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1. Atrial Fibrillation and Other Cardiac Arrhythmias and Diseases After Radiotherapy for Breast Cancer : Watch Your HeaRT (WATCH)

Author: Clinique Pasteur Toulouse, Centre Francois Baclesse, Institut Curie, and Sophie JACOB, Study Coordinator
Published: 2023

2. French Cohort Evaluating the effectiveneSs of Atrioventricular Synchrony by the micRa AV (AV-CESAR)

Author: CHU de Tours, European Georges Pompidou Hospital, Hôpital privé Clairval - Marseille, Clinique Pasteur Toulouse, University Hospital, Bordeaux, Infirmerie Protestante Lyon, Institut Jacques Cartier - Massy, University Hospital, Grenoble, Hôpital de la Timone, University Hospital, Toulouse, Hopital Prive Saint Martin - Bordeaux, Hospices Civils de Lyon, CHU de Rouen - Accueil, University Hospital, Caen, Médipôle Lyon-Villeurbanne, Hospital Ambroise Paré Paris, Clinique Saint Augustin - Bordeaux, Rennes University Hospital, Clinique de la Sauvegarde - Lyon, University Hospital of Saint-Etienne, Hôpital Privé de Parly II - Le Chesnay, Institut Mutualiste Montsouris, Centre Hospitalier Universitaire, Amiens, University Hospital, Clermont-Ferrand, Centre Hospitalier Régional et Universitaire de Brest, Poitiers University Hospital, Clinique Saint-Gatien - Tours, CHU de Reims, Centre Hospitalier Universitaire de Besancon, Centre Hospitalier Universitaire Dijon, Hôpital Privé de Lille Métropole, University Hospital, Montpellier, University Hospital, Strasbourg, France, Nantes University Hospital, Centre Cardio-Thoracique de Monaco, Hospital St. Joseph, Marseille, France, Centre Hospitalier Régional Metz-Thionville, Centre Hospitalier Annecy Genevois, Clinique du Millenaire, University Hospital, Limoges, Clinique Saint Pierre - Perpignan, Bichat Hospital, Universite de La Reunion, CHU de Lille, Institute Arnault Tzanck, France, Hôpital Privé Les Franciscaines, CHU de Fort de France - Martinique, Henri Mondor University Hospital, University Hospital, Angers, Centre Hospitalier de Lens, and Central Hospital, Nancy, France
Published: 2023

3. Intravascular Lithotripsy in Comparison to Rotational Atherectomy: An Evaluation by OFDI (ICARE)

Author: Clinique Pasteur Toulouse
Published: 2022

4. S-ICD French Cohort Study (HONEST) (HONEST)

Author: Centre Cardio-Thoracique de Monaco, Centre Cardiologique du Nord, Groupe Hospitalier de la Region de Mulhouse et Sud Alsace, Centre Hospitalier Annecy Genevois, Centre Hospitalier Bretagne Atlantique, Centre Hospitalier William Morey - Chalon sur Saône, Centre Hospitalier du Pays d'Aix, Centre Hospitalier Albi, Centre Hospitalier Antibes - Juan Les Pins, Centre Hospitalier Argenteuil, Centre Hospitalier Henri Duffaut - Avignon, Centre Hospitalier Auxerre, Centre Hospitalier de Bastia, Centre Hospitalier de Bigorre - Tarbes, Boulogne sur Mer Hospital Center, Centre Hospitalier de Carcassonne, Centre hospitalier de Chambéry, Centre Hospitalier of Chartres, Centre Hospitalier de Compiègne, Centre Hospitalier de Haguenau (Est France), Centre hospitalier de la Polynésie française - Papeete, Centre Hospitalier de La Rochelle, Centre Hospitalier de Lens, Ch Mont de Marsan, Centre Hospitalier de Montauban, Centre Hospitalier de Moulins Yzeure, Centre Hospitalier de PAU, Centre Hospitalier de Perigueux, Centre hospitalier de Perpignan, Centre Hospitalier de Roubaix, Centre Hospitalier de Saint-Brieuc, Centre Hospitalier de Troyes, Centre Hospitalier de Valence, Centre Hospitalier de Valenciennes, Centre Hospitalier Departemental Vendee, Centre Hospitalier le Mans, Centre Hospitalier Eure-Seine, Centre Hospitalier Henri Mondor - Aurillac, Centre Hospitalier Intercommunal Castres-Mazamet, Centre Hospitalier Jacques Cœur - Bourges, Centre Hospitalier Libourne, Centre Hospitalier Princesse Grace, Centre Hospitalier Régional d'Orléans, Hôpital NOVO, Centre Hospitalier Rodez, Centre Hospitalier Saint Joseph Saint Luc de Lyon, Central Hospital Saint Quentin, Centre Hospitalier Saintonge - Saintes, Centre Hospitalier Sud Francilien, Centre Hospitalier Territorial- Nouméa, Centre Hospitalier Toulon, Centre Hospitalier Universitaire de Saint Etienne, Poissy-Saint Germain Hospital, CHR Mercy - Metz, Amiens University Hospital, University Hospital, Angers, Centre Hospitalier Universitaire de Besancon, University Hospital, Clermont-Ferrand, University Hospital, Bordeaux, University Hospital, Caen, Centre Hospitalier Universitaire de la Réunion, CHU de Lille, University Hospital, Limoges, University Hospital, Montpellier, CHU de Nancy, Nantes University Hospital, Poitiers University Hospital, CHU de Rouen - Accueil, University Hospital, Strasbourg, France, University Hospital, Toulouse, CHU de Tours, Centre Hospitalier Universitaire Dijon, Centre Hospitalier Felix Guyon, University Hospital, Grenoble, Centre Hospitalier Régional et Universitaire de Brest, Centre Hospitalier Universitaire de Nice, CHU de Reims, CHU Rennes - Hopital Pontchaillou, Clinique Alleray Labrouste, CMC Ambroise Paré, Clinique Belledonne - Grenoble, Clinique Claude Bernard - Metz, Clinique du Millenaire, Clinique du Parc - Castelnau le Lez - Montpellier, Clinique du Tonkin - Lyon - Villeurbane, Clinique Saint-Hilaire, Clinique Les Fontaines - Melun, Clinique Louis Pasteur Essey-lès-Nancy, Clinique Oreliance - Orléans, Clinique Pasteur Toulouse, Clinique Rhône Durance - Avignon, Clinique Saint Augustin - Bordeaux, Clinique Saint Georges - Nice, Clinique Saint Pierre - Perpignan, Clinique Saint Vincent - Besancon, Clinique Saint-Gatien - Tours, Clinique Saint Joseph, Liège, GCS Cardiologie - Bayonne, Groupe Hospitalier de Bretagne Sud, Groupe Hospitalier du Havre, Raincy Montfermeil Hospital Group, European Georges Pompidou Hospital, Hopital Antoine Beclere, Bichat Hospital, Centre Hospitalier Universitaire de Nīmes, Hôpital de la Croix-Rousse, Hôpital de la Timone, Henri Mondor University Hospital, Hôpital Marie Lannelongue - Le Plessis Robinson, Hôpital Necker-Enfants Malades, University Hospital, Marseille, Hopital Nord Franche-Comte, Hôpital Privé Arnault Tzanck - Mougins - Sophia Antipolis, Hôpital privé Bois Bernard - Lens, Hôpital privé Clairval - Marseille, Hôpital privé Claude Galien - Quincy-sous-Sénart, Hôpital Privé de la Loire- Saint Etienne, Hôpital Privé de Parly II - Le Chesnay, Hôpital privé du Confluent - Nantes, Hôpital privé Le Bois - Lille MetropoleHôpital Privé Les Franciscaines - Nîmes, Hôpital Privé Marseille - Beauregard, Hôpital privé Saint-Martin - Caen, Hospital St. Joseph, Marseille, France, Hôpital Saint Philibert - Lille - GHICL, Hospices Civils de Lyon, Institut Jacques Cartier - Massy, Institut Mutualiste Montsouris, Pitié-Salpêtrière Hospital, Pôle Santé République, Pôle Santé Sud - Le Mans, Polyclinique Les Fleurs - Toulon, Polyclinique Lyon-Nord - Rillieux, Polyclinique Reims-Bezannes-Courlancy, Polyclinique Saint Laurent - Rennes, Polyclinique Vauban - Valencienne, and Amiens SAS
Published: 2022

5. Cardiac Resynchronization Therapy in Congenital Heart Diseases With Systemic Right Ventricle

Author: Marie Lannelongue Hospital, Le Plessis Robinson, France, Clinique Pasteur Toulouse, Groupe Hospitalier Pitie-Salpetriere, Hopital Louis Pradel, University Hospital, Montpellier, and European Georges Pompidou Hospital
Published: 2021

6. Prospective Evaluation of Programmed Ventricular Stimulation Before Pulmonary Valve Replacement in Patients With Tetralogy of Fallot

Author: European Georges Pompidou Hospital, Centre Chirurgical Marie Lannelongue, Clinique Pasteur Toulouse, Hopital Louis Pradel, and Hôpital Necker-Enfants Malades
Published: 2021

7. Catheter Ablation in Congenital Heart Disease: French National Prospective Registry (CATCH-Registry)

Author: European Georges Pompidou Hospital, Centre Chirurgical Marie Lannelongue, and Clinique Pasteur Toulouse
Published: 2021

8. Left Atrial Appendage Occlusion Guided by 3D Printing (LAA-PrintRegis)

Author: Hôpital Privé Les Franciscaines, Henri Mondor University Hospital, Rangueil Hospital, Clinique Pasteur Toulouse, University Hospital, Bordeaux, Clinique du Millenaire, Clinique Saint Pierre - Perpignan, Hôpital Dupuytren, Hospital St. Joseph, Marseille, France, European Georges Pompidou Hospital, University Hospital, Grenoble, and University Hospital, Lille
Published: 2020

9. Primary Prevention ICD French Registry (DAI-PP)

Author: Clinique Pasteur Toulouse, European Georges Pompidou Hospital, University Hospital, Grenoble, University Hospital, Bordeaux, University Hospital, Lille, University Hospital, Marseille, Centre Cardiologique du Nord, St Denis, Nouvelles Cliniques Nantaises, Nantes, Hopital Antoine Beclere, Clamart, Rennes University Hospital, Central Hospital, Nancy, France, University Hospital, Tours, and Serge Boveda, MD
Published: 2013

10. Twenty-year trends in profile, management and outcomes of patients with ST-segment elevation myocardial infarction according to use of reperfusion therapy: Data from the FAST-MI program 1995-2015

Author: Batric Popovic, Patrick Henry, Etienne Puymirat, Jean Ferrières, Francois Schiele, Gilles Lemesle, Stephane Andrieu, Yves Cottin, Tabassome Simon, Guillaume Cayla, Nicolas Danchin, François Roubille, Edouard Gerbaud, Bruno Farah, Meyer Elbaz, Jean-Noël Labèque, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Toulouse [Toulouse], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Bordeaux (UB), CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de cardiologie [Clinique Pasteur - Toulouse], Clinique Pasteur [Toulouse], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier de la Côte Basque, Centre Hospitalier Henri Duffaut, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Cardio-Vascular Polymers Bioengineering (LBPC), and Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Time Factors, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Myocardial Reperfusion, 030204 cardiovascular system & hematology, Time-to-Treatment, Profile management, 03 medical and health sciences, Percutaneous Coronary Intervention, Sex Factors, 0302 clinical medicine, Reperfusion therapy, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Fibrinolytic Agents, Intensive care, Internal medicine, Fibrinolysis, medicine, Humans, ST segment, cardiovascular diseases, Registries, 030212 general & internal medicine, Myocardial infarction, Mortality, business.industry, Hazard ratio, Percutaneous coronary intervention, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Cardiology, ST Elevation Myocardial Infarction, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background: The increased use of reperfusion therapy in ST-segment-elevation myocardial infarction (STEMI) patients in the past decades is generally considered the main determinant of improved outcomes. The aim was to assess 20-year trends in profile, management, and one-year outcomes in STEMI patients in relation with use or non-use of reperfusion therapy (primary percutaneous coronary intervention (pPCI) or fibrinolysis).Methods: We used data from 5 one-month French nationwide registries, conducted 5 years apart from 2005 to 2015, including 8579 STEMI patients (67% with and 33% without reperfusion therapy) admitted to cardiac intensive care units in France.Results: Use of reperfusion therapy increased from 49% in 1995 to 82% in 2015, with a shift from fibrinolysis (37.5% to 6%) to pPCI (12% to 76%). Early use of evidence-based medications gradually increased over the period in both patients with and without reperfusion therapy, although it remained lower at all times in those without reperfusion therapy. One-year mortality decreased in patients with reperfusion therapy (from 11.9% in 1995 to 5.9% in 2010 and 2015, hazard ratio [HR] adjusted on baseline profile 0.40; 95% CI: 0.29-0.54, P
Published: 2019

11. Limites de la dose moyenne au coeur dans l’évaluation de l’exposition du ventricule gauche et des artères coronaires au cours d’une radiothérapie pour un cancer du sein: évaluation dosimétrique à l’échelle individuelle (Etude BACCARAT)

Author: Jacob, Sophie, CAMILLERI, Jeremy, DERREUMAUX, Sylvie, WALKER, Valentin, Lairez, Olivier, LAPEYRE, Matthieu, BRUGUIERE, Eric, JIMENEZ, Gaëlle, BERNIER, Marie Odile, Laurier, Dominique, FERRIERES, Jean, BROGGIO, David, PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Radiothérapie, Oncorad Clinique Pasteur [Toulouse], PSE-SANTE/SER/UEM, CARDIOLOGIE, CHU RANGUEIL, RADIOLOGIE, Clinique Pasteur, RADIOTHÉRAPIE (ONCORAD), Clinique Pasteur [Toulouse], PSE-SANTE/SESANE, Department of Cardiology B and Epidemiology, Toulouse University Hospital, and PSE-SANTE/SDOS/LEDI
Subjects: [STAT]Statistics [stat]
Abstract: International audience; Cette étude dosimétrique chez des patientes traitées par radiothérapie (RT) pour un cancer du sein avait pour objectifs :- analyser la distribution des doses déterminées à l’échelle individuelle au niveau du cœur et de ses sous-structures,notamment les artères coronaires- évaluer si la dose moyenne au cœur (DMC) est un bon indicateur de dose pour ces sous-structures
Published: 2019

12. Impact of Mitral Regurgitation Etiology on Mitral Surgery After Transcatheter Edge-to-Edge Repair

Author: Zaid, Syed, Avvedimento, Marisa, Vitanova, Keti, Akansel, Serdar, Bhadra, Oliver, Ascione, Guido, Saha, Shekhar, Noack, Thilo, Tagliari, Ana Paula, Pizano, Alejandro, Donatelle, Marissa, Squiers, John, Goel, Kashish, Leurent, Guillaume, Asgar, Anita, Ruaengsri, Chawannuch, Wang, Lin, Leroux, Lionel, Flagiello, Michele, Algadheeb, Muhanad, Werner, Paul, Ghattas, Angie, Bartorelli, Antonio, Dumonteil, Nicholas, Geirsson, Arnar, van Belle, Eric, Massi, Francesco, Wyler von Ballmoos, Moritz, Goel, Sachin, Reardon, Michael, Bapat, Vinayak, Nazif, Tamim, Kaneko, Tsuyoshi, Modine, Thomas, Denti, Paolo, Tang, Gilbert, Tang, Gilbert H.L., Houston Methodist Hospital [Houston, TX, USA], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], CHU Bordeaux [Bordeaux], Hospices Civils de Lyon (HCL), Clinique Pasteur, Clinique Pasteur [Toulouse], CHU Lille, Mount Sinai Health System, Dr Bhadra has received travel compensation from Edwards Lifesciences. Dr Tagliari has received research support from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Dr Leurent has been a consultant and physician proctor for and has received speaker honoraria from Abbott. Dr Asgar has been a consultant for Medtronic, Abbott, Edwards Lifesciences, and W. L. Gore & Associates, and has received research grants from Abbott. Dr Leroux has been a physician proctor for Medtronic and Abbott, and a consultant for Edwards Lifesciences. Dr Dumonteil has received speaker honoraria and travel reimbursement by Edwards Lifesciences, and has been a physician proctor and consultant for Edwards Lifesciences. Dr Geirsson has been a member of the Medtronic Strategic Surgical Advisory Board. Dr Wyler von Ballmoos has served as a consultant for LivaNova, Medtronic, and Boston Scientific. Dr Reardon has been a consultant for Medtronic, Boston Scientific, Abbott, and W. L. Gore & Associates. Dr Bapat has served as a consultant for Medtronic, Edwards Lifesciences, 4C Medical, and Boston Scientific. Dr Nazif has equity in Venus Medtech, and has received consulting fees or honoraria from Keystone Heart, Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Kaneko has been a speaker for Edwards Lifesciences, Medtronic, Abbott, and Baylis Medical, and has been a consultant for 4C Medical. Dr Modine has been a physician proctor and consultant for Medtronic, Edwards Lifesciences, and Abbott. Dr Denti has received speaker honoraria from Abbott and Edwards Lifesciences, and has been a consultant for InnovHeart. Dr Tang has been a physician proctor for Medtronic, a consultant for Medtronic, Abbott, and NeoChord, and a physician advisory board member for Abbott, Boston Scientific and JenaValve, and and has received speaker honoraria from Siemens Healthineers and East End Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Subjects: MESH: Aged, MESH: Mitral Valve Insufficiency, MESH: Humans, MESH: Middle Aged, MESH: Registries, transcatheter edge-to-edge repair, MESH: Retrospective Studies, MESH: Mitral Valve, mitral valve replacement, mitral valve repair, MESH: Aged, 80 and over, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiology and Cardiovascular Medicine, mitral valve surgery, MESH: Treatment Outcome
Abstract: International audience; Background: Although >150,000 mitral TEER procedures have been performed worldwide, the impact of MR etiology on MV surgery after TEER remains unknown.Objectives: The authors sought to compare outcomes of mitral valve (MV) surgery after failed transcatheter edge-to-edge repair (TEER) stratified by mitral regurgitation (MR) etiology.Methods: Data from the CUTTING-EDGE registry were retrospectively analyzed. Surgeries were stratified by MR etiology: primary (PMR) and secondary (SMR). MVARC (Mitral Valve Academic Research Consortium) outcomes at 30 days and 1 year were evaluated. Median follow-up was 9.1 months (IQR: 1.1-25.8 months) after surgery.Results: From July 2009 to July 2020, 330 patients underwent MV surgery after TEER, of which 47% had PMR and 53.0% had SMR. Mean age was 73.8 ± 10.1 years, median STS risk at initial TEER was 4.0% (IQR: 2.2%-7.3%). Compared with PMR, SMR had a higher EuroSCORE, more comorbidities, lower LVEF pre-TEER and presurgery (all P < 0.05). SMR patients had more aborted TEER (25.7% vs 16.3%; P = 0.043), more surgery for mitral stenosis after TEER (19.4% vs 9.0%; P = 0.008), and fewer MV repairs (4.0% vs 11.0%; P = 0.019). Thirty-day mortality was numerically higher in SMR (20.4% vs 12.7%; P = 0.072), with an observed-to-expected ratio of 3.6 (95% CI: 1.9-5.3) overall, 2.6 (95% CI: 1.2-4.0) in PMR, and 4.6 (95% CI: 2.6-6.6) in SMR. SMR had significantly higher 1-year mortality (38.3% vs 23.2%; P = 0.019). On Kaplan-Meier analysis, the actuarial estimates of cumulative survival were significantly lower in SMR at 1 and 3 years.Conclusions: The risk of MV surgery after TEER is nontrivial, with higher mortality after surgery, especially in SMR patients. These findings provide valuable data for further research to improve these outcomes.
Published: 2023

