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Durand E, Beziau-Gasnier D, Michel M, Iung B, Tchetche D, Bonnet G, Lhermusier T, Gilard M, Souteyrand G, Bouleti C, Ohlmann P, Lefevre T, Beygui F, Chassaing S, Chevreul K, Eltchaninoff H. Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial. Eur Heart J 2024; 45:952-962. [PMID: 38437633 DOI: 10.1093/eurheartj/ehae081] [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: 06/30/2023] [Revised: 11/22/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND AND AIMS The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI. METHODS FAST-TAVI II is a prospective, multicentre, cluster, randomized, controlled study including patients with severe symptomatic aortic stenosis, who had transfemoral TAVI. The intervention consisted in a dedicated training programme to implement 10 quality of care measures to reduce LOS with an implementation phase of eight weeks. The primary endpoint was the proportion of patients discharged early within 3 days. Secondary endpoints included: LOS, 30-day mortality and 30-day incidence of readmission for cardiovascular events. RESULTS During the study period, 969 patients were enrolled in the intervention group and 860 patients in the control group. Mean age was 81.9 ± 6.6 years and mean EuroSCORE II was 4.4 ± 4.5%. Early discharge was achieved in 563 (58.1%) patients in the intervention group vs. 364 (42.3%) patients in the control group (P < .0001). Median LOS was significantly reduced in the intervention group compared to the control group [3 (IQR: 3) vs. 4 days (IQR: 3), P < .0001]. Thirty-day mortality was low and similar in the two groups (0.5% vs. 0.9%, P = .30), as were 30-day readmissions (4.6% vs. 2.8%, P = .28). CONCLUSIONS The intervention was simple and fast to implement, and was effective and safe to reduce LOS and increase the proportion of patients discharged early after TAVI (NCT04503655).
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Affiliation(s)
- Eric Durand
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France
| | - Delphine Beziau-Gasnier
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France
| | - Morgane Michel
- Université Paris Cité, Paris, France
- Inserm, ECEVE, Paris, France
- Clinical Epidemiology Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bernard Iung
- Cardiology Department, Bichat-Claude-Bernard Hospital Cardiology Service, Paris, France
| | | | - Guillaume Bonnet
- Unité médico-chirurgicale des valvulopathies, CHU de Bordeaux, 33600 Pessac, France
| | | | - Martine Gilard
- Department of Cardiology, CHRU Brest, 29200 Brest, France
| | | | - Claire Bouleti
- Clinical Investigation Center (INSERM 1204), Cardiology Department, ACTION and FACT study groups, University of Poitiers, Poitiers Hospital, France
| | - Patrick Ohlmann
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Thierry Lefevre
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Générale de santé, Massy, France
| | - Farzin Beygui
- Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France
| | - Stephan Chassaing
- Cardiology Department, Clinique NCT+-Saint Gatien-Alliance, Tours, France
| | - Karine Chevreul
- Université Paris Cité, Paris, France
- Inserm, ECEVE, Paris, France
- Clinical Epidemiology Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène Eltchaninoff
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France
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Rangé G, Motreff P, Benamer H, Commeau P, Cayla G, Chassaing S, Laure C, Monsegu J, Van Belle E, Py A, Amabile N, Beygui F, Honton B, Lhermusier T, Boiffard E, Boueri Z, Lhoest N, Deharo P, Adjedj J, Pouillot C, Pereira B, Koning R, Collet JP. The France PCI registry: Design, methodology and key findings. Arch Cardiovasc Dis 2023; 116:489-497. [PMID: 37783602 DOI: 10.1016/j.acvd.2023.08.005] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Obstructive coronary artery disease is the main cause of death worldwide. By tracking events and gaining feedback on patient management, the most relevant information is provided to public health services to further improve prognosis. AIMS To create an inclusive and accurate registry of all percutaneous coronary intervention (PCI) procedures performed in France, to assess and improve the quality of care and create research incentives. Also, to describe the methodology of this French national registry of interventional cardiology, and present early key findings. METHODS The France PCI registry is a multicentre observational registry that includes consecutive patients undergoing coronary angiography and/or PCI. The registry was set up to provide online data analysis and structured reports of PCI activity, including process of care measures and assessment of risk-adjusted outcomes in all French PCI centres that are willing to participate. More than 150 baseline data items, describing demographic status, PCI indications and techniques, and in-hospital and 1-year outcomes, are captured into local reporting software by medical doctors and local research technicians, with subsequent encryption and internet transfer to central data servers. Annual activity reports and scoring tools available on the France PCI website enable users to benchmark and improve clinical practices. External validation and consistency assessments are performed, with feedback of data completeness to centres. RESULTS Between 01 January 2014 and 31 December 2022, participating centres increased from six to 47, and collected 364,770 invasive coronary angiograms and 176,030 PCIs, including 54,049 non-ST-segment elevation myocardial infarction cases and 31,631 ST-segment elevation myocardial infarction cases. Fifteen studies stemming from the France PCI registry have already been published. CONCLUSIONS This fully electronic, daily updated, high-quality, low-cost, national registry is sustainable, and is now expanding. Merging with medicoeconomic databases and nested randomized scientific studies are ongoing steps to expand its scientific potential.
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Affiliation(s)
- Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Chartres, France.
| | - Pascal Motreff
- Cardiology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, 02200 Soissons, France
| | - Philippe Commeau
- Cardiology Department, Polyclinique Les Fleurs, Groupe ELSAN, 83190 Ollioules, France
| | - Guillaume Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, 30029 Nîmes, France
| | - Stephan Chassaing
- Cardiology Department, Nouvelle Clinique Tourangelle, 37540 Saint-Cyr-sur-Loire, France
| | - Christophe Laure
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Chartres, France
| | - Jacques Monsegu
- Department of Interventional Cardiology, Institut Cardio-Vasculaire, Groupe Hospitalier Mutualiste, 38028 Grenoble, France
| | - Eric Van Belle
- Department of Cardiology, Institut Coeur-Poumon-CHU Lille and INSERM U1011, 59000 Lille, France
| | - Antoine Py
- Department of Cardiology, Clinique Victor Pauchet, 80094 Amiens, France
| | - Nicolas Amabile
- Cardiology Department, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Farzin Beygui
- Cardiology Department, CHU de Caen, 14000 Caen, France
| | - Benjamin Honton
- Department of Interventional Cardiology, Clinique Pasteur, 31076 Toulouse, France
| | - Thomas Lhermusier
- Department of Cardiology, Toulouse University Hospital, 31000 Toulouse, France
| | - Emmanuel Boiffard
- Department of Cardiology, Centre Hospitalier Départemental de Vendée, 85000 La Roche-sur-Yon, France
| | - Ziad Boueri
- Department of Cardiology, Centre Hospitalier de Bastia, 20600 Bastia, France
| | - Nicolas Lhoest
- Department of Cardiology, Clinique Rhéna, 67000 Strasbourg, France
| | - Pierre Deharo
- Department of Cardiology, CHU Timone, Aix Marseille Université, INSERM, INRA, C2VN, 13005 Marseille, France
| | - Julien Adjedj
- Department of Cardiology, Arnault Tzanck Institute, 06700 Saint-Laurent-du-Var, France
| | - Christophe Pouillot
- Department of Cardiology, Clinique Sainte Clotilde, 97400 Saint-Denis, Reunion
| | - Bruno Pereira
- Cardiology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - René Koning
- Cardiology Department, Clinique Saint-Hilaire, 76000 Rouen, France
| | - Jean-Philippe Collet
- Sorbonne Université, Action Study Group (action-groupe.org), Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Duband B, Souteyrand G, Clerc JM, Chassaing S, Fichaux O, Marcollet P, Deballon R, Roussel L, Pereira B, Collet JP, Commeau P, Cayla G, Koning R, Motreff P, Benamer H, Rangé G. Prevalence, Management and Outcomes of Percutaneous Coronary Intervention for Coronary In-Stent Restenosis: Insights From the France PCI Registry. Cardiovasc Revasc Med 2023; 52:39-46. [PMID: 36813696 DOI: 10.1016/j.carrev.2023.02.006] [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] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Despite the evolution of stent technology, there is a non-negligible risk of in-stent restenosis (ISR) after Percutaneous coronary intervention (PCI). Large-scale registry data on the prevalence and clinical management of ISR is lacking. METHODS The aim was to describe the epidemiology and management of patients with ≥1 ISR lesions treated with PCI (ISR PCI). Data on characteristics, management and clinical outcomes were analyzed for patients undergoing ISR PCI in the France-PCI all-comers registry. RESULTS Between January 2014 and December 2018, 31,892 lesions were treated in 22,592 patients, 7.3 % of whom underwent ISR PCI. Patients undergoing ISR PCI were older (68.5 vs 67.8; p < 0.001), and more likely to have diabetes (32.7 % vs 25.4 %, p < 0.001), chronic coronary syndrome or multivessel disease. ISR PCI concerned drug eluting stents (DES) ISR in 48.8 % of cases. Patients with ISR lesions were more frequently treated with DES than drug eluting balloon or balloon angioplasty (74.2 %, 11.6 % and 12.9 %, respectively). Intravascular imaging was rarely used. At 1 year, patients with ISR had higher target lesion revascularization rates (4.3 % vs. 1.6 %; HR 2.24 [1.64-3.06]; p < 0.001). CONCLUSIONS In a large all-comers registry, ISR PCI was not infrequent and associated with worse prognosis than non-ISR PCI. Further studies and technical improvements are warranted to improve the outcomes of ISR PCI.
