64 results on '"Fabien Doguet"'
Search Results
2. Corrigendum: Robotic Cardiac Surgery in Europe: Status 2020
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Stepan Cerny, Wouter Oosterlinck, Burak Onan, Sandeep Singh, Patrique Segers, Cengiz Bolcal, Cem Alhan, Emiliano Navarra, Matteo Pettinari, Frank Van Praet, Herbert De Praetere, Jan Vojacek, Theodor Cebotaru, Paul Modi, Fabien Doguet, Ulrich Franke, Ahmed Ouda, Ludovic Melly, Ghislain Malapert, Louis Labrousse, Monica Gianoli, Alfonso Agnino, Tine Philipsen, Jean-Luc Jansens, Thierry Folliguet, Meindert Palmen, Daniel Pereda, Francesco Musumeci, Piotr Suwalski, Koen Cathenis, Jef Van den Eynde, and Johannes Bonatti
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cardiac surgery ,coronary artery bypass grafting ,keyhole surgery ,minimally invasive surgery ,mitral valve surgery ,robotic surgery ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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3. Robotic Cardiac Surgery in Europe: Status 2020
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Stepan Cerny, Wouter Oosterlinck, Burak Onan, Sandeep Singh, Patrique Segers, Cengiz Bolcal, Cem Alhan, Emiliano Navarra, Matteo Pettinari, Frank Van Praet, Herbert De Praetere, Jan Vojacek, Theodor Cebotaru, Paul Modi, Fabien Doguet, Ulrich Franke, Ahmed Ouda, Ludovic Melly, Ghislain Malapert, Louis Labrousse, Monica Gianoli, Alfonso Agnino, Tine Philipsen, Jean-Luc Jansens, Thierry Folliguet, Meindert Palmen, Daniel Pereda, Francesco Musumeci, Piotr Suwalski, Koen Cathenis, Jef Van den Eynde, and Johannes Bonatti
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cardiac surgery ,coronary artery bypass grafting ,keyhole surgery ,minimally invasive surgery ,mitral valve surgery ,robotic surgery ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundEuropean surgeons were the first worldwide to use robotic techniques in cardiac surgery and major steps in procedure development were taken in Europe. After a hype in the early 2000s case numbers decreased but due to technological improvements renewed interest can be noted. We assessed the current activities and outcomes in robotically assisted cardiac surgery on the European continent.MethodsData were collected in an international anonymized registry of 26 European centers with a robotic cardiac surgery program.ResultsDuring a 4-year period (2016–2019), 2,563 procedures were carried out [30.0% female, 58.5 (15.4) years old, EuroSCORE II 1.56 (1.74)], including robotically assisted coronary bypass grafting (n = 1266, 49.4%), robotic mitral or tricuspid valve surgery (n = 945, 36.9%), isolated atrial septal defect closure (n = 225, 8.8%), left atrial myxoma resection (n = 54, 2.1%), and other procedures (n = 73, 2.8%). The number of procedures doubled during the study period (from n = 435 in 2016 to n = 923 in 2019). The mean cardiopulmonary bypass time in pump assisted cases was 148.6 (63.5) min and the myocardial ischemic time was 88.7 (46.1) min. Conversion to larger thoracic incisions was required in 56 cases (2.2%). Perioperative rates of revision for bleeding, stroke, and mortality were 56 (2.2%), 6 (0.2 %), and 27 (1.1%), respectively. Median postoperative hospital length of stay was 6.6 (6.6) days.ConclusionRobotic cardiac surgery case numbers in Europe are growing fast, including a large spectrum of procedures. Conversion rates are low and clinical outcomes are favorable, indicating safe conduct of these high-tech minimally invasive procedures.