13. Target volume delineation for radiotherapy of meningiomas: an ANOCEF consensus guideline

Author: Martz, Nicolas, Salleron, Julia, Dhermain, Frédéric, Vogin, Guillaume, Daisne, Jean-François, Mouttet-Audouard, Raphaelle, Tanguy, Ronan, Noel, Georges, Peyre, Matthieu, Lecouillard, Isabelle, Jacob, Julian, Attal, Justine, Charissoux, Marie, Veresezan, Ovidiu, Hanzen, Chantal, Huchet, Aymeri, Latorzeff, Igor, Coutte, Alexandre, Doyen, Jérôme, Stefan, Dinu, Feuvret, Loic, Garcia, Gabriel, Royer, Philippe, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Institut Gustave Roussy (IGR), Luxembourg Institute of Health (LIH), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Centre Léon Bérard [Lyon], CRLCC Paul Strauss, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), CRLCC Eugène Marquis (CRLCC), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Claudius Regaud, UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CHU Bordeaux [Bordeaux], Clinique Pasteur [Toulouse], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Université Côte d'Azur (UCA), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
Subjects: Radiotherapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Delineation, Target volume, Meningiomas, Consensus guidelines
Abstract: International audience; Purpose Radiotherapy is, with surgery, one of the main therapeutic treatment strategies for meningiomas. No prospective study has defined a consensus for the delineation of target volumes for meningioma radiotherapy. Therefore, target volume definition is mainly based on information from retrospective studies that include heterogeneous patient populations. The aim is to describe delineation guidelines for meningioma radiotherapy as an adjuvant or definitive treatment with intensity-modulated radiation therapy and stereotactic radiation therapy techniques. This guideline is based on a consensus endorsed by a multidisciplinary group of brain tumor experts, members of the Association of French-speaking Neuro-oncologists (ANOCEF). Materials and methods A 3-step procedure was used. First, the steering group carried out a comprehensive review to identify divergent issues on meningiomas target volume delineation. Second, an 84-item web-questionnaire has been developed to precisely define meningioma target volume delineation in the most common clinical situations. Third, experts members of the ANOCEF were requested to answer. The first two rounds were completed online. A third round was carried out by videoconference to allow experts to debate and discuss the remaining uncertain questions. All questions remained in a consensus. Results Limits of the target volume were defined using visible landmarks on computed tomography and magnetic resonance imaging, considering the pathways of tumor extension. The purpose was to develop clear and precise recommendations on meningiomas target volumes. Conclusion New recommendations for meningiomas delineation based on simple anatomic boundaries are proposed by the ANOCEF. Improvement in uniformity in target volume definition is expected.
Published: 2023

14. Outcomes after cryoablation vs. radiofrequency in patients with paroxysmal atrial fibrillation: impact of pulmonary veins anatomy

Author: François Jourda, F. Massin, P-A Sousa, J.P. Albenque, Ziad Khoueiry, Eloi Marijon, C. Cardin, Nicolas Combes, Rui Providência, Jean-Luc Pasquié, Stéphane Combes, T.T. Cung, Serge Boveda, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Clinique Pasteur, Toulouse, France., Barts Health NHS Trust [London, UK], Tissus animaux, nutrition, digestion, écosystème et métabolisme (TANDEM), Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-INP. Ecole Nationale Supérieure Agronomique de Toulouse, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Clinique Pasteur [Toulouse], Department of Cardiology, Auxerre Hospital, Auxerre, France., University Hospital Rangueil, Toulouse, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie [Montpellier], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Paroxysmal atrial fibrillation, Radiofrequency ablation, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Catheter ablation, 030204 cardiovascular system & hematology, law.invention, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, law, Physiology (medical), Internal medicine, medicine, In patient, 030212 general & internal medicine, Cryoballoon ablation, business.industry, Pulmonary vein anatomy, Cryoablation, Ablation, 3. Good health, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Pulmonary vein isolation is the mainstay of treatment in catheter ablation of paroxysmal atrial fibrillation (AF). Cryoballoon ablation has been introduced more recently than radiofrequency ablation, the standard technique in most centres. Pulmonary veins frequently display anatomical variants, which may compromise the results of cryoballoon ablation. We aimed to evaluate the mid-term outcomes of cryoballoon ablation in an unselected population with paroxysmal AF from an anatomical viewpoint.
Published: 2016

15. French Registry on Acute ST-elevation and non-ST-elevation Myocardial Infarction 2015 (FAST-MI 2015). Design and baseline data

Author: Martine Gilard, Patrick Goldstein, Nicolas Naccache, Pierre Coste, Jean Ferrières, Jacques Gauthier, Jean-Noël Labèque, Yves Cottin, Khalife Khalife, Thibaut Perret, Francois Schiele, Loic Belle, François Braun, Vincent Bataille, Bruno Farah, Elodie Drouet, Pierre-Yves Gueugniaud, Guillaume Cayla, Nicolas Danchin, Jean-Yves Le Heuzey, Etienne Puymirat, Tabassome Simon, Service de Cardiologie [Centre hospitalier Annecy-Genevois, Annecy], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service de cardiologie - Soins intensifs [CHR Metz-Thionville], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Service de cardiologie [Centre Hospitalier de la Côte Basque, Bayonne], Centre Hospitalier de la Côte Basque, Service de cardiologie [Clinique Pasteur - Toulouse], Clinique Pasteur [Toulouse], Service de cardiologie [centre hospitalier St-Joseph-et-St-Luc, Lyon], Centre hospitalier Saint Joseph - Saint Luc [Lyon], SAMU 59 et Pôle de l'Urgence, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Société Française de Médecine d'Urgence [Paris, France], SAMU 75 [Paris], Collège national des cardiologues français, Société française de cardiologie, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Dpt Cardiologie [CHU Georges Pompidou], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Service de cardiologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de pharmacologie - Dosage de médicaments [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), CHU Saint-Antoine [APHP], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), and CHU Saint-Antoine [APHP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Male, Pediatrics, Complications, Time Factors, health care facilities, manpower, and services, Comorbidity, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Medicine, Thrombolytic Therapy, 030212 general & internal medicine, Myocardial infarction, Hospital Mortality, Prospective Studies, Registries, Non-ST Elevated Myocardial Infarction, health care economics and organizations, Aged, 80 and over, ST elevation, General Medicine, Middle Aged, 3. Good health, Management, Data Accuracy, Hospitalization, Treatment Outcome, Research Design, Registre, Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Registry, Prise en charge, Infarctus du myocarde, Outcomes, 03 medical and health sciences, Percutaneous Coronary Intervention, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, St elevation myocardial infarction, Humans, cardiovascular diseases, Aged, business.industry, Patient Selection, Cardiovascular Agents, Baseline data, medicine.disease, Emergency medicine, ST Elevation Myocardial Infarction, business
Abstract: The FAST-MI programme, consisting of 1-month surveys of patients admitted to hospital for acute myocardial infarction (AMI) in France, has run since 2005.To gather data on the characteristics, management and outcomes of patients hospitalized for AMI at the end of 2015 in France and to provide comparisons with the previous surveys.Consecutive adults with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment-elevation myocardial infarction (NSTEMI) with symptom onset≤48hours were included over a 1-month period, with a possible extension of recruitment for 1 additional month. Patients with AMI following cardiovascular procedures were excluded. In all, 204 centres participated in the survey (114 community hospitals, 40 academic, 48 private clinics, 2 army hospitals), representing 78% of French centres managing AMI patients. Inclusion started from 5 October 2015. Data were collected on-site from source files by external research technicians, using an electronic case record form with automatic quality checks. Centralized biology was organized in voluntary centres to collect RNA and DNA samples, serum and stools. Long-term follow-up was organized centrally with interrogation of municipal registry offices, physicians and by direct contact with the patients or their families.A total of 5291 patients were included over the entire recruitment period, with 3813 included during the first month (STEMI: 49%, NSTEMI: 51%). Mean age was 66±14 years, 29% were≥75 years of age, 28% were women; 80% presented with typical chest pain. In STEMI patients, 6% received intravenous fibrinolysis and 71% underwent primary PCI. The hospital death rate was 2.7% (STEMI: 2.8%, NSTEMI: 2.5%).Recruitment was in line with expectations and the first data show that management has continued to evolve since the 2010 survey, with continued improvement in hospital outcomes.
Published: 2017

16. Mid-term outcome of de novo lesions vs. in stent restenosis treated by intravascular lithotripsy procedures: Insights from the French Shock Initiative

Author: Honton, Benjamin, Lipiecki, Janusz, Monségu, Jacques, Leroy, Fabrice, Benamer, Hakim, Commeau, Philippe, Motreff, Pascal, Cayla, Guillaume, Banos, Jean Luc, Bouchou, Gael, Laperche, Clémence, Farah, Bruno, Rangé, Grégoire, Lefevre, Thierry, Amabile, Nicolas, Clinique Pasteur [Toulouse], CHU Clermont-Ferrand, Groupe Hospitalier Mutualiste [Grenoble] (GHM), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Hôpitaux de Chartres [Chartres], Hôpital Privé Jacques Cartier [Massy], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and Institut Mutualiste de Montsouris (IMM)
Subjects: In-stent restenosis, MESH: Humans, Constriction, Pathologic, Coronary Angiography, Coronary calcification, MESH: Coronary Angiography, Coronary Restenosis, MESH: Stents, MESH: Constriction, Pathologic, Percutaneous Coronary Intervention, Treatment Outcome, MESH: Lithotripsy, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Coronary Restenosis, Lithotripsy, Intravascular lithotripsy, Humans, Stents, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, MESH: Treatment Outcome
Abstract: International audience; Background: Intravascular lithotripsy (IVL) is a promising new technology for disrupting de-novo calcified coronary lesions (DNL) before percutaneous coronary intervention (PCI). We assessed 12-month outcomes of IVL in patients undergoing PCI for DNL or intra stent restenosis (ISR) lesions related to device underexpansion.Methods: Prospective analysis of patients in the multicentre all-comers French Shock Initiative IVL registry. The primary safety endpoints in this analysis were in-hospital and 12-month major adverse cardiovascular events (MACE: cardiac death, myocardial infarction or target vessel revascularization). The primary effectiveness endpoint was procedural success, defined as
Published: 2022

17. Association of preoperative COVID-19 and postoperative respiratory morbidity during the Omicron epidemic wave: the DROMIS-22 multicentre prospective observational cohort study

Author: Marc Garnier, Jean-Michel Constantin, Raphaël Cinotti, Chafia Daoui, Dimitri Margetis, Grégory Destruhaut, Cédric Cirenei, Eric Noll, Christophe Quesnel, Agnes Lecinq, Sigismond Lasocki, Hélène Charbonneau, Stanislas Abrard, Cyril Quemeneur, Bruno Pastene, Nathanaël Lapidus, Marc Leone, El Mahdi Hafiani, Olivier Imauven, Emmanuel Rineau, Maxime Léger, Marc Danguy des Deserts, Johan Schmitt, Philippe Aries, Aurélie Gouel, Julia Voulgaropoulos, Laura Soldan, Romain Deransy, Quentin Laurent, Etienne Gayat, Franck Verdonk, Sabrina Chaouche, Amélie Cambriel, Vincent Degos, Julie Dupont, Laura Daoud, Romain Salettes, Malory Favreau, Julien Pottecher, Sophie Diemunsch, Cyril Bidon, Clémence Roy, Laëtitia Ottolenghi, Damien Edouard, Agnès Lecinq, Frédéric Mercier, Delphine Garrigue, Elsa Jozefowicz, Marie Pariès, Fabien Espitalier, Charlène Piat, Richard Descamps, Maëlle Duchesne, Stéphanie Sigaut, Laurie-Anne Thion, Julie Renard, Elsa Brocas, Besma Zbidi, Mohamed Fki, Guillaume Dufour, Mario Bucciero, Charles-Edouard Rochon, Céline Delerue, Virginie Trehel-Tursis, Julien Raft, Olivier Rangeard, Claire Thiriet, Kevin Lagarde, Angélina Pollet, Félix Pelen, Anaïs Caillard, Philippe Penven, Olivier Huet, Floriane Puel, Xavier Pichon, Laetitia Ligneres, Pauline Bleuze, Stéphanie Deryckere, Lionel Velly, Pierre Simeone, Hery Andrianjatovo, Youri Chipouline, Mouna Boolad, Denis Frasca, Quentin Plouviez, Benoit Plaud, Eric Roland, Delphine Cheron-Leroy, Samy Figueiredo, Antonia Blanié, Olivier Joannes-Boyau, Simon Monziols, Jean-Jacques Robin, Matthieu Biais, Hugues De Courson, Cécile Degryse, Marie Do-Khac, Marie-Pierre Bonnet, Aurélien Mazeraud, Jean Bardon, Eléonore Bouchereau, Karine Bezulier, Ségolène Mrozek, Nicolas Mayeur, Sandrine Lopez, Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire (GRC 29 - ARPE), Sorbonne Université (SU), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Clermont Auvergne (UCA), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre hospitalier universitaire de Nantes (CHU Nantes), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Univ - UFR Pharmacie), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), SFAR Research Network, Société Française d'Anesthésie Réanimation et médecine péri-opératoire (SFAR), 74 rue Raynouard, Paris 75016, France, Clinique du sport de Bordeaux-Mérignac, Pôle d'Anesthésie-Réanimation, Centre Hospitalier Universitaire de Lille, Boulevard du Professeur Jules Leclerc, Lille Cedex 59037, France, Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital de Hautepierre [Strasbourg], Université Paris-Saclay, AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Clinique Pasteur [Toulouse], Hospices Civils de Lyon (HCL), Department of Anesthesiology, Clinique Drouot Sport, 37 rue Molitor, Paris 75016, France, Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], and Funding: The study was fully funded by the French Society of Anaesthesiology and Intensive Care Medicine (SFAR).
Subjects: Anaesthesia, Respiratory complications, Postoperative pneumonia, COVID-19, Surgery, General Medicine, Perioperative risk, Acute respiratory failure, Prognosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: Preoperative COVID-19 has been associated with excess postoperative morbi-mortality. Consequently, guidelines were developed that recommended the postponement of surgery for at least 7 weeks after the infection. We hypothesised that vaccination against the SARS-CoV-2 and the large predominance of the Omicron variant attenuated the effect of a preoperative COVID-19 on the occurrence of postoperative respiratory morbidity.Methods: We conducted a prospective cohort study in 41 French centres between 15 March and 30 May 2022 (ClinicalTrials NCT05336110), aimed at comparing the postoperative respiratory morbidity between patients with and without preoperative COVID-19 within 8 weeks prior to surgery. The primary outcome was a composite outcome combining the occurrence of pneumonia, acute respiratory failure, unexpected mechanical ventilation, and pulmonary embolism within the first 30 postoperative days. Secondary outcomes were 30-day mortality, hospital length-of-stay, readmissions, and non-respiratory infections. The sample size was determined to have 90% power to identify a doubling of the primary outcome rate. Adjusted analyses were performed using propensity score modelling and inverse probability weighting.Findings: Of the 4928 patients assessed for the primary outcome, of whom 92.4% were vaccinated against the SARS-CoV-2, 705 had preoperative COVID-19. The primary outcome was reported in 140 (2.8%) patients. An 8-week preoperative COVID-19 was not associated with increased postoperative respiratory morbidity (odds ratio 1.08 [95% CI 0.48-2.13]; p = 0.83). None of the secondary outcomes differed between the two groups. Sensitivity analyses concerning the timing between COVID-19 and surgery, and the clinical presentations of preoperative COVID-19 did not show any association with the primary outcome, except for COVID-19 patients with ongoing symptoms the day of surgery (OR 4.29 [1.02-15.8]; p = 0.04).Interpretation: In our Omicron-predominant, highly immunised population undergoing general surgery, a preoperative COVID-19 was not associated with increased postoperative respiratory morbidity.
Published: 2023