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Affiliation(s)
- Benjamin Duband
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
| | - Géraud Souteyrand
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean Michel Clerc
- Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France
| | | | - Olivier Fichaux
- Cardiology Department, Centre Hospitalo-Régional d'Orléans, Orléans, France
| | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier Jacques Cœur, Bourges, France
| | | | - Laurent Roussel
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
| | - Bruno Pereira
- Biostatistics Unit, Direction de la Recherche Clinique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Philippe Commeau
- Cardiology Department, Polyclinique Les Fleurs, Groupe ELSAN, Ollioules, France
| | - Guillaume Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, Rouen, France
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, Soissons, France
| | - Gregoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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Mesrar H, Hakim R, Chassaing S, Fichaux O, Marcollet P, Decomis MP, Beygui F, Angoulvant D, Motreff P, Rangé G. Impact of the COVID-19 pandemic on overall percutaneous coronary interventions from the France-PCI registry: Comparative analysis of the years 2019 and 2020. Archives of Cardiovascular Diseases. Supplements 2023. [PMCID: PMC9800760 DOI: 10.1016/j.acvdsp.2022.10.013] [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] [Indexed: 01/01/2023]
Abstract
Introduction In 2020, the coronavirus disease 2019 (COVID-19) pandemic disrupted the health system and a drop in percutaneous coronary interventions (PCI) was observed. Objective The objective of this study was to evaluate the impact of the COVID-19 pandemic on a full year of elective and urgent PCIs, from the national France-PCI registry. Method The primary endpoint was to compare the number of PCIs performed in 2019 (before the pandemic), and 2020 (during the pandemic). Results Between January 1, 2019 and December 31, 2020, in the 20 participating centers, 22,807 consecutive PCIs were included. The total number of PCIs was reduced by −11.5% between 2019 and 2020 (12,102 versus 10,705; P < 0.001), mainly due to a reduction in elective interventions (−21.9%; P < 0.001). There was a significant decrease in PCIs for stable angina (P < 0.001) and silent ischemia (P < 0.001). For urgent PCIs, the decrease was less, mainly driven by a non-ST+ acute coronary syndromes (ACS) reduction (−5.7%; P = 0.01), as well as a decrease of early ST-Elevation myocardial infarctions (STEMIs) < 24 Hours (−7.1%; P = 0.02). There was also a significant increase in the number of late STEMIs > 24H (+23.4%; P = 0.002). Following the decrease in ACS during the first lockdown from March to May 2020, there was an unexpected significant increase in urgent interventions (“rebound effect”) out of step with the rest of the year (P = 0.002) (Fig. 1A). Nevertheless, there was no increase in elective PCIs after the first lockdown in comparison with the rest of the year 2020 (P = 0.67) (Fig. 1B). In 2020, patients were significantly younger (P = 0.001), with less prior history of coronary artery disease (P = 0.001), and prasugrel was more often prescribed after PCIs (P = 0.001). In 2020, the radial approach was more often performed (P = 0.001), as well as an “Ad-hoc” PCI (P = 0.01), and the median fluoroscopy time was lengthened (P < 0.001). For STEMIs < 24H, there was more frequently anterior localizations (P = 0.03), and ground medical transport was the majority (P = 0.03). The time from onset of symptoms to first medical contact was significantly lengthened (P = 0.01), and a non-significant increase in total ischemic time (P = 0.08) was found. Finally, there was no significant increase in intra-hospital cardiovascular events during the pandemic in 2020. Conclusion We show an extraordinary reduction in elective and urgent PCIs, as well as a never described paradoxical increase in urgent PCIs after the first lockdown, during the COVID-19 pandemic.
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Affiliation(s)
- H. Mesrar
- Cardiologie, CH de Chartres, Le Coudray,Corresponding author
| | - R. Hakim
- Cardiologie, CH de Chartres, Le Coudray
| | - S. Chassaing
- Cardiologie interventionnelle et imagerie cardiaque, Nouvelle Clinique Tourangelle, Saint-Cyr-sur-Loire
| | - O. Fichaux
- Cardiologie, CH régional d’Orléans, hôpital de La Source, Orléans
| | | | | | | | | | - P. Motreff
- Cardiologie, CHU Clermont-Fd: Site Gabriel-Montpied, Clermont-Ferrand
| | - G. Rangé
- Cardiologie, CH de Chartres, Le Coudray
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Le Bras A, Puymirat E, Rabetrano H, Cayla G, Simon T, Steg G, Montalescot G, Varenne O, Bonello L, Coste P, Delarche N, Georges JL, Chassaing S, Letocart V, Chatellier G, Danchin N, Durand-Zaleski I. Economic evaluation of fractional flow reserve-guided versus angiography-guided multivessel revascularisation in ST-segment elevation myocardial infarction patients in the FLOWER-MI randomised trial. EUROINTERVENTION 2022; 18:235-241. [PMID: 35191838 PMCID: PMC9980404 DOI: 10.4244/eij-d-21-00867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND In patients with ST-segment elevation myocardial infarction (STEMI) who have multivessel disease, the FLOWER-MI trial found no significant clinical benefit to fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared to angiography-guided PCI. AIMS Our aim was to estimate the cost-effectiveness and cost-utility of FFR-guided PCI, the secondary endpoint of the FLOWER-MI trial. METHODS Costs, major adverse cardiovascular events (composite of all-cause death, non-fatal myocardial infarction [MI], and unplanned hospitalisation leading to urgent revascularisation), and quality-adjusted life years were calculated in both groups. The incremental cost-effectiveness and cost-utility ratios were estimated. Uncertainty was explored by probabilistic bootstrapping. The analysis was conducted from the perspective of the health care provider with a time horizon of one year. RESULTS At one year, the average cost per patient was 7,560€ (±2,218) in the FFR-guided group and 7,089€ (±1,991) in the angiography-guided group (p-value<0.01). The point estimates for the incremental cost-effectiveness and cost-utility ratios found that the angiography-guided strategy was cost saving and improved outcomes, with a probabilistic sensitivity analysis confirming dominance. CONCLUSIONS The FFR-guided strategy at one year is unlikely to be cost effective compared to the angiography-guided strategy on both clinical and quality of life outcomes.
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Affiliation(s)
- Alicia Le Bras
- Unité de Recherche Clinique en Économie de la Santé, Hôpital Hôtel Dieu AP-HP, 1 Parvis Notre-Dame, 75004 Paris, France
| | - Etienne Puymirat
- Department of Cardiology, Hôpital Européen Georges Pompidou AP-HP, Paris, France,Université de Paris, Paris, France,French Alliance for Cardiovascular Trials (FACT), Paris, France
| | - Hasina Rabetrano
- Clinical Research Unit Eco Ile de France, Hôpital Hôtel Dieu AP-HP, Paris, France
| | | | - Tabassome Simon
- French Alliance for Cardiovascular Trials (FACT), Paris, France,Department of Clinical Pharmacology, Hôpital Saint Antoine AP-HP, Paris, France,Université Pierre et Marie Curie (UPMC), Paris, France
| | - Gabriel Steg
- French Alliance for Cardiovascular Trials (FACT), Paris, France,Université Paris-Diderot, Sorbonne Paris Cité, Paris, France,Hôpital Bichat – Claude Bernard AP-HP, Paris,France
| | - Gilles Montalescot
- ACTION Groupe, Institut de Cardiologie (AP-HP) and INSERM UMRS 1166, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Varenne
- Université de Paris, Paris, France,Department of Cardiology, Hôpital Cochin AP-HP, Paris, France
| | - Laurent Bonello
- Mediterranean Association for research and studies in cardiology (MARS CARDIO) and Centre for cardiovascular and nutrition research, INSERM 1263, INRA 1260, Marseille, France,Cardiology Department, Hôpital Nord, Marseille, France
| | - Pierre Coste
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Nicolas Delarche
- Department of Cardiology, Centre Hospitalier de Pau, Pau, France
| | - Jean-Louis Georges
- Cardiology Department, Centre Hospitalier de Versailles, Le Chesnay-Rocquencourt, France
| | | | - Vincent Letocart
- Department of Cardiology, Thorax Institute, Nantes University Hospital, Nantes, France
| | - Gilles Chatellier
- Clinical Research Unit and CIC 1418 INSERM, Hôpital Européen Georges Pompidou AP-HP, Paris, France
| | - Nicolas Danchin
- Department of Cardiology, Hôpital Européen Georges Pompidou AP-HP, Paris, France,Université de Paris, Paris, France,French Alliance for Cardiovascular Trials (FACT), Paris, France
| | - Isabelle Durand-Zaleski
- Clinical Research Unit Eco Ile de France, Hôpital Hôtel Dieu AP-HP, Paris, France,Université de Paris Est Creteil (UPEC), Créteil, France
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Beygui F, Roule V, Ivanes F, Dechery T, Bizeau O, Roussel L, Dequenne P, Arnould MA, Combaret N, Collet JP, Commeau P, Cayla G, Montalescot G, Benamer H, Motreff P, Angoulvant D, Marcollet P, Chassaing S, Blanchart K, Koning R, Rangé G. Indirect Transfer to Catheterization Laboratory for ST Elevation Myocardial Infarction Is Associated With Mortality Independent of System Delays: Insights From the France-PCI Registry. Front Cardiovasc Med 2022; 9:793067. [PMID: 35360033 PMCID: PMC8962625 DOI: 10.3389/fcvm.2022.793067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFirst medical contact (FMC)-to-balloon time is associated with outcome of ST-elevation myocardial infarction (STEMI). We assessed the impact on mortality and the determinants of indirect vs. direct transfer to the cardiac catheterization laboratory (CCL).MethodsWe analyzed data from 2,206 STEMI patients consecutively included in a prospective multiregional percutaneous coronary intervention (PCI) registry. The primary endpoint was 1-year mortality. The impact of indirect admission to CCL on mortality was assessed using Cox models adjusted on FMC-to-balloon time and covariables unequally distributed between groups. A multivariable logistic regression model assessed determinants of indirect transfer.ResultsA total of 359 (16.3%) and 1847 (83.7%) were indirectly and directly admitted for PCI. Indirect admission was associated with higher risk features, different FMCs and suboptimal pre-PCI antithrombotic therapy.At 1-year follow-up, 51 (14.6%) and 137 (7.7%) were dead in the indirect and direct admission groups, respectively (adjusted-HR 1.73; 95% CI 1.22–2.45). The association of indirect admission with mortality was independent of pre-FMC and FMC characteristics. Older age, paramedics- and private physician-FMCs were independent determinants of indirect admission (adjusted-HRs 1.02 per year, 95% CI 1.003–1.03; 5.94, 95% CI 5.94 3.89–9.01; 3.41; 95% CI 1.86–6.2, respectively).ConclusionsOur study showed that, indirect admission to PCI for STEMI is associated with 1-year mortality independent of FMC to balloon time and should be considered as an indicator of quality of care. Indirect admission is associated with higher-risk features and suboptimal antithrombotic therapy. Older age, paramedics-FMC and self-presentation to a private physician were independently associated with indirect admission. Our study, supports population education especially targeting elderly, more adequately dispatched FMC and improved pre-CCL management.