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- 2022
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4. ACURATE neo™ aortic valve implantation via carotid artery access: first case report
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Chadi Aludaat, Alexandre Canville, Quentin Landolff, Matthieu Godin, Fabrice Bauer, and Fabien Doguet
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TAVR ,Carotid artery access ,Case report ,Surgery ,RD1-811 ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background The ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) is predominantly implanted via femoral access. Transcarotid use of this prothesis has never been reported. Case presentation We present the case of an 89-year-old woman referred to us for a transcatheter aortic valve replacement (TAVR). After apparatus imaging of the aortic annulus and the peripheral vascular pathway, the heart team was confronted with a triple challenge: (i) The preferable choice of a self-expanding valve because of a small aortic annulus in an obese woman. (ii) Gaining favorable access to the coronary ostia, considering multiple recent coronary stenting. (iii) Utilizing an alternative arterial access because of iliac and femoral severely calcified stenosis. Implanting the ACURATE neo™ transcatheter heart valve (THV) via carotidal access allowed us to overcome these challenges. The procedure was performed successfully without any short-term complications. Conclusion We report the first case of implantation of an ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) via the right common carotid artery.
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- 2021
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5. Priming of Cardiopulmonary Bypass with Human Albumin Decreases Endothelial Dysfunction after Pulmonary Ischemia–Reperfusion in an Animal Model
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Jean Selim, Mouad Hamzaoui, Antoine Ghemired, Zoubir Djerada, Laurence Chevalier, Nicolas Piton, Emmanuel Besnier, Thomas Clavier, Anaïs Dumesnil, Sylvanie Renet, Paul Mulder, Fabien Doguet, Fabienne Tamion, Benoît Veber, Jérémy Bellien, Vincent Richard, and Jean-Marc Baste
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lung transplantation ,ischemia–reperfusion ,cardiopulmonary bypass ,endothelial dysfunction ,glycocalyx ,human albumin ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The routine use of mechanical circulatory support during lung transplantation (LTx) is still controversial. The use of prophylactic human albumin (HA) or hypertonic sodium lactate (HSL) prime in mechanical circulatory support during LTx could prevent ischemia–reperfusion (IR) injuries and pulmonary endothelial dysfunction and thus prevent the development of pulmonary graft dysfunction. The objective was to investigate the impact of cardiopulmonary bypass (CPB) priming with HA and HSL compared to a CPB prime with Gelofusine (GF) on pulmonary endothelial dysfunction in a lung IR rat model. Rats were assigned to four groups: IR-CPB-GF group, IR-CPB-HA group, IR-CPB-HSL group and a sham group. The study of pulmonary vascular reactivity by wire myograph was the primary outcome. Glycocalyx degradation (syndecan-1 and heparan) was also assessed by ELISA and electron microscopy, systemic and pulmonary inflammation by ELISA (IL-1β, IL-10, and TNF-α) and immunohistochemistry. Clinical parameters were evaluated. We employed a CPB model with three different primings, permitting femoral–femoral assistance with left pulmonary hilum ischemia for IR. Pulmonary endothelium-dependent relaxation to acetylcholine was significantly decreased in the IR-CPB-GF group (11.9 ± 6.2%) compared to the IR-CPB-HA group (52.8 ± 5.2%, p < 0.0001), the IR-CPB-HSL group (57.7 ± 6.3%, p < 0.0001) and the sham group (80.8 ± 6.5%, p < 0.0001). We did not observe any difference between the groups concerning glycocalyx degradation, and systemic or tissular inflammation. The IR-CPB-HSL group needed more vascular filling and developed significantly more pulmonary edema than the IR-CPB-GF group and the IR-CPB-HA group. Using HA as a prime in CPB during Ltx could decrease pulmonary endothelial dysfunction’s IR-mediated effects. No effects of HA were found on inflammation.