18. Physical activity prescription for improving health in patients with cardiometabolic risk : Using empirical evidence to provide clear public health messages

Author: Guiraud , Thibaut, Labrunée , Marc, Pathak , Atul, Pillard , Fabien, Stapley , Paul J., Grémeaux , Vincent, Centre de Rééducation Cardiovasculaire et Pulmonaire [Clinique Saint Orens - Toulouse), Clinique Saint-Orens, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de cardiologie [Clinique Pasteur - Toulouse], Clinique Pasteur [Toulouse], Hôpital Larrey, Service d'Exploration de la Fonction Respiratoire et de Médecine du Sport, Toulouse, School of Medicine [University of Wollongong], Faculty of Science, Medicine and Health [Wollongong], University of Wollongong [Australia]-University of Wollongong [Australia], Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] (PIT), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie (CIC-P803), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Hôpital de Rangueil-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Cardiologie [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, Faculty of Science, Medicine and Health [University of Wollongong], University of Wollongong-University of Wollongong, Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] ( PIT ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie ( CIC-P803 ), Université de Bourgogne ( UB ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon )
Subjects: Public health, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physical activité, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: Type de document : lettre à l'éditeur; International audience
Published: 2015

19. Evolution of TAVI patients and techniques over the past decade: The French TAVI registries

Author: Didier, Romain, Le Breton, Herve, Eltchaninoff, Helene, Cayla, Guillaume, Commeau, Philippe, Collet, Jean-Philippe, Cuisset, Thomas, Dumonteil, Nicolas, Verhoye, Jean-Philippe, Beurtheret, Sylvain, Lefevre, Thierry, Iung, Bernard, Gilard, Martine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Timone [CHU - APHM] (TIMONE), Clinique Pasteur [Toulouse], Hôpital Saint-Joseph [Marseille], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), French Government, man-aged by the National Research Agency (ANR) [ANR-16-RHUS-0003], and ANR-16-RHUS-0003,STOP-AS,STOP-AS(2016)
Subjects: Aged, 80 and over, Transcatheter aortic valve implantation, Time Factors, Outcomes, Aortic Valve Stenosis, General Medicine, Evolution over time, Transcatheter Aortic Valve Replacement, Treatment Outcome, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Aortic Valve, Humans, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Registries, Cardiology and Cardiovascular Medicine
Abstract: International audience; Background. - The French transcatheter aortic valve implantation (TAVI) registries, linked with the nationwide administrative databases, have collected data on TAVI procedures from the first experience to current practices.Objective. - To investigate changes over the past decade in patient and procedural characteristics, major complications and mortality after TAVI.Methods. - Data from the France TAVI and FRANCE 2 registries, collected between 2010 and 2021, were linked using a probabilistic algorithm to the French national health single-payer claims database (SNDS). The algorithm created patient profiles from TAVI procedures in SNDS, matching them as closely as possible to the profiles in the registry databases.Results. - A total of 84,783 TAVI patients were included during the study period. The median age was 83 years (quartile 1, 79 years; quartile 3, 87 years) and remained stable over time. The median EuroSCORE 1 surgical risk score was 12.8 (quartile 1, 7.9; quartile 3, 21.0), and decreased over time. The number of procedures increased linearly, from 1556 in 2010 to 14,114 in 2021. The prevalence of iliofemoral access increased, whereas use of the other approaches decreased. Rates of in-hospital, 30-day and 1-year mortality per year were lower in patients undergoing TAVI after 2015, regardless of the surgical risk score. Finally, hospital length of stay decreased progressively, from 8 days in 2010 to 4 days in 2021.Conclusion. - The TAVI registries provide the cornerstone for recording changes in TAVI. Over the past decade, patient profiles have improved whereas their age has remained stable. Simplification of the procedure reduced rates of death and major complications as well as length of hospital stay.
Published: 2022

20. Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study

Author: Michael, Mounié, Nadège, Costa, Pierre, Gourdy, Christelle, Latorre, Solène, Schirr-Bonnans, Jean-Marc, Lagarrigue, Henri, Roussel, Jacques, Martini, Jean-Christophe, Buisson, Marie-Christine, Chauchard, Jacqueline, Delaunay, Soumia, Taoui, Marie-France, Poncet, Valeria, Cosma, Sandrine, Lablanche, Magali, Coustols-Valat, Lucie, Chaillous, Charles, Thivolet, Caroline, Sanz, Alfred, Penfornis, Benoît, Lepage, Hélène, Colineaux, Hélène, Hanaire, Laurent, Molinier, Marie-Christine, Turnin, Université Fédérale Toulouse Midi-Pyrénées, Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), MSA Midi-Pyrénées Nord [Montauban] (MSA-MPN), Directions régionales du Service médical Occitanie [Toulouse] (DRSM / CNAM), DIAMIP Network [Toulouse] ( Association Diabète Occitanie), Ecole Nationale Supérieure d'Electrotechnique, d'Electronique, d'Informatique, d'Hydraulique et de Télécommunications (ENSEEIHT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Clinique Claude Bernard - ELSAN [Albi] (CCBE), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Grenoble, Clinique Ambroise Paré - ELSAN [Toulouse] (CAPE), Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de Lyon (CHU Lyon), Clinique Pasteur [Toulouse], Centre Hospitalier Sud Francilien, Educ@dom Study Group, and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Telemonitoring, Educ@dom, Economic assessment, Tele-education, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, Internal Medicine, Lifestyle management, Type 2 diabetes, Cost-effectiveness
Abstract: Erratum inCorrection to: Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study.Mounié M, Costa N, Gourdy P, Latorre C, Schirr-Bonnans S, Lagarrigue JM, Roussel H, Martini J, Buisson JC, Chauchard MC, Delaunay J, Taoui S, Poncet MF, Cosma V, Lablanche S, Coustols-Valat M, Chaillous L, Thivolet C, Sanz C, Penfornis A, Lepage B, Colineaux H, Hanaire H, Molinier L, Turnin MC; Educ@dom Study Group, Benhamou PY, Rodier M, Ayon F, Puel-Olivier F, Fontaine S, Perron M, Arrivié J, Cousty-Pech F, Rouby C, Lafon F, Moura I.Diabetes Ther. 2022 May;13(5):1131-1132. doi: 10.1007/s13300-022-01248-6.PMID: 35316510 Free PMC article. No abstract available.; International audience; INTRODUCTION: Telemedicine programs using health technological innovation to remotely monitor the lifestyles of patients with type 2 diabetes (T2D) can improve glycaemic control and thus reduce the incidence of complications as well as management costs. In this context, an assessment was made of the 1-year and 2-year cost-effectiveness of the EDUC@DOM telemonitoring and tele-education program. METHODS: The EDUC@DOM study was a multicentre randomized controlled trial conducted between 2013 and 2017 that compared a telemonitoring group (TMG) to a control group (CG) merged with health insurance databases to extract economic data on resource consumption. Economic analysis was performed from the payer perspective, and direct costs and indirect costs were considered. The clinical outcome used was the intergroup change in glycated haemoglobin (HbA1c) levels from baseline. Missing economic data were imputed using multiple imputation, and fitted values from a generalized linear mixed model were used to calculate the incremental cost-effectiveness ratio (ICER). Bootstrapped 95% confidence ellipses were drawn in the cost-effectiveness plan. RESULTS: The main analysis included data from 256 patients: 126 in the TMG and 130 in the CG. Incremental costs over 1 and 2 years were equal to €2129 and €5101, respectively, in favour of the TMG. Once imputed and adjusted for confounding factors, the TMG trends to a 21% cost decrease over 1 and 2 years of follow-up (0.79 [0.58; 1.08], p = 0.1452 and 0.79 [0.61; 1.03], p = 0.0879, respectively). The EDUC@DOM program led to a €1334 cost saving and a 0.17 decrease in HbA1c over 1 year and a €3144 cost saving and a 0.14 decrease in HbA1c over 2 years. According to the confidence ellipse, EDUC@DOM was a cost-effective strategy. CONCLUSION: This study provides additional economic information on telemonitoring and tele-education programs to enhance their acceptance and promote their use. In the light of this work, the EDUC@DOM program is a cost-saving strategy in T2D management. TRIAL REGISTRATION: This trial was registered in the Clinical Trials Database on 27 September 2013 under no. NCT01955031 and bears ID-RCB no. 2013-A00391-44.
Published: 2022

21. Pulmonary vein isolation alone or in combination with substrate modulation after electrical cardioversion failure in patients with persistent atrial fibrillation: The PACIFIC trial: Study design

Author: Agustín Alfonso, Bortone, Eloi, Marijon, Luca Rosario, Limite, Philippe, Lagrange, François, Brigadeau, Raphaël, Martins, Cyril, Durand, Jean-Paul, Albenque, Clinique des Franciscaines, Nîmes, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Clinique Saint Pierre, Perpignan, Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique de l'Infirmerie Protestante de Lyon (CIPL), Clinique Pasteur [Toulouse], Biosense Webster, Inc., Diamond Bar, CA, USA, and Groupement de Cooperation Sanitaire ELSAN
Subjects: Physiology (medical), [SDV]Life Sciences [q-bio], Marshall-PLAN, atrial fibrillation, Cardiology and Cardiovascular Medicine, electrical cardioversion, randomized study, comparative study, pulmonary vein isolation
Abstract: Pulmonary vein isolation (PVI) is effective at treating 50% of unselected patients with persistent atrial fibrillation (AF). Alternatively, PVI combined with a new ablation strategy entitled the Marshall-PLAN ensures a 78% 1-year sinus rhythm (SR) maintenance rate in the same population. However, a substantial subset of patients could undergo the Marshall-PLAN unnecessarily. It is therefore essential to identify those patients who can be treated with PVI alone versus those who may truly benefit from the Marshall-PLAN before ablation is performed. In this context, we hypothesized that electrical cardioversion (EC) could help to select the most appropriate strategy for each patient.In this multicentre, prospective, randomized study, patients with AF recurrence within 4 weeks after EC will be randomized 1:1 to PVI alone or the Marshall-PLAN. Conversely, patients in whom SR is maintained for ≥4 weeks after EC will be treated with PVI only and included in a prospective registry. The primary endpoint will be the 1-year SR maintenance rate after a single ablation procedure.The Marshall-PLAN might be necessary in patients with an advanced degree of persistent AF (i.e., where SR is not maintained for ≥4 uninterrupted weeks after EC). Conversely, in patients with mild or moderate persistent AF (i.e., where SR is maintained for ≥4 weeks after EC), PVI alone might be a sufficient ablation strategy. The PACIFIC trial is the first study designed to assess whether rhythm monitoring after EC could help to identify patients who should undergo adjunctive ablation strategies beyond PVI.
Published: 2022

22. Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Author: Pierre Deharo, Lionel Leroux, Alexis Theron, Jérome Ferrara, Antoine Vaillier, Nicolas Jaussaud, Alizée Porto, Pierre Morera, Vlad Gariboldi, Bernard Iung, Thierry Lefevre, Philippe Commeau, Margaux Gouysse, Florence du Chayla, Nicolas Glatt, Guillaume Cayla, Herve Le Breton, Hakim Benamer, Sylvain Beurtheret, Jean Philippe Verhoye, Helene Eltchaninoff, Martine Gilard, Jean Philippe Collet, Nicolas Dumonteil, Frederic Collart, Thomas Modine, Thomas Cuisset, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Timone [CHU - APHM] (TIMONE), Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux], CHU Bordeaux [Bordeaux], Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Privé Jacques Cartier [Massy], Polyclinique Les Fleurs - ELSAN [Ollioules] (PLF), Clinityx, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Pontchaillou [Rennes], Hôpital Saint-Joseph [Marseille], Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Clinique Pasteur, Clinique Pasteur [Toulouse], and ANR-16-RHUS-0003,STOP-AS,STOP-AS(2016)
Subjects: TAVI, Mismatch, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, General Medicine, mismatch, paravalvular leak, Paravalvular leak
Abstract: Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.
Published: 2022
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23. What do we need to deliver 'online' adapted radiotherapy treatment plans?

Author: G, Delpon, A, Barateau, A, Beneux, I, Bessières, I, Latorzeff, J, Welmant, A, Tallet, Laboratoire de physique subatomique et des technologies associées (SUBATECH), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Nantes université - UFR des Sciences et des Techniques (Nantes univ - UFR ST), Nantes Université - pôle Sciences et technologie, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Sciences et technologie, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CRLCC Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Clinique Pasteur [Toulouse], Institut du Cancer de Montpellier (ICM), Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
Subjects: [PHYS]Physics [physics], Adaptive radiotherapy, Artificial Intelligence, Radiotherapy Planning, Computer-Assisted, Radiothérapie adaptative, Humans, CBCT, Radiotherapy Dosage, Radiotherapy, Intensity-Modulated, Radiotherapy, Image-Guided, IRM, MRI
Abstract: National audience; During the joint SFRO/SFPM session of the 2019 congress, a state of the art of adaptive radiotherapy announced a strong impact in our clinical practice, in particular with the availability of treatment devices coupled to an MRI system. Three years later, it seems relevant to take stock of adaptive radiotherapy in practice, and especially the “online” strategy because it is indeed more and more accessible with recent hardware and software developments, such as coupled accelerators to a three-dimensional imaging device and algorithms based on artificial intelligence. However, the deployment of this promising strategy is complex because it contracts the usual time scale and upsets the usual organizations. So what do we need to deliver adapted treatment plans with an “online” strategy?
Published: 2022

24. Recommendations for planning and delivery of radical radiotherapy for localized urothelial carcinoma of the bladder

Author: Renaud de Crevoisier, David Azria, Christophe Hennequin, Jonathan Khalifa, Pierre Graff-Cailleaud, Igor Latorzeff, Gilles Créhange, Pierre Blanchard, Arnaud Mejean, Nicolas Magné, Morgane Cabaillé, Olivier Riou, Morgan Rouprêt, Géraldine Pignot, S. Belhomme, Olivier Chapet, Paul Sargos, Stéphane Culine, David Pasquier, Stéphane Supiot, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Endothelium Radiobiology and Targeting (CRCINA-ÉQUIPE 14), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Gustave Roussy (IGR), Department of Radiotherapy, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Institut de Cancérologie Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Eugène Marquis (CRLCC), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut du Cancer de Montpellier (ICM), Institut Bergonié [Bordeaux], UNICANCER, Clinique Pasteur [Toulouse], Equipe IFTIM [ImViA - EA7535], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Imagerie et Vision Artificielle [Dijon] (ImViA), Université de Bourgogne (UB)-Université de Bourgogne (UB), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Guidelines, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Medical physics, Adaptive radiotherapy, Adaptative radiotherapy, Urothelial carcinoma, Image-guided radiation therapy, Carcinoma, Transitional Cell, Bladder cancer, Image guided radiation therapy, Radiotherapy, business.industry, Radiotherapy Planning, Computer-Assisted, Standard treatment, Radiotherapy Dosage, Radical radiotherapy, Hematology, medicine.disease, Clinical trial, Radiation therapy, Urinary Bladder Neoplasms, Oncology, 030220 oncology & carcinogenesis, Radiotherapy, Intensity-Modulated, Trimodal therapy, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Radiotherapy, Image-Guided
Abstract: International audience; Purpose: Curative radio-chemotherapy is recognized as a standard treatment option for muscle-invasive bladder cancer (MIBC). Nevertheless, the technical aspects for MIBC radiotherapy are heterogeneous with a lack of practical recommendations.Methods and materials: In 2018, a workshop identified the need for two cooperative groups to develop consistent, evidence-based guidelines for irradiation technique in the delivery of curative radiotherapy. Two radiation oncologists performed a review of the literature addressing several topics relative to radical bladder radiotherapy: planning computed tomography acquisition, target volume delineation, radiation schedules (total dose and fractionation) and dose delivery (including radiotherapy techniques, image-guided radiotherapy (IGRT) and adaptive treatment modalities). Searches for original and review articles in the PubMed and Google Scholar databases were conducted from January 1990 until March 2020. During a meeting conducted in October 2020, results on 32 topics were presented and discussed with a working group involving 15 radiation oncologists, 3 urologists and one medical oncologist. We applied the American Urological Association guideline development's method to define a consensus strategy.Results: A consensus was obtained for all 34 except 4 items. The group did not obtain an agreement on CT enhancement added value for planning, PTV margins definition for empty bladder and full bladder protocols, and for pelvic lymph-nodes irradiation. High quality evidence was shown in 6 items; 8 items were considered as low quality of evidence.Conclusion: The current recommendations propose a homogenized modality of treatment both for routine clinical practice and for future clinical trials, following the best evidence to date, analyzed with a robust methodology. The XXX group formulates practical guidelines for the implementation of innovative techniques such as adaptive radiotherapy.
Published: 2021

25. First-in-Man trial of a drug-free bioresorbable stent designed to minimize the duration of coronary artery scaffolding

