, France
| | - David Dawei Yang
- Assistance Publique–Hôpitaux de Paris, Paediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Marion Grimaud
- Assistance Publique–Hôpitaux de Paris, Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, EA7323, Université de Paris, Paris, France
| | - Mehdi Oualha
- Assistance Publique–Hôpitaux de Paris, Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, EA7323, Université de Paris, Paris, France
| | - Slimane Allali
- Assistance Publique–Hôpitaux de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, Université de Paris, Paris, France
| | - Fanny Bajolle
- Assistance Publique–Hôpitaux de Paris, M3C Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Constance Beyler
- Assistance Publique–Hôpitaux de Paris, Cardiopaediatric Unit, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Ulrich Meinzer
- Assistance Publique–Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
- Centre for Research on Inflammation, UMR1149, INSERM, Paris, France
| | - Michael Levy
- Assistance Publique–Hôpitaux de Paris, Paediatric Intensive Care Unit, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Ana-Maria Paulet
- Hôpital Nord Franche-Comté, Paediatric Department, Trévenans, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Alexandre Belot
- Hospices Civils de Lyon, Paediatric Nephrology, Rheumatology, Dermatology, Hopital Femme, Mère Enfant, Centre International de Recherche en Infectiologie/INSERM U1111, Bron, France
| | - François Angoulvant
- Assistance Publique–Hôpitaux de Paris, Paediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
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Lenoir M, Desnous B, Rahmani B, El Gueddari N, Aries É, El Louali F, Aldebert P, Ovaert C, Metras D, Macé L, Fouilloux V. Anterograde blood flow associated with modified Blalock-Taussig shunt does not modify pulmonary artery growth compared with modified Blalock-Taussig shunt alone. Arch Cardiovasc Dis 2021; 114:268-276. [PMID: 33509744 DOI: 10.1016/j.acvd.2020.11.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The main difference between extreme tetralogy of Fallot (TOF) and pulmonary atresia with ventricle septal defect (PA/VSD) is anterograde pulmonary blood flow (APBF). It is speculated that the association of modified Blalock-Taussig shunt (mBTS) with APBF favours shunt thrombosis, but promotes better pulmonary artery growth. AIM To compare pulmonary artery growth after mBTS between TOF and PA/VSD. METHODS From 1995 to 2018, 77 mBTS procedures were performed in infants (aged<1 year): 45 for TOF; 32 for PA/VSD. Using a 1/1 propensity score-matched analysis, 38 patients were included (19 per group). Delta Nakata was defined as the difference in the Nakata index before biventricular repair and before mBTS. RESULTS After matching, the preoperative Nakata index was similar in the two groups (TOF 101±34 vs. PA/VSD 106±35 mm2/m2; P=0.75). Age and weight were similar (TOF 24±20 days, 3.3±0.6kg vs. PA/VSD 24±33 days, 3.3±0.9kg; P=0.84 and P=0.77, respectively). There was no difference in rates of in-hospital mortality (TOF 0% vs. PA/VSD 10%; P=0.13) or mBTS thrombosis (TOF 15% vs. PA/VSD 10%; P=0.63). The left and right pulmonary artery diameters at time of biventricular repair were similar (TOF 7.5±2.2 and 6.7±2.1 vs. PA/VSD 8±2.7 and 7.1±2.5mm; P=0.43 and P=0.78, respectively), as were delta Nakata (TOF 112±102 vs. PA/VSD 107±66 mm2/m2; P=0.89), median age for biventricular repair (P=0.83) and reintervention rates (TOF 10% vs. PA/VSD 15%; P=0.67). CONCLUSIONS We found no difference in pulmonary artery growth between APBF with mBTS versus mBTS alone. Thus, we could not show an increase in mBTS thrombosis with APBF.