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- 2022
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6. A Weak Response to Endoplasmic Reticulum Stress Is Associated With Postoperative Organ Failure in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass
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Thomas Clavier, Zoé Demailly, Xavier Semaille, Caroline Thill, Jean Selim, Benoit Veber, Fabien Doguet, Vincent Richard, Emmanuel Besnier, and Fabienne Tamion
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bypass ,cardiopulmonary ,cardiac surgery ,endoplasmic reticulum stress ,endothelium ,inflammation ,Medicine (General) ,R5-920 - Abstract
Introduction: Endoplasmic reticulum stress (ERS) is involved in inflammatory organ failure. Our objective was to describe ERS, its unfolded protein response (UPR) expression/kinetics during cardiac surgery with cardiopulmonary bypass (CPB) and its association with postoperative organ failure (OF).Methods: Prospective study conducted on patients undergoing cardiac surgery with CPB. Blood samples were taken before (Pre-CPB), 2 h (H2-CPB) and 24 h (H24-CPB) after CPB. Plasma levels of 78 kDa Glucose- Regulated Protein (GRP78, final effector of UPR) were evaluated by ELISA. The expression of genes coding for key elements of UPR (ATF6, ATF4, sXBP1, CHOP) was evaluated by quantitative PCR performed on total blood. OF was defined as invasive mechanical ventilation and/or acute kidney injury and/or hemodynamic failure requiring catecholamines.Results: We included 46 patients, GRP78 was decreased at H2-CPB [1,328 (878–1,730) ng/ml vs. 2,348 (1,655–3,730) ng/ml Pre-CPB; p < 0.001] but returned to basal levels at H24-CPB [2,068 (1,436–3,005) ng/ml]. The genes involved in UPR had increased expression at H2 and H24. GRP78 plasma levels in patients with OF at H24-CPB (n = 10) remained below Pre-CPB levels [−27.6 (−51.5; −24.2)%] compared to patients without OF (n = 36) in whom GRP78 levels returned to basal levels [0.6 (−28.1; 26.6)%; p < 0.01]. H24-CPB ATF6 and CHOP expressions were lower in patients with OF than in patients without OF [2.3 (1.3–3.1) vs. 3.0 (2.7–3.7), p < 0.05 and 1.3 (0.9–2.0) vs. 2.2 (1.7–2.9), p < 0.05, respectively].Conclusions: Low relative levels of GRP78 and weak UPR gene expression appeared associated with postoperative OF. Further studies are needed to understand ERS implication during acute organ failure in humans.
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- 2021
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7. Predictive value of the TRI-SCORE for in-hospital mortality after redo isolated tricuspid valve surgery
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Julien Dreyfus, Yohann Bohbot, Augustin Coisne, Yoan Lavie-Badie, Michele Flagiello, Baptiste Bazire, Florian Eggenspieler, Florence Viau, Elisabeth Riant, Yannick Mbaki, Damien Eyharts, Thomas Sénage, Thomas Modine, Martin Nicol, Fabien Doguet, Thierry Le Tourneau, Christophe Tribouilloy, Erwan Donal, Jacques Tomasi, Gilbert Habib, Christine Selton-Suty, Costin Radu, Pascal Lim, Richard Raffoul, Bernard Iung, Jean-Francois Obadia, Etienne Audureau, David Messika-Zeitoun, Centre cardiologique du Nord (CCN), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Lille, 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), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance Publique - Hôpitaux de Marseille (APHM), 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 Nantes (CHU Nantes), Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Lariboisière-Fernand-Widal [APHP], CHU Rouen, Normandie Université (NU), 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), 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, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Cardiologie [Hôpital de la Timone - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
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tricuspid valve insufficiency ,Cardiology and Cardiovascular Medicine ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
ObjectivesThe TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.MethodsUsing a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017. Baseline characteristics and outcomes were collected from chart review and surgical scores were calculated.ResultsWe identified 70 patients who underwent a redo ITVS (54±15 years, 63% female). Prior intervention was a tricuspid valve repair in 51% and a replacement in 49%, and was combined with another surgery in 41%. A tricuspid valve replacement was performed in all patients for the redo surgery. Overall, in-hospital mortality and major postoperative complication rates were 10% and 34%, respectively. The TRI-SCORE was the only surgical risk score associated with in-hospital mortality (p=0.005). The area under the receiver operating characteristic curve for the TRI-SCORE was 0.83, much higher than for the logistic EuroSCORE (0.58) or EuroSCORE II (0.61). The TRI-SCORE was also associated with major postoperative complication rates and survival free of readmissions for heart failure.ConclusionRedo ITVS was rarely performed and was associated with an overall high in-hospital mortality and morbidity, but hiding important individual disparities. The TRI-SCORE accurately predicted in-hospital mortality after redo ITVS and may guide clinical decision-making process (www.tri-score.com).