Author: Pierre Coste, Jean Fajadet, Michel Vert, Antoine Lafont, Marco G. Mennuni, Didier Carrié, Paul Barragan, Clinique Pasteur, Clinique Pasteur [Toulouse], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Hôpital de Rangueil, CHU Toulouse [Toulouse], Polyclinique des fleurs, CHU Bordeaux [Bordeaux], Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] (IBMM), and Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Drug, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, media_common.quotation_subject, Biomedical Engineering, Biophysics, Bioengineering, 030204 cardiovascular system & hematology, Coronary Angiography, Prosthesis Design, Biomaterials, 03 medical and health sciences, 0302 clinical medicine, Angioplasty, Absorbable Implants, medicine, [CHIM]Chemical Sciences, Humans, cardiovascular diseases, 030212 general & internal medicine, media_common, business.industry, Stent, Drug-Eluting Stents, equipment and supplies, Coronary Vessels, 3. Good health, Surgery, Treatment Outcome, surgical procedures, operative, medicine.anatomical_structure, Stents, Artery diseases, business, Artery
Abstract: International audience; For the last two decades, various degradable stents have been proposed to treat coronary artery diseases and replace metallic stents to avoid residual foreign material after healing. To date, the right balance between suitable scaffolding and loss of radial strength soon after endothelium restoration is still an unmet need. The present article reports on the First-in-Man trial of a drug-free bioresorbable stent based on a lactic acid stereocopolymer composed of 98% l-lactyl units selected to release stress shielding earlier than in the case of homopoly(l-lactic acid). Thirty patients with single de novo coronary lesions were included in the trial. The fate of scaffolds was monitored by clinical and imaging follow-ups to assess rate of adverse events, acute recoil, late luminal loss, and late lumen recovery. There was no death, no myocardial infarction, and no stent thrombosis observed over the 36 months trial. Dismantling occurred about 3 months after implantation. Bioresorption was almost completed at 2 years. The late lumen loss observed at the end of the first year was partly compensated one year later by enlarging remodeling. At one year, a neointimal hyperplasia slightly greater than for drug-eluting metallic and bioresorbable stents was shown using optical coherence tomography. The excess of hyperplasia was discussed relative to struts thickness, absence of anti-proliferative drug, and release of degradation by-products.
Published: 2021

26. Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump

Author: Paul-Michel Mertes, Michel Kindo, Julien Amour, Christophe Baufreton, Lionel Camilleri, Thierry Caus, Didier Chatel, Bernard Cholley, Alain Curtil, Jean-Philippe Grimaud, Rémi Houel, Fehmi Kattou, Jean-Luc Fellahi, Catherine Guidon, Pierre-Grégoire Guinot, Guillaume Lebreton, Sandrine Marguerite, Alexandre Ouattara, Sophie Provenchère Fruithiot, Bertrand Rozec, Jean-Philippe Verhoye, André Vincentelli, Hélène Charbonneau, Les Hôpitaux Universitaires de Strasbourg (HUS), Nouvel Hôpital Civil de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Hôpital Privé Jacques Cartier [Massy], MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Clermont-Ferrand, CHU Amiens-Picardie, Nouvelle Clinique de Tours Saint Gatien-Alliance [Tours] (CTSGA), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Innovations thérapeutiques en hémostase (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Clinique de la Sauvegarde [Lyon], Clinique Saint Augustin, Hôpital Saint-Joseph [Marseille], Institut Mutualiste de Montsouris (IMM), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital de la Timone [CHU - APHM] (TIMONE), Aix Marseille Université (AMU), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Dijon, Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Hôpital Pontchaillou, CHU Lille, Université de Lille, Clinique Pasteur [Toulouse], DESSAIVRE, Louise, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis (IThEM - U1140), École Pratique des Hautes Études (EPHE), and UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)
Subjects: Adult, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Cardiopulmonary Bypass, Critical Care, Coronary Artery Bypass, Off-Pump, off pump cardiac surgery, General Medicine, Cardiac surgery, Guidelines, Length of Stay, Critical Care and Intensive Care Medicine, Enhanced recovery after surgery (ERAS), Anesthesiology and Pain Medicine, Anesthesiology, Patient Satisfaction, Humans, Anesthesia, Cardiac Surgical Procedures, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Objective: To provide recommendations for enhanced recovery after cardiac surgery (ERACS) based on a multimodal perioperative medicine approach in adult cardiac surgery patients with the aim of improving patient satisfaction, reducing postoperative mortality and morbidity, and reducing the length of hospital stay. Design: A consensus committee of 20 experts from the French Society of Anaesthesia and Intensive Care Medicine (Societe francaise d'anesthesie et de reanimation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Societe francaise de chirurgie thoracique et cardio-vasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guideline process was conducted independently of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence. Methods: Six fields were defined: (1) selection of the patient pathway and its information; (2) preoperative management and rehabilitation; (3) anaesthesia and analgesia for cardiac surgery; (4) surgical strategy for cardiac surgery and bypass management; (5) patient blood management; and (6) postoperative enhanced recovery. For each field, the objective of the recommendations was to answer questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). Based on these questions, an extensive bibliographic search was carried out and analyses were performed using the GRADE approach. The recommendations were formulated according to the GRADE methodology and then voted on by all the experts according to the GRADE grid method. Results: The SFAR/SFCTCV guideline panel provided 33 recommendations on the management of patients undergoing cardiac surgery under cardiopulmonary bypass or off-pump. After three rounds of voting and several amendments, a strong agreement was reached for the 33 recommendations. Of these recommendations, 10 have a high level of evidence (7 GRADE 1+ and 3 GRADE 1-); 19 have a moderate level of evidence (15 GRADE 2+ and 4 GRADE 2-); and 4 are expert opinions. Finally, no recommendations were provided for 3 questions. Conclusions: Strong agreement existed among the experts to provide recommendations to optimise the complete perioperative management of patients undergoing cardiac surgery. (C) 2022 The Authors. Published by Elsevier Masson SAS on behalf of Societe francaise d'anesthesie et de reanimation (Sfar).
Published: 2022

27. A national healthcare response to intensive care bed requirements during the COVID-19 outbreak in France

Author: Lefrant, Jean-Yves, Fischer, Marc-Olivier, Potier, Hugo, Degryse, Cécile, Jaber, Samir, Muller, Laurent, Pottecher, Julien, Charboneau, Hélène, Meaudre, Eric, Lanot, Pierre, Bruckert, Vincent, Plaud, Benoît, Dureuil, Bertrand, Samain, Emmanuel, Bouaziz, Hervé, Ecoffey, Claude, Capdevila, Xavier, Lammens, Stéphane, Bonnet, Vincent, Prevost, Fabrice, Aussant, Philippe, Merouani, Karim, Alaoui, Samir Sidiki, Kalfon, Pierre, Mfam, Willy-Serge, Oilleau, Jean-Ferréol, Moussa, Mouhamed, Arab, Osama Abou, FELLAHI, Jean-Luc, Suzanne, Stéphanie, Coucoravas, Jérémy, Espitalier, Fabien, Bavozet, Florent, Fermier, Brice, Vincent, Jean-François, Ouchikhe, Abdelali, Herbland, Alexandre, Godde, Fréféric, Frasca, Denis, Desebe, Oliver, Riu, Béatrice, Faure, Henri, Hurel, Dominique, Bedos, Jean-Pierre, Lefevres-Scelles, Antoine, Hayon, Jan, Chanques, Gerald, Boutonnet, Mathieu, Pasquier, Pierre, Audibert, Gérard, Mertes, Paul Michel, Losser, Marie Reine, Collange, Olivier, Pottecher, Thierry, Aubrun, Frédéric, Payen, Jean François, Albaladejo, Pierre, Bouzat, Pierre, Ichaï, Carole, Leone, Marc, Bruder, Nicolas, Velly, Lionel, Fourcade, Olivier, Biais, Matthieu, Ouattara, Alexandre, Debaene, Bertrand, Fizelier, Claire Dahyot, Asehnoune, Karim, Lasocki, Sigismond, Roquilly, Antoine, Tavernier, Benoit, Kipnis, Eric, Lorne, Emmanuel, Bouhemad, Belaid, Dupont, Hervé, Morel, Jérome, Molliex, Serge, Beuret, Pascal, Constantin, Jean-Michel, Gayat, Etienne, Mebazaa, Alexandre, Schoeffler, Mathieu, Mateu, Philippe, Verdier, Philippe, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Initial MAnagement and prevention of acute orGan failures IN critically ill patiEnts (IMAGINE), Université de Montpellier (UM), Université de Caen Normandie (UNICAEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), BESPIM, CHU Bordeaux [Bordeaux], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Les Hôpitaux Universitaires de Strasbourg (HUS), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Clinique Pasteur [Toulouse], Hôpital d'Instruction des Armées Sainte Anne, Service de Santé des Armées, École du Val de Grâce (EVDG), Hôpital Privé d'Antony, Centre Hospitalier Universitaire de Nice (CHU Nice), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Paris (UP), CHU Rouen, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pontchaillou [Rennes], Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: medicine.medical_specialty, National Health Programs, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], health care facilities, manpower, and services, Personnel Staffing and Scheduling, Context (language use), Critical Care and Intensive Care Medicine, Pacu, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Acute care, Intensive care, Bed availability, Health care, medicine, Humans, Bed Conversion, 030212 general & internal medicine, Pandemics, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Ventilators, Mechanical, biology, SARS-CoV-2, business.industry, COVID-19, Outbreak, 030208 emergency & critical care medicine, General Medicine, biology.organism_classification, medicine.disease, Intensive care unit, 3. Good health, Hospitalization, Personnel, Hospital, Intensive Care Units, Anesthesiology and Pain Medicine, Hospital Bed Capacity, Health Care Surveys, ICU, Original Article, France, Medical emergency, business
Abstract: Background Whereas 5415 Intensive Care Unit (ICU) beds were initially available, 7148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed. Methods All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak. Results Among 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5054/5531 (91%) ICU beds. During the outbreak, 4806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9860, 1982 and 3089 ICU, ACU and PACU beds were made available. Before the outbreak, 3548 physicians (2224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1785 residents, 11,023 nurses and 6763 nursing auxiliaries worked in established ICUs. During the outbreak, 2524 physicians, 715 residents, 7722 nurses and 3043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3212 new ventilators were added to the 5997 initially available in ICU. Conclusion During the COVID-19 outbreak, the French Health Care system created 4806 ICU beds (+95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.
Published: 2020

28. FRAGILE: FRench Attitude reGistry in case of ICD LEad replacement

Author: Eloi Marijon, Nicolas Clementy, Olivier Piot, Christine Alonso, A. Dompnier, Serge Boveda, Nicolas Sadoul, Christelle Marquié, Guillaume Caudron, Pascal Defaye, 'groupe Rythmologie—Stimulation cardiaque de la société française de cardiologie', Antoine Da Costa, Christophe Leclercq, Françoise Hidden-Lucet, Jean-Claude Deharo, Pierre Mondoly, Hôpital Ambroise Paré [AP-HP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Clinique Pasteur, Clinique Pasteur [Toulouse], Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Pontchaillou [Rennes], Hôpital saint Pierre, GH Sud Réunion, Centre cardiologique du Nord (CCN), Hôpital de la Timone [CHU - APHM] (TIMONE), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Clinical sciences, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, Registry, Pediatrics, medicine.medical_specialty, Icd lead, Electric Countershock, Statistical difference, 030204 cardiovascular system & hematology, Implantable cardioverter-defibrillator lead, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Lead failure, Physiology (medical), Clinical endpoint, Humans, Medicine, Registries, 030212 general & internal medicine, Device Removal, Aged, Lead extraction, business.industry, Middle Aged, medicine.disease, Comorbidity, Defibrillators, Implantable, attitude, Abandonment (emotional), Observational study, Cardiology and Cardiovascular Medicine, business
Abstract: Aims FRench Attitude reGistry in case of ICD LEad replacement (FRAGILE) registry was set-up to describe the attitude in different French institutions in case of implantable cardioverter-defibrillator (ICD) lead replacement, extraction, or abandonment and to compare outcomes in both groups. Methods and results Prospective observational study comparing two attitudes in case of ICD lead replacement, extraction, or abandonment. Primary endpoint describes the attitude in different French centres, collect parameters that may influence the decision. Secondary endpoint compares early and mid-term (2 years) complications in both groups. Between April 2013 and April 2017, 552 patients were included in 32 centres. 434 (78.6%) were male, mean patient’s age was 60.3 ± 14.4 years. In 56.9% of the cases, the decision was to explant the lead. Patients in the extraction group were younger than in the abandonment group (56.7 ± 14.5 vs. 65 ± 12.7 P Conclusion In this registry, the strategy in case of non-infected ICD lead replacement was mainly influenced by patient’s age and comorbidities and lead dwelling time. No difference was observed in outcomes in both strategies.
Published: 2020

29. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators

Author: Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessière, Fabien Labombarda, Christelle Marquié, Jean-Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Alain Al Arnaout, Frédéric Anselme, Caroline Audinet, Yvette Bernard, Serge Boveda, Sok Sithikun Bun, Morgane Chassignolle, Gaël Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphaël Martins, Jean-Luc Pasquié, Jean-Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Chrystelle Akret, Jean-Paul Albenque, Vincent Algalarrondo, Christine Alonso, Denis Amet, Frédéric Ansselme, Anouk Asselin, Nicolas Badenco, Hugues Bader, Marc Badoz, Pierre Baudinaud, Nathalie Behar, Mouna Ben Kilani, Géraldine Bertaux, Cathy Bertrand, Francis Bessiere, Hughes Blangy, Damien Bonnet, Pierre Bordchar, Paul Bru, Adrien Carabelli, Christèle Cardin, Bruno Cauchemez, Tej Chalbia, Laure Champ-Rigot, Thomas Chastre, Philippe Chevallier, Nicolas Clementy, Stéphane Combes, Christian De Chillou, Maxime De Guillebon, Bruno Degand, Jean-Claude Deharo, Nicolas Derval, Sylvie Di Filippo, Guillaume Domain, Antoine Dompnier, Arnaud Dulac, Alexandre Duparc, D Cécile Duplantier, Rim El Bouazzaoui, Bogdan Enache, Fabrice Extramiana, Pierre Fiorello, Pierre Frey, Luc Freysz, Vincent Galand, Estelle Gandjbakhch, Kevin Gardey, Olivier Geoffroy, Bénédicte Godin, Samuel Goussot, Caroline Grimard, Jean-Baptiste Guichard, Michel Haissaguerre, David Hamon, Sébastien Hascoet, Karim Hasni, Jean-Sylvain Hermida, Françoise Hidden-Lucet, Mélèze Hocini, Jérome Hourdain, Peggy Jacon, Gaël Jauvert, Frédéric Jean, Nicolas Johnson, Pierre Khattar, Ziad Khoueiry, Rita Koutbi, Guillaume Laborie, Gabriel Lactu, Pierre-Marc Lallemand, Gabriel Laurent, Thomas Lavergne, Arnaud Lazarus, Laurianne Le Gloan, Christophe Leclercq, Antoine Leenhardt, Nicolas Lellouche, Christophe Loose, Philippe Mabo, Alice Maltret, Franck Mandel, Christelle Marquie, Carole Maupain, Antoine Milhelm, Paul Milliez, Adrian Mirolo, Ghassan Moubarak, Stéphane Mourot, Jacky Ollitrault, Pierre Ollitrault, Akli Otmani, Jean-Luc Pasquie, Dominique Pavin, Séverinne Philibert, Damien Poindron, Charlotte Potelle, Vincent Probst, Paul Puie, Anne Rollin, Cécile Romeyer-Bouchard, Nicolas Sadoul, Audrey Sagnard, Arnaud Savoure, Didier Scarlatti, Fabien Squara, Nikita Tanese, Jean Benoit Thambo, Olivier Thomas, Emie Varlet, Sandrine Venier, Quentin Voglimacci Stephanopoli, Xavier Waintraub, Françoise Wiart, Alexandre Zhao, Amir Zouaghi, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Clinique Pasteur, Clinique Pasteur [Toulouse], and This work was supported by the French Institute of Health and Medical Research, Fédération Française de Cardiologie, and Société Française de Cardiologie. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Subjects: Male, Adult, Heart Defects, Congenital, Sex Characteristics, sudden death, Middle Aged, congenital heart disease, Defibrillators, Implantable, Cohort Studies, implantable cardioverter-defibrillator, Death, Sudden, Cardiac, Tetralogy of Fallot, sex, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, women, ventricular arrhythmia
Abstract: International audience; Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010. Clinical events were centrally adjudicated by a blinded committee.Results: A total of 165 patients (mean age 42.2 ± 13.3 years) were enrolled from 40 centers, including 49 women (29.7%). Among the 9,692 patients with TOF recorded in the national database, the proportion of women with ICDs was estimated to be 1.1% (95% CI: 0.8%-1.5%) vs 2.2% (95% CI: 1.8%-2.6%) in men (P < 0.001). The clinical profiles of patients at implantation, including the number of risk factors for ventricular arrhythmias, were similar between women and men. During a median follow-up period of 6.8 years (IQR: 2.5-11.4 years), 78 patients (47.3%) received at least 1 appropriate ICD therapy, without significant difference in annual incidences between women (12.1%) and men (9.9%) (HR: 1.22; 95% CI: 0.76-1.97; P = 0.40). The risk for overall ICD-related complications was similar in women and men (HR: 1.33; 95% CI: 0.81-2.19; P = 0.30), with 24 women (49.0%) experiencing at least 1 complication.Conclusions: Our findings suggest that women with TOF at high risk for sudden cardiac death have similar benefit/risk balance from ICD therapy compared with men. Whether ICD therapy is equally offered to at-risk women vs men warrants further evaluation in TOF as well as in other congenital heart disease populations. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574)
Published: 2022

