1
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Guerin P, Jalal Z, Cueff C, Hascoet S, Bouvaist H, Levy F, Hugues N, Ladouceur M, Malekzadeh-Milani SG, Iriart X, Silini A, Karam N, Iserin L, Le Gloan L, Thambo JB. Percutaneous edge-to-edge repair for systemic tricuspid valve regurgitation in patients with congenital heart disease: the first descriptive cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
In patients with congenital heart diseases (CHD) systemic tricuspid regurgitation (STR) is frequent.
Here, we report our experience with percutaneous edge-to-edge repair (PETER) in a series of 12 CHD patients with STR using the MitraClip system.
Twelve patients (median age = 35 years, 83% males) with severe STR (ccTGA (n=5), asTGA (n=3), SV (n=4)), at high-risk for surgical treatment, gave informed consent for treatment using PETER. The XTR MitraClip device (Abbott, Santa Clara, CA) was used. At baseline, 7/12 patients were in NYHA functional class ≥ III. Standard femoral venous access was successfully used in 10/12 patients. In SV patients, the systemic valve was accessed directly through the right atrium (n=2), after a Fontan conduit puncture (n=1), or after direct atrial surgical access (n=1). In TGA patients, either transseptal (ccTGA patients, n=4) or transbaffle (asTGA patients, n=3) puncture was performed (4).
Mitraclip devices were successfully implanted in 11/12 patients (Figure 1). One procedural complication was reported for a patient with SV in whom a septal leaflet rupture occurred following clip release, leading to severe STR; the patient died from refractory cardiac failure one week later. Peri-procedural complications included one case of left femoral vein injury and one case of atrial flutter treated by catheter ablation. After a median follow-up of 12-months (range 1–25) following device implantation, no death had occurred. The patients had significant reduction in STR (from severe to moderate in 10/11 patients) and clinically improved (10/11 patients were in NYHA class I or II).
To conclude, percutaneous edge-to-edge therapy of STR in CHD patients is feasible, safe and effective to reduce STR and SRV dilatation. This reduction is associated with a significant clinical improvement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Guerin
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - Z Jalal
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - C Cueff
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - S Hascoet
- Surgical Centre Marie Lannelongue, Departmentof Pediatric and Adult Congenital cardiology , Le Plessis Robinson , France
| | - H Bouvaist
- University Hospital of Grenoble, Interventional Cardiology , Grenoble , France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - N Hugues
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - M Ladouceur
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - S G Malekzadeh-Milani
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - X Iriart
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - A Silini
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - N Karam
- Georges Pompidou APHP Site of Paris Ouest University Hospital, Department of Cardiology , Paris , France
| | - L Iserin
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - L Le Gloan
- Hospital G.R. Laennec - University Hospital Centre of Nantes, Adult Congenital Heart Disease Unit , St Herblain , France
| | - J B Thambo
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
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2
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Canu M, Khouri C, Marliere S, Vautrin E, Piliero N, Ormezzano O, Bertrand B, Bouvaist H, Riou L, Djaileb L, Charlon C, Vanzetto G, Roustit M, Barone-Rochette G. Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.019] [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: 11/16/2022]
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3
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Hascoët S, Smolka G, Champagnac D, Brochet E, Bauer F, Pilliere R, Lavie-Badie Y, Nejjari M, Leurent G, Spaulding C, Combes N, Mangin L, Hammoudi N, Dauphin C, Aminian A, Ciobotaru V, Bouvaist H, Iriart X, Armero S, Gerardin B. Mitral and aortic paravalvular leaks closure: Insights from the prospective international multicenter FFPP cohort study. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.223] [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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4
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Gérardin B, Champagnac D, Smolka G, Bouvaist H, Jakamy R, Ghostine S, Naël J, Garcia C, Kloeckner M, Potier A, Isorni MA, Brenot P, Hascoet S. [Para valvular leak closure in TAVI]. Ann Cardiol Angeiol (Paris) 2019; 68:453-461. [PMID: 31733689 DOI: 10.1016/j.ancard.2019.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 06/10/2023]
Abstract
Literature concerning transcutaneous symptomatic para valvular cardiac leaks closure (PVLC) after trans aortic valve implantation (TAVI) is relatively scarce. Hereby we present 2 clinical cases, one on an Edwards® Sapien 3 valve and the other one on a Medtronic® Evolut R valve. We present also the preliminary results of the 7 PVLC on TAVI included in our prospective FFPP registry during the 2 first years of enrolment (2017-2018), for a total of 158 inclusions for all valves. Seven procedures were performed on 8 leaks, using a majority of vascular plugs (3 Abbott® Amplatzer Vascular Plugs 2 (AVP2), 3 AVP3, 1 AVP4, and 1 muscular Ventricular Septal Defect (VSD) occluder). All procedures were successful without complication. At 1-month follow-up, all patients became asymptomatic. One-year follow-up was already available for 4 patients: 3 of them were symptoms free, and one-who had a second leak not suitable for PVLC-, underwent a « TAVI in TAVI » procedure 2 months after PVLC. This short experience demonstrates the feasibility, the efficacy and the safety of PVLC on TAVI. We expect to be able to offer more in depth information at the end of our prospective ongoing study.
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Affiliation(s)
- B Gérardin
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | | | - G Smolka
- Medical University of Silesia, 40055 Katowice, Pologne
| | - H Bouvaist
- Centre hospitalo-universitaire de Grenoble, 38700 La-Tronche, France
| | - R Jakamy
- Centre hospitalo universitaire Haut-Lévêque, 33600 Pessac, France
| | - S Ghostine
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - J Naël
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - C Garcia
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - M Kloeckner
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - A Potier
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - M A Isorni
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - P Brenot
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
| | - S Hascoet
- Hôpital Marie-Lannelongue, Le-Plessis-Robinson, 92350 France
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5
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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6
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Hascoët S, Smolka G, Bagate F, Hadeed K, Lavie-Badie Y, Bouvaist H, Dauphin C, Bauer F, Nejjari M, Mangin L, Bonnet G, Ciobotaru V, Leurent G, Hammoudi N, Aminian A, Karsenty C, Armero S, Champagnac D, Ternacle J, Isorni M. Multimodality imaging guidance for percutaneous paravalvular leak closure: Insights from the multicenter FFPP register. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.01.037] [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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7
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Bouvaist H, Piliero N, Thony F, Jondot M, Pison C. Angioplastie pulmonaire percutanée pour l’hypertension pulmonaire thromboembolique chronique (HTP-TEC) chez 53 patients consécutifs. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.054] [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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8
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Gallouche M, Barone-Rochette G, Pavese P, Bertrand B, Vanzetto G, Bouvaist H, Pierre I, Schmitt D, Fauconnier J, Caspar Y, Recule C, Picot-Guéraud R, Stahl JP, Mallaret MR, Landelle C. Incidence and prevention of infective endocarditis and bacteraemia after transcatheter aortic valve implantation in a French university hospital: a retrospective study. J Hosp Infect 2017; 99:94-97. [PMID: 29191610 DOI: 10.1016/j.jhin.2017.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 09/19/2017] [Accepted: 11/23/2017] [Indexed: 10/18/2022]
Abstract
Infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is a rare but severe complication. Among 326 patients who underwent TAVI at Grenoble Alpes University Hospital, six (1.8%) cases of IE and 11 (3.4%) cases of bacteraemia were identified. No cases of IE were linked to the intervention; one was due to Staphylococcus aureus despite a screening and targeted decolonization strategy. This underscores the need for randomized studies to evaluate the benefit and cost-effectiveness of this policy.
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Affiliation(s)
- M Gallouche
- Hospital Hygiene Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - G Barone-Rochette
- Cardiology Unit, Grenoble Alpes University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France; French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Toulouse, France
| | - P Pavese
- Infectious Diseases Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - B Bertrand
- Cardiology Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - G Vanzetto
- Cardiology Unit, Grenoble Alpes University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France; French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Toulouse, France
| | - H Bouvaist
- Cardiology Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - I Pierre
- Infectious Diseases Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - D Schmitt
- Pharmacy, Grenoble Alpes University Hospital, Grenoble, France
| | - J Fauconnier
- Medical Information Department, Grenoble Alpes University Hospital, Grenoble, France; University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France
| | - Y Caspar
- Bacteriology Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - C Recule
- Bacteriology Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - R Picot-Guéraud
- Interhospital Network for Prevention of Nosocomial Infections, Grenoble Alpes University Hospital, Grenoble, France
| | - J P Stahl
- Infectious Diseases Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - M R Mallaret
- Hospital Hygiene Unit, Grenoble Alpes University Hospital, Grenoble, France; University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France
| | - C Landelle
- Hospital Hygiene Unit, Grenoble Alpes University Hospital, Grenoble, France; University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France.
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9
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Bouvaist H. [Balloon pulmonary angioplasty: An additional treatment option to improve the status of patients with chronic thromboembolic pulmonary hypertension]. Rev Pneumol Clin 2017; 73:50-54. [PMID: 28162796 DOI: 10.1016/j.pneumo.2016.12.005] [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] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/27/2016] [Indexed: 06/06/2023]
Abstract
In chronic thromboembolic pulmonary hypertension (CTEPH), stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension and progressive right heart failure. CTEPH can be cured surgically by pulmonary endarterectomy (PEA); however, patients deemed unsuitable for PEA due to distal lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, an alternative interventional strategy of balloon pulmonary angioplasty (BPA) reduces pulmonary artery hypertension in patients with CTEPH. Risk/benefit inbalance appear to be safe in experimented center. BPA can treat the lesions from lobar to subsegmental pulmonary arteries, improving functional and hemodynamic status for inoperable patients. This review highlights this recent progress.
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Affiliation(s)
- H Bouvaist
- Pole thorax et vaisseaux, service de cardiologie, centre de compétence pour l'HTAP sévère de l'enfant et de l'adulte, CHU de Grenoble, 38043 Grenoble cedex 09, France.
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10
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Houeijeh A, Godart F, Hascoet S, Bouvaist H, Petit J, Fraisse A. Transcatheter closure of large atrial septal defects (ASDs) in symptomatic children with device/weight ratio 1.5. European multicentric study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Vautrin E, Marlière S, Bouvaist H, Guerbaai R, Barone-Rochette G. [Coronary disease in women: The role of sexual hormones]. Ann Cardiol Angeiol (Paris) 2016; 65:404-410. [PMID: 27814783 DOI: 10.1016/j.ancard.2016.10.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
During their lives, women go through three different phases during which sex hormones play a fundamental role in contributing to specific cardiovascular and coronary risks. To evaluate this risk, we must take into account these various phases with their associated cardiovascular risk factors, and this during three key steps: contraception, pregnancy and menopause. Arterial risk linked to estrogen combined with progestin contraception, depends on the dosage of estrogen. The main cardiovascular risk factor responsible for increasing the risk of myocardial infarction is tobacco, especially after 35 years of age, contraindicating estrogen combined with progestin contraception at the benefit of progestin. Spontaneous dissections and coronary emboli are the most common coronary lesions linked with oestroprogestative contraception. Acute myocardial infarction during pregnancy occurs mostly in the peripartum or postpartum period; and is often caused by spontaneous coronary dissection lesions. Fertility treatment is not associated with an increased risk of developing cardiovascular disease later in life. Hormone therapy during menopause does not increase coronary risk in the first 10 years after menopause and may even have a protective effect, by sustaining arterial integrity. The transdermal route is to be preferred for its metabolic effect. Hormonal treatment during menopause is nonetheless contraindicated in the case of proven coronary disease and uncontrolled cardiovascular risk factors.