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- 2023
8. Clinical utility of a deep-learning mortality prediction model for cardiac surgery decision making
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Nicolas Allou, Jérôme Allyn, Sophie Provenchere, Benjamin Delmas, Eric Braunberger, Matthieu Oliver, Jean Louis De Brux, Cyril Ferdynus, Paul Achouh, Stéphane Aubert, Christophe Baufreton, Eric Bezon, Nicolas Bonnet, Olivier Bouchot, Lionel Camilleri, Thierry Caus, Didier Chatel, Nicolas Chavanis, Sidney Chocron, Pierre Corbi, Alain Curtil, Philippe Delentdecker, Philippe Deleuze, Roland Demaria, Patrice Dervanian, Fabien Doguet, Olivier Fabre, Thierry Folliguet, Jean-Marc Frapier, Jean-Philippe Frieh, Jérôme Jouan, Joël Lapeze, Pascal Leprince, Bertrand Marcheix, Juan Pablo Maureira, Jean-Philippe Mazzucotelli, Patrick Nataf, Jean-François Obadia, Jean-Christian Roussel, Vito Giovanni Ruggieri, Jean-Philippe Verhoye, and André Vincentelli
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Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2023
9. Current state of the art and recommendations in robotic mitral valve surgery
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Meindert Palmen, Emiliano Navarra, Johannes Bonatti, Ulrich Franke, Stepan Cerny, Francesco Musumeci, Paul Modi, Sandeep Singh, Elena Sandoval, Matteo Pettinari, Patrique Segers, Monica Gianoli, Frank van Praet, Herbert de Praetere, Jan Vojacek, Theodor Cebotaru, Burak Onan, Cengiz Bolcal, Cem Alhan, Ahmed Ouda, Ludovic Melly, Ghislain Malapert, Louis Labrousse, Alfonso Agnino, Tine Phillipsen, Jean-Luc Jansens, Thierry Folliguet, Piotr Suwalski, Koen Cathenis, Fabien Doguet, Anton Tomšič, Wouter Oosterlinck, Daniel Pereda, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie cardio-vasculaire et thoracique, MUMC+: MA Med Staf Spec CTC (9), RS: FHML non-thematic output, and Acibadem University Dspace
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Pulmonary and Respiratory Medicine ,Treatment Outcome ,Robotic Surgical Procedures ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Surgery ,Robotics ,Cardiac Surgical Procedures ,Cardiology and Cardiovascular Medicine - Abstract
ispartof: INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY vol:35 issue:6 ispartof: location:England status: published
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- 2022
10. Aortic valve repair versus mechanical valve replacement for root aneurysm: the CAVIAAR multicentric study
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Emmanuel Lansac, Isabelle Di Centa, Pichoy Danial, Olivier Bouchot, Eric Arnaud-Crozat, Rachid Hacini, Fabien Doguet, Roland Demaria, Jean Philippe Verhoye, Jerome Jouan, Didier Chatel, Stephane Lopez, Thierry Folliguet, Pascal Leprince, Thierry Langanay, Christian Latremouille, Georges Fayad, Jean Philippe Fleury, Jean Luc Monin, Leila Mankoubi, Milena Noghin, Alain Berrebi, Sarah Pousset, Aline Laubriet-Jazayeri, Alexandre Lafourcade, Estelle Marcault, Michel Kindo, Laurent Payot, Eric Bergoend, Cecile Jourdain Hoffart, Mathieu Debauchez, and Florence Tubach
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Pulmonary and Respiratory Medicine ,Reoperation ,Heart Valve Prosthesis Implantation ,Aortic Valve Insufficiency ,General Medicine ,Middle Aged ,Cardiac Valve Annuloplasty ,Aortic Aneurysm ,Treatment Outcome ,Aortic Valve ,Quality of Life ,Humans ,Surgery ,Prospective Studies ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