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Affiliation(s)
- Farzin Beygui
- Cardiology Department, CHU de Caen, Caen, France
- *Correspondence: Farzin Beygui
| | | | | | - Thierry Dechery
- Cardiology Department, Center Hospitalier de Bourges, Bourges, France
| | | | - Laurent Roussel
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
| | | | - Marc-Antoine Arnould
- Cardiology Department, Nouvelle clinique Tourangelle, Saint-Cyr-sur-Loire, France
| | - Nicolas Combaret
- Cardiology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Philippe Commeau
- Cardiology Department, Polyclinique les fleurs, Ollioules, France
| | | | - Gilles Montalescot
- Cardiology Department, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, Aubervilliers, France
| | - Pascal Motreff
- Cardiology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Pierre Marcollet
- Cardiology Department, Center Hospitalier de Bourges, Bourges, France
| | - Stephan Chassaing
- Cardiology Department, Nouvelle clinique Tourangelle, Saint-Cyr-sur-Loire, France
| | | | - René Koning
- Cardiology Department, Clinique Saint Hilaire, Saint Hilaire, France
| | - Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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7
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Beygui F, Ivanes F, Roule V, Dechery T, Roussel L, Dequenne P, Arnould MA, Combaret N, Collet JP, Commeau P, Cayla G, Montalescot G, Benamer H, Motreff P, Angoulvant D, Marcollet P, Chassaing S, Blanchart K, Koning R, Range G. INDIRECT TRANSFER TO CATHETERIZATION LABORATORY FOR ST ELEVATION MYOCARDIAL INFARCTION IS ASSOCIATED WITH MORTALITY INDEPENDENT OF SYSTEM DELAYS: INSIGHTS FROM THE FRANCE-PCI REGISTRY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02088-5] [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: 10/18/2022]
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8
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Bensaid R, Georges JL, Angoulvant D, Chassaing S, Deballon R, Marcollet P, Albert F, Fichaux O, Bar O, Rangé G. INCREASED EXPOSURE TO X-RAYS DURING CORONARY ANGIOGRAPHY AND PERCUTANEOUS CORONARY INTERVENTIONS ASSOCIATED WITH FRACTIONAL FLOW RESERVE MEASUREMENT AND ENDOCORONARY IMAGING TECHNIQUES. Radiat Prot Dosimetry 2021; 194:18-26. [PMID: 33954788 DOI: 10.1093/rpd/ncab065] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
Growing use of fractional flow reserve (FFR) and intracoronary imaging techniques by optical coherence tomography or intravascular ultrasound has raised concerns about additional exposure during coronary angiography and percutaneous coronary interventions (PCIs). Using data from the prospective CRAC-France PCI Prospective Multicentre registry, we sought to evaluate the effect of these new techniques on the radiation dose to patients undergoing coronary procedures. Data on Kerma Area Product (PKA), total air kerma (KAr) and fluoroscopy time from 42 182 coronary procedures were retrospectively compared, using multivariable linear regression, according to whether they included FFR and intracoronary imaging. In coronary angiography, FFR was associated with longer fluoroscopy time and higher PKA (21.0 vs. 18.9 Gy.cm2) and KAr (372 vs. 299 mGy) (all p < 0.001). Intracoronary imaging was associated with longer fluoroscopy time, higher contrast volume (both p < 0.001), lower PKA (18.3 vs. 19.0 Gy.cm2, p = 0.02) and similar KAr. In PCI, FFR was associated with a moderate increase in KAr (682 vs. 626 mGy, p < 0.01) but not PKA (35.9 vs. 33.7 Gy.cm2, p = 0.34). For intracoronary imaging, there were no differences between groups, except for contrast volume. Increased patient exposure associated with FFR and intracoronary imaging is moderate in diagnostic coronary angiography and minimal or none in PCI, provided optimization techniques are used. It should not be a limitation on the use of these techniques given the important additional information they provide.
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Affiliation(s)
- Réda Bensaid
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Le Coudray, France
| | - Jean-Louis Georges
- Cardiology Department, Centre Hospitalier de Versailles, 78150 Le Chesnay-Rocquencourt, France
| | - Denis Angoulvant
- Cardiology Department, Centre Hospitalo-Universitaire de Tours, and Tours University, 37000 Tours, France
| | - Stephan Chassaing
- Cardiology Department, Centre Hospitalier Régional d'Orléans, 45100 Orléans, France
| | - Ronan Deballon
- Cardiology Department, Clinique Oréliance, 45770 Saran, France
| | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier de Bourges, 18000 Bourges, France
| | - Franck Albert
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Le Coudray, France
| | - Olivier Fichaux
- Cardiology Department, Centre Hospitalier Régional d'Orléans, 45100 Orléans, France
| | - Olivier Bar
- Cardiology Department, Nouvelle clinique Tourengelle, 37000 Tours, France
| | - Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Le Coudray, France
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9
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Puymirat E, Nakache A, Saint Etienne C, Marcollet P, Fichaux O, Decomis MP, Chassaing S, Commeau P, Danchin N, Cayla G, Montalescot G, Benamer H, Koning R, Motreff P, Rangé G. Is coronary multivessel disease in acute myocardial infarction patients still associated with worse clinical outcomes at 1-year? Clin Cardiol 2021; 44:429-437. [PMID: 33586188 PMCID: PMC7943894 DOI: 10.1002/clc.23567] [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: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background ST‐elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) are associated with a worse prognosis. However, few comparisons are available according to coronary status in the era of modern reperfusion and optimized secondary prevention. Hypothesis We hypothesized that the difference in prognosis according to number of vessel disease in STEMI patients has reduced. Methods All consecutive STEMI patients undergoing primary percutaneous coronary intervention (PCI) within 24 h of symptoms onset between January 1, 2014 and June 30, 2016 enrolled in the CRAC (Club Régional des Angioplasticiens de la région Centre) France PCI registry were analyzed. Baseline characteristics, management, and outcomes at 1‐year were analyzed according to coronary status (one‐, two‐, and three‐VD). Results A total of 1886 patients (mean age 62.2 ± 14.0 year; 74% of male) were included. Patients with MVD (two or three‐VD) represented 53.7%. They were older with higher cardiovascular risk factor profile. At 1 year, the rate of major adverse cardiovascular events (MACE, defined as all‐cause death, stroke or re‐MI) was 10%, 12%, and 12% in one‐, two, and three‐VD respectively (p = .28). In multivariable adjusted Cox proportional hazard regression model, two‐ and three‐VD were not associated with higher rate of MACE compared to patients with single VD (HR, 1.09; 95%CI 0.76–1.56 for two‐VD; HR, 0.74; 95%CI 0.48–1.14 for three‐VD). Conclusions MVD still represents an important proportion of STEMI patients but their prognoses were not associated with worse clinical outcomes at 1‐year compared with one‐VD patients in a modern reperfusion area and secondary medication prevention.
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Affiliation(s)
- Etienne Puymirat
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | - Ariel Nakache
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | | | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier de Bourges, Bourges, France
| | - Olivier Fichaux
- Cardiology Department, Centre Hospitalo-régional d'Orléans, Orléans, France
| | | | | | - Philippe Commeau
- Cardiology Department, Polyclinique les Fleurs, Ollioules, France
| | - Nicolas Danchin
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | - Guillaume Cayla
- Cardiology Department, CHU Nîmes, Université Montpellier, Nîmes, France
| | - Gilles Montalescot
- Cardiology Department, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie; ICPS Massy Ramsay group, Paris 13, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, Rouen, France
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont Ferrand, France
| | - Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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10
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Hakim R, Revue E, Saint Etienne C, Marcollet P, Chassaing S, Decomis MP, Yafi W, Laure C, Gautier S, Godillon L, Akkoyun-Farinez J, Angoulvant D, Koning R, Motreff P, Grammatico-Guillon L, Rangé G. Does helicopter transport delay prehospital transfer for STEMI patients in rural areas? Findings from the CRAC France PCI registry. European Heart Journal. Acute Cardiovascular Care 2020; 9:958-965. [DOI: 10.1177/2048872619848976] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims:
The aim of this study was to analyse delays in emergency medical system transfer of ST-segment elevation myocardial infarction (STEMI) patients to percutaneous coronary intervention (PCI) centres according to transport modality in a rural French region.
Methods and results:
Data from the prospective multicentre CRAC / France PCI registry were analysed for 1911 STEMI patients: 410 transferred by helicopter and 1501 by ground transport. The primary endpoint was the percentage of transfers with first medical contact to primary percutaneous coronary intervention within the 90 minutes recommended in guidelines. The secondary endpoint was time of first medical contact to primary percutaneous coronary intervention. With helicopter transport, time of first medical contact to primary percutaneous coronary intervention in under 90 minutes was less frequently achieved than with ground transport (9.8% vs. 37.2%; odds ratio 5.49; 95% confidence interval 3.90; 7.73; P<0.0001). Differences were greatest for transfers under 50 km (13.7% vs. 44.7%; P<0.0001) and for primary transfers (22.4% vs. 49.6%; P<0.0001). The median time from first medical contact to primary percutaneous coronary intervention and from symptom onset to primary percutaneous coronary intervention (total ischaemic time) were significantly higher in the helicopter transport group than in the ground transport group (respectively, 137 vs. 103 minutes; P<0.0001 and 261 vs. 195 minutes; P<0.0001). There was no significant difference in inhospital mortality between the helicopter and ground transport groups (6.9% vs. 6.6%; P=0.88).
Conclusions:
Helicopter transport of STEMI patients was five times less effective than ground transport in maintaining the 90-minute first medical contact to primary percutaneous coronary intervention time recommended in guidelines, particularly for transfer distances less than 50 km.
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Affiliation(s)
- Radwan Hakim
- Cardiology Department, Les Hôpitaux de Chartres, France
| | - Eric Revue
- Emergency Unit Department, Les Hôpitaux de Chartres, France
| | | | | | | | | | - Wael Yafi
- Cardiology Department, Centre Hospitalo-régional de Orléans, France
| | | | | | | | | | - Denis Angoulvant
- Cardiology Department, Centre Hospitalo-Universitaire de Tours, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, France
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalo-Universitaire de Clermont-Ferrand, France
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11
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Gerbaud E, Arabucki F, Nivet H, Barbey C, Cetran L, Chassaing S, Seguy B, Lesimple A, Cochet H, Montaudon M, Laurent F, Bar O, Tearney GJ, Coste P. OCT and CMR for the Diagnosis of Patients Presenting With MINOCA and Suspected Epicardial Causes. JACC Cardiovasc Imaging 2020; 13:2619-2631. [PMID: 32828786 DOI: 10.1016/j.jcmg.2020.05.045] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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: 02/13/2020] [Revised: 04/07/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Among all patients presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA), epicardial causes may be suspected when there is a correlation between electrocardiogram (ECG) changes and regional wall motion abnormalities (WMAs). We evaluated the diagnostic yield of intravascular optical coherence tomography (OCT) and cardiac magnetic resonance (CMR) in this specific setting. BACKGROUND OCT is able to identify different morphologic features of coronary plaques that are well known causes of MINOCA. Furthermore, CMR has become the gold standard for detection of myocardial infarction in the setting of MINOCA. METHODS In a prospective 2-center study, consecutive patients with MINOCA including ECG features of ischemia associated with corresponding WMAs underwent OCT and CMR. RESULTS Forty patients (mean age: 50 ± 11 years, 62.5% male, 32.5% with ST-segment elevation) were enrolled. Coronary arteries were normal on coronary angiography in 10 patients (25%); 18 patients (45%) presented minimal lumen irregularities, whereas the remaining 12 patients (30%) showed mild to moderate (≥30% but <50%) coronary lesions. Plaque rupture, eruptive calcific nodule, plaque erosion, lone thrombus, and spontaneous coronary artery dissection were found in 14 (35%), 1 (2.5%), 12 (30%), 3 (7.5%), and 2 (5%) patients, respectively. Acute myocardial infarction was evident at CMR in 31 of 40 patients (77.5%). Twenty-three patients (57.5%) had a substrate and/or diagnosis supported by both techniques with an evident relationship between the findings obtained by the 2 techniques. By coupling OCT with CMR, a substrate and/or diagnosis was found in 100% of cases. CONCLUSIONS OCT coupled with CMR can provide a clear substrate and/or diagnosis in the vast majority of patients presenting with MINOCA including ECG features of ischemia associated with corresponding WMAs.
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Affiliation(s)
- Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France.
| | - Fabien Arabucki
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Hubert Nivet
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Christophe Barbey
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Laura Cetran
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Stephan Chassaing
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Benjamin Seguy
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Arnaud Lesimple
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Hubert Cochet
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Michel Montaudon
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - François Laurent
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Olivier Bar
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA
| | - Pierre Coste
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France
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12
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Durand E, Sokoloff A, Urena-Alcazar M, Chevalier B, Chassaing S, Didier R, Tron C, Litzler PY, Bouleti C, Himbert D, Hovasse T, Bar O, Avinée G, Iung B, Blanchard D, Gilard M, Cribier A, Lefevre T, Eltchaninoff H. Assessment of Long-Term Structural Deterioration of Transcatheter Aortic Bioprosthetic Valves Using the New European Definition. Circ Cardiovasc Interv 2020; 12:e007597. [PMID: 30998397 DOI: 10.1161/circinterventions.118.007597] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND The durability of transcatheter aortic bioprosthetic valves is a crucial issue, but data are scarce, especially beyond 5 years of follow-up. We aimed to assess long-term (7 years) structural valve deterioration (SVD) and bioprosthetic valve failure of transcatheter aortic bioprosthetic valves. METHODS AND RESULTS Consecutive patients with at least 5-year follow-up available undergoing transcatheter aortic valve implantation from April 2002 to December 2011 in 5 French centers were included. Incidence of SVD and bioprosthetic valve failure were defined according to newly standardized criteria of the European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio-Thoracic Surgery and reported as cumulative incidence function to account for the competing risk of death. One thousand four hundred three consecutive patients were included with a mean age of 82.6±7.5 years and with a mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) of 21.3±7.5%. A balloon-expandable valve was used in 83.7% of cases. Survival rates were 83.5% (95% CI, 81.4%-85.5%) and 18.6% (95% CI, 15.3%-21.8%) at 1 and 7 years, respectively. Median duration of follow-up was 3.9 years. Bioprosthetic valve failure occurred in 19 patients with a 7-year cumulative incidence of 1.9% (95% CI, 1.4%-2.4%). SVD occurred in 49 patients (moderate, n=32; severe, n=17) with a 7-year cumulative incidence of moderate and severe SVD of 7.0% (95% CI, 5.6%-8.4%) and 4.2% (95% CI, 2.9%-5.5%), respectively. Five patients had aortic valve reintervention (1.0%; 95% CI, 0.4%-1.6%) including 1 case of surgical aortic valve replacement and 4 redo-transcatheter aortic valve implantation. The incidences of SVD and bioprosthetic valve failure were not significantly different between balloon and self-expandable prostheses. CONCLUSIONS The long-term assessment of transcatheter aortic bioprosthetic valves durability is limited by the poor survival of our population beyond 5 years. Further studies are warranted, particularly in younger and lower-risk patients.
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Affiliation(s)
- Eric Durand
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Anastasia Sokoloff
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Marina Urena-Alcazar
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Faculté de Médecine Paris-Diderot University, Department of Cardiology, DHU Fire, INSERM U1148, Paris-Diderot University Paris, France (M.U.-A., C.B., D.H., B.I.)
| | - Bernard Chevalier
- Institut Hospitalier Jacques Cartier, Ramsay Générale de Santé, Department of Cardiology, Massy, France (B.C., T.H., T.L.)
| | - Stephan Chassaing
- Clinique Saint Gatien, Department of Cardiology, Tours, France (S.C., O.B., D.B.)
| | - Romain Didier
- Brest University Hospital, Department of Cardiology, France (R.D., M.G.)
| | - Christophe Tron
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Pierre-Yves Litzler
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Claire Bouleti
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Faculté de Médecine Paris-Diderot University, Department of Cardiology, DHU Fire, INSERM U1148, Paris-Diderot University Paris, France (M.U.-A., C.B., D.H., B.I.)
| | - Dominique Himbert
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Faculté de Médecine Paris-Diderot University, Department of Cardiology, DHU Fire, INSERM U1148, Paris-Diderot University Paris, France (M.U.-A., C.B., D.H., B.I.)
| | - Thomas Hovasse
- Institut Hospitalier Jacques Cartier, Ramsay Générale de Santé, Department of Cardiology, Massy, France (B.C., T.H., T.L.)
| | - Olivier Bar
- Clinique Saint Gatien, Department of Cardiology, Tours, France (S.C., O.B., D.B.)
| | - Guillaume Avinée
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Bernard Iung
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Faculté de Médecine Paris-Diderot University, Department of Cardiology, DHU Fire, INSERM U1148, Paris-Diderot University Paris, France (M.U.-A., C.B., D.H., B.I.)
| | - Didier Blanchard
- Clinique Saint Gatien, Department of Cardiology, Tours, France (S.C., O.B., D.B.)
| | - Martine Gilard
- Brest University Hospital, Department of Cardiology, France (R.D., M.G.)
| | - Alain Cribier
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
| | - Thierry Lefevre
- Institut Hospitalier Jacques Cartier, Ramsay Générale de Santé, Department of Cardiology, Massy, France (B.C., T.H., T.L.)
| | - Hélène Eltchaninoff
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, France (E.D., A.S., C.T., P.Y.L., G.A., A.C., H.E.)
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13
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Grammatico-Guillon L, Florent AM, Godillon L, Chassaing S, Laurent E, Rangé G. Devenir des infarctus du myocarde pris en charge en centre de cardiologie interventionnelle en Centre-Val-de-Loire : cohorte prospective régionale CRAC. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.023] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Hakim R, Revue E, Saint Etienne C, Marcollet P, Chassaing S, Decomis MP, Yafi W, Laure C, Gautier S, Godillon L, Akkoyun-Farinez J, Koning R, Motreff P, Grammatico-Guillon L, Range G. P1739Does helicopter transport delay prehospital transfer for STEMI patients in rural areas? Findings from the CRAC France PCI registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0493] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Whether helicopter transportation for ST-Elevation Myocardial Infarction (STEMI) patients in France is the faster alternative is not known. Data from United States and Europe are controversial and studies have been limited to small series of patients
Purpose
The aim of this study was to analyse delays in emergency medical system (EMS) transfer of STEMI patients from home to the nearest percutaneous coronary intervention (PCI) centre (primary transfer) or from non-PCI centres to PCI centres (secondary transfer) according to transport modalityin a rural French region.
Methods and results
Data from the prospective multicentre CRAC France PCI registrywere analysed for 1911 STEMI patients: 410 transferred by helicopter (HEMS) and 1501 by ground transport (GEMS). The primary endpoint was the percentage of transfers with first medical contact (FMC) to primary PCI (PPCI) within the 90-min recommended in guidelines. The secondary endpoint was time FMC–PPCI. With HEMS,FMC-PPCI <90 min was less frequently achieved than with GEMS (9.8% vs 37.2%; odds ratio 5.49; 95% confidence interval [3.90; 7.73]; p<0.0001). Differences were greatest for transfers <50 km (13.7% vs 44.7%; p<0.0001) and for primary transfers (22.4% vs 49.6%; p<0.0001). Median time from FMC to PPCI and from symptom onset to PPCI (total ischemic time) were significantly higher in HEMS group than in GEMS group (respectively 137 min vs 103 min; p<0.0001 and 261min vs 195 min; p<0,0001). There was no significant difference in in-hospital mortality between the HEMS and GEMS groups (6.9% vs 6.6%; p=0.88).