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Affiliation(s)
- E Vautrin
- Clinique de cardiologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
| | - S Marlière
- Clinique de cardiologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France
| | - H Bouvaist
- Clinique de cardiologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France
| | - R Guerbaai
- Clinique de cardiologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France
| | - G Barone-Rochette
- Clinique de cardiologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France; Inserm, U1039, radiopharmaceutiques biocliniques, 38043 Grenoble cedex 09, France
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12
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Champey J, Pavese P, Bouvaist H, Maillet M, Kastler A, Boussat B, Francois P. Is brain angio-MRI useful in infective endocarditis management? Eur J Clin Microbiol Infect Dis 2016; 35:2053-2058. [PMID: 27599711 DOI: 10.1007/s10096-016-2764-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Abstract
In infective endocarditis (IE), brain magnetic resonance imaging (MRI) is helpful to diagnose clinically silent neurological events. We assessed the usefulness of systematic early brain MRI in IE diagnosis and medico-surgical management. Over a period of 1 year, all patients admitted in one of the three hospitals participating in and fulfilling the Duke criteria for definite or possible IE underwent cerebral MRI within 7 days of IE suspicion. Eight panels of experts analyzed the records a posteriori. For each case, one record with and one record without the MRI results were randomly assigned to two panels, which determined the theoretical diagnosis and treatment. Paired comparisons were performed using a symmetry test. Thirty-seven brain MRIs were performed within a median of 5 days after inclusion. MRI was pathological in 26 patients (70 %), showing 62 % microischemia and 58 % microbleeds. The expert advice did not differ significantly between the two evaluations (with or without the MRI results). The therapeutic strategies determined diverged in five cases (13.5 %). Diagnosis differed in two cases (5.4 %), with an upgrading of diagnosis from possible to definite IE using MRI results. Early brain MRI did not significantly affect the IE diagnosis and medico-surgical treatment plan. These results suggest that systematic use of early brain MRI is irrelevant in IE. Further studies are necessary to define whether MRI is mandatory in IE management within a multidisciplinary approach, with particular attention paid to better timing and the subset of patients in whom this imaging examination could be beneficial.
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Affiliation(s)
- J Champey
- Intensive Care Medicine, CHU de Grenoble, BP 218, 38043, Grenoble Cedex 9, France.
| | - P Pavese
- Infectious Disease Department, CHU Grenoble, Grenoble, France
| | - H Bouvaist
- Cardiology Department, CHU Grenoble, Grenoble, France
| | - M Maillet
- Infectious Disease Department, CHU Grenoble, Grenoble, France
| | - A Kastler
- Neuroradiology Department, CHU Grenoble, Grenoble, France
| | - B Boussat
- Public Health Department, CHU Grenoble, Grenoble, France
| | - P Francois
- Public Health Department, CHU Grenoble, Grenoble, France
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13
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Champey J, Pavese P, Bouvaist H, Kastler A, Krainik A, Francois P. Value of brain MRI in infective endocarditis: a narrative literature review. Eur J Clin Microbiol Infect Dis 2015; 35:159-68. [PMID: 26585337 PMCID: PMC4724368 DOI: 10.1007/s10096-015-2523-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/02/2015] [Indexed: 11/28/2022]
Abstract
The nervous system is frequently involved in patients with infective endocarditis (IE). A systematic review of the literature was realized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). This study sought to systematically evaluate the published evidence of the contribution of brain magnetic resonance imaging (MRI) in IE. The aim was to identify studies presenting the incidence and type of MRI brain lesions in IE. Fifteen relevant studies were isolated using the Medline, Embase, and Cochrane databases. Most of them were observational studies with a small number of patients. MRI studies demonstrated a wide variety and high frequency of cerebral lesions, around 80 % of which were mostly clinically occult. This review shows MRI’s superiority compared to brain computed tomography (CT) for the diagnosis of neurologic complications. Recent developments of sensitive MRI sequences can detect microinfarction and cerebral microhemorrhages. However, the clinical significance of these microhemorrhages, also called cerebral microbleeds (CMBs), remains uncertain. Because some MRI neurological lesions are a distinctive IE feature, they can have a broader involvement in diagnosis and therapeutic decisions. Even if cerebral MRI offers new perspectives for better IE management, there is not enough scientific proof to recommend it in current guidelines. The literature remains incomplete regarding the impact of MRI on concerted decision-making. The long-term prognosis of CMBs has not been evaluated to date and requires further studies. Today, brain MRI can be used on a case-by-case basis based on a clinician’s appraisal.
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Affiliation(s)
- J Champey
- Medical Intensive Care Department, CHU de Grenoble, BP 218, 38043, Grenoble Cedex 9, France.
| | - P Pavese
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38043, Grenoble Cedex 9, France.
| | - H Bouvaist
- Cardiology Department, CHU Grenoble, Grenoble, France
| | - A Kastler
- Neuroradiology Department, CHU Grenoble, Grenoble, France
| | - A Krainik
- Neuroradiology Department, CHU Grenoble, Grenoble, France
| | - P Francois
- Public Health Department, CHU Grenoble, Grenoble, France
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14
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Hascoët S, Jalal Z, Baruteau A, Mauri L, Acar P, Bouvaist H, Houeijeh A, Chalard A, Lusson J, Piéchaud J, Bouzguenda I, Thambo J, Godart F, Fraisse A. Stents in pediatric and adult congenital cardiac catheterization in France in 2013. Arch Cardiovasc Dis 2014. [DOI: 10.1016/j.acvd.2014.07.023] [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: 10/24/2022]
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15
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Sitbon O, Jais X, Savale L, Cottin V, Bergot E, Macari EA, Bouvaist H, Dauphin C, Picard F, Bulifon S, Montani D, Humbert M, Simonneau G. Upfront triple combination therapy in pulmonary arterial hypertension: a pilot study. Eur Respir J 2014; 43:1691-7. [DOI: 10.1183/09031936.00116313] [Citation(s) in RCA: 243] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gabriel L, Bedouch P, Khouatra C, Delavenne X, Bouvaist H, Cordier J, Pison C, Cottin V, Bertoletti L. Traitements anticoagulants et risques d’interactions médicamenteuses chez les patients traités pour hypertension pulmonaire. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.063] [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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17
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Montani D, Bergot E, Günther S, Savale L, Bergeron A, Bourdin A, Bouvaist H, Canuet M, Pison C, Macro M, Poubeau P, Natali D, Guignabert C, Perros F, O’callaghan DS, Jais X, Zalcman G, Sitbon O, Simonneau G, Humbert M. Hypertension artérielle pulmonaire induite par le dasatinib (dual Src/Abl kinase inhibitor). Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.072] [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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18
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Debaty G, Berthelot K, Bouvaist H, Fluttaz A, Ageron F, Gay S, Bach V, Durand M, Savary D, Schmidt M, Danel V. Refractory cardiac arrest treated by extracorporeal life support in prehospital setting debaty guillaume. Resuscitation 2010. [DOI: 10.1016/j.resuscitation.2010.09.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Boignard A, Bonadona A, Hamidfar R, Pavese P, Bouvaist H, Hammer L, Rey I, Schwebel C, Vanzetto G, Barnoud D. [Cardiogenic shock due to acute myocarditis complicating leptospirosis]. Arch Mal Coeur Vaiss 2006; 99:251-4. [PMID: 16618030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A 48 year old man was admitted to the intensive care unit with septicaemic shock associated with febrile jaundice and anuric renal failure. Within hours, he developed cardiogenic shock with multi-organ failure due to an acute myocarditis refractory to catecholamines and requiring intra-aortic balloon pumping. The diagnosis was an ictero-haemorrhagic leptospirosis, the outcome of which was finally favourable. Myocarditis is an underestimated complication of leptospirosis because it is often symptomless. The main signs are arrhythmias, conduction defects and ST-T wave abnormalities which have little clinical expression. The disease may progress and is sometimes fatal. Leptospirosis myocarditis should therefore be carefully considered because of its potential severity and its reversibility with appropriate antibiotic therapy and also the necessity of initial management in a specific infrastructure.
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Affiliation(s)
- A Boignard
- Unité de réanimation médicale, Fédération des maladies cardiovasculaire et thoraciques, CHU de Grenoble, BP 217, 38043 Grenoble 9
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20
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Belle L, Labarere J, Meunier O, Amon V, Fourny M, Bouvaist H, Guenot O, Hugon V, Broin P, Fromage P, Haddad C, François P. [Factors associated with early invasive strategy in patients with acute coronary syndrome. A multicenter study]. Ann Cardiol Angeiol (Paris) 2006; 55:39-48. [PMID: 16457035 DOI: 10.1016/j.ancard.2005.09.004] [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] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To identify the factors associated with early cardiac catheterization in patients with a non ST-segment elevation acute coronary syndrome. METHODS We analyzed data collected by retrospective chart review for 208 patients presenting at seven French hospitals with an acute coronary syndrome (chest pain at rest within 24 h prior to presentation with positive cardiac markers and/or electrocardiographic changes) between January and March 2005. RESULTS Eighty-seven patients (42%) were first admitted to hospitals with cardiac catheterization facilities. One hundred ten patients (53%, 95% confidence interval [95% CI], 46-60) underwent early cardiac catheterization less than 48 h following presentation. In addition to presentation at hospitals with catheterization facilities, factors independently associated with early catheterization included positive cardiac markers in patients first admitted to hospitals without catheterization facilities (adjusted odds ratio [aOR] 34.5, 95% CI, 4.4-268.0) and diabetes mellitus (aOR, 0.4, 95%CI, 0.2-0.9). With the exception of positive cardiac markers, no risk factors comprising the TIMI risk score were associated with increased odds of early cardiac catheterization. During the index hospital stay, six patients (3%) died, seven patients (3%) had pulmonary edema, three patients (1%) had major or minor bleeding, and none had ST segment elevation myocardial infarction. CONCLUSION Despite the dissemination of international guidelines, the use of early cardiac catheterization remains related to initial presentation at hospitals with catheterization facilities rather than risk assessment in patients with a non ST-segment elevation acute coronary syndrome.