OBJECTIVES Despite growing evidence that aortic valve repair improves long-term patient outcomes and quality of life, aortic valves are mostly replaced. We evaluate the effect of aortic valve repair versus replacement in patients with dystrophic aortic root aneurysm up to 4 years. METHODS The multicentric CAVIAAR (Conservation Aortique Valvulaire dans les Insuffisances Aortiques et les Anévrismes de la Racine aortique) prospective cohort study enrolled 261 patients: 130 underwent standardized aortic valve repair (REPAIR) consisting of remodelling root repair with expansible aortic ring annuloplasty, and 131 received mechanical composite valve and graft replacement (REPLACE). Primary outcome was a composite criterion of mortality, reoperation, thromboembolic or major bleeding events, endocarditis or operating site infections, pacemaker implantation and heart failure, analysed with propensity score-weighted Cox model analysis. Secondary outcomes included major adverse valve-related events and components of primary outcome. RESULTS The mean age was 56.1 years, and valve was bicuspid in 115 patients (44.7%). Up to 4 years, REPAIR did not significantly differ from REPLACE in terms of primary outcome [Hazard Ratio (HR) 0.66 (0.39; 1.12)] but showed significantly less valve-related deaths (HR 0.09 [0.02; 0.34]) and major bleeding events (HR 0.37 [0.16; 0.85]) without an increased risk of valve-related reoperation (HR 2.10 [0.64; 6.96]). When accounting for the occurrence of multiple events in a single patient, the REPAIR group had half the occurrence of major adverse valve-related events (HR 0.51 [0.31; 0.86]). CONCLUSIONS Although the primary outcome did not significantly differ between the REPAIR and REPLACE groups, the trend is in favour of REPAIR by a significant reduction of valve-related deaths and major bleeding events. Long-term follow-up beyond 4 years is needed to confirm these findings.
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- 2021
11. ACURATE neo™ Aortic Valve implantation via carotid artery access: First case report
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Quentin Landolff, Fabrice Bauer, Fabien Doguet, Matthieu Godin, Alexandre Canville, and Chadi Aludaat
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Pulmonary and Respiratory Medicine ,Aortic valve ,medicine.medical_specialty ,RD1-811 ,Carotid Artery, Common ,medicine.medical_treatment ,Case Report ,030204 cardiovascular system & hematology ,TAVR ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Right Common Carotid Artery ,Valve replacement ,Anesthesiology ,Medicine ,Humans ,RD78.3-87.3 ,Heart valve ,Cardiac skeleton ,Aged, 80 and over ,business.industry ,Carotid artery access ,General Medicine ,Aortic Valve Stenosis ,medicine.disease ,Surgery ,Cardiac surgery ,Stenosis ,medicine.anatomical_structure ,030228 respiratory system ,Cardiothoracic surgery ,Aortic Valve ,Heart Valve Prosthesis ,cardiovascular system ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) is predominantly implanted via femoral access. Transcarotid use of this prothesis has never been reported. Case presentation We present the case of an 89-year-old woman referred to us for a transcatheter aortic valve replacement (TAVR). After apparatus imaging of the aortic annulus and the peripheral vascular pathway, the heart team was confronted with a triple challenge: (i) The preferable choice of a self-expanding valve because of a small aortic annulus in an obese woman. (ii) Gaining favorable access to the coronary ostia, considering multiple recent coronary stenting. (iii) Utilizing an alternative arterial access because of iliac and femoral severely calcified stenosis. Implanting the ACURATE neo™ transcatheter heart valve (THV) via carotidal access allowed us to overcome these challenges. The procedure was performed successfully without any short-term complications. Conclusion We report the first case of implantation of an ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) via the right common carotid artery.