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Affiliation(s)
- Marien Lenoir
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - Beatrice Desnous
- Department of paediatric neurology, Timone hospital, AP-HM, 13005 Marseille, France
| | - Bilal Rahmani
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - Nabila El Gueddari
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - Édouard Aries
- Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France
| | - Fedoua El Louali
- Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France
| | - Philippe Aldebert
- Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France
| | - Caroline Ovaert
- Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France
| | - Dominique Metras
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - Loic Macé
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - Virginie Fouilloux
- Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
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Guenver C, Oualha M, Levy C, Antona D, Madhi F, Toubiana J, Lachaume N, Javouhey E, Lorrot M, Yang DD, Levy M, Caseris M, Galeotti C, Ovaert C, Wiedemann A, Girardin ML, Rybak A, Cohen R, Belot A, Angoulvant F, Ouldali N. Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System. Front Pediatr 2021; 9:745364. [PMID: 34765576 PMCID: PMC8576449 DOI: 10.3389/fped.2021.745364] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C. Methods: We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening. Results: We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38). Conclusion: Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.
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Affiliation(s)
- Celia Guenver
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,Sorbonne Université, Université de Paris, Paris, France
| | - Mehdi Oualha
- Assistance Publique-Hôpitaux de Paris, Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Corinne Levy
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Denise Antona
- Santé Publique France, Agence nationale de Santé publique, Saint-Maurice, France
| | - Fouad Madhi
- Centre Hospitalier Intercommunal, Paediatric Department, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Julie Toubiana
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, Université de Paris, Paris, France.,Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Noémie Lachaume
- Assistance Publique-Hôpitaux de Paris, Paediatric Emergency Department, Louis Mourier University Hospital, Colombes, France
| | - Etienne Javouhey
- Hospices Civils de Lyon, Paediatric Intensive Care Unit, Hopital Femme, Mère Enfant, University of Lyon, Le Born, France.,EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", University Claude Bernard Lyon 1, Hospices Civils of Lyon, Lyon, France
| | - Mathie Lorrot
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatric, Armand Trousseau University Hospital, Sorbonne Université, Paris, France
| | - David Dawei Yang
- Assistance Publique-Hôpitaux de Paris, Paediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Michael Levy
- Assistance Publique-Hôpitaux de Paris, Paediatric Intensive Care Unit, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Marion Caseris
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Caroline Galeotti
- Assistance Publique-Hôpitaux de Paris, Department of Paediatric Rheumatology, Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), Bicêtre University hospital, Université de Paris Saclay, Le Kremlin-Bicêtre, France
| | - Caroline Ovaert
- Assistance Publique-Hôpitaux de Marseille, Paediatric and Congenital Cardiology, Timone Hospital Marseille, University Hospital, Marseille, France.,INSERM, Marseille Medical Genetics, UMR 1251, Aix Marseille Université, Marseille, France
| | - Arnaud Wiedemann
- Children's Hospital, University Hospital of Nancy, Paediatric Department, Université de Lorraine, Vandoeuvre les Nancy, France.,INSERM UMRS 1256 NGERE, Nutrition, Genetics, and Environmental Risk Exposure, National Center of Inborn Errors of Metabolism, Université de Lorraine, Vandoeuvre les Nancy, France
| | - Marie-Laure Girardin
- Strasbourg University Hospital, Paediatric Intensive Care Unit, Hautepierre University Hospital, Strasbourg, France
| | - Alexis Rybak
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Robert Cohen
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Alexandre Belot
- Hospices Civils de Lyon, Paediatric Nephrology, Rheumatology, Dermatology, Hopital Femme, Mère Enfant, & Centre International de Recherche en Infectiologie/INSERM U1111, Bron, France
| | - François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Naïm Ouldali
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Université de Paris, INSERM UMR 1123, ECEVE, Paris, France
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La Fay C, Lemoine P, Ovaert C, Aries E, Blanc L, Abouchahla W, Suc A, Phan Hoang N, Vial-Cholley E, Cojean N, Revon-Riviere G. Pediatric cardiology teams interact with pediatric palliative care (PPC) Teams for children's and family's best interest: Results from a multicentric study in France. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.289] [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: 11/16/2022]
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41
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Wanert C, El Louali F, Ovaert C, Schouvey S, Lenoir M, Fouilloux V, Tsimaratos M, Garaix F. Evaluation of a cardiac transplanted children cohort: Long term pediatric follow-up and transiant to adulthood, twenty years of monocentric experience. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.288] [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: 10/22/2022]
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Lenoir M, Wanert C, Bonnet D, Méot M, Tosello B, Fouilloux V, Ovaert C, Malekzadeh-Milani S. Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants. Front Pediatr 2021; 9:700284. [PMID: 34869092 PMCID: PMC8640484 DOI: 10.3389/fped.2021.700284] [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] [Received: 04/25/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Patent ductus arteriosus (PDA) is common in preterm infants and contributes to morbidity and mortality. Several studies have shown the feasibility and safety of percutaneous PDA closure. Minimally invasive surgical ligation by anterior thoracotomy is an alternative, bedside technique for PDA closure in very low birth weight preterm infants. Our study aimed to compare short- and medium-term morbidity and mortality between anterior minithoracotomy and transcatheter PDA closure. Methods: From 2010 to 2020, 92 preterm infants <1,600 g underwent PDA closure in two centers: 44 surgical anterior minithoracotomies (center 1) and 48 transcatheter closures (center 2). Using a 1:1 propensity score match analysis, 22 patients in each group were included. The primary outcome was time to extubation after intervention. Results: Preoperative characteristics were similar in both groups after propensity matching (mean weight at procedure, 1,171 ± 183 g; p = 0.8). Mean time to extubation was similar: 10 ± 15 days in the surgical group vs. 9 ± 13 days in the transcatheter group (p = 0.9). Mean age at hospital discharge was 114 ± 29 days vs. 105 ± 19 days (p = 0.2). Two deaths occurred in the surgical group and one in the transcatheter group (p = 0.61). Five complications (pneumothorax n = 2, chylothorax n = 2, phrenic nerve injury n = 1) occurred in three patients after surgery. Three complications (chylothorax n = 1, endocarditis n = 1, renal vein thrombosis n = 1) occurred in two patients after percutaneous closure (p = 0.63). Conclusion: Equivalent efficiency and safety of surgical mini-invasive vs. transcatheter PDA closure in preterm infants <1,600 g are in favor of applying these alternative techniques according to centers' facilities and competences.
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Affiliation(s)
- Marien Lenoir
- Department of Pediatric Cardiac Surgery, Hôpital Timone Enfant, AP-HM, Marseille, France
| | - Chloé Wanert
- Department of Pediatric Cardiology, Hôpital Timone Enfant, AP-HM, Marseille, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,University of Paris, Paris, France
| | - Mathilde Méot
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Barthélémy Tosello
- Department of Neonatology, Hôpital Nord, AP-HM, Marseille, France.,Aix-Marseille University, MMG, INSERM, Marseille, France
| | - Virginie Fouilloux
- Department of Pediatric Cardiac Surgery, Hôpital Timone Enfant, AP-HM, Marseille, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, Hôpital Timone Enfant, AP-HM, Marseille, France.,Aix-Marseille University, MMG, INSERM, Marseille, France
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Wanert C, Lenoir M, Bonnet D, Fouilloux V, Gran C, Ovaert C, Malekzadeh-Milani S. Anterior mini-thoracotomy versus transcatheter closure of the patent ductus arteriosus in the extremely low birth weight preterm infant: A comparative bi-centric study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.295] [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: 10/22/2022]
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44
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Ovaert C, Bonnet D, Malekzadeh-Milani S. Letter by Ovaert et al Regarding Article, "Novel Panna Guide Wire Facilitates Percutaneous and Nonfluoroscopic Procedure for Atrial Septal Defect Closure: A Randomized Controlled Trial". Circ Cardiovasc Interv 2020; 13:e010121. [PMID: 33153296 DOI: 10.1161/circinterventions.120.010121] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Caroline Ovaert
- Paediatric and Congenital Cardiology, Timone, AP-HM, Aix-Marseille University, Marseille, France (C.O.)
| | - Damien Bonnet
- Paediatric and Congenital Cardiology, Hopital Necker-Enfants malades, AP-HP, Université de Paris, France (D.B., S.M.-M.)
| | - Sophie Malekzadeh-Milani
- Paediatric and Congenital Cardiology, Hopital Necker-Enfants malades, AP-HP, Université de Paris, France (D.B., S.M.-M.)
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Fouilloux V, El Louali F, Gran C, Henaine R, Roubertie F, Chenu C, Fiorini M, Le Bel S, Mauriat P, Neidecker J, Macé L, Kreitmann B, Ovaert C. Berlin Heart EXCOR Paediatric Ventricular Assist Device: Does Weight Matter? Heart Lung Circ 2020; 30:585-591. [PMID: 32972811 DOI: 10.1016/j.hlc.2020.08.012] [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: 11/10/2019] [Revised: 07/13/2020] [Accepted: 08/24/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Berlin Heart EXCOR (BH) ventricular assist devices provide mechanical long-term circulatory support in children with end-stage heart failure, as a bridge to transplantation or to recovery. Most studies are from large-volume paediatric cardiac centres. AIM The aim of this study was to analyse the experiences of three French centres and to compare these with available published data. METHOD We performed a retrospective observational study of three paediatric cardiac intensive care units. All children supported with BH devices were included. Morbidity and mortality data were collected and risk factors analysed. RESULTS Fifty-four (54) patients (54% male) were included. Survival rate was 73% while on a BH device. Median age at BH device implantation was 17 months (range 2-180 months). The predominant indication was dilated cardiomyopathy (61%). Bi-ventricular assist device was used in 25 (46%) cases. The total length of long-term circulatory support was 3,373 days, with a mean length per patient of 62.5 days (range 5-267 days). Thirty-two (32) patients were transplanted (59%) and seven (13%) were successfully weaned. Type and length of support did not influence morbidity. Main complications were renal dysfunction (57%), bleeding (41%), and infection (39%). In multivariate analysis, a weight <5 kg was significantly associated with higher mortality. CONCLUSIONS The weight seems to be the most important risk factor of mortality in this precarious condition.
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Affiliation(s)
- Virginie Fouilloux
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Fedoua El Louali
- Department of Paediatric and Congenital Cardiology, Timone Hospital, Marseille, France.
| | - Célia Gran
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Roland Henaine
- Congenital Cardiology Unit, Cardiologic Hospital Louis Pradel, Lyon, France
| | - François Roubertie
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, Bordeaux, France
| | - Caroline Chenu
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France
| | - Marion Fiorini
- Department of Anaesthesia and Intensive Care, Timone Children Hospital, Marseille, France
| | - Stéphane Le Bel
- Department of Anaesthesia and Intensive Care, Timone Children Hospital, Marseille, France
| | - Philippe Mauriat
- Department of Intensive Care Unit, Bordeaux Heart University Hospital, Bordeaux, France
| | - Jean Neidecker
- Department of Intensive Care Unit, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Loïc Macé
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Bernard Kreitmann
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, Bordeaux, France
| | - Caroline Ovaert
- Faculty of Medicine, Aix-Marseille University, Marseille, France; Department of Paediatric and Congenital Cardiology, Timone Hospital, Marseille, France
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Belot A, Antona D, Renolleau S, Javouhey E, Hentgen V, Angoulvant F, Delacourt C, Iriart X, Ovaert C, Bader-Meunier B, Kone-Paut I, Levy-Bruhl D. SARS-CoV-2-related paediatric inflammatory multisystem syndrome, an epidemiological study, France, 1 March to 17 May 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32524957 PMCID: PMC7336112 DOI: 10.2807/1560-7917.es.2020.25.22.2001010] [Citation(s) in RCA: 204] [Impact Index Per Article: 51.0] [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] [Indexed: 12/13/2022]
Abstract
End of April 2020, French clinicians observed an increase in cases presenting with paediatric inflammatory multisystem syndrome (PIMS). Nationwide surveillance was set up and demonstrated temporospatial association with the coronavirus disease (COVID-19) epidemic for 156 reported cases as at 17 May: 108 were classified as confirmed (n = 79), probable (n = 16) or possible (n = 13) post-COVID-19 PIMS cases. A continuum of clinical features from Kawasaki-like disease to myocarditis was observed, requiring intensive care in 67% of cases.
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Affiliation(s)
- Alexandre Belot
- Filière de santé des maladies auto-immunes et auto-inflammatoires rares (FAI2R), Lyon, France
| | - Denise Antona
- Santé Publique France, Agence nationale de Santé publique, Saint-Maurice cedex, France
| | - Sylvain Renolleau
- Groupe francophone de réanimation et d'urgences pédiatriques (GFRUP), Paris, France
| | - Etienne Javouhey
- Groupe francophone de réanimation et d'urgences pédiatriques (GFRUP), Paris, France
| | - Véronique Hentgen
- Groupe de pathologies infectieuses pédiatriques (GPIP), Nice, France
| | | | | | - Xavier Iriart
- Société Française de Cardiologie, filiale de Cardiologie pédiatrique et congénitale (FCPC), Paris, France
| | - Caroline Ovaert
- Société Française de Cardiologie, filiale de Cardiologie pédiatrique et congénitale (FCPC), Paris, France
| | - Brigitte Bader-Meunier
- Société francophone dédiée à l'étude des maladies inflammatoires pédiatriques (SOFREMIP), Paris, France
| | - Isabelle Kone-Paut
- Société francophone dédiée à l'étude des maladies inflammatoires pédiatriques (SOFREMIP), Paris, France
| | - Daniel Levy-Bruhl
- Santé Publique France, Agence nationale de Santé publique, Saint-Maurice cedex, France
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Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, Auriau J, Grimaud M, Oualha M, Beghetti M, Wacker J, Ovaert C, Hascoet S, Selegny M, Malekzadeh-Milani S, Maltret A, Bosser G, Giroux N, Bonnemains L, Bordet J, Di Filippo S, Mauran P, Falcon-Eicher S, Thambo JB, Lefort B, Moceri P, Houyel L, Renolleau S, Bonnet D. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation 2020; 142:429-436. [PMID: 32418446 DOI: 10.1161/circulationaha.120.048360] [Citation(s) in RCA: 825] [Impact Index Per Article: 206.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention. METHODS Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state. RESULTS Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2-16 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was <30% in one-third; 80% required inotropic support with 28% treated with extracorporeal membrane oxygenation. Inflammation markers were suggestive of cytokine storm (interleukin-6 median, 135 pg/mL) and macrophage activation (D-dimer median, 5284 ng/mL). Mean BNP (B-type natriuretic peptide) was elevated (5743 pg/mL). Thirty-one of 35 patients (88%) tested positive for SARS-CoV-2 infection by polymerase chain reaction of nasopharyngeal swab or serology. All patients received intravenous immunoglobulin, with adjunctive steroid therapy used in one-third. Left ventricular function was restored in the 25 of 35 of those discharged from the intensive care unit. No patient died, and all patients treated with extracorporeal membrane oxygenation were successfully weaned. CONCLUSIONS Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.
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Affiliation(s)
- Zahra Belhadjer
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Mathilde Méot
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Fanny Bajolle
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Diala Khraiche
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Antoine Legendre
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Samya Abakka
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Johanne Auriau
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Marion Grimaud
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Mehdi Oualha
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Maurice Beghetti
- Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)
| | - Julie Wacker
- Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)
| | - Caroline Ovaert
- Paediatric and Congenital Cardiology Department, M3C Regional CHD Center, La Timone University Hospital, Marseille, France (C.O.)
- INSERM UMR 1251, Marseille Medical Genetics, University of Aix-Marseille, Marseille, France (C.O.)
| | - Sebastien Hascoet
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Groupe Hospitalier Saint-Joseph, Paris Sud University, Plessis-Robinson, France (S.H.)
| | - Maëlle Selegny
- Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France (M.S.)
| | - Sophie Malekzadeh-Milani
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Alice Maltret
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Gilles Bosser
- CHRU de Nancy, Service de cardiologie congénitale et pédiatrique, Vandoeuvre-lès-Nancy, France (G.B., N..G.)
| | - Nathan Giroux
- CHRU de Nancy, Service de cardiologie congénitale et pédiatrique, Vandoeuvre-lès-Nancy, France (G.B., N..G.)
| | - Laurent Bonnemains
- Department of Cardiac Surgery, University of Strasbourg, France (L.B., J.B.)
| | - Jeanne Bordet
- Department of Cardiac Surgery, University of Strasbourg, France (L.B., J.B.)
| | - Sylvie Di Filippo
- Pediatric Cardiology and Congenital Heart Disease Department, Cardiovascular Louis-Pradel Hospital, Hospices Civils de Lyon, France (S.D.F.)
| | - Pierre Mauran
- Department of Paediatric and Congenital Cardiology, Center de compétence M3C, American Memorial Hospital, CHU de Reims, France (P. Mauran)
| | | | - Jean-Benoît Thambo
- CHU Bordeaux, Department of Pediatric Cardiology, Bordeaux-II University, France (J.-B.T.)
| | - Bruno Lefort
- Unité de Cardiologie Pédiatrique, Hôpital des Enfants Gatien de Clocheville, INSERM UMR 1069 et Université François Rabelais, Tours, France (B.L.)
| | - Pamela Moceri
- Department of Cardiology, Hôpital Pasteur, CHU de Nice, France (P. Moceri)
| | - Lucile Houyel
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Sylvain Renolleau
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Damien Bonnet
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
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Amedro P, Gavotto A, Abassi H, Picot MC, Matecki S, Malekzadeh-Milani S, Levy M, Ladouceur M, Ovaert C, Aldebert P, Thambo JB, Fraisse A, Humbert M, Cohen S, Baruteau AE, Karsenty C, Bonnet D, Hascoet S. Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV-INHIBITION study design. ESC Heart Fail 2020; 7:747-756. [PMID: 32147955 PMCID: PMC7160497 DOI: 10.1002/ehf2.12630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/03/2019] [Revised: 01/04/2020] [Accepted: 01/12/2020] [Indexed: 12/14/2022] Open
Abstract
Aims In univentricular hearts, selective lung vasodilators such as phosphodiesterase type 5 (PDE5) inhibitors would decrease pulmonary resistance and improve exercise tolerance. However, the level of evidence for the use of PDE5 inhibitors in patients with a single ventricle (SV) remains limited. We present the SV‐INHIBITION study rationale, design, and methods. Methods and results The SV‐INHIBITION trial is a nationwide multicentre, randomized, double blind, placebo‐controlled, Phase III study, aiming to evaluate the efficacy of sildenafil on the ventilatory efficiency during exercise, in teenagers and adult patients (>15 years old) with an SV. Patients with a mean pulmonary arterial pressure >15 mmHg and a trans‐pulmonary gradient >5 mmHg, measured by cardiac catheterization, will be eligible. The primary outcome is the variation of the VE/VCO2 slope, measured by a cardiopulmonary exercise test, between baseline and 6 months of treatment. A total of 50 patients are required to observe a decrease of 5 ± 5 points in the VE/VCO2 slope, with a power of 90% and an alpha risk of 5%. The secondary outcomes are clinical outcomes, oxygen saturation, 6 min walk test, SV function, NT‐proBNP, peak VO2, stroke volume, mean pulmonary arterial pressure, trans‐pulmonary gradient, SF36 quality of life score, safety, and acceptability. Conclusions The SV‐INHIBITION study aims to answer the question whether PDE5 inhibitors should be prescribed in patients with an SV. This trial has been built focusing on the three levels of research defined by the World Health Organization: disability (exercise tolerance), deficit (SV function), and handicap (quality of life).
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Affiliation(s)
- Pascal Amedro
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | - Arthur Gavotto
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France
| | - Hamouda Abassi
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France
| | | | - Stefan Matecki
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | - Sophie Malekzadeh-Milani
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Marilyne Levy
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Magalie Ladouceur
- Adult Congenital Heart Disease Unit, Department of Cardiology, M3C National Reference Centre, European Hospital Georges Pompidou, Paris, France
| | - Caroline Ovaert
- Paediatric and Congenital Medico-Surgical Cardiology Department, M3C Regional Reference Centre, AP-HM, La Timone University Hospital, Marseille, France.,Laboratory of Medical Genetics, INSERM UMR 1251, Aix-Marseille University, Marseille, France
| | - Philippe Aldebert
- Paediatric and Congenital Medico-Surgical Cardiology Department, M3C Regional Reference Centre, AP-HM, La Timone University Hospital, Marseille, France
| | - Jean-Benoit Thambo
- Paediatric and Adult Congenital Heart Disease Department, Hôpital Cardiologique du Haut-Lévêque, M3C National Reference Centre, CHU de Bordeaux, Bordeaux, France
| | - Alain Fraisse
- Pediatric Cardiology Service, Royal Brompton and Harefield Hospital Trust, London, UK
| | - Marc Humbert
- Department of Pulmonology, PH National Reference Centre, APHP, Kremlin-Bicetre, Paris, France.,Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
| | - Sarah Cohen
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
| | - Alban-Elouen Baruteau
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Nantes, Nantes, France
| | - Clement Karsenty
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Toulouse, Toulouse, France
| | - Damien Bonnet
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Sebastien Hascoet
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
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Thoré P, Girerd B, Jaïs X, Savale L, Ghigna MR, Eyries M, Levy M, Ovaert C, Servettaz A, Guillaumot A, Dauphin C, Chabanne C, Boiffard E, Cottin V, Perros F, Simonneau G, Sitbon O, Soubrier F, Bonnet D, Remy-Jardin M, Chaouat A, Humbert M, Montani D. Phenotype and outcome of pulmonary arterial hypertension patients carrying a TBX4 mutation. Eur Respir J 2020; 55:13993003.02340-2019. [DOI: 10.1183/13993003.02340-2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/05/2020] [Indexed: 12/16/2022]
Abstract
IntroductionTBX4 mutation causes small patella syndrome (SPS) and/or pulmonary arterial hypertension (PAH). The characteristics and outcomes of PAH associated with TBX4 mutations are largely unknown.MethodsWe report the clinical, functional, radiologic, histologic and haemodynamic characteristics and outcomes of heritable PAH patients carrying a TBX4 mutation from the French pulmonary hypertension (PH) network.Results20 patients were identified in 17 families. They were characterised by a median age at diagnosis of 29 years (0–76 years) and a female to male ratio of three. Most of the patients (70%) were in New York Heart Association (NYHA) functional class III or IV with a severe haemodynamic impairment (median pulmonary vascular resistance (PVR) of 13.6 (6.2–41.8) Wood units). Skeletal signs of SPS were present in 80% of cases. Half of the patients had mild restrictive or obstructive limitation and diffusing capacity of the lung for carbon monoxide (DLCO) was decreased in all patients. High-resolution computed tomography (HRCT) showed bronchial abnormalities, peri-bronchial cysts, mosaic distribution and mediastinal lymphadenopathies. PAH therapy was associated with significant clinical improvement. At follow-up (median 76 months), two patients had died and two had undergone lung transplantation. One-year, three-year and five-year event-free survival rates were 100%, 94% and 83%, respectively. Histologic examination of explanted lungs revealed alveolar growth abnormalities, major pulmonary vascular remodelling similar to that observed in idiopathic pulmonary arterial hypertension (IPAH) and accumulation of cholesterol crystals within the lung parenchyma.ConclusionPAH due to TBX4 mutations may occur with or without skeletal abnormalities across a broad age range from birth to late adulthood. PAH is usually severe and associated with bronchial and parenchymal abnormalities.
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50
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Karsenty C, Malekzadeh-Milani S, Fraisse A, Gewillig M, Bonnet D, Aldebert P, Ovaert C, Bouvaist H, Kempny A, Houeijeh A, Petit J, Hascoet S. Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. Arch Cardiovasc Dis 2020; 113:113-120. [PMID: 32081640 DOI: 10.1016/j.acvd.2019.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/30/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The indications for percutaneous pulmonary valve implantation (PPVI) have been extended to include large dysfunctional right ventricular outflow tracts (RVOTs). Prestenting of the RVOT is commonly performed before PPVI in order to ensure a stable landing zone. The AndraStent XXL (AndraMed GmbH, Reutlingen, Germany), a cobalt-chromium stent with semi-open cell design, has unique mechanical properties in this indication but is no longer available in France. AIMS To assess the efficiency of AndraStent XXL before PPVI. METHODS In this retrospective multicentre cohort study, 86 AndraStents XXL were implanted in 77 patients in 6 centres. RESULTS PPVI was indicated mainly for pulmonary regurgitation (75.3%) in native or patched RVOT (88.3%). The stents were manually mounted on balloon catheters and delivered through sheaths using a conventional femoral approach. PPVI was performed successfully in 97.4% of patients after successful prestenting, generally during the same procedure (77.9%). There were no deaths associated with stent implantation, and four patients experienced five complications, mainly stent embolization, including one requiring surgery. Neither stent fracture nor dysfunction were observed in any patient during a mean follow-up of 19.2±8.7months. Stent analysis showed an excellent maximal stent expansion (97.1%) regardless of balloon size. A 22.3%±3.4 stent shortening with a 30mm balloon was observed. CONCLUSIONS Implantation of large cobalt-chromium AndraStent XXL stents is efficient for prestenting before PPVI.
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Affiliation(s)
- Clement Karsenty
- CHU Toulouse, Pediatric and Congenital Cardiology, Children's Hospital, Université de Toulouse, 31300 Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, INSERM U1048, I2MC, 1, Avenue Jean-Poulhès, BP 84225, Toulouse, France.
| | - Sophie Malekzadeh-Milani
- Centre de Référence Malformations Cardiaques Congénitales, Complexes-M3C, Necker Hospital for Sick Children, George-Pompidou European Hospital, Assistance Publique des Hopitaux de Paris (AP-HP), 75015 Paris, France
| | - Alain Fraisse
- Paediatric Cardiology and Cardiac Surgery Services, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Marc Gewillig
- Fetal and Pediatric Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Damien Bonnet
- Centre de Référence Malformations Cardiaques Congénitales, Complexes-M3C, Necker Hospital for Sick Children, George-Pompidou European Hospital, Assistance Publique des Hopitaux de Paris (AP-HP), 75015 Paris, France
| | - Philippe Aldebert
- Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille, France
| | - Helene Bouvaist
- Department of Cardiology, M3C Regional Reference CHD Centre, CHU Grenoble, France
| | | | - Ali Houeijeh
- Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France
| | - Jerome Petit
- Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France
| | - Sebastien Hascoet
- Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France
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