STEMI patients FMC-PPCI < 90 min
Conclusion
Helicopter transport of STEMI patients was 5 times less effective than ground transport in maintaining the 90-min FMC-PPCI time recommended in guidelines, particularly for transfer distances <50 km.
Acknowledgement/Funding
Regional health agency of CVL, Medtronic, Boston Scientific, Abbot, Biosensor, Terumo, Biotronik, Lilly Daichii Sankyo, Hexacath and Braun.
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Affiliation(s)
- R Hakim
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
| | - E Revue
- Hospital Louis Pasteur of Chartres, Emergency, Chartres, France
| | | | - P Marcollet
- Centre hospitalier de Bourges, Cardiology, BOURGES, France
| | - S Chassaing
- Clinique St Gatien, Cardiology, Tours, France
| | - M P Decomis
- Clinique ORELIANCE, Cardiology, ORLEANS, France
| | - W Yafi
- Centre hospitalier régional d'Orléans, Cardiology, ORLEANS, France
| | - C Laure
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
| | - S Gautier
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
| | - L Godillon
- Unité Régionale d'Epidémiologie Hospitalière (UREH), Epidemiology, TOURS, France
| | | | - R Koning
- Clinic Saint-Hilaire, Rouen, France
| | - P Motreff
- University Hospital Gabriel Montpied, Cardiology, Clermont-Ferrand, France
| | | | - G Range
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
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15
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Hakim R, Thuaire C, Saint-Etienne C, Marcollet P, Chassaing S, Dequenne P, Laure C, Gautier S, Akkoyun-Farinez J, Motreff P, Rangé G. [Non-ST elevation acute coronary syndrome: CRAC register experience]. Ann Cardiol Angeiol (Paris) 2018; 67:422-428. [PMID: 30391012 DOI: 10.1016/j.ancard.2018.09.016] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the clinical, angiographic, therapeutic and prognostic characteristics of nonagenarians presenting with non-ST elevation acute coronary syndrome with those of patients under 90 years of age. METHODS We used the CRAC register database including 6 catheterization laboratories in the Center Val-de-Loire region. Only patients with positive-troponin non-ST elevation ACS included in the registry from 2014 to 2017 were selected for epidemiological and procedural data. Regarding antiplatelet therapy, hospital and one-year follow-up data, only patients in the 2014-2015 period were analyzed. RESULTS From January 1st, 2014 to December 31st, 2017, 5.964 patients with a positive-troponin non-ST ACS, including 133 nonagenarians (2.2%) were included in the CRAC registry. Arterial hypertension and the history of coronary angioplasty were more common among nonagenarians. They present more multivessel and left main disease. The use of the bare metal stent was predominant in 2014-2015 and then became marginal in 2016-2017. Clopidogrel was the most widely used anti platelet and more than one in two nonagenarians remain on dual therapy after 12 months. One-year stroke and hospital and one-year mortality were higher in this age group. CONCLUSIONS Nonagenarians with a positive-troponin non-ST elevation ACS have more severe coronary artery disease and a poorer prognosis than those younger than 90 years of age.
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Affiliation(s)
- R Hakim
- Service de cardiologie, les hôpitaux de Chartres, Chartres, France
| | - C Thuaire
- Service de cardiologie, les hôpitaux de Chartres, Chartres, France
| | - C Saint-Etienne
- Service de cardiologie, centre hospitalo universitaire de Tours, 37170 Tours, France
| | - P Marcollet
- Service de cardiologie, centre hospitalier de Bourges, 18000 Bourges, France
| | - S Chassaing
- Service de cardiologie, clinique Saint-Gatien, 37000 Tours, France
| | - P Dequenne
- Service de cardiologie, clinique Oréliance, 45770 Saran, France
| | - C Laure
- Service de cardiologie, les hôpitaux de Chartres, Chartres, France
| | - S Gautier
- Service de cardiologie, les hôpitaux de Chartres, Chartres, France
| | | | - P Motreff
- Service de cardiologie, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - G Rangé
- Service de cardiologie, les hôpitaux de Chartres, Chartres, France.
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Sokoloff A, Durand E, Urena-Alcazar M, Chevalier B, Chassaing S, Didier R, Litzler PY, Himbert D, Hovasse T, Bar O, Iung B, Blanchard D, Gilard M, Lefevre T, Eltchaninoff H. 3071Assessment of long-term structural deterioration of transcatheter aortic bioprosthetic valves using standardized new european definitions, a multicenter study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3071] [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: 11/13/2022] Open
Affiliation(s)
- A Sokoloff
- University Hospital of Rouen, Department of Cardiology, Rouen, France
| | - E Durand
- University Hospital of Rouen, Department of Cardiology, Rouen, France
| | - M Urena-Alcazar
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - B Chevalier
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - S Chassaing
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - R Didier
- University Hospital of Brest, Department of Cardiology, Brest, France
| | - P Y Litzler
- University Hospital of Rouen, Department of Cardiac Surgery, Rouen, France
| | - D Himbert
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - T Hovasse
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - O Bar
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - B Iung
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - D Blanchard
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - M Gilard
- University Hospital of Brest, Department of Cardiology, Brest, France
| | - T Lefevre
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - H Eltchaninoff
- University Hospital of Rouen, Department of Cardiology, Rouen, France
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17
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Helleu B, Auffret V, Bedossa M, Gilard M, Letocart V, Chassaing S, Angoulvant D, Commeau P, Range G, Prunier F, Sabatier R, Filippi E, Delaunay R, Boulmier D, Le Breton H, Leurent G. Current indications for the intra-aortic balloon pump: The CP-GARO registry. Arch Cardiovasc Dis 2018; 111:739-748. [PMID: 29908713 DOI: 10.1016/j.acvd.2018.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/22/2017] [Revised: 02/08/2018] [Accepted: 03/21/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. AIMS The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. METHODS This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. RESULTS A total of 172 patients were included (mean age 65.5±12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n=107; 62.2%), followed by bridge to revascularization (n=34; 19.8%) and four other "rare" aetiologies (n=29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). CONCLUSIONS Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.
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Affiliation(s)
- Benoit Helleu
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Vincent Auffret
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Marc Bedossa
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Martine Gilard
- EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France
| | - Vincent Letocart
- L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Stephan Chassaing
- Service de cardiologie interventionnelle et d'imagerie cardiaque, clinique Saint-Gatien, 37000 Tours, France
| | - Denis Angoulvant
- EA 4245 and Loire Valley Cardiovascular Collaboration, Service de Cardiologie, CHRU de Tours et Université de Tours, 37000 Tours, France
| | - Philippe Commeau
- Service de cardiologie, polyclinique les Fleurs, 83190 Ollioules, France
| | - Grégoire Range
- Service de cardiologie, Les hôpitaux de Chartres, 28000 Chartres, France
| | - Fabrice Prunier
- Institut Mitovasc, UMR CNRS 6015 - INSERM U1083, Service de cardiologie, CHU d'Angers, Université d'Angers, 49100 Angers, France
| | - Remi Sabatier
- Cardiology Department, University Hospital of Caen, 14033 Caen, France
| | - Emmanuelle Filippi
- Service de cardiologie, centre hospitalier de Vannes, 56000 Vannes, France
| | - Régis Delaunay
- Service de cardiologie, centre hospitalier de Saint-Brieuc, 22000 Saint-Brieuc, France
| | - Dominique Boulmier
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Hervé Le Breton
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Guillaume Leurent
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France.
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Rangé G, Chassaing S, Marcollet P, Saint-Étienne C, Dequenne P, Goralski M, Bardiére P, Beverilli F, Godillon L, Sabine B, Laure C, Gautier S, Hakim R, Albert F, Angoulvant D, Grammatico-Guillon L. The CRAC cohort model: A computerized low cost registry of interventional cardiology with daily update and long-term follow-up. Rev Epidemiol Sante Publique 2018; 66:209-216. [DOI: 10.1016/j.respe.2018.01.135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/10/2018] [Accepted: 01/17/2018] [Indexed: 12/25/2022] Open
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Corré J, Chassaing S, Lepage O, Blanchard D. A strange nature of right ventricular tumour: the first case report of osseous metaplasia in the heart. Eur Heart J Cardiovasc Imaging 2017; 18:1069. [PMID: 28444159 DOI: 10.1093/ehjci/jex098] [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: 11/14/2022] Open
Affiliation(s)
- Jérôme Corré
- Service de cardiologie interventionnelle et d'imagerie cardiaque, Clinique Saint Gatien, 8 place de la cathédrale, 37000 Tours, France
| | - Stephan Chassaing
- Service de cardiologie interventionnelle et d'imagerie cardiaque, Clinique Saint Gatien, 8 place de la cathédrale, 37000 Tours, France
| | - Olivier Lepage
- Service de chirurgie cardiaque Clinique Saint Gatien, Tours, France
| | - Didier Blanchard
- Service de cardiologie interventionnelle et d'imagerie cardiaque, Clinique Saint Gatien, 8 place de la cathédrale, 37000 Tours, France
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20
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Chassaing S, Chaabouni S, Pinkerton N, Abid S, Galaup C. Photochemistry of ortho-Azidocinnamoyl Derivatives: Facile and Modular Synthesis of 2-Acylated Indoles and 2-Substituted Quinolines under Solvent Control. Synlett 2017. [DOI: 10.1055/s-0036-1590861] [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] [Indexed: 10/19/2022]
Abstract
The light-promoted potential of ortho-azidocinnamoyl compounds is evaluated for heterocycle synthesis. Depending on the nature of the solvent, 2-acylated indoles were obtained under aprotic conditions, whereas the use of a protic medium led to 2-substituted quinolines. The synthetic significance of this metal-free method is that, by simply changing the solvent, the reaction outcome can be directed towards different key heterocyclic scaffolds.
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Affiliation(s)
- S. Chassaing
- Institut des Technologies Avancées en Sciences du Vivant (ITAV), Université de Toulouse, CNRS, UPS
| | - S. Chaabouni
- Institut des Technologies Avancées en Sciences du Vivant (ITAV), Université de Toulouse, CNRS, UPS
- Laboratoire de Chimie Appliquée: HGP, Université de Sfax, Faculté des Sciences
- Laboratoire de Synthèse et Physicochimie de Molécules d’Intérêt Biologique (SPCMIB), CNRS-UMR5068, Université Paul Sabatier-Toulouse III
| | - N. Pinkerton
- Institut des Technologies Avancées en Sciences du Vivant (ITAV), Université de Toulouse, CNRS, UPS
| | - S. Abid
- Laboratoire de Chimie Appliquée: HGP, Université de Sfax, Faculté des Sciences
| | - C. Galaup
- Laboratoire de Synthèse et Physicochimie de Molécules d’Intérêt Biologique (SPCMIB), CNRS-UMR5068, Université Paul Sabatier-Toulouse III
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21
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Didier R, Blanchard D, Puymirat E, Chassaing S, Bar O, Barbey C, Iung B, Fajadet J, Leprince P, Leguerrier A, Lievre M, Prat A, Teiger A, Eltchaninoff H, Gilard M. P458Impact of Coronary Artery Disease in Patients Undergoing Transcatheter aortic Valve Replacement: Inside The FRANCE-2 Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p458] [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: 11/12/2022] Open
Affiliation(s)
- R. Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - D. Blanchard
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - E. Puymirat
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - S. Chassaing
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - O. Bar
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - C. Barbey
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - B. Iung
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - J. Fajadet
- Clinic Pasteur of Toulouse, Toulouse, France
| | - P. Leprince
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | | | - M. Lievre
- University Claude Bernard of Lyon, Lyon, France
| | | | - A. Teiger
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | | | - M. Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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22
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Auffret V, Lefevre T, Van Belle E, Eltchaninoff H, Iung B, Koning R, Motreff P, Leprince P, Verhoye JP, Manigold T, Souteyrand G, Boulmier D, Joly P, Pinaud F, Himbert D, Collet JP, Rioufol G, Ghostine S, Bar O, Dibie A, Champagnac D, Leroux L, Collet F, Teiger E, Darremont O, Folliguet T, Leclercq F, Lhermusier T, Olhmann P, Huret B, Lorgis L, Drogoul L, Bertrand B, Spaulding C, Quilliet L, Cuisset T, Delomez M, Beygui F, Claudel JP, Hepp A, Jegou A, Gommeaux A, Mirode A, Christiaens L, Christophe C, Cassat C, Metz D, Mangin L, Isaaz K, Jacquemin L, Guyon P, Pouillot C, Makowski S, Bataille V, Rodés-Cabau J, Gilard M, Le Breton H, Le Breton H, Eltchaninoff H, Gilard M, Iung B, Le Breton H, Lefevre T, Van Belle E, Laskar M, Leprince P, Iung B, Bataille V, Chevalier B, Garot P, Hovasse T, Lefevre T, Donzeau Gouge P, Farge A, Romano M, Cormier B, Bouvier E, Bauchart JJ, Bodart JC, Delhaye C, Houpe D, Lallemant R, Leroy F, Sudre A, Van Belle E, Juthier F, Koussa M, Modine T, Rousse N, Auffray JL, Richardson M, Berland J, Eltchaninoff H, Godin M, Koning R, Bessou JP, Letocart V, Manigold T, Roussel JC, Jaafar P, Combaret N, Souteyrand G, D’Ostrevy N, Innorta A, Clerfond G, Vorilhon C, Auffret V, Bedossa M, Boulmier D, Le Breton H, Leurent G, Anselmi A, Harmouche M, Verhoye JP, Donal E, Bille J, Joly P, Houel R, Vilette B, Abi Khalil W, Delepine S, Fouquet O, Pinaud F, Rouleau F, Abtan J, Himbert D, Urena M, Alkhoder S, Ghodbane W, Arangalage D, Brochet E, Goublaire C, Barthelemy O, Choussat R, Collet JP, Lebreton G, Leprince P, Mastrioanni C, Isnard R, Dauphin R, Dubreuil O, Durand De Gevigney G, Finet G, Harbaoui B, Ranc S, Rioufol G, Farhat F, Jegaden O, Obadia JF, Pozzi M, Ghostine S, Brenot P, Fradi S, Azmoun A, Deleuze P, Kloeckner M, Bar O, Blanchard D, Barbey C, Chassaing S, Chatel D, Le Page O, Tauran A, Bruere D, Bodson L, Meurisse Y, Seemann A, Amabile N, Caussin C, Dibie A, Elhaddad S, Drieu L, Ohanessian A, Philippe F, Veugeois A, Debauchez M, Zannis K, Czitrom D, Diakov C, Raoux F, Champagnac D, Lienhart Y, Staat P, Zouaghi O, Doisy V, Frieh JP, Wautot F, Dementhon J, Garrier O, Jamal F, Leroux PY, Casassus F, Leroux L, Seguy B, Barandon L, Labrousse L, Peltan J, Cornolle C, Dijos M, Lafitte S, Bayet G, Charmasson C, Collet F, Vaillant A, Vicat J, Giacomoni MP, Teiger E, Bergoend E, Zerbib C, Darremont O, Louis Leymarie J, Clerc P, Choukroun E, Elia N, Grimaud JP, Guibaud JP, Wroblewski S, Abergel E, Bogino E, Chauvel C, Dehant P, Simon M, Angioi M, Lemoine J, Lemoine S, Popovic B, Folliguet T, Maureira P, Huttin O, Selton Suty C, Cayla G, Delseny D, Leclercq F, Levy G, Macia JC, Maupas E, Piot C, Rivalland F, Robert G, Schmutz L, Targosz F, Albat B, Dubar A, Durrleman N, Gandet T, Munos E, Cade S, Cransac F, Bouisset F, Lhermusier T, Grunenwald E, Marcheix B, Fournier P, Morel O, Ohlmann P, Kindo M, Hoang MT, Petit H, Samet H, Trinh A, Huret B, Lecoq G, Morelle JF, Richard P, Derieux T, Monier E, Joret C, Lorgis L, Bouchot O, Eicher JC, Drogoul L, Meyer P, Lopez S, Tapia M, Teboul J, Elbeze JP, Mihoubi A, Bertrand B, Vanzetto G, Wittenberg O, Bach V, Martin C, Sauier C, Casset C, Castellant P, Gilard M, Bezon E, Choplain JN, Kallifa A, Nasr B, Jobic Y, Blanchard D, Lafont A, Pagny JY, Spaulding C, Abi Akar R, Fabiani JN, Zegdi R, Berrebi A, Puscas T, Desveaux B, Ivanes F, Quilliet L, Saint Etienne C, Bourguignon T, Aupy B, Perault R, Bonnet JL, Cuisset T, Lambert M, Grisoli D, Jaussaud N, Salaun E, Delomez M, Laghzaoui A, Savoye C, Beygui F, Bignon M, Roule V, Sabatier R, Ivascau C, Saplacan V, Saloux E, Bouchayer D, Claudel JP, Tremeau G, Diab C, Lapeze J, Pelissier F, Sassard T, Matz C, Monsarrat N, Carel I, Hepp A, Sibellas F, Curtil A, Dambrin G, Favereau X, Jegou A, Ghorayeb G, Guesnier L, Khoury W, Kucharski C, Pouzet B, Vaislic C, Cheikh-Khelifa R, Hilpert L, Maribas P, Gommeaux A, Hannebicque G, Hochart P, Paris M, Pecheux M, Fabre O, Guesnier L, Leborgne L, Mirode A, Peltier M, Trojette F, Carmi D, Tribouilloy C, Christiaens L, Mergy J, Corbi P, Raud Raynier P, Carillo S, Christophe C, Hueber A, Moulin F, Pinelli G, Cassat C, Darodes N, Pesteil F, Metz D, Aludaat C, Torossian F, Belle L, Mangin L, Chavanis N, Akret C, Cerisier A, Isaaz K, Favre JP, Fuzellier JF, Pierrard R, Jacquemin L, Roth O, Wiedemann JY, Bischoff N, Gavra G, Bourrely N, Digne F, Guyon P, Najjari M, Stratiev V, Bonnet N, Mesnildrey P, Attias D, Dreyfus J, Karila Cohen D, Laperche T, Nahum J, Scheuble A, Pouillot C, Rambaud G, Brauberger E, Ah Hot M, Allouch P, Beverelli F, Makowski S, Rosencher J, Aubert S, Grinda JM, Waldman T. Temporal Trends in Transcatheter Aortic Valve Replacement in France. J Am Coll Cardiol 2017; 70:42-55. [DOI: 10.1016/j.jacc.2017.04.053] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 04/05/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
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Corré J, Chassaing S, Blanchard D. An unusual cause of cardiogenic shock: Left atrial compression by a spontaneous rupture of an aneurysm of the descending thoracic aorta. J Cardiol Cases 2017; 15:153-154. [PMID: 30279765 DOI: 10.1016/j.jccase.2016.12.009] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/20/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022] Open
Abstract
A 77-year-old woman presented with a feverish hemodynamic collapse, acute respiratory distress, and dorsal pain, initially treated as a septic shock. Transthoracic echocardiogram revealed an impressive compression of the left atrial cavity, by an extrinsic mass preventing the left ventricle from refilling. Thoracic computed tomography revealed a large hemomediastinum emerging from an aneurysm of the descending thoracic aorta compressing the left atrium. The patient died in refractory cardiogenic collapse. <Learning objective: In the management of cardiovascular collapse, the understanding of the mechanism or the cause is essential. For this purpose, echocardiogram is a fast and indispensable tool, sometimes allowing discovering surprising etiology.>.