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- 2021
12. Autopsy and clinical discrepancies in patients undergoing extracorporeal membrane oxygenation: a case series—a step towards understanding 'Why'?
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Fabien Doguet, Jean-Marc Baste, Chadi Aludaat, and Matthieu Sarsam
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cardiogenic shock ,Autopsy ,Oxygenation ,030204 cardiovascular system & hematology ,medicine.disease ,Extracorporeal ,Editorial Commentary ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,030228 respiratory system ,Life support ,Circulatory system ,medicine ,Extracorporeal membrane oxygenation ,In patient ,Intensive care medicine ,business ,Letter to the Editor - Abstract
Veno-arterial extracorporeal membranous oxygenation (VA-ECMO) is a form of temporary mechanical circulatory support that is used as a salvage technique in cardiac arrest and cardiogenic shock. The setting up of an ECMO is often a difficult decision that is taken in an emergency environment, in hemodynamically unstable patients. Despite all advances that veno-arterial ECMO has witnessed over the past 50 years (1), its related mortality is still very high. Referring to the Extracorporeal Life Support Organization (ELSO) registry, VA-ECMO cardiac patients have overall survival to discharge of only 43% (2).
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- 2019
13. Aortic Valve Surgery in Nonelderly Patients: Insights Gained From AVIATOR
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Jean-François Fuzellier, Christophe de Meester, Rémi Houel, Florence Tubach, Georges Fayad, Maciej Matuszewski, Eric Arnaud-Crozat, Svenja Rauch, Jean-François Obadia, Adrian Kolesar, Matteo Pettinari, Bardia Arabkhani, Jos A. Bekkers, Fabrizio Ceresa, Andrea Mangini, Dave R. Koolbergen, Daniel Czytrom, František Sabol, Thomas J van Brakel, Ignacio Bibiloni, Pallav Shah, Rosina Ziller, Alain Leguerrier, Marek Jasiński, Gianclaudio Mecozzi, Mihail Svetkin, Taoufik Benkacem, Jaroslav Hlubocky, Hans-Joachim Schäfers, Vincent Doisy, Jean-Luc Monin, Christine Leon, Carlo Antona, Jan Vojacek, Munir Boodhwani, Francesco Patane, Andrey Slautin, Gebrine Elkhoury, Rubina Rosa, Yutaka Okita, Ismail El-Hamamsy, Wenke Goossens, Alain Berrebi, Paolo Ferrero, Jan Nijs, Fabien Doguet, Mauro Masat, Monica Contino, Edward P. Chen, Gregorio Rábago, Stéphane Lopez, Duke E. Cameron, Johannes Steindl, José Aramendi, Eric Bergoend, Maurice Enriquez-Sarano, Jean-Louis Vanoverschelde, Bart Meuris, Virginia Alvarez-Asiain, Robert Novotny, Davor Barić, Michael A. Borger, Tomas Toporcer, Ruggero De Paulis, Leila Mankoubi, J. M. Marnette, Christelle Diakov, Amaia Melero, Said Soliman, Michael Tousch, Ryan E. Accord, Philippe Pibarot, Mikita Karalko, Vladislav Aminov, Agnes Pasquet, Serban Stoica, David Messika Zeitoun, Olivier Bouchot, Bernard Albat, Jérôme Jouan, Savica Gjorgijevska, Klaartje Van den Bossche, Igor Rudez, J. Kluin, Laurent de Guillaume Jondeau, Didier Chatel, Pascal Leprince, Sarah Pousset, Rafael Sadaba, Veerle Van Mossevelde, Evi Schepmans, Johanna J.M. Takkenberg, Carlos Porras, Herbert Gutermann, Isabelle Di Centa, Aude Boignard, Joseph E. Bavaria, Pierre-Emmanuel Noly, Yves Glock, Corinne Coulon, Bart Loeys, Rita K. Milewski, Christian Dinges, Marien Lenoir, Francesco Grigioni, Alejandro Crespo, Patrick Moeller, Frederiek de Heer, Mohamad Bashir, Milean Noghin, Fadoua Kaddouri, Takashi Kunihara, Isaac Wenger, Ilaria Chirichilli, Claudia Romagnoni, Diana Aicher, Arturo Evangelista Masip, Daniel Unić, Emmanuel Lansac, Fabrice Wautot, Peter Verbrugghe, Laurent de Kerchove, Pouya Youssefi, Josip Varvodić, Robert J.M. Klautz, Patrick Yiu, Frank Theisohn, Pavel Zacek, Guy Fernandez, Takeshi Miyairi, Thierry Bourguignon, Cardiothoracic Surgery, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, and UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