30. Mitral valve-in-valve and valve-in-ring procedures: Midterm outcomes in a French nationwide registry

Author: Robin Le Ruz, Patrice Guérin, Guillaume Leurent, Lionel Leroux, Thierry Lefevre, Mohammed Nejjari, Didier Champagnac, Didier Tchétché, Thibault Lhermusier, Thomas Senage, Pierre‐Guillaume Piriou, Christophe Caussin, Maxence Delomez, Guillaume Bonnet, Xavier Favereau, Nicole Karam, Antoine Gerbay, Francis Juthier, Martine Gilard, Jean‐Francois Obadia, Bernard Iung, Thibaut Manigold, Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Institut du Thorax [Nantes], Université de Rennes (UR), Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut Cardiovasculaire Paris Sud [Massy] (ICPS), Centre cardiologique du Nord (CCN), Clinique du Tonkin [Villeurbanne] (CT), Clinique Pasteur [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), PHU 2 - Institut du Thorax et du Sytème Nerveux [CHU Nantes] (ITSN), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Mutualiste de Montsouris (IMM), Hôpital Privé Le Bois Ramsay Santé [Lille], Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital privé de Parly 2 - Ramsay Santé [Le Chesnay-Rocquencourt], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université Jean Monnet - Saint-Étienne (UJM), CHU Lille, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, and CarMeN, laboratoire
Subjects: Male, Cardiac Catheterization, [SDV]Life Sciences [q-bio], heart failure, Ventricular Function, Left, paravalvular leak, percutaneous intervention, percutaneous valve therapy, Humans, Radiology, Nuclear Medicine and imaging, Registries, mitral valve disease, Aged, 80 and over, Bioprosthesis, Heart Valve Prosthesis Implantation, Mitral Valve Insufficiency, Stroke Volume, General Medicine, Prosthesis Failure, [SDV] Life Sciences [q-bio], structural heart disease intervention, Treatment Outcome, Heart Valve Prosthesis, Mitral Valve, Female, Cardiology and Cardiovascular Medicine
Abstract: International audience; OBJECTIVES: Report contemporary outcomes in patients included in the Mitragister registry and treated with transcatheter mitral valve implantation for failed surgical annuloplasty rings or deteriorated bioprosthesis. BACKGROUND: Midterm survival rates have been reported, but little is known about contemporary morbimortality endpoints. METHODS: The primary safety outcome was the technical success rate. The primary efficacy composite endpoint was a composite of cardiovascular mortality and heart failure hospitalizations. RESULTS: From 2016 to 2021, 102 patients (median age: 81 [74;84] years, 61% female, Euroscore II 11.0% [7.8;16.0]) undergoing valve-in-valve (ViV; n = 89) or valve-in-ring (ViR; n = 13) procedures were consecutively included. At baseline, ViR group patients had worse left ventricular ejection fraction (50% vs. 60%; p = 0.004) and more frequently severe regurgitation (46% vs. 15%; p = 0.014). The primary safety outcome was 95%: 77% and 98% in the ViR and ViV populations, respectively, (p = 0.014). At intermediate follow-up (6-12 months) clinical improvement was notable, 88% of the patients were in NYHA class ≤ II (vs. 25% at baseline; p \textless 0.001). At a mean follow-up of 17.1 ± 11.0 months, the primary efficacy composite reached 27%. By multivariate analysis, paravalvular leak (PVL) was the only independent predictor (hazard ratio: 2.39, 95% confidence interval: 1.08-5.29; p = 0.031) while ViR was not found statistically associated (p = 0.456). CONCLUSIONS: This study confirms the safety and efficacy of the mitral ViV procedure. ViR patients appear at higher risk of procedural complications. The presence of PVL could be associated with markedly worse midterm prognosis. Whatever the intervention, procedural strategies to reduce PVL incidence remain to be assessed to prevent latter adverse outcomes.
Published: 2022

31. Infective Endocarditis Caused by Staphylococcus Aureus after Transcatheter Aortic Valve Replacement

Author: Fernando Alfonso, Marco Barbanti, Oliver Husser, Harindra C. Wijeysundera, Jean-Bernard Masson, Ignacio J. Amat-Santos, Samir R. Kapadia, Marina Urena, Francisco Campelo-Parada, Vinicius Esteves, Roger R. Godinho, Tarun Chakravarty, Marcos Antonio Marino, Stamatios Lerakis, Alexandre Siciliano Colafranceschi, Marouane Boukhris, Chekrallah Chamandi, Lisa Crusius, Tomasz Gasior, Azeem Latib, Norman Mangner, Utz Kappert, Josep Rodés-Cabau, José Armando Mangione, Francesco Rosato, Axel Linke, Sandro Sponga, Erika Muñoz-García, Valter Corriea de Lima, Susheel Kodali, Asim N. Cheema, Lars Søndergaard, Igor Vendramin, Alexandre Abizaid, Antonio L. Bartorelli, Annapoorna Kini, Rosana Hernández-Antolín, John G. Webb, Costanza Pellegrini, Didier Tchetche, Howard C. Herrmann, John Lisko, Claudia Fiorina, Mohamed Abdel-Wahab, Kim Won-Keun, Hélène Eltchaninoff, Alberto Alperi, Martin Landt, Dominique Himbert, Frédéric Maes, Victoria Vilalta, Luca Testa, Isaac Pascual, Luisa Salido, Jan Malte Sinning, Vicenç Serra, Guglielmo Mario Actis Dato, Antonio Miceli, Clement Servoz, David del Val, Rafael Romaguera, Maria-Cristina Ferreira, Eric Durand, Julio Andrea, Fabio Sandoli de Brito, Vincent Auffret, Philippe Gervais, Stefan Stortecky, Paolo Olivares, Francesco Giannini, Enrique Gutiérrez-Ibañes, Raj Makkar, Nikolaj Ihlemann, Wojtek Wojakowski, Hervé Le Breton, Abdullah Alkhodair, Juan C. Castillo, Ander Regueiro, David Holzhey, Luis Nombela-Franco, Henrique Barbosa Ribeiro, Saif Siddiqui, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Toulouse [Toulouse], Clinique Pasteur, Clinique Pasteur [Toulouse], Mount Sinai Hospital [Toronto, Canada] (MSH), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), University Hospital Leipzig, Edwards Lifesciences, Fundación Alfonso Martín Escudero, Abbott Laboratories, Medtronic, Boston Scientific Corporation, UCL - (SLuc) Département cardiovasculaire, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Hôpital de Rangueil, Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, medicine.medical_specialty, Staphylococcus aureus, Prosthesis-Related Infections, Transcatheter aortic, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, medicine.disease_cause, Global Health, Prosthesis, Sepsis, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Endocarditis, Humans, 030212 general & internal medicine, Hospital Mortality, Registries, 610 Medicine & health, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Incidence, Aortic Valve Stenosis, Endocarditis, Bacterial, Staphylococcal Infections, medicine.disease, 3. Good health, Surgery, Survival Rate, Infective endocarditis, Aortic Valve, Heart Valve Prosthesis, Etiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: International audience; Background - Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods - Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results - SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if ≥ 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions - SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
Published: 2022

32. Non-invasive diagnosis and follow-up of non-alcoholic fatty liver disease

Author: Sarra Smatti, Victor de Lédinghen, Bertrand Cariou, Maeva Guillaume, Charlotte Bouzbib, M. Bourlière, Nathalie Ganne-Carrié, Christophe Bureau, Raluca Pais, Adrien Lannes, Jérôme Boursier, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Clinique Pasteur [Toulouse], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Hôpital Saint-Joseph [Marseille], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Bordeaux Research In Translational Oncology [Bordeaux] (BaRITOn), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), École pratique des hautes études (EPHE), and Malbec, Odile
Subjects: Liver Cirrhosis, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, Disease, Asymptomatic, digestive system, Liver disease, Non-alcoholic Fatty Liver Disease, Internal medicine, Diabetes mellitus, medicine, Humans, education, education.field_of_study, Hepatology, medicine.diagnostic_test, business.industry, Fatty liver, Gastroenterology, nutritional and metabolic diseases, medicine.disease, digestive system diseases, [SDV] Life Sciences [q-bio], Liver, Liver biopsy, Elasticity Imaging Techniques, Metabolic syndrome, medicine.symptom, business, Follow-Up Studies
Abstract: International audience; NAFLD is a frequent disease that affects 25% of the worldwide population. There is no specific diagnostic test for NAFLD, and the diagnosis mainly relies on the elimination of the other causes of chronic liver diseases with liver biopsy kept for unsure diagnoses. Non-invasive tests are now available to assess NAFLD severity and therefore to help physicians decide on the patient management and follow-up. These non-invasive tests can also be used to define pathways that organize referrals from primary care and diabetology clinics to the liver specialist, with the ambition to improve the screening of asymptomatic patients with NAFLD and advanced liver disease. NAFLD being the liver expression of the metabolic syndrome, physicians need also take care to screen for diabetes and to evaluate the cardiovascular risk in those patients. These recommendations from the French Association for the Study of the Liver (AFEF) aim at providing guidance on the following questions: how to diagnose NAFLD; how non-invasive tests should be used to assess NAFLD severity; how to follow patients with NAFLD; when to perform liver biopsy in NAFLD; and how to decide referral to the liver specialist for a patient with NAFLD.
Published: 2022

33. Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1-year results from the CHOICE-MI registry

Author: Ben Ali, Walid, Ludwig, Sebastian, Duncan, Alison, Weimann, Jessica, Nickenig, Georg, Tanaka, Tetsu, Coisne, Augustin, Vincentelli, Andre, Makkar, Raj, Webb, John G., Akodad, Mariama, Muller, David W.M., Praz, Fabien, Wild, Mirjam G., Hausleiter, Jörg, Goel, Sachin S., von Ballmoos, Moritz Wyler, Denti, Paolo, Chehab, Omar, Redwood, Simon, Dahle, Gry, Baldus, Stephan, Adam, Matti, Ruge, Hendrik, Lange, Rüdiger, Kaneko, Tsuyoshi, Leroux, Lionel, Dumonteil, Nicolas, Tchetche, Didier, Treede, Hendrik, Flagiello, Michele, Obadia, Jean Francois, Walther, Thomas, Taramasso, Maurizio, Søndergaard, Lars, Bleiziffer, Sabine, Rudolph, Tanja K., Fam, Neil, Kempfert, Joerg, Granada, Juan F., Tang, Gilbert H.L., von Bardeleben, Ralph Stephan, Conradi, Lenard, Modine, Thomas, Kalbacher, Daniel, Blankenberg, Stefan, Koell, Benedikt, Schofer, Niklas, Westermann, Dirk, Weber, Marcel, CarMeN, laboratoire, Montreal Heart Institute - Institut de Cardiologie de Montréal, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), Cardiovascular Research Foundation [New York, NY, USA] (CRF), Royal Brompton Hospital, Heart Center Bonn [Bonn, Germany] (HCB), University Hospital Bonn, CHU Lille, Cedars-Sinai Medical Center, St. Paul’s Hospital - University of British Columbia [Vancouver, BC, Canada] (SPH-UBC), St. Vincent's Hospital, Sydney, Bern University Hospital [Berne] (Inselspital), Ludwig Maximilian University [Munich] (LMU), Houston Methodist Hospital [Houston, TX, USA], IRCCS Ospedale San Raffaele [Milan, Italy], Guy's and St Thomas' Hospital [London], Oslo University Hospital [Oslo], University Hospital of Cologne [Cologne], German Heart Center = Deutsches Herzzentrum München [Munich, Germany] (GHC), Brigham and Women’s Hospital [Boston, MA], Harvard Medical School [Boston] (HMS), CHU Bordeaux [Bordeaux], Clinique Pasteur [Toulouse], University Medical Center [Mainz], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Frankfurt University Hospital, Heart Center Hirslanden = HerzZentrum Hirslanden [Zürich, Switzerland] (HCL), Hôpital national = Rigshospitalet [Copenhagen, Denmark] (HNC), Heart and Diabetes Center NRW [Bad Oeynhausen, Germany] (HDC), St. Michael's Hospital, Mount Sinai Hospital [New York City, NY, USA] (MSH), University Heart Center [Hamburg], CHOICE-MI Investigators: Daniel Kalbacher, Stefan Blankenberg, Benedikt Koell, Niklas Schofer, Dirk Westermann, Marcel Weber, Johanna Vogelhuber, François Pontana, Eric Van Belle, Sung-Han Yoon, Anthony Chuang, Robert H Boone, Paul Jansz, Ning Song, Sara Hungerford, Stephan Windecker, David Reineke, Michael Reardon, Neal S Kleiman, Alessandra Sala, Eustachio Agricola, Francesco Maisano, Ronak Rajani, Bernard Prendergast, Kjell A Rein, Maria I Koerber, Laurin Ochs, Keti Vitanova, Magdalena Erlebach, Pinak Shah, Morgan Harloff, Guillaume Bonnet, Mathieu Pernot, Melchior Jonveaux, Felix Kreidel, Tobias Ruf, Matteo Pozzi, Razvan Dragulescu, Tomas Holubec, Heike Strohschnitter, Claudia Walther, Alberto Pozzoli, Ivan Wong, Kai Friedrichs, Mark Peterson, Axel Unbehaun, Markus Kofler., Ben Ali, Walid, Ludwig, Sebastian, Duncan, Alison, Weimann, Jessica, Nickenig, Georg, Tanaka, Tetsu, Coisne, Augustin, Vincentelli, Andre, Makkar, Raj, Webb, John G, Akodad, Mariama, Muller, David W M, Praz, Fabien, Wild, Mirjam G, Hausleiter, Jörg, Goel, Sachin S, von Ballmoos, Moritz Wyler, Denti, Paolo, Chehab, Omar, Redwood, Simon, Dahle, Gry, Baldus, Stephan, Adam, Matti, Ruge, Hendrik, Lange, Rüdiger, Kaneko, Tsuyoshi, Leroux, Lionel, Dumonteil, Nicola, Tchetche, Didier, Treede, Hendrik, Flagiello, Michele, Obadia, Jean-Francoi, Walther, Thoma, Taramasso, Maurizio, Søndergaard, Lar, Bleiziffer, Sabine, Rudolph, Tanja K, Fam, Neil, Kempfert, Joerg, Granada, Juan F, Tang, Gilbert H L, von Bardeleben, Ralph Stephan, Conradi, Lenard, Modine, Thoma, and Agricola, Eustachio
Subjects: Heart Failure, Heart Valve Prosthesis Implantation, Cardiac Catheterization, Medical therapy, [SDV]Life Sciences [q-bio], 610 Medizin, Mitral valve surgery, Mitral Valve Insufficiency, 610 Medicine & health, [SDV] Life Sciences [q-bio], Treatment Outcome, 610 Medical sciences, Humans, Mitral Valve, Registries, Cardiology and Cardiovascular Medicine, Transcatheter mitral valve implantation, Transcatheter edge-to-edge repair, Mitral regurgitation
Abstract: AIMS Transcatheter mitral valve implantation (TMVI) represents a novel treatment option for patients with mitral regurgitation (MR) unsuitable for established therapies. The CHOICE-MI registry aimed to investigate outcomes of patients undergoing screening for TMVI. METHODS AND RESULTS From 05/2014 to 03/2021, patients with MR considered suboptimal candidates for transcatheter edge-to-edge repair (TEER) and at high risk for mitral valve surgery underwent TMVI screening at 26 centres. Characteristics and outcomes were investigated for patients undergoing TMVI and for TMVI-ineligible patients referred to bailout-TEER, high-risk surgery or medical therapy (MT). The primary composite endpoint was all-cause mortality or heart failure hospitalisation after 1 year. Among 746 patients included (78.5 years [IQR 72.0-83.0], EuroSCORE II 4.7% [IQR 2.7-9.7]), 229 patients (30.7%) underwent TMVI with ten different dedicated devices. At 1 year, residual MR ≤1+ was present in 95.2% and the primary endpoint occurred in 39.2% of patients treated with TMVI. In TMVI-ineligible patients (N = 517, 69.3%), rates of residual MR ≤1+ were 37.2%, 100.0% and 2.4% after bailout-TEER, high-risk surgery and MT, respectively. The primary endpoint at 1 year occurred in 28.8% of patients referred to bailout-TEER, in 42.9% of patients undergoing high-risk surgery and in 47.9% of patients remaining on MT. CONCLUSION This registry included the largest number of patients treated with TMVI to date. TMVI with ten dedicated devices resulted in predictable MR elimination and sustained functional improvement at 1 year. In TMVI-ineligible patients, bailout-TEER and high-risk surgery represented reasonable alternatives, while MT was associated with poor clinical and functional outcomes. This article is protected by copyright. All rights reserved.
Published: 2022

34. Motivation to pursue anti-TNFα treatment in patients with Crohn's disease – the SPACE motivation study

Author: Ferdinando D'Amico, Laurent Peyrin-Biroulet, Hervé Hagège, Luc Vandromme, Maria Nachury, Salim Benkhalifa, Xavier Hébuterne, Patrick Faure, Yoram Bouhnik, Stéphane Nahon, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Humanitas University [Milan] (Hunimed), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Polyclinique Courlancy (PC), Polyclinique de Courlancy, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Clinique Pasteur, Clinique Pasteur [Toulouse], Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Universitaire de Nice (CHU Nice), Université Côte d'Azur (UCA), AbbVie, CHU Lille, Service de Gastro-entérologie et Nutrition[Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut des Maladies de l'Appareil Digestif, and Université de Nantes (UN)
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Disease, Satisfaction of patients with Crohn's disease questionnaire (SPACE-Q), Treatment satisfaction, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Surveys and Questionnaires, Internal medicine, medicine, Adalimumab, Humans, Treatment adherence, In patient, Longitudinal Studies, Prospective Studies, Prospective cohort study, Motivation, Crohn's disease, Hepatology, business.industry, Anti-tumor necrosis factor α, Gastroenterology, Middle Aged, medicine.disease, Infliximab, Chronic disorders, 3. Good health, Treatment Outcome, Patient Satisfaction, 030220 oncology & carcinogenesis, Linear Models, Female, Tumor Necrosis Factor Inhibitors, 030211 gastroenterology & hepatology, France, business, medicine.drug
Abstract: International audience; Background: Crohn's disease (CD) is a chronic disorder requiring long-term treatment. However, up to 20% of patients interrupt temporarily or permanently anti-TNFα. Primary aim was to identify internal and external factors influencing patient's motivation to pursue anti-TNFα in active CD.Methods: This was a French, multicentre, prospective study enrolling CD patients on anti-TNFα therapy since more than 3 months. Patients completed the Satisfaction of Patients with Crohn's Disease questionnaire (SPACE-Q) and other patient-reported-outcome tools at inclusion visit, and after 6 and 12 months.Results: A total of 274 patients were included: 146 (53.3%) received adalimumab, while 128 (46.7%) infliximab. Most patients (78%) were still treated with anti-TNFα 12 months after enrolment. Patients' perception of necessity (p = 0.01) and concerns (p
Published: 2020

35. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology (SFC) and the Société française d’imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) on magnetic resonance imaging in patients with cardiac electronic implantable devices

Author: Jacques Mansourati, Louis Boyer, A Jacquier, Didier Klug, Nicolas Sadoul, Olivier Piot, Philippe Maury, Laurent Fauchier, Lucie Cassagnes, Frédéric Anselme, Jérôme Taieb, F. Sacher, B. Dubourg, Michel Chauvin, Daniel Gras, Jean-Nicolas Dacher, Eloi Marijon, Hubert Cochet, Gabriel Laurent, Axel Bartoli, Estelle Gandjbakhch, Serge Boveda, François Pontana, Nouvelles Cibles Pharmacologiques de la Protection Endothéliale et de l'Insuffisance Cardiaque (EnVI), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [APHP], DAM Île-de-France (DAM/DIF), Direction des Applications Militaires (DAM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service de cardiologie [Strasbourg], CHU Strasbourg, Service de cardiologie [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Institut d’Electronique et des Systèmes (IES), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), service d'Imagerie, Centre Hospitalier Universitaire de Clermont-Ferrand, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Adhésion et Inflammation (LAI), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie Pédiatrique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département Cardiologie, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Météorologie Dynamique (UMR 8539) (LMD), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut national des sciences de l'Univers (INSU - CNRS)-École polytechnique (X)-École des Ponts ParisTech (ENPC)-Centre National de la Recherche Scientifique (CNRS)-Département des Géosciences - ENS Paris, École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris), Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Récepteurs nucléaires, maladies cardiovasculaires et diabète (EGID), Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Clinique Pasteur, Toulouse, France., Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Working Group of Pacing, Electrophysiology of the French Society of Cardiology, Société française d’imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV)., CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département des Géosciences - ENS Paris, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École des Ponts ParisTech (ENPC)-École polytechnique (X)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille, DACHER, Jean Nicolas, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Clermont Université-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: medicine.medical_specialty, Medical device, Cardiac pacing, artificial, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Magnetic resonance imaging (MRI), Contraindication, Radiological and Ultrasound Technology, medicine.diagnostic_test, medical device, business.industry, Magnetic resonance imaging, General Medicine, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Pacemaker, 030220 oncology & carcinogenesis, Cardiology, Position paper, Safety, business, Defibrillators
Abstract: International audience; Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.
Published: 2020

36. Ischemic Stroke in Patients With Sinus Node Disease, Atrial Fibrillation, and Other Cardiac Conditions

Author: Sacher, Frederic, Fauchier, Laurent, Boveda, Serge, de Chillou, Christian, Defaye, Pascal, Deharo, Jean Claude, Gandjbakhch, Estelle, Probst, Vincent, Cohen, Ariel, Leclercq, Christophe, Bisson, Arnaud, Bodin, Alexandre, Herbert, Julien, Lacour, Thibaud, Saint Etienne, Christophe, Pierre, Bertrand, Clementy, Nicolas, Deharo, Pierre, Babuty, Dominique, Gaborit, Christophe, Lip, Gregory Y.H., Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Clinique Pasteur, Clinique Pasteur [Toulouse], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), CHU Saint-Antoine [AP-HP], CHU Pontchaillou [Rennes], CHU Trousseau [APHP], Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Service d'Information Médicale d'Epidemiologie et d'Economie de la Santé, University of Liverpool, Liverpool Heart & Chest Hospital, and Aalborg University [Denmark] (AAU)
Subjects: Male, medicine.medical_specialty, Databases, Factual, Disease, [SHS]Humanities and Social Sciences, Risk Factors, Thromboembolism, Internal medicine, Atrial Fibrillation, Humans, Medicine, In patient, Sinus (anatomy), Aged, Retrospective Studies, Aged, 80 and over, Sick Sinus Syndrome, Advanced and Specialized Nursing, business.industry, Incidence, Incidence (epidemiology), Node (networking), Atrial fibrillation, Middle Aged, medicine.disease, Stroke, medicine.anatomical_structure, Heart failure, Ischemic stroke, Cardiology, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: Background and Purpose— Atrial fibrillation (AF) is known to increase risk of ischemic stroke (IS), but the risk of IS in isolated sinus node disease (SND) is unclear. We compared the incidence of IS in patients with SND, patients with AF, and in a control population with other cardiac diseases (disease of the circulatory system using the International Classification of Diseases, Tenth Revision ). Methods— This French longitudinal cohort study was based on the national database covering hospital care for the entire population from 2008 to 2015. Results— Of 1 692 157 patients included in the cohort, 100 366 had isolated SND, 1 564 270 had isolated AF, and 27 521 had AF associated with SND. Incidence of IS during follow-up was higher in isolated patients with AF than in AF associated with SND (yearly rate 2.22% versus 2.06%) and in isolated patients with AF than in isolated patients with SND (yearly rate 2.22% versus 1.59%). The incidence of IS was lower in a control population with other cardiac conditions (n=479 108) compared with SND and patients with AF (0.96%/y, 1.59%/y, and 2.22%/y, respectively). After 1:1 propensity score matching, SND was associated with lower incidence of IS compared to AF (hazard ratio, 0.77 [95% CI, 0.73–0.82]) but higher incidence of IS compared to control population (hazard ratio, 1.27 [95%CI, 1.19–1.35]). Conclusions— Patients with SND had a lower risk of thromboembolic events than patients with AF but a higher risk than a control population with other cardiac diseases. Randomized clinical trial in a selected SND population, with, for example, a high CHA 2 DS 2 -VASc score, would be required to determine the value of IS prevention by anticoagulation.
Published: 2020

37. Guidelines: Anaesthesia in the context of COVID-19 pandemic

Author: Lionel Velly, Etienne Gayat, Hervé Quintard, Emmanuel Weiss, Audrey De Jong, Philippe Cuvillon, Gérard Audibert, Julien Amour, Marc Beaussier, Matthieu Biais, Sébastien Bloc, Marie Pierre Bonnet, Pierre Bouzat, Gilles Brezac, Claire Dahyot-Fizelier, Souhayl Dahmani, Mathilde de Queiroz, Sophie Di Maria, Claude Ecoffey, Emmanuel Futier, Thomas Geeraerts, Haithem Jaber, Laurent Heyer, Rim Hoteit, Olivier Joannes-Boyau, Delphine Kern, Olivier Langeron, Sigismond Lasocki, Yoan Launey, Frederic le Saché, Anne Claire Lukaszewicz, Axel Maurice-Szamburski, Nicolas Mayeur, Fabrice Michel, Vincent Minville, Sébastien Mirek, Philippe Montravers, Estelle Morau, Laurent Muller, Jane Muret, Karine Nouette-Gaulain, Jean Christophe Orban, Gilles Orliaguet, Pierre François Perrigault, Florence Plantet, Julien Pottecher, Christophe Quesnel, Vanessa Reubrecht, Bertrand Rozec, Benoit Tavernier, Benoit Veber, Francis Veyckmans, Hélène Charbonneau, Isabelle Constant, Denis Frasca, Marc-Olivier Fischer, Catherine Huraux, Alice Blet, Marc Garnier, Assistance Publique - Hôpitaux de Marseille (APHM), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de pharmacologie moléculaire et cellulaire (IPMC), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service d'Anesthésie et Réanimation [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Mutualiste de Montsouris (IMM), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Neuro-imagerie fonctionnelle et métabolique (ANTE-INSERM U836, équipe 5), Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anesthésie-réanimation, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'anesthésie réanimation chirurgicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Service Anesthésie - Réanimation [Bordeaux], CHU Bordeaux [Bordeaux], Physiopathologie et Pharmacologie Clinique de la Douleur, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Juge - Clinique du sport [Marseille], Pôle d'Anesthésie-Réanimation [CHU Rangueil], CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital de Rangueil, Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'anesthésie - réanimation chirurgicale [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Département d'Anesthésie Réanimation, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de réanimation médicale [CHU de Carémeau, Nîmes], Institut Curie [Paris], Réanimation Médico-Chirurgicale, Service d'Anesthésie Réanimation, CHU Necker - Enfants Malades [AP-HP], Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Mitochondries, stress oxydant et protection musculaire (Strasbourg), Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA)-Université de Strasbourg (UNISTRA), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de soins intensifs [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Groupe d’Anesthésie-Réanimation Chirurgie cardio-thoracique et vasculaire [Toulouse], Clinique Pasteur [Toulouse], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Département d'anesthésiologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UR)-Hôpital Pontchaillou, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Pôle Anesthésie Réanimation [CHU de Toulouse], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS), Histoire et Cultures de l'Antiquité et du Moyen Âge (HISCANT-MA), Université de Lorraine (UL), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Emergency Department, Université Bordeaux Segalen - Bordeaux 2-Hôpital Pellegrin - Bordeaux, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM), Anaesthesiology, Robert Debré Hospital, Service d'anesthésie réanimation chirurgicale, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie mitochondriale, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité Mixte de Recherches sur les Herbivores - UMR 1213 (UMRH), Institut National de la Recherche Agronomique (INRA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire d'Anesthésiologie, Université Pierre et Marie Curie - Paris 6 (UPMC), and Department of Anesthesia, Burn and Critical Care, University Hospitals Saint-Louis - Lariboisière, AP-HP, Paris, France.
Subjects: Infection prevention and control, [SDV]Life Sciences [q-bio], Psychological intervention, Airway management, Context (language use), Critical Care and Intensive Care Medicine, Article, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030202 anesthesiology, Informed consent, Personal protective equipment, Pandemic, Health care, Medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Modalities, SARS-CoV-2, business.industry, COVID-19, 030208 emergency & critical care medicine, General Medicine, Guideline, 3. Good health, Anesthesiology and Pain Medicine, Universal precautions, Anesthesia, Viruses, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Objectives The world is currently facing an unprecedented healthcare crisis caused by the COVID-19 pandemic. The objective of these guidelines is to produce a framework to facilitate the partial and gradual resumption of intervention activity in the context of the COVID-19 pandemic. Methods The group has endeavoured to produce a minimum number of recommendations to highlight the strengths to be retained in the 7 predefined areas: (1) protection of staff and patients; (2) benefit/risk and patient information; (3) preoperative assessment and decision on intervention; (4) modalities of the preanaesthesia consultation; (5) specificity of anaesthesia and analgesia; (6) dedicated circuits and (7) containment exit type of interventions. Results The SFAR Guideline panel provides 51 statements on anaesthesia management in the context of COVID-19 pandemic. After one round of discussion and various amendments, a strong agreement was reached for 100% of the recommendations and algorithms. Conclusion We present suggestions for how the risk of transmission by and to anaesthetists can be minimised and how personal protective equipment policies relate to COVID-19 pandemic context.
Published: 2020

38. Telemonitoring versus standard care in heart failure: a randomised multicentre trial

Author: Galinier, Michel, Roubille, François, Berdagué, Philippe, Brierre, Gilles, Cantie, Philippe, Dary, Patrick, Ferradou, Jean‐Marc, Fondard, Olivier, Labarre, Jean Philippe, Mansourati, Jacques, Picard, François, Ricci, Jean‐Etienne, Salvat, Muriel, Tartière, Lamia, Ruidavets, Jean‐Bernard, Bongard, Vanina, Delval, Cécile, Lancman, Guila, Pasche, Hélène, Ramirez‐Gil, Juan Fernando, Pathak, Atul, Machecourt, Jacques, Valeix, Bernard, Royer, Thierry, Louvard, Yves, Aboyans, Victor, Beard, Thierry, Cheggour, Saïda, Cottin, Yves, Delarche, Nicolas, Eicher, Jean‐Christophe, Faure, Antoine, Gibelin, Pierre, Gosse, Philippe, Inamo, Jocelyn, Lescure‐Ducay, Maryse, Litalien, Jean, Milhau, Sabine, Pouchelon, Elisabeth, Prunier, Fabrice, Salloum, Antoine, Aloun, Jocelyn Souk, Tartière, Jean‐Michel, Taudou, Marie‐José, Thuny, Franck, Tribouilloy, Christophe, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), MSP Beziers, Centre Hospitalier de Beziers, Centre Hospitalier Intercommunal Castres-Mazamet, Clinique Pasteur [Toulouse], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Toulouse [Toulouse], Air Liquide Santé International, Service de Pharmacologie Clinique, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Limoges, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier de Pau, Hôpital Pasteur [Nice] (CHU), Hôpital Saint-André, Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Laboratoire de Protection et Remodelage du Myocarde (PMRM), Université d'Angers (UA)-Université d'Angers (UA), Hôpital Sainte-Musse, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie [Amiens], CHU Amiens-Picardie, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Pharmacologie Clinique [CHU Toulouse], and Pôle Santé publique et médecine publique [CHU Toulouse]
Subjects: Male, Relative risk reduction, Telemonitoring, medicine.medical_specialty, Class iii, 030204 cardiovascular system & hematology, Rate ratio, 03 medical and health sciences, 0302 clinical medicine, Primary outcome, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Standard care, Internal medicine, Hospitalisation, medicine, Humans, Editorial Comments, Aged, Aged, 80 and over, Heart Failure, business.industry, Hazard ratio, Standard of Care, Patient education, Body weight, Middle Aged, medicine.disease, Telemedicine, Confidence interval, 3. Good health, Hospitalization, Heart failure, [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Cardiology and Cardiovascular Medicine, business, Editorial Comment
Abstract: International audience; Aims: The aim was to assess the effect of a telemonitoring programme vs. standard care (SC) in preventing all‐cause deaths or unplanned hospitalisations in heart failure (HF) at 18 months.Methods and results: OSICAT was a randomised, multicentre, open‐label French study in 937 patients hospitalised for acute HF ≤12 months before inclusion. Patients were randomised to telemonitoring (daily body weight measurement, daily recording of HF symptoms, and personalised education) (n = 482) or to SC (n = 455). Mean ± standard deviation number of events for the primary outcome was 1.30 ± 1.85 for telemonitoring and 1.46 ± 1.98 for SC [rate ratio 0.97, 95% confidence interval (CI) 0.77–1.23; P = 0.80]. In New York Heart Association (NYHA) class III or IV HF, median time to all‐cause death or first unplanned hospitalisation was 82 days in the telemonitoring group and 67 days in the SC group (P = 0.03). After adjustment for known predictive factors, telemonitoring was associated with a 21% relative risk reduction in first unplanned hospitalisation for HF [hazard ratio (HR) 0.79, 95% CI 0.62–0.99; P = 0.044); the relative risk reduction was 29% in patients with NYHA class III or IV HF (HR 0.71, 95% CI 0.53–0.95; P = 0.02), 38% in socially isolated patients (HR 0.62, 95% CI 0.39–0.98; P = 0.043), and 37% in patients who were ≥70% adherent to body weight measurement (HR 0.63, 95% CI 0.45–0.88; P = 0.006).Conclusion: Telemonitoring did not result in a significantly lower rate of all‐cause deaths or unplanned hospitalisations in HF patients. The pre‐specified subgroup results suggest the telemonitoring approach improves clinical outcomes in selected populations but need further confirmation.
Published: 2020

39. Les interruptions la nuit : mise en lumière du travail réel des soignants

Author: Anne-Philippine Dargent, Jérôme Sartori, Marlène Cheyrouze, Béatrice Barthe, Cognition, Langues, Langage, Ergonomie (CLLE), Centre National de la Recherche Scientifique (CNRS)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Toulouse - Jean Jaurès (UT2J), Cognition, Langues, Langage, Ergonomie (CLLE-LTC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Toulouse - Jean Jaurès (UT2J)-Centre National de la Recherche Scientifique (CNRS), Clinique Pasteur, Clinique Pasteur [Toulouse], and Université Toulouse - Jean Jaurès (UT2J)
Subjects: Health Policy, 0502 economics and business, 05 social sciences, [SHS.PSY]Humanities and Social Sciences/Psychology, 050109 social psychology, 0501 psychology and cognitive sciences, ComputingMilieux_MISCELLANEOUS, 050203 business & management, General Nursing
Abstract: International audience
Published: 2020

40. Short-term androgen deprivation therapy combined with radiotherapy as salvage treatment after radical prostatectomy for prostate cancer (GETUG-AFU 16): a 112-month follow-up of a phase 3, randomised trial

Author: Stéphanie Servagi-Vernat, Paul Sargos, Sylvie Chabaud, Yazid Belkacemi, Nicolas Magné, Gilles Créhange, Alain Ruffion, Nedla Allouache, I. Latorzeff, Stéphane Supiot, Bernard Dubray, Christian Carrie, Jean-Philippe Suchaud, Didier Peiffert, Nicolas Barbier, Stephane Guerif, Jean-Léon Lagrange, Celine Ferlay, Pierre Graff-Cailleaud, Patricia Burban-Provost, Meryem Brihoum, Sophie Dussart, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), PRISME (PRISME), Institut de Physique des 2 Infinis de Lyon (IP2I Lyon), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Léon Bérard [Lyon], Institut de Cancérologie Lucien Neuwirth, CHU Saint-Etienne, Institut de Physique Nucléaire de Lyon (IPNL), Université de Lyon-Université de Lyon-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Hôpital Privé des Côtes d'Armor (HPCA), Institut Bergonié [Bordeaux], Clinique Pasteur, Clinique Pasteur [Toulouse], Hôpital Henri Mondor, CRLCC René Gauducheau, Université Paris-Est (UPE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lorraine (UL), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut Jean Godinot [Reims], Centre Hospitalier de Roanne, Catalan Institute of Oncology [Perpignan], Hospices Civils de Lyon (HCL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CCSD, Accord Elsevier
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030232 urology & nephrology, Urology, Salvage therapy, Adenocarcinoma, Androgen suppression, Androgen deprivation therapy, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Humans, Survival rate, ComputingMilieux_MISCELLANEOUS, Aged, Prostatectomy, Salvage Therapy, business.industry, Goserelin, Prostatic Neoplasms, Androgen Antagonists, Chemoradiotherapy, Middle Aged, Prognosis, medicine.disease, 3. Good health, Survival Rate, [SDV] Life Sciences [q-bio], Radiation therapy, Oncology, 030220 oncology & carcinogenesis, Radiotherapy, Conformal, business, Follow-Up Studies, medicine.drug
Abstract: Radiotherapy is the standard salvage treatment after radical prostatectomy. To date, the role of androgen deprivation therapy has not been formally shown. In this follow-up study, we aimed to update the results of the GETUG-AFU 16 trial, which assessed the efficacy of radiotherapy plus androgen suppression versus radiotherapy alone.GETUG-AFU 16 was an open-label, multicentre, phase 3, randomised, controlled trial that enrolled men (aged ≥18 years) with Eastern Cooperative Oncology Group performance status of 0 or 1, with histologically confirmed adenocarcinoma of the prostate (but no previous androgen suppression or pelvic radiotherapy), stage pT2, T3, or T4a (bladder neck involvement only) and pN0 or pNx according to the tumour, node, metastasis (TNM) staging system, whose prostate-specific antigen (PSA) concentration increased from 0·1 ng/mL to between 0·2 ng/mL and 2·0 ng/mL after radical prostatectomy, without evidence of clinical disease. Patients were assigned through central randomisation (1:1) to short-term androgen suppression (subcutaneous injection of 10·8 mg goserelin on the first day of irradiation and 3 months later) plus radiotherapy (3D conformal radiotherapy or intensity modulated radiotherapy of 66 Gy in 33 fractions, 5 days a week for 7 weeks) or radiotherapy alone. Randomisation was stratified using a permuted block method (block sizes of two and four) according to investigational site, radiotherapy modality, and prognosis. The primary endpoint was progression-free survival in the intention-to-treat population. This post-hoc one-shot data collection done 4 years after last data cutoff included patients who were alive at the time of the primary analysis and updated long-term patient status by including dates for first local progression, metastatic disease diagnosis, or death (if any of these had occurred) or the date of the last tumour evaluation or last PSA measurement. Survival at 120 months was reported. Late serious adverse effects were assessed. This trial is registered on ClinicalTrials.gov, NCT00423475.Between Oct 19, 2006, and March 30, 2010, 743 patients were randomly assigned, 374 to radiotherapy alone and 369 to radiotherapy plus goserelin. At the time of data cutoff (March 12, 2019), the median follow-up was 112 months (IQR 102-123). The 120-month progression-free survival was 64% (95% CI 58-69) for patients treated with radiotherapy plus goserelin and 49% (43-54) for patients treated with radiotherapy alone (hazard ratio 0·54, 0·43-0·68; stratified log-rank test p0·0001). Two cases of secondary cancer occurred since the primary analysis, but were not considered to be treatment related. No treatment-related deaths occurred.The 120-month progression-free survival confirmed the results from the primary analysis. Salvage radiotherapy combined with short-term androgen suppression significantly reduced risk of biochemical or clinical progression and death compared with salvage radiotherapy alone. The results of the GETUG-AFU 16 trial confirm the efficacy of androgen suppression plus radiotherapy as salvage treatment in patients with increasing PSA concentration after radical prostatectomy for prostate cancer.The French Health ministry, AstraZeneca, la Ligue Contre le Cancer, and La Ligue de Haute-Savoie.
Published: 2019

41. Early detection of subclinical left ventricular dysfunction after breast cancer radiation therapy using speckle-tracking echocardiography: association between cardiac exposure and longitudinal strain reduction (BACCARAT study)

Author: Valentin, Walker, Olivier, Lairez, Olivier, Fondard, Atul, Pathak, Baptiste, Pinel, Christian, Chevelle, Denis, Franck, Gaëlle, Jimenez, Jérémy, Camilleri, Loïc, Panh, David, Broggio, Sylvie, Derreumaux, Marie-Odile, Bernier, Dominique, Laurier, Jean, Ferrières, Sophie, Jacob, PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), CHU Toulouse [Toulouse], Clinique Pasteur [Toulouse], RADIOTHÉRAPIE (ONCORAD), PSE-SANTE/SDOS, PSE-SANTE/SER/UEM, and PSE-SANTE/SESANE
Subjects: Adult, lcsh:Medical physics. Medical radiology. Nuclear medicine, lcsh:R895-920, Hypercholesterolemia, 3D conformal radiation therapy, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, lcsh:RC254-282, Body Mass Index, Ventricular Dysfunction, Left, Imaging, Three-Dimensional, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiac Dosimetry, Risk Factors, Breast Cancer, Image Processing, Computer-Assisted, Humans, Prospective Studies, Radiometry, Aged, Retrospective Studies, Research, Heart, Strain imaging, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Cardiotoxicity, Early Diagnosis, Echocardiography, Hypertension, Multivariate Analysis, Cardiac dysfunction, Regression Analysis, Female, Radiotherapy, Conformal, Follow-Up Studies
Abstract: International audience; Background Breast cancer (BC) radiotherapy (RT) can induce cardiotoxicity, with adverse events often observed many years after BC RT. Subclinical left ventricular (LV) dysfunction can be detected early after BC RT with global longitudinal strain (GLS) measurement based on 2D speckle-tracking echocardiography. This 6-month follow-up analysis from the BACCARAT prospective study aimed to investigate the association between cardiac radiation doses and subclinical LV dysfunction based on GLS reduction.Methods The patient study group consisted of 79 BC patients (64 left-sided BC, 15 right-sided BC) treated with RT without chemotherapy. Echocardiographic parameters, including GLS, were measured before RT and 6 months post-RT. The association between subclinical LV dysfunction, defined as GLS reduction > 10%, and radiation doses to whole heart and the LV were performed based on logistic regressions. Non-radiation factors associated with subclinical LV dysfunction including age, BMI, hypertension, hypercholesterolemia and endocrine therapy were considered for multivariate analyses.Results A mean decrease of 6% in GLS was observed (-15.1% ± 3.2% at 6 months vs.-16.1% ± 2.7% before RT, p = 0.01). For left-sided patients, mean heart and LV doses were 3.1 ± 1.3 Gy and 6.7 ± 3.4 Gy respectively. For right-sided patients, mean heart dose was 0.7 ± 0.5 Gy and median LV dose was 0.1 Gy. Associations between GLS reduction > 10% (37 patients) and mean doses to the heart and the LV as well as the V20 were observed in univariate analysis (Odds Ratio = 1.37[1.01-1.86], p = 0.04 for Dmean Heart; OR = 1.14 [1.01-1.28], p = 0.03 for Dmean LV; OR = 1.08 [1.01-1.14], p = 0.02 for LV V20). In multivariate analysis, these associations did not remain significant after adjustment for non-radiation factors. Further exploratory analysis allowed identifying a subgroup of patients (LV V20 > 15%) for whom a significant association with subclinical LV dysfunction was found (adjusted OR = 3.97 [1.01-15.70], p = 0.048).Conclusions This analysis indicated that subclinical LV dysfunction defined as a GLS decrease > 10% is associated with cardiac doses, but adjustment for non-radiation factors such as endocrine therapy lead to no longer statistically significant relationships. However, LV dosimetry may be promising to identify high-risk subpopulations. Larger and longer follow-up studies are required to further investigate these associations. Trial registration ClinicalTrials.gov NCT02605512, Registered 6 November 2015-Retrospectively registered © 2019 The Author(s).
Published: 2019

42. Perivalvular Extension of Infective Endocarditis after Transcatheter Aortic Valve Replacement

Author: Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Tomasz Gasior, Wojtek Wojakowski, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C Herrmann, Luca Testa, Won Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B Ribeiro, Jose Armando Mangione, Fabio Sandoli de Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G Webb, Sandro Sponga, Raj Makkar, Annapoorna S Kini, Marouane Boukhris, Philippe Gervais, Axel Linke, Lisa Crusius, David Holzhey, Josep Rodés-Cabau, Université Laval [Québec] (ULaval), Universität Leipzig, Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Clinique Pasteur [Toulouse], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Leipzig University, Universität Leipzig [Leipzig], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hôpital de Rangueil, CHU Toulouse [Toulouse], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Microbiology (medical), Coagulase, Infective endocarditis, TAVI, TAVR, heart surgery, Endocarditis, infective endocarditis, 610 Medicine & health, Endocarditis, Bacterial, 030204 cardiovascular system & hematology, Abscess, 3. Good health, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, 030212 general & internal medicine, Renal Insufficiency, Chronic, Aneurysm, False
Abstract: Background Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53–421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. Results A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57–4.69; P Conclusions PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.
Published: 2021

43. Risk of pacemaker implantation after radiotherapy for breast cancer: A study based on French nationwide health care database sample

Author: M.Y. Errahmani, J. Thariat, J. Ferrières, L. Panh, M. Locquet, M. Lapeyre-Mestre, G. Guernec, M.O. Bernier, S. Boveda, S. Jacob, ATHENA, Irsn, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Department of Cardiology B and Epidemiology, Toulouse University Hospital, Clinique Pasteur [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Rythmologie, and Clinique Pasteur
Subjects: History, Original Paper, Polymers and Plastics, Radiotherapy, [SDV]Life Sciences [q-bio], Industrial and Manufacturing Engineering, [SDV] Life Sciences [q-bio], Pacemaker, RC666-701, Breast Cancer, Cardiac complications, Diseases of the circulatory (Cardiovascular) system, Business and International Management, Cardiology and Cardiovascular Medicine, French national health insurance database
Abstract: International audience; Background: Among cardiac complications of breast cancer radiotherapy (BC RT), there are very limited data on arrhythmia and conduction disorders, in particular severe cases requiring permanent pacemaker implantation (PPMI). Therefore, this exploratory study aimed to evaluate the risk of PPMI for BC patients treated with RT, compared with the general population and with BC patients not treated with RT.Methods: The study was performed on a 1/97 representative sample of the French health care database (EGB database). Adult women with a first BC treated with or without RT between 2008 and 2016 were included, followed until 2018, and de novo PPMI were identified. We compared the PPMI incidence in BC cohort relative to the general population with standardized incidence ratio (SIR) and evaluated the risk of PPMI in RT patients compared to patients without RT with a competing risk survival analysis. Results: A total of 3853 BC patients were included. Among BC patients treated with RT, 28 PPMI cases were observed compared with 13 expected cases, corresponding to a SIR of 2.18 [95% CI: 1.45-3.06]. For BC patients not treated with RT, the SIR was 1.01 [95%CI: 0.40-1.90]. Patients treated with RT showed a borderline significant higher risk of PPMI compared with those not treated with RT (subdistribution Hazard Ratio=2.08, 95%CI 0.87-4.97, p=0.09). Conclusions: Our exploratory findings indicate that, over the last decade in France, BC patients treated with RT appeared to be at higher risk of PPMI than general population. Further studies are needed to expand on this topic.
Published: 2021

44. Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation

Author: Norman Mangner, David del Val, Mohamed Abdel-Wahab, Lisa Crusius, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Tomasz Gasior, Wojtek Wojakowski, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N. Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C. Herrmann, Luca Testa, Won-Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L. Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C. Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean-Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B. Ribeiro, Jose Armando Mangione, Fabio Sandoli de Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria-Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R. Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G. Webb, Sandro Sponga, Raj Makkar, Annapoorna S. Kini, Marouane Boukhris, Philippe Gervais, Mélanie Côté, David Holzhey, Axel Linke, Josep Rodés-Cabau, Technische Universität Dresden = Dresden University of Technology (TU Dresden), Université Laval [Québec] (ULaval), Leipzig University, Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Toulouse [Toulouse], Clinique Pasteur [Toulouse], UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Aged, 80 and over, Male, Prosthesis-Related Infections, infective endocarditis, Endocarditis, Bacterial, Staphylococcal Infections, Combined Modality Therapy, antibiotics, Anti-Bacterial Agents, TAVI, Transcatheter Aortic Valve Replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, outcome, Humans, cardiac surgery, Female, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine, 610 Medicine & health, Aged
Abstract: BACKGROUND The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain. OBJECTIVES The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB). METHODS Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE. The study used data from the Infectious Endocarditis after TAVI International Registry. RESULTS Among 584 patients, 111 patients (19%) were treated with IE-CS and 473 patients (81%) with IE-AB. Compared with IE-AB, IE-CS was not associated with a lower in-hospital mortality (HRunadj: 0.85; 95% CI: 0.58-1.25) and 1-year all-cause mortality (HRunadj: 0.88; 95% CI: 0.64-1.22) in the crude cohort. After adjusting for selection and immortal time bias, IE-CS compared with IE-AB was also not associated with lower mortality rates for in-hospital mortality (HRadj: 0.92; 95% CI: 0.80-1.05) and 1-year all-cause mortality (HRadj: 0.95; 95% CI: 0.84-1.07). Results remained similar when patients with and without TAVI prosthesis involvement were analyzed separately. Predictors for in-hospital and 1-year all-cause mortality included logistic EuroSCORE I, Staphylococcus aureus, acute renal failure, persistent bacteremia, and septic shock. CONCLUSIONS In this registry, the majority of patients with TAVI-IE were treated with antibiotics alone. Cardiac surgery was not associated with an improved all-cause in-hospital or 1-year mortality. The high mortality of patients with TAVI-IE was strongly linked to patients' characteristics, pathogen, and IE-related complications. (C) 2022 by the American College of Cardiology Foundation.
Published: 2021

45. Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair: Mid-Term Outcomes From the CUTTING-EDGE International Registry

Author: Kaneko, Tsuyoshi, Hirji, Sameer, Zaid, Syed, Lange, Rudiger, Kempfert, Jörg, Conradi, Lenard, Hagl, Christian, Borger, Michael A, Taramasso, Maurizio, Nguyen, Tom C, Ailawadi, Gorav, Shah, Ashish S, Smith, Robert L, Anselmi, Amedeo, Romano, Matthew A, Ben Ali, Walid, Ramlawi, Basel, Grubb, Kendra J, Robinson, Newell B, Pirelli, Luigi, Chu, Michael W A, Andreas, Martin, Obadia, Jean-Francois, Gennari, Marco, Garatti, Andrea, Tchetche, Didier, Nazif, Tamim M, Bapat, Vinayak N, Modine, Thomas, Denti, Paolo, Tang, Gilbert H L, Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Houston Methodist Hospital [Houston, TX, USA], West German Heart Center, Universität Duisburg-Essen = University of Duisburg-Essen [Essen], Ludwig Maximilian University [Munich] (LMU), University of California [San Francisco] (UC San Francisco), University of California (UC), University of Michigan [Ann Arbor], University of Michigan System, Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Bayler Scott and White Research Institute Dallas, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Montreal Heart Institute - Institut de Cardiologie de Montréal, Lankenau Institute for Medical Research [Wynnewood] (LIMR), Emory University [Atlanta, GA], London Health Sciences Center (LHSC), Medizinische Universität Wien = Medical University of Vienna, Hospices Civils de Lyon (HCL), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Clinique Pasteur [Toulouse], Columbia University Irving Medical Center (CUIMC), CHU Bordeaux [Bordeaux], Mount Sinai Health System, Universität Duisburg-Essen [Essen], University of California [San Francisco] (UCSF), University of California, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: transcatheter edge-to-edge repair, [SDV.IB]Life Sciences [q-bio]/Bioengineering, mitral valve surgery, mitral valve replacement
Abstract: International audience; OBJECTIVES: The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER). BACKGROUND: Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking. METHODS: Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year. RESULTS: From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery. CONCLUSIONS: In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only
Published: 2021