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Affiliation(s)
- Jérôme Corré
- Service de Cardiologie Interventionnelle et d'Imagerie Cardiaque, Clinique Saint Gatien, Tours, France
| | - Stephan Chassaing
- Service de Cardiologie Interventionnelle et d'Imagerie Cardiaque, Clinique Saint Gatien, Tours, France
| | - Didier Blanchard
- Service de Cardiologie Interventionnelle et d'Imagerie Cardiaque, Clinique Saint Gatien, Tours, France
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Pinkerton NM, Behar L, Hadri K, Amouroux B, Mingotaud C, Talham DR, Chassaing S, Marty JD. Ionic Flash NanoPrecipitation (iFNP) for the facile, one-step synthesis of inorganic-organic hybrid nanoparticles in water. Nanoscale 2017; 9:1403-1408. [PMID: 28074196 DOI: 10.1039/c6nr09364g] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ionic Flash NanoPrecipitation (iFNP) was evaluated as a novel method for the synthesis of inorganic-organic hybrid nanomaterials and proved to be remarkably effective, fast and practical. To prove the potential of iFNP, various nanostructured GdPO4-based materials of biomedical imaging relevance were easily prepared in a one-step, tunable and highly controlled manner using only water as solvent.
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Affiliation(s)
- N M Pinkerton
- ITAV, Université de Toulouse, CNRS, UPS, 1 place Pierre Potier, 31106 Toulouse Cedex 1, France.
| | - L Behar
- Department of Chemistry, Mars Hill University, Mars Hill, NC 28754, USA
| | - K Hadri
- ITAV, Université de Toulouse, CNRS, UPS, 1 place Pierre Potier, 31106 Toulouse Cedex 1, France. and IMRCP, Université de Toulouse, CNRS UMR 5623, UPS, 118 route de Narbonne, 31062 Toulouse, France.
| | - B Amouroux
- IMRCP, Université de Toulouse, CNRS UMR 5623, UPS, 118 route de Narbonne, 31062 Toulouse, France.
| | - C Mingotaud
- IMRCP, Université de Toulouse, CNRS UMR 5623, UPS, 118 route de Narbonne, 31062 Toulouse, France.
| | - D R Talham
- Department of Chemistry, University of Florida, Gainesville, Florida 32611-7200, USA
| | - S Chassaing
- ITAV, Université de Toulouse, CNRS, UPS, 1 place Pierre Potier, 31106 Toulouse Cedex 1, France.
| | - J-D Marty
- IMRCP, Université de Toulouse, CNRS UMR 5623, UPS, 118 route de Narbonne, 31062 Toulouse, France.
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Gouffran G, Blanchard D, Chassaing S, Bar O, Barbey C, Arnould M, Lepage O, Chatel D. Prognostic value of NT pro-BNP levels on mild to long term outcome after TAVI: a monocentric study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30204-5] [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: 11/30/2022]
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26
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Grammatico-Guillon L, Laure C, Baron S, Bardière P, Godillon L, Gautier S, Chassaing S, Angoulvant D, Rangé G. Mise en place du registre SCA ST+ : syndromes coronariens aigus avec sus-décalage du segment ST, région Centre-Val de Loire, 2014. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.06.051] [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: 11/30/2022] Open
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27
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Mohty D, Isorni MA, Chassaing S, Maudière A, Barbey C, Bar O, Bruère D, Blanchard D. 0488: Assessment of aortic regurgitation severity: a cardiac magnetic resonance and echocardiographic comparison study. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30164-1] [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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28
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Basílio N, Garnier T, Avó J, Danel M, Chassaing S, Pina F. Synthesis and multistate characterization of bis-flavylium dications – symmetric resorcinol- and phloroglucinol-type derivatives as stochastic systems. RSC Adv 2016. [DOI: 10.1039/c6ra12017b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Two as one! Full kinetic and thermodynamic characterization of two easy-to-prepare bis-flavylium multistate systems showed stochastic behavior, thus revealing lack of interactions between flavylium moieties.
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Affiliation(s)
- N. Basílio
- LAQV
- REQUIMTE
- Departmento de Quimica
- Faculdade de Ciências e Tecnologica
- Universidade NOVA de Lisboa
| | - T. Garnier
- ITAV
- Université de Toulouse
- CNRS
- UPS
- 31106 Toulouse Cedex 1
| | - J. Avó
- LAQV
- REQUIMTE
- Departmento de Quimica
- Faculdade de Ciências e Tecnologica
- Universidade NOVA de Lisboa
| | - M. Danel
- ITAV
- Université de Toulouse
- CNRS
- UPS
- 31106 Toulouse Cedex 1
| | - S. Chassaing
- ITAV
- Université de Toulouse
- CNRS
- UPS
- 31106 Toulouse Cedex 1
| | - F. Pina
- LAQV
- REQUIMTE
- Departmento de Quimica
- Faculdade de Ciências e Tecnologica
- Universidade NOVA de Lisboa
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Isorni MA, Mohty D, Chassaing S, Maudiere A, Barbey C, Bar O, Bruere D, Blanchard D, Puymirat E. 0146: Comparison of cardiac magnetic resonance imaging and echocardiography for the assessment of aortic valve area. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Within the green chemistry context, heterogeneous catalysis is more and more applied to organic synthesis. The well known ‘click chemistry’ and especially its flagship, the copper-catalyzed azide–alkyne cycloaddition reaction (CuAAC), is now catch up by such heterogenisation process and copper ions or metals have been grafted or deposited on or into various solids, such as (bio)polymers, charcoal, silica, zeolites, POM or MOF.
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Affiliation(s)
- S. Chassaing
- Institut des Technologies Avancées en Sciences du Vivant
- Université de Toulouse
- France
| | - V. Bénéteau
- Institut de Chimie de Strasbourg
- UMR 7177
- Université de Strasbourg
- 67000 Strasbourg
- France
| | - P. Pale
- Institut de Chimie de Strasbourg
- UMR 7177
- Université de Strasbourg
- 67000 Strasbourg
- France
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31
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Durand E, Blanchard D, Chassaing S, Gilard M, Laskar M, Borz B, Lafont A, Barbey C, Godin M, Tron C, Zegdi R, Chatel D, Le Page O, Litzler PY, Bessou JP, Danchin N, Cribier A, Eltchaninoff H. Comparison of two antiplatelet therapy strategies in patients undergoing transcatheter aortic valve implantation. Am J Cardiol 2014; 113:355-60. [PMID: 24169016 DOI: 10.1016/j.amjcard.2013.09.033] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/27/2013] [Accepted: 09/27/2013] [Indexed: 11/15/2022]
Abstract
Dual antiplatelet therapy is commonly used in patients undergoing transcatheter aortic valve implantation (TAVI), but the optimal antiplatelet regimen is uncertain and remains to be determined. The objective of this study was to compare 2 strategies of antiplatelet therapy in patients undergoing TAVI. A strategy using monoantiplatelet therapy (group A, n = 164) was prospectively compared with a strategy using dual antiplatelet therapy (group B, n = 128) in 292 consecutive patients undergoing TAVI. The primary end point was a combination of mortality, major stroke, life-threatening bleeding (LTB), myocardial infarction, and major vascular complications at 30 days. All adverse events were adjudicated according to the Valve Academic Research Consortium. The primary end point occurred in 22 patients (13.4%) in the group A and in 30 patients (23.4%) in the group B (hazard ratio 0.51, 95% confidence interval 0.28 to 0.94, p = 0.026). LTB (3.7% vs 12.5%, p = 0.005) and major bleedings (2.4% vs 13.3%, p <0.0001) occurred less frequently in the group A, whereas the incidence of stroke (1.2% vs 4.7%, p = 0.14) and myocardial infarction (1.2% vs 0.8%, p = 1.0) was not significantly different between the 2 groups. The benefit of a strategy using mono versus dual antiplatelet therapy persisted after multivariate adjustment and propensity score analysis (hazard ratio 0.53, 95% confidence interval 0.28 to 0.95, p = 0.033). In conclusion, a strategy using mono versus dual antiplatelet therapy in patients undergoing TAVI reduces LTB and major bleedings without increasing the risk of stroke and myocardial infarction. The results of our study question the justification of dual antiplatelet therapy and require confirmation in a randomized trial.
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Affiliation(s)
- Eric Durand
- University Paris-Descartes; AP-HP; European Georges Pompidou Hospital, Departments of Cardiology and Cardiac Surgery, Paris, France; University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France.
| | - Didier Blanchard
- University Paris-Descartes; AP-HP; European Georges Pompidou Hospital, Departments of Cardiology and Cardiac Surgery, Paris, France; Clinique Saint Gatien, Departments of Cardiology and Cardiac Surgery, Tours, France
| | - Stephan Chassaing
- Clinique Saint Gatien, Departments of Cardiology and Cardiac Surgery, Tours, France
| | - Martine Gilard
- Université de Bretagne Occidentale, Department of Cardiology, CHU de la Cavale Blanche, EA 4524, Brest, France
| | - Marc Laskar
- University Hospital Dupuytren, Department of cardiac Surgery, Limoges, France
| | - Bogdan Borz
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Antoine Lafont
- University Paris-Descartes; AP-HP; European Georges Pompidou Hospital, Departments of Cardiology and Cardiac Surgery, Paris, France
| | - Christophe Barbey
- Clinique Saint Gatien, Departments of Cardiology and Cardiac Surgery, Tours, France
| | - Matthieu Godin
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Christophe Tron
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Rachid Zegdi
- University Paris-Descartes; AP-HP; European Georges Pompidou Hospital, Departments of Cardiology and Cardiac Surgery, Paris, France
| | - Didier Chatel
- Clinique Saint Gatien, Departments of Cardiology and Cardiac Surgery, Tours, France
| | - Olivier Le Page
- Clinique Saint Gatien, Departments of Cardiology and Cardiac Surgery, Tours, France
| | - Pierre-Yves Litzler
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Jean-Paul Bessou
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Nicolas Danchin
- University Paris-Descartes; AP-HP; European Georges Pompidou Hospital, Departments of Cardiology and Cardiac Surgery, Paris, France
| | - Alain Cribier
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
| | - Hélène Eltchaninoff
- University Hospital of Rouen, Hospital Charles Nicolle, Departments of Cardiology and Thoracic and Cardiovascular Surgery, INSERM UMR 1096, Rouen, France
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Arnould MA, Barbey C, Chassaing S. An unusual right coronary artery obstruction after mitral surgery. Arch Cardiovasc Dis 2013; 106:63-5. [PMID: 23374973 DOI: 10.1016/j.acvd.2011.08.006] [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] [Received: 07/11/2011] [Revised: 08/29/2011] [Accepted: 08/30/2011] [Indexed: 10/28/2022]
Affiliation(s)
- Marc-Antoine Arnould
- Service de cardiologie interventionnelle et d'imagerie cardiaque, clinique Saint-Gatien, Tours, France.
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Affiliation(s)
- Stephan Chassaing
- Clinique Saint Gatien, Service de cardiologie interventionnelle, Tours, France.
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Puymirat E, Chassaing S, Trinquart L, Barbey C, Chaudeurge A, Bar O, Blanchard D. Hakki's formula for measurement of aortic valve area by magnetic resonance imaging. Am J Cardiol 2010; 106:249-54. [PMID: 20599011 DOI: 10.1016/j.amjcard.2010.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 03/02/2010] [Accepted: 03/02/2010] [Indexed: 11/18/2022]
Abstract
Hakki's formula (simplified Gorlin formula) can be used during cardiac catheterization to calculate the stenosed cardiac valve areas and can also be adapted to magnetic resonance imaging (MRI) to measure the stenosed cardiac valve areas. We evaluated the reliability of this approach to determine the severity of aortic stenosis compared to the continuity equation using transthoracic echocardiography and planimetry using MRI. We included all eligible symptomatic patients with known aortic stenosis referred to our department during a 1-year period. The aortic valve area (AVA) was estimated using Hakki's formula (MRI), planimetry (MRI), and the continuity equation (transthoracic echocardiography). The agreement among the measurement methods was analyzed using the Bland-Altman method. A total of 63 patients were included (mean age 72 +/- 10 years, 35 men [56%]). The mean AVA was 0.70 +/- 0.21 cm(2) using the continuity equation (transthoracic echocardiography), 0.67 +/- 0.18 cm(2) using planimetry (MRI), and 0.64 +/- 0.21 cm(2) using Hakki's formula (MRI). The mean difference was 0.03 cm(2) (95% limits of agreement -0.32 to 0.25) between planimetry and the continuity equation, 0.05 cm(2) (95% limits of agreement -0.40 to 0.29) between Hakki's formula and the continuity equation, 0.02 cm(2) (95% limits of agreement -0.20 to 0.25) between Hakki's formula and planimetry. The inter- and intraobserver reproducibility using Hakki's formula was excellent. In conclusion, measurement of the AVA using Hakki's formula yielded similar results to those obtained using planimetry and slightly different ones from those obtained using the continuity equation. However, Hakki's formula has the advantage of being easy to use, fast, and reproducible and can be used regardless of the status of the valve (in contrast to planimetry).
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Puymirat E, Barbey C, Chassaing S, Bar O, Blanchard D. [Iatrogenic dissection of the right coronary artery and the ascending aorta during coronary intervention]. Ann Cardiol Angeiol (Paris) 2010; 59:168-171. [PMID: 20003961 DOI: 10.1016/j.ancard.2009.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 04/10/2009] [Accepted: 05/12/2009] [Indexed: 05/28/2023]
Abstract
Iatrogenic acute dissection of the ascending aorta following coronary angiography and percutaneous intervention is rare. The options for treatment are dictated by patient stability, nature of dissection of the coronary vessel, ability to restore the coronary circulation and extent of aortic dissection. Usually localized aortic dissections have been managed conservatively or treated by sealing the entry with a coronary stent. Extensive dissections may require a surgical intervention. We report the case of a 52-year-old man with iatrogenic dissection of the right coronary artery ostium and extension of the dissection to the ascending aorta during intraluminal angioplasty of an obstructive lesion in the first portion of the right coronary artery. The patient was managed conservatively without stenting (failure stenting of the right coronary artery) and without surgery. Aortic dissection was monitored by means of transesophageal echocardiography. Serial computed tomography scans demonstrated spontaneous resolution of the dissection. The evolution of the patient was satisfactory. Causes, frequency and treatment procedures of this iatrogeny are discussed.
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Affiliation(s)
- E Puymirat
- Service de cardiologie interventionnelle, clinique Saint-Gatien, 8, place de Cathédrale, 37042 Tours, France.
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Chatel D, Chaib A, Barbey C, Baud F, Chassaing S, Bar O, Blanchard D. Impact of purely internal thoracic artery T-graft technique on the mode and quality of surgical myocardial revascularization evaluated by early postoperative coronary angiography. Arch Cardiovasc Dis 2009; 102:677-83. [PMID: 19913769 DOI: 10.1016/j.acvd.2009.06.008] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 06/17/2009] [Accepted: 06/26/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND The use of the internal thoracic artery for coronary artery bypass has improved the results of such surgery. However, bypass using only the internal thoracic arteries sometimes requires a T-graft. This purely internal thoracic artery T-graft technique has progressively become part of our surgical protocol for coronary artery bypass surgery. AIMS The aim of the study was to analyse the impact of this surgical technique on the degree and quality of coronary revascularization using early postoperative angiography. METHODS Between January 2004 and December 2006, 148 patients underwent coronary artery bypass surgery exclusively using both internal thoracic arteries in a T-graft configuration. Systematic postoperative angiography was offered to all 148 patients; it was accepted by 108 patients and refused by 40 patients. RESULTS There were no statistically significant differences between the two groups. In-patient mortality was 2.02% (n=3) for the whole population studied, and 1.49% (n=2) for the 134 patients who received only coronary artery bypass grafts. The revascularization rate was 89% and 3.46 coronary anastomoses were constructed per patient (range 2-6). Angiography was performed on 108 right internal thoracic artery to left internal thoracic artery anastomoses, 374 anastomoses of internal thoracic arteries to coronary arteries and 382 inter-anastomosis segments: 98% of the anastomoses and segments were patent. CONCLUSION The exclusive recourse to the purely internal thoracic artery T-graft technique meant that it has been possible to dispense with other types of graft while achieving complete and effective revascularization of the coronary artery.
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Affiliation(s)
- Didier Chatel
- Clinique Saint-Gatien, 8, place de la Cathédrale, 37000 Tours, France.
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Chassaing S, Garrigoux P, Redheuil A, Blanchard D, Bar O, Maudière A, Mousseaux E. [The potential of magnetic resonance imaging for the surveillance of septal alcohol ablation in hypertrophic obstructive cardiomyopathy. A case report]. Arch Mal Coeur Vaiss 2006; 99:828-31. [PMID: 17067103] [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: 05/12/2023]
Abstract
We describe here the MRI surveillance of septal alcohol ablation in a case of symptomatic obstructive cardiomyopathy. MRI examinations were performed before, 15 days and 2 months after alcohol ablation using an identical protocol to study the function, regional perfusion and the equilibrium perfusion in order to directly visualize the infarction. MRI seems to be an excellent investigation in the surveillance of such patients, allowing precise quantification of the infarcted zone. The various stages of cellular necrosis in the induced infarct were demonstrated, and the role of remodelling in increasing the functional area of the systolic ejection pathway.
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Brouillard R, Chassaing S, Fougerousse A. Why are grape/fresh wine anthocyanins so simple and why is it that red wine color lasts so long? Phytochemistry 2003; 64:1179-1186. [PMID: 14599515 DOI: 10.1016/s0031-9422(03)00518-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Vitis vinifera red berries are characterized by anthocyanins whose chemical structures are among the simplest encountered in higher plants. On the contrary, many plants, including orchids, petunias, red cabbage, elderberries, potatoes for instance, have developed very complicated anthocyanins featuring side-chains at the available positions of the aglycone skeleton. Such pigments were shown to possess bio-physico-chemical properties not to be seen with the grape common anthocyanins. Among beverages (water, tea, beer, wine, coffee, juices, milk), red wine is the only one whose organoleptic properties improve with time and this is called ageing. The grape/fresh red wine pigments, after a few months, disappear from the wine giving birth to new pigments resulting from the wine spontaneous chemistry allowing it to remain red for many years. What are the wine pigments and why are they so stable is the purpose of this mini-review. The structural simplicity of grape anthocyanins and the long lasting colour of red wine is another French paradox; we call it French paradox II.
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Affiliation(s)
- R Brouillard
- Laboratoire de Chimie des Polyphénols, Université Strasbourg I, UMR CNRS 7509, Faculté de Chimie, 1 rue Blaise Pascal, 67 Strasbourg, France.
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Chassaing S, Eltchaninoff H, Koning R, Cribier A. [Percutaneous revascularization of multivessel coronary disease with systematic stent implantation. Immediate results and clinical follow-up and middle term angiography]. Arch Mal Coeur Vaiss 2001; 94:95-102. [PMID: 11265559] [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: 02/19/2023]
Abstract
The aim of this retrospective study was to assess the immediate and medium-term clinical and angiographic results of multiple angioplasty with stenting in 100 consecutive patients with multivessel coronary artery disease. The mean age of the population was 62 +/- 11 years. Two hundred and eight lesions were treated (2.5 +/- 0.7 per patient) with implantation of 1.14 +/- 0.4 stents per lesion. The angiographic success rate was 98.7%. There were 5 major complications in the hospital period: 3 deaths, including 2 of cardiac causes, one coronary bypass procedure and one Q wave myocardial infarction. During follow-up (17 +/- 6 months), eight patients died (5 of cardiac causes) and secondary revascularisation procedures were required in 22 patients. At 6 months, the angiographic restenosis rate was 32% per lesion, 28.8% per stent and 33 patients had at least one restenosis.
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Affiliation(s)
- S Chassaing
- Service de cardiologie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen
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Barbier-Frebourg N, Chassaing S, Derumeaux G, Bessou J, Lemeland J. Endocardite à Gemella morbillorum. Med Mal Infect 1998. [DOI: 10.1016/s0399-077x(98)80154-6] [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: 10/22/2022]
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Mouton Schleifer D, Chassaing S, Caron F, Borg JY, Bouchart F, Soyer R. [Hypereosinophilia after calcium heparinate]. Presse Med 1996; 25:1848. [PMID: 8991043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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