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Affiliation(s)
- L Belle
- Réseau des urgences coronariennes (RESURCOR), réseau nord-alpin des urgences, centre hospitalier de la région d'Annecy, BP 2333, 74011 Annecy, France.
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21
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Bouvaist H, Rossignol AM, Rocca C, Andrini P, Durand C, Bost M. [Aneurysm of the vein of Galen and cardiac insufficiency. Current therapeutic approach]. Arch Mal Coeur Vaiss 1998; 91:637-43. [PMID: 9749216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Aneurysm of the ampulla of Galien is a rare but serious cause of cardiac failure in the neonate or child. The diagnosis is suspected on finding a continuous murmur on auscultation of the skull. It is an intracranial arterio-venous malformation which is sometimes responsible for a very important shunt between the arterial (carotid or vertebral) and venous systems. The vital and neurological prognosis of these children is classically very poor. The authors report the cases of the last three consecutive children aneurysms of the ampulla of Galien followed up at Grenoble Hospital in the last five years. The clinical presentations were very different, corresponding to the usual three forms described in the literature: a reputedly very severe form with cardiac failure at the 3rd day of life requiring multiple percutaneous embolisations; a neonatal form revealed by an isolated macrocranium; and a form diagnosed late (4.5 years) in the investigation of effort dyspnoea which regressed after two sessions of embolisation. All three children are alive and have normal psychomotor development for their age. A multidisciplinary approach involving neonatal physicians, paediatric cardiologists and neurologists, with complementary non-invasive investigations such as transfontanellar ultrasonography, electroencephalography, MRI and echocardiography are necessary to optimise the management and limit the neurological sequellae in children with this type of malformation. Cerebral arteriography and percutaneous embolisation under general anaesthesia by a trained team gave very good medium-term results in two of these cases, lightening the usual pessimism surrounding this condition.
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Affiliation(s)
- H Bouvaist
- Service de cardiologie pédiatrique, CHU Grenoble
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22
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Bouvaist H, Rossignol AM, Jouk PS, Perez I, Rocca C. [An unusual site of cardiac myxoma. Apropos of a case in an 11-year old child]. Arch Mal Coeur Vaiss 1997; 90:729-33. [PMID: 9295959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cardiac myxoma, a relatively common condition in adults, is exceptionally rare in childhood. It is usually observed in the left atrium. The condition may be latent and a chance echocardiographic finding or present with arrhythmias, intermittent mitral obstruction or embolic phenomena. The authors report the case of an 11-year old child with no previous medical history, admitted to hospital after sudden right hemiplegia due to an ischaemic cerebrovascular accident. The investigation of a cardiac embolic abnormality led to the finding of a very large left ventricular tumour inserted into the mitral annulus and prolapsing into the left ventricular outflow tract, the histological examination of which confirmed the diagnosis of myxoma. Cardiac myxomas in children seem to have a much more variable site of implantation than in adults, especially in the right heart in infancy. Treatment is always surgical. Echocardiography should be requested early in children presenting with a murmur of recent origin, malaises, or unexplained inflammatory syndromes, and would seem to be the only means of avoiding the severe embolic complications of these histologically benign tumours.
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Affiliation(s)
- H Bouvaist
- Département de médecine infantile, CHRU Grenoble
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