46. TAVR Patients Requiring Anticoagulation: Direct Oral Anticoagulant or Vitamin K Antagonist?

Author: Didier, Romain, Lhermusier, Thibault, Auffret, Vincent, Eltchaninoff, Hélène, Le Breton, Herve, Cayla, Guillaume, Commeau, Philippe, Collet, J. P., Cuisset, Thomas, Dumonteil, Nicolas, Verhoye, J. P., Beurtheret, Sylvain, Lefevre, Thierry, Teiger, Emmanuel, Carrié, Didier, Himbert, Dominique, Albat, Bernard, Cribier, Alain, Sudre, Arnaud, Blanchard, Didier, Bar, Olivier, Rioufol, Gilles, Collet, Frédéric, Houel, Remi, Labrousse, Louis, Meneveau, Nicolas, Ghostine, Said, Manigold, Thibaut, Guyon, Philippe, Delepine, Stephane, Favereau, Xavier, Souteyrand, Geraud, Ohlmann, Patrick, Doisy, Vincent, Beygui, Farzin, Gommeaux, Antoine, Claudel, Jean-Philippe, Bourlon, Francois, Bertrand, Bernard, Iung, Bernard, Gilard, Martine, Service de cardiologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Polyclinique Les Fleurs - ELSAN [Ollioules] (PLF), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Timone [CHU - APHM] (TIMONE), Clinique Pasteur [Toulouse], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Hôpital Saint-Joseph [Marseille], Sorbonne Université (SU), CHU Henri Mondor [Créteil], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de génétique humaine (IGH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Nouvelle Clinique de Tours Saint Gatien-Alliance [Tours] (CTSGA), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Bordeaux [Bordeaux], Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Chirurgical Marie Lannelongue (CCML), Service de Cardiologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Max Planck Institute for Chemistry (MPIC), Max-Planck-Gesellschaft, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital privé de Parly 2 - Ramsay Santé [Le Chesnay-Rocquencourt], CHU Clermont-Ferrand, CHU Strasbourg, Médipôle Lyon-Villeurbanne, Hôpital privé de Bois-Bernard - Ramsay Santé [Bois-Bernard], Clinique de l'Infirmerie Protestante de Lyon (CIPL), Centre Cardio-Thoracique de Monaco (CCTM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire [Grenoble] (CHU), Service de cardiologie [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), ANR-16-RHUS-0003,STOP-AS,STOP-AS(2016), CHU Toulouse [Toulouse], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Service de Cardiologie [CHU Pitié-Salpêtrière], CHU Henri Mondor, Institut des Sciences Chimiques de Rennes (ISCR), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Centre chirurgical Marie Lannelongue, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Transcatheter aortic valve replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV]Life Sciences [q-bio], Anticoagulant, Antithrombotic treatment, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: International audience; OBJECTIVES: Using French transcatheter aortic valve replacement (TAVR) registries linked with the nationwide administrative databases, the study compared the rates of long-term mortality, bleeding, and ischemic events after TAVR in patients requiring oral anticoagulation with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). BACKGROUND: The choice of optimal drug for anticoagulation after TAVR remains debated. METHODS: Data from the France-TAVI and FRANCE-2 registries were linked to the French national health single-payer claims database, from 2010 to 2017. Propensity score matching was used to reduce treatment-selection bias. Two primary endpoints were death from any cause (efficacy) and major bleeding (safety). RESULTS: A total of 24,581 patients who underwent TAVR were included and 8,962 (36.4%) were treated with OAC. Among anticoagulated patients, 2,180 (24.3%) were on DOACs. After propensity matching, at 3 years, mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.12-1.67; P \textless 0.005) and major bleeding including hemorrhagic stroke (HR: 1.64; 95% CI: 1.17-2.29; P \textless 0.005) were lower in patients on DOACs compared with those on VKAs. The rates of ischemic stroke (HR: 1.32; 95% CI: 0.81-2.15; P = 0.27) and acute coronary syndrome (HR: 1.17; 95% CI: 0.68-1.99; P = 0.57) did not differ among groups. CONCLUSIONS: In these large multicenter French TAVR registries with an exhaustive clinical follow-up, the long-term mortality and major bleeding were lower with DOACs than VKAs at discharge. The present study supports preferential use of DOACs rather than VKAs in patients requiring oral anticoagulation therapy after TAVR.
Published: 2021

47. High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry

Author: Jean Fajadet, Michel Lievre, Thierry Lefèvre, Clément Bénic, Romain Didier, Bahaa Nasr, Martine Gilard, Edward Koifman, Alain Leguerrier, Alain Prat, Hervé Le Breton, Emmanuel Teiger, Thomas Cuisset, Sinda Hannachi, Florent Le Ven, Patrick Donzeau-Gouge, Vincent Auffret, Bernard Iung, Hélène Eltchaninoff, Pascal Leprince, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Pharmacologie des Dysfonctionnements Endotheliaux et Myocardiques, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Soroka University Medical Center [Beer Sheva, Israel], Institut Cardiovasculaire Paris Sud (ICPS), Clinique Pasteur [Toulouse], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Henri Mondor, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Timone [CHU - APHM] (TIMONE), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), and RANCHON, GUILLAUME
Subjects: medicine.medical_specialty, Transcatheter aortic, [SDV]Life Sciences [q-bio], Population, 030204 cardiovascular system & hematology, Article, TAVI, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, education, education.field_of_study, business.industry, Incidence (epidemiology), General Medicine, Gradient Increase, post-procedural mean gradient, medicine.disease, structural valve degeneration, [SDV] Life Sciences [q-bio], Stenosis, Cardiology, Medicine, mean gradient, business
Abstract: Mean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify incidence, influence on prognosis, and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (6 to 12 months after TAVI, DMGI) in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry. The registry includes all consecutive symptomatic patients with severe aortic stenosis who have undergone TAVI. Three groups were analyzed: (1) PPMG &lt, 20 mmHg without DMGI &gt, 10 mmHg (control), (2) PPMG &lt, 20 mmHg with DMGI &gt, 10 mmHg (Group 1), and (3) PPMG ≥ 20 mmHg (Group 2). From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. Controls comprised 2078 patients. In Group 1(n = 131 patients), DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-years mortality than in controls (32.6% vs. 40.1%, p = 0.27). In Group 2 (n = 144 patients), PPMG was at least 20 mmHg in 6.1% and was associated with higher 4-year mortality (48.7% versus 40.1%, p = 0.005). A total of two-thirds of the patients with PPMG ≥ 20 mmHg had MG &lt, 20 mmHg at 1 year, with mortality similar to the controls (39.2% vs. 40.1%, p = 0.73). Patients with PPMG &gt, 20 mmHg 1 year post-TAVI had higher 4-years mortality than the general population of the registry, unlike patients with MG normalization.
Published: 2021

48. Cohort profile: the ESC EURObservational Research Programme Atrial Fibrillation III (AF III) Registry

Author: Maury, Philippe, Thambo, Jean Benoit, Maltret, Alice, Combes, Nicolas, Hascoet, Sébastien, Derval, Nicolas, Ladouceur, Magalie, Acar, Philippe, Amedro, Pascal, Anselm, Frederic, Bajolle, Fanny, Basquin, Adeline, Belli, Emre, Bordachar, Pierre, Duthoit, Guillaume, Di Filippo, Sylvie, Fauchier, Laurent, Gandjbakhch, Estelle, Gras, Daniel, Gronier, Celine, Karsenty, Clement, Klug, Didier, Koutbi, Linda, Lacotte, Jérôme, Laurent, Gabriel, Laux, Daniela, Mansourati, Jacques, Marijon, Eloi, Ovaert, Caroline, Sacher, Frederic, Sadoul, Nicolas, Warin-Fresse, Karine, Taieb, Jérôme, Waldmann, Victor, Defaye, Pascal, Chauvin, Michel, Anselme, Frederic, Piot, Olivier, Boveda, Serge, Cassagnes, Lucie, Dacher, Jean-Nicolas, Bartoli, Axel, Boyer, Louis, Cochet, Hubert, Deharo, Jean-Claude, Dubourg, Benjamin, Pontana, François, Jacquier, Alexis, Potpara, Tatjana, Lip, Gregory, Dagres, Nikolaos, Crijns, Harry, Boriani, Giuseppe, Kirchhof, Paulus, Arbelo, Elena, Savelieva, Irina, Lenarczyk, Radoslaw, Maggioni, Aldo, Gale, Chris, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Cardiologie (9), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pessac, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Pasteur [Toulouse], Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Department of Cardiology, Georges Pompidou European Hospital and Necker-Enfants Malades Hospital, AP-HP, Adult Congenital Heart Disease Unit, Centre de Référence des Malformations Cardiaques Congénitales Complexes (M3C), 75015 Paris, France, Inserm U970, PARCC, 75015 Paris, France., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), M3C-Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Pôle des Cardiopathies Congénitales, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Service de Cardiologie Pédiatrique, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université Paris Cité (UPCité), Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Centre Hospitalier Universitaire [Grenoble] (CHU), Les Hôpitaux Universitaires de Strasbourg (HUS), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre cardiologique du Nord (CCN), CHU Clermont-Ferrand, Service de Radiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Service d’Imagerie Médicale et Radiologie Interventionnelle [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Belgrade [Belgrade], University of Liverpool, Aalborg University [Denmark] (AAU), Universität Leipzig, Department of Physiology [Maastricht], Maastricht University [Maastricht], Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), University of Birmingham [Birmingham], Lomonosov Moscow State University (MSU), EURObservational Research Programme, European Society of Cardiology, and Maria Cecilia Hospital [Cotignola]
Subjects: medicine.medical_specialty, Registry, EORP, Cardiology, SOCIETY, MEMBER COUNTRIES, atrial fibrillation, non-interventional, observational, prospective, registry, GUIDELINES, ADHERENT ANTITHROMBOTIC TREATMENT, [SHS]Humanities and Social Sciences, ANTICOAGULATION, medicine, MANAGEMENT, Humans, Registries, HIGH-RISK PATIENTS, Stroke, Observational, Fibrillation, business.industry, STROKE PREVENTION, Health Policy, Anticoagulants, Non-interventional, Atrial fibrillation, Guideline, IMPROVED OUTCOMES, medicine.disease, Optimal management, Prospective, EURO HEART SURVEY, Stroke prevention, Emergency medicine, Cohort, Quality of Life, Observational study, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP)-Atrial Fibrillation (AF) III Registry aims to identify contemporary patterns in AF management in clinical practice, assess their compliance with the 2016 ESC AF Guidelines, identify major gaps in guideline implementation, characterize the clinical practice settings associated with good vs. poor guideline implementation and assess and compare the 1-year outcome of guideline-adherent vs. guideline non-adherent management strategies. Methods and results Consecutive adult AF patients (n = 8306) were enrolled between 1 July 2018 and 15 July 2019, and individual patient data were prospectively collected across 192 centres and 31 participating countries during the 3-month enrolment period per centre. The Registry collected baseline and 1-year follow-up data in the eight main domains: patient demographic/enrolment setting, AF diagnosis/characterization, diagnostic assessment, stroke prevention treatments, arrhythmia-directed therapies, integrated AF management, major outcomes (death, non-fatal stroke or systemic embolic event, and non-fatal bleeding event), and the quality of life questionnaire. Conclusion The EORP-AF III Registry is an international, prospective registry of care and outcomes of patients treated for AF, which will provide insights into the contemporary patterns in AF management, ESC AF Guidelines implementation in routine practice and barriers to optimal management of this highly prevalent arrhythmia.
Published: 2021

49. ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement

Author: Hervé Le Breton, Jean-Michal Paradis, Marco Barbanti, Marcelo Santaló-Corcoy, Victor Fradejas-Sastre, Montserrat Bach-Oller, François Roubille, Giuliano Costa, Vincent Auffret, Stefan Toggweiler, Lluis Asmarats, Giuseppe Patti, Stephan Windecker, Sameh Elsaify, Christian Hengstenberg, Lars Søndergaard, Juan G. Córdoba-Soriano, Flavien Vincent, Georg Goliasch, Saifullah Siddiqui, Henrique Barbosa Ribeiro, Jesus Jimenez-Mazuecos, Uri Landes, Eric Van Belle, Quentin Fischer, Pierre Donaint, Luis Nombela-Franco, Troels Jorgensen, Andrea Rognoni, Enrique Gutiérrez-Ibañes, Antonio J. Muñoz-García, Mohamed Abdel-Wahab, Antonio Mangieri, Harindra C. Wijeysundera, Francisco Campelo-Parada, Guillem Muntané-Carol, Francesco Bruno, Thomas Pilgrim, Damien Metz, Marina Urena, Mohammed Nejjari, Josep Rodés-Cabau, Joan Antoni Gómez-Hospital, Giuseppe Tarantini, Gabriela Veiga, Rosana Hernández-Antolín, Didier Tchetche, Laurent Faroux, Diego Carter Campanha-Borges, Chekrallah Chamandi, Thibault Lhermusier, Victor Alfonso Jimenez-Diaz, Chiara Fraccaro, Ramiro Trillo-Nouche, Fabrizio D'Ascenzo, Eric Durand, Francesco Saia, Erika Muñoz-García, Ignacio Cruz-González, Maria Tamargo, John G. Webb, Hélène Eltchaninoff, Raúl Moreno, German Armijo, Vicens Serra, Université Laval [Québec] (ULaval), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Clinique Pasteur [Toulouse], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre cardiologique du Nord (CCN), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital de Rangueil, CHU Toulouse [Toulouse], Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires (RNMCD - U1011), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Time Factors, acute coronary syndrome, mortality, percutaneous coronary intervention, ST-segment elevation myocardial infarction, transcatheter aortic valve replacement, IMPACT, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Coronary Angiography, Global Health, ACUTE CORONARY SYNDROME, 0302 clinical medicine, Postoperative Complications, Valve replacement, Interquartile range, Risk Factors, ST segment, 030212 general & internal medicine, Myocardial infarction, Hospital Mortality, 610 Medicine & health, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, education.field_of_study, OUTCOMES, Incidence, FRENCH REGISTRY, 3. Good health, surgical procedures, operative, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Acute coronary syndrome, Population, Risk Assessment, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, MANAGEMENT, Humans, cardiovascular diseases, education, business.industry, Percutaneous coronary intervention, Aortic Valve Stenosis, medicine.disease, OSTIA, Conventional PCI, ST Elevation Myocardial Infarction, business, Follow-Up Studies
Abstract: BACKGROUND Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. OBJECTIVES The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR.METHODS This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (inter quartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries.RESULTS Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4% and 42.4%, respectively (20.6% and 38.2% in primary PCI patients), and estimated glomerular filtration rate < 60 ml/min (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class $2 (HR: 2.74; 95% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95% CI: 1.42 to 7.31; p = 0.005) determined an increased risk.CONCLUSIONS STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes. (J Am Coll Cardiol 2021;77:2187-99)(c) 2021 by the American College of Cardiology Foundation.
Published: 2021

50. Stroke Complicating Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author: Fernando Alfonso, Marco Barbanti, Alexandre Abizaid, Howard C. Herrmann, John Lisko, Luis Nombela-Franco, Eric Durand, Julio Andrea, Sandro Sponga, Oliver Husser, Vincent Auffret, Ander Regueiro, Susheel Kodali, Victoria Vilalta, Marcos Antonio Marino, Marouane Boukhris, Asim N. Cheema, Saif Siddiqui, Isaac Pascual, David Holzhey, Paolo Olivares, Josep Rodés-Cabau, Maria Cristina Ferreira, Hervé Le Breton, Norman Mangner, Vinicius Esteves, Tarun Chakravarty, Vicenç Serra, Martin Landt, Guglielmo Mario Actis Dato, Abdullah Alkhodair, Francesco Giannini, Dominique Himbert, Tomasz Gasior, Wojtek Wojakowski, Valter C. Lima, Azeem Latib, Utz Kappert, Antonio L. Bartorelli, Annapoorna Kini, Enrique Gutiérrez-Ibañes, Juan C. Castillo, Mohamed Abdel-Wahab, Erika Muñoz-García, José Armando Mangione, Clement Servoz, Ignacio J. Amat-Santos, Francisco Campelo-Parada, Stefan Stortecky, Francesco Rosato, Luca Testa, Marina Urena, Luisa Salido, Ugolino Livi, Alexandre Siciliano Colafranceschi, Chekrallah Chamandi, Lisa Crusius, Samir R. Kapadia, Harindra C. Wijeysundera, Roger R. Godinho, Stamatios Lerakis, Frédéric Maes, Jean Bernard Masson, Rosana Hernández-Antolín, Didier Tchetche, Antonio Miceli, Fabio Sandoli de Brito, David del Val, Axel Linke, Lars Søndergaard, Costanza Pellegrini, Alberto Alperi, Jan Malte Sinning, John G. Webb, Claudia Fiorina, Kim Won-Keun, Hélène Eltchaninoff, Henrique Barbosa Ribeiro, Nikolaj Ihlemann, Rafael Romaguera, Philippe Gervais, Raj Makkar, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital de Rangueil, CHU Toulouse [Toulouse], Clinique Pasteur [Toulouse], Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, medicine.medical_specialty, infective endocarditis, prosthetic valve endocarditis, stroke, TAVR, transcatheter aortic valve implantation, medicine.medical_treatment, 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Valve replacement, Risk Factors, Internal medicine, medicine, Humans, Endocarditis, 030212 general & internal medicine, Embolization, 610 Medicine & health, Stroke, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Incidence, Mortality rate, Incidence (epidemiology), Endocarditis, Bacterial, medicine.disease, 3. Good health, Infective endocarditis, Bacteremia, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: BACKGROUND Stroke is one of the most common and potentially disabling complications of infective endocarditis (IE). However, scarce data exist about stroke complicating IE after transcatheter aortic valve replacement (TAVR). OBJECTIVES The purpose of this study was to determine the incidence, risk factors, clinical characteristics, management, and outcomes of patients with definite IE after TAVR complicated by stroke during index IE hospitalization. METHODS Data from the Infectious Endocarditis after TAVR International Registry (including 569 patients who developed definite IE following TAVR from 59 centers in 11 countries) was analyzed. Patients were divided into two groups according to stroke occurrence during IE admission (stroke [S-IE] vs. no stroke [NS-IE]). RESULTS A total of 57 (10%) patients had a stroke during IE hospitalization, with no differences in causative microorganism between groups. S-IE patients exhibited higher rates of acute renal failure, systemic embolization, and persistent bacteremia (p < 0.05 for all). Previous stroke before IE, residual aortic regurgitation >= moderate after TAVR, balloon-expandable valves, IE within 30 days after TAVR, and vegetation size >8 mm were associated with a higher risk of stroke during the index IE hospitalization (p < 0.05 for all). Stroke rate in patients with no risk factors was 3.1% and increased up to 60% in the presence of >3 risk factors. S-IE patients had higher rates of in-hospital mortality (54.4% vs. 28.7%; p < 0.001) and overall mortality at 1 year (66.3% vs. 45.6%; p < 0.001). Surgical treatment was not associated with improved outcomes in S-IE patients (in-hospital mortality: 46.2% in surgical vs. 58.1% in no surgical treatment; p = 0.47). CONCLUSIONS Stroke occurred in 1 of 10 patients with IE post-TAVR. A history of stroke, short time between TAVR and IE, vegetation size, valve prosthesis type, and residual aortic regurgitation determined an increased risk. The occurrence of stroke was associated with increased in-hospital and 1-year mortality rates, and surgical treatment failed to improve clinical outcomes. (C) 2021 by the American College of Cardiology Foundation.
Published: 2021

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