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36 results on '"Alacoque, Xavier"'

30. Inside Anesthesia Breathing Circuits

Author

Kern, Delphine, primary, Larcher, Claire, additional, Basset, Bertrand, additional, Alacoque, Xavier, additional, Fesseau, Rose, additional, Samii, Kamran, additional, Minville, Vincent, additional, and Fourcade, Olivier, additional

Published
2012
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33. Aortic arch aneurysm: short- and mid-term results comparing open arch surgery and the hybrid procedure.

Author

Cazavet, Alexandre, Alacoque, Xavier, Marcheix, Bertrand, Chaufour, Xavier, Rousseau, Herve, Glock, Yves, and Leobon, Bertrand

Subjects
*AORTIC arch aneurysms, *AORTIC aneurysm treatment, *ENDOVASCULAR surgery, *SURGERY, *THERAPEUTICS
Abstract

OBJECTIVES: Open arch surgery for aortic arch aneurysm was historically associated with a high risk of postoperative morbi-mortality. Improved operative techniques have now lowered the incidence of these complications but in parallel, hybrid arch procedures have emerged. Nowadays, very little data are available about their mid-term results compared with open surgery. METHODS: From January 2002 to January 2014, 46 patients had treatment for an exclusive aortic arch aneurysm including 25 open arch surgeries and 21 type I hybrid arch procedures in our institution. All cases involved arch aneurysms involving at least one carotid artery (Zone 0 and Zone 1). Aneurysms of the distal arch and descending aorta were excluded (Zone 2 and beyond). Results from a retrospective database are reported. There were no patients lost to the follow-up. RESULTS: There was no significant difference in preoperative comorbidities between the two groups. The incidence of in-hospital mortality was similar at 20% (5/25) for open surgery and 19% (4/21) for hybrid procedure (P = 0.830). The incidence of permanent cerebral neurological deficit was comparable at 17.4% (4/23) for open surgery and 21.1% (4/19) for hybrid procedure (P = 1). Median survival was 109.5 months for open surgery and 56.3 months for hybrid procedure. Freedom from all-cause mortality was 78, 63, 63 and 57% at 1, 3, 5 and 7 years, respectively in the open surgical group. Freedom from all-cause mortality was 74, 55, 46 and 28% at 1, 3, 5 and 7 years, respectively in the hybrid group. Survival rates and incidence of major adverse cardiac and cerebro-vascular event between open surgery and hybrid procedure were not statistically different (P = 0.530 and P = 0.325, respectively). However, incidence of reintervention was in favour of open surgery [14.5 vs 44.8% at 7 years, P = 0.045; 95% confidence interval: (0.06-0.97)]. CONCLUSIONS: The type I hybrid arch procedure fails to demonstrate better results compared with open surgery, regarding morbi-mortality at the short- and mid-term follow-up. Moreover, it increases the risk of reintervention. Patients treated by this technique must undergo a closer follow-up because of this risk. Larger randomized studies are needed to better define the exact indications of this therapy. [ABSTRACT FROM AUTHOR]

Published
2016
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36. The relation between atrial septal defect shape, diameter, and area using three-dimensional transoesophageal echocardiography and balloon sizing during percutaneous closure in children.

Author

Hascoet S, Hadeed K, Marchal P, Dulac Y, Alacoque X, Heitz F, and Acar P

Subjects
Balloon Occlusion methods, Cardiac Catheterization methods, Child, Cohort Studies, Female, Follow-Up Studies, Heart Septal Defects, Atrial physiopathology, Humans, Male, Retrospective Studies, Risk Assessment, Treatment Outcome, Cardiac Catheterization instrumentation, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal methods, Heart Septal Defects, Atrial diagnostic imaging, Heart Septal Defects, Atrial therapy
Abstract

Background: A trans-catheter closure of an atrial septal defect (ASD) is efficient. Balloon sizing (BS) during the catheterization leads to an overestimation of ASD size. Three-dimensional transoesophageal echocardiography (3D-TEE) allows the ASD morphology to be assessed comprehensively. The aim of this study was to assess the relationships between the shape and the measurements of ASDs by 2D-, 3D-TEE, and BS in children., Methods and Results: Thirty children who underwent percutaneous closures of a single ASD were enrolled. ASD diameters were measured by 2D-transthoracic echocardiography (TTE), 2D-TEE, 3D-TEE and compared with BS. The ASD area was measured on 3D-TEE images after multi-planar reconstruction. ASD was estimated as round or oval on 3D-TEE 'en-face' view. 2D-TTE, 2D-TEE, and 3D-TEE(max) ASD diameters were well correlated with BS (r = 0.75; 0.80, and 0.85, respectively). Mean diameters were all significantly smaller than the mean BS. The mean difference between the balloon area and 3D-TEE area was 1.6 ± 1.4 cm(2) (P < 0.0001). The mean difference between BS and 3D-TEE(max) diameters was higher in round ASDs than in oval ASDs (4.0 ± 3.3 vs. 1.1 ± 3.3, P = 0.02). With multivariate linear regression analysis, two formulas were built to predict BS. The first model was BS = 1.07 × 3D-TEE(max)- 3.1 × ASDshape + 3. The ASD shape was 0 for round and 1 for oval ASDs. A second model was BS = 4.5 × ASDarea + 11.5., Conclusion: The ASD shape is accurately estimated by 3D-TEE and influences the relationship between echocardiographic measurements and BS. The ASD shape, its maximal diameter and the area assessed by 3D-TEE may be sufficient to determine the device size without BS in children., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Published
2015
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