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Aortic valve ,Time Factors ,Nonelderly patients ,medicine.medical_treatment ,Heart Valve Diseases ,AVIATOR ,Aortic valve surgery ,Adult ,Age Factors ,Aortic Valve ,Bioprosthesis ,Evidence-Based Medicine ,Heart Valve Prosthesis ,Life Expectancy ,Middle Aged ,Prosthesis Failure ,Recovery of Function ,Registries ,Risk Factors ,Treatment Outcome ,Heart Valve Prosthesis Implantation ,Transcatheter Aortic Valve Replacement ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Aortic valve repair ,Quality of life ,Expectancy theory ,education.field_of_study ,Ross procedure ,General Medicine ,medicine.anatomical_structure ,Cardiology and Cardiovascular Medicine ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Population ,03 medical and health sciences ,medicine ,Humans ,education ,business.industry ,Mechanical Aortic Valve ,Surgery ,Settore MED/23 ,030228 respiratory system ,Life expectancy ,business - Abstract
Aortic valve surgery in non-elderly patients represents a very challenging patient population. The younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be, with longer exposure to valve-related complications and risk for re-operation. Although the latest international guidelines recommend aortic valve repair in patients with aortic valve insufficiency, what we see in the real world is that the vast majority of these aortic valves are replaced. However, current prosthetic valves has now been shown to lead to significant loss of life expectancy for non-elderly patients up to 50% for patients in their 40s undergoing mechanical aortic valve replacement. Bioprostheses carry an even worse long-term survival, with higher rates of re-intervention. The promise of trans-catheter valve-in-valve technology is accentuating the trend of bioprosthetic implantation in younger patients, without yet the appropriate evidence. In contrast, aortic valve repair has shown excellent outcomes in terms of quality of life, freedom from re-operation and freedom from major adverse valve-related events with similar life expectancy to general population as it is also found for the Ross procedure, the only available living valve substitute. We are at a time when the paradigm of aortic valve surgery needs to change for the better. To better serve our patients, we must acquire high quality real-world evidence from multiple centers globally - this is the vision of the AVIATOR registry and our common responsibility.
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- 2019
14. Isolated tricuspid valve surgery: impact of aetiology and clinical presentation on outcomes
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Jean-François Obadia, Martin Nicol, Richard Raffoul, Christine Selton-Suty, Augustin Coisne, Thierry Le Tourneau, Erwan Donal, David Messika-Zeitoun, Michele Flagiello, Henri Dubrulle, D. Eyharts, J. Dreyfus, Yannick Mbaki, Florence Viau, Elisabeth Riant, Yohann Bohbot, Christophe Tribouilloy, Gilbert Habib, Florian Eggenspieler, Bernard Iung, Baptiste Bazire, Jacques Tomasi, Thomas Senage, Fabien Doguet, Virginia Nguyen, Yoan Lavie-Badie, Centre cardiologique du Nord (CCN), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance Publique - Hôpitaux de Marseