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Background: Left ventricle dysfunction and co-morbidities are responsible for a large number of complications after coronary artery bypass graft (CABG) surgery. The best strategy for these patients, including the use or not and type of extracorporeal circulation (ECC), the use of minimized ECC (MECC), or conventional ECC (CECC), remains unclear. The aim of the present study was to investigate the potential effect of on-pump beating-heart (OPBH) surgery with the help of MECC for CABG in patients with a high-risk EuroSCORE and to compare this strategy to three other different procedures, including OPCAB and MECC or CECC with cardiac arrest.Methods: Patients were included if their EuroSCORE was strictly >" xbd="1427" xhg="1404" ybd="1477" yhg="1440"/>9. Four groups were retrospectively compared: an OPCAB, an OPBH, a MECC and a CECC group under cardiac arrest.Results: 214 patients, mean age 74.26 ± 8.5 years, 68.7% male, were operated. Mean EuroSCORE was 12.1 ± 2.9, left ventricular (LV) function 37.4 ± 12.3%, recent myocardial infarction (MI) 49.5%, renal failure 48.1%, chronic obstructive pulmonary disease (COPD) 42.2%, and peripheral vascular disease (PVD) 55.6%. Mean number of grafts per patient was 2.4 ± 0.7. Our study showed that it was possible, in very high-risk patients, to carry out revascularisation with OPBH similar to that using MECC or CECC under cardiac arrest (p=NS). This technique reduces troponin release (3.23 vs 6.56, p<0.01), postoperative myocardial complications (2% vs 8%, p<0.01), cardiotonic drug prescription (15.7% vs 31.3%, p<0.01), ventilation time (4.57H vs 6.48H, p<0.01) and length of stay (LOS) in ICU (2.16 vs 2.53, p=0.02).Conclusion: The OPBH method seems to be safe, secure and effective in this population of very high-risk patients, reducing early complications and multi-organ failure. OPBH surgery, combining MECC without aortic cross-clamping, makes it possible to perform complete revascularization and is an interesting alternative for CABG in high-risk patients. [ABSTRACT FROM PUBLISHER]

• Sufficiency is an emerging concept with many practical translations for buildings. • It applies both at the level of the building stock and that of the building itself. • It can contribute to deeper carbon savings and to prevent new ones (space cooling...). • It has systemic impacts (land take, building waste, energy consumption in the industrial sector...). In France, the building sector (residential and commercial) represented 16% of carbon emissions in 2015 (use-phase). The building sector therefore has a major role to play in the carbon transition by acting on all available levers: sufficiency, efficiency, decarbonised energy and carbon sinks. How much can the sector contribute to the overall goal of carbon neutrality by 2050? The article presents findings from Transition(s) 2050, a set of scenarios developed for the whole economy by ADEME, the French Environmental Transition Agency. It focuses on sufficiency: which role can it play in the decarbonation of the building sector, both in the use-phase and beyond? What would enabling conditions be? Sufficiency can contribute to achieve further energy savings compared to "efficiency-only" scenarios in areas such as domestic electrical appliances or space cooling, hence easing the wider decarbonation effort. Furthermore, sufficiency has systemic implications beyond the use-phase. It contributes to decreasing energy consumption in the industrial sector, as building less has direct impact on the demand for construction material. It also has impact on other resources such as land. Land take and building waste are significantly lower in the most sufficient scenarios. However, implementing sufficiency requires profound changes both in policies for the building sector and the way these policies are designed. [ABSTRACT FROM AUTHOR]