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Benali K, Hamel-Bougault M, Bessière F, Extramiana F, Guenancia C, Ninni S, Defaye P, Maille B, Baudinaud P, Champ-Rigot L, Sellal JM, Jesel L, Anselme F, Delmas C, Galand V, Flécher E, Martins R. Heart transplantation as a rescue strategy for patients with refractory electrical storm. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.173] [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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Bounader K, Galand V, Gervais M, Nesseler N, Verhoye JP, Flécher E. Stimulation électrique du système nerveux autonome cardiaque EpiCANS : étude clinique chez l’homme. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.200] [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: 01/01/2023]
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Charbonneau E, Flécher E. Morbidity and mortality of long-term mechanical ventricular assistance: Feedback from a center. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.081] [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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Hébert M, Noly P, Lamarche Y, Voisine P, Robles-Cortes J, Verhoye J, Flécher E, Carrier M. Use of Extracorporeal Membrane Oxygenation for Heart Graft Dysfunction in Adults: Incidence, Risk Factors, and Outcomes in a Multicentric Study. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.400] [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] Open
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Hébert M, Noly P, Lamarche Y, Bouhout I, Mauduit M, Giraldeau G, Lelong B, Verhoye J, Flécher E, Carrier M. Early and Long-Term Outcomes after Direct Bridge-to-Transplantation with Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.392] [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: 10/21/2022] Open
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Siméon S, Flécher E, Revest M, Niculescu M, Roussel JC, Michel M, Leprince P, Tattevin P. Left ventricular assist device-related infections: a multicentric study. Clin Microbiol Infect 2017; 23:748-751. [PMID: 28323195 DOI: 10.1016/j.cmi.2017.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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: 12/06/2016] [Revised: 02/27/2017] [Accepted: 03/12/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The implantable left ventricular assist device (LVAD) is a major therapeutic development for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections. METHODS We enrolled all consecutive patients diagnosed with LVAD-related infections in three referral centres in France, using a standardized definition of infections in patients with LVAD. Data were collected from medical charts using a standardized questionnaire. RESULTS Between 2007 and 2012, 159 patients received LVAD for end-stage heart failure. Among them, 36 (22.6%; 5 women, 31 men) presented at least one infectious complication, after a median time of 2.9 months from LVAD implantation (interquartile range, 1.8-7.5), with a median follow up of 12 months (interquartile range 8-17). Main co-morbidities were alcoholism (33%), diabetes (11%) and immunosuppression (11%). Mean age at implantation was 51 (±11) years. LVAD were implanted as bridge-to-transplantation (n=22), bridge-to-recovery (n=8), destination therapy (n=4), or unspecified (n=2). LVAD-related infections were restricted to the driveline exit site (n=17), had loco-regional extension (n=13), or reached the internal pump (n=3). The main bacteria isolated were Staphylococcus aureus (n=20), coagulase-negative staphylococci (n=7), Enterobacteriaceae (n=14), Pseudomonas aeruginosa (n=10) and Corynebacterium sp. (n=7), with polymicrobial infections in 19 cases. LVAD could be retained in all patients, with the use of prolonged antibacterial treatment in 34 (94%), and debridement in 17 (47%). One patient died due to LVAD-associated infection. CONCLUSIONS LVAD-related infections are common after LVAD implantation, and may be controlled by prolonged antibiotic treatment.
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Affiliation(s)
- S Siméon
- Department of Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - E Flécher
- Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France
| | - M Revest
- Department of Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; Inserm U835, Rennes-1 University, France
| | - M Niculescu
- Anaesthesiology Department, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie, Assistance Publique des Hôpitaux de Paris, France
| | - J-C Roussel
- Department of Cardio-Thoracic and Vascular Surgery, Thorax Institute, Laennec University Hospital, Nantes, France
| | - M Michel
- Department of Cardiovascular Diseases, Laennec University Hospital, Nantes, France
| | - P Leprince
- Surgery Department, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie, Assistance Publique des Hôpitaux de Paris, France
| | - P Tattevin
- Department of Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; Inserm U835, Rennes-1 University, France.
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Rouzé S, Leguerrier A, Verhoye JP, Flécher E. [Severe infective endocarditis through the history]. Ann Cardiol Angeiol (Paris) 2017; 66:26-31. [PMID: 28129901 DOI: 10.1016/j.ancard.2016.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/22/2016] [Indexed: 01/16/2023]
Abstract
The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress - clinical and surgical, that allows its current management.
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Affiliation(s)
- S Rouzé
- Service de chirurgie cardiothoracique et cardiovasculaire, CHU Pontchailloux, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
| | - A Leguerrier
- Service de chirurgie cardiothoracique et cardiovasculaire, CHU Pontchailloux, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - J P Verhoye
- Service de chirurgie cardiothoracique et cardiovasculaire, CHU Pontchailloux, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - E Flécher
- Service de chirurgie cardiothoracique et cardiovasculaire, CHU Pontchailloux, 2, rue Henri-le-Guilloux, 35000 Rennes, France
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Aymami M, Donal E, Guihaire J, Le Helloco A, Federspiel M, Galli E, Carré F, Lelong B, Chabanne C, Corbineau H, Flécher E. Rest and Exercise Adaptation of the Right Ventricle in Long-Term Left Ventricular Assist Device Patients: A Prospective, Pilot Study. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.529] [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] Open
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Rouzé S, Flécher E, de Latour B, Meunier C, Sellin M, Lena H, Verhoye JP. [Tracheal adenoid cystic carcinoma treated by complete carinal reconstruction with the help of an ECMO: about a case]. Rev Pneumol Clin 2013; 69:144-148. [PMID: 23597633 DOI: 10.1016/j.pneumo.2013.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 06/02/2023]
Abstract
Primitive tumors of the trachea are rare, accounting for 0.1% of the airway tumors. Cystic adenoid carcinoma (or cylindroma) represents the second most frequent type of tracheal cancers. Histologically speaking, this tumor type is divided in three patterns: cribriform, tubular and solid; it presents a slow growth, perineural invasion and potential local recurrence and metastasis. We presented herein the case of a 56-year-old female suffering from a cystic adenoid carcinoma of the low trachea. She has been treated by carinal resection with negative airway margin and complete reconstruction, with the help of an extra corporeal membrane oxygenation (ECMO).
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Affiliation(s)
- S Rouzé
- Département de chirurgie thoracique et cardiovasculaire, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
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Harmouche M, Flécher E, Abouliatim I, Fouquet O, Lelong B, Chabanne C, Verhoye JP, Leguerrier A. [Heart transplantation for patients on high emergency list with or without extracorporeal membrane oxygenation support]. Ann Cardiol Angeiol (Paris) 2011; 60:15-20. [PMID: 20797692 DOI: 10.1016/j.ancard.2010.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 07/11/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Severely impaired patients may wait in France on a special and temporary high emergency national list (called SU). Some of these patients need mechanical circulatory support with ECMO. In order to compare two groups of patients on SU, who acceeded to heart transplantation (HT) with or without ECMO, we reviewed retrospectively 20 consecutive patients transplanted on SU between January 2004 and September 2007 in Rennes. PATIENTS AND METHODS Among them, 10 were transplanted without ECMO and 10 others were implanted with a femoro-femoral ECMO before HT. RESULTS (1) Considering the group SU without pretransplantation ECMO: 2 years survival rate was 70%. Mean hospital stay was 26.4 days. Three patients were implanted with ECMO for graft dysfunction during postoperative course, without inherent complication. None graft dysfunction occurred after initial hospitalization; (2) considering the group SU with pretransplantation ECMO: 2 years survival rate was 90% (one early death). Mean hospital stay was 45 days with multiple complications due to the ECMO (leg's ischemia: n = 2; lung oedema: n = 1; lymphorrhea: n = 3, low flow requiring change of canulae: n = 1). None graft dysfunction occurred after initial hospitalization. CONCLUSION Although we didn't reach statistical significance, it seems that ECMO for patients in SU may be useful as bridge to transplant but with a higher morbidity than for similar patients transplanted without ECMO. Additional data from other transplant centers are needed to confirm our findings.
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Affiliation(s)
- M Harmouche
- Département de chirurgie thoracique et cardiovasculaire, service de chirurgie thoracique et cardiovasculaire, CHU Pontchaillou, Rennes, France
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Langanay T, Fouquet O, Flécher E, Le Floch JY, Conan N, Bressol D, Charles E, Bouétard A, Ménestret P, Leguerrier A. Perfusion cérébrale, non prévue, en cours de CEC dans les dissections aortiques. Ing Rech Biomed 2008. [DOI: 10.1016/s1959-0318(08)74447-6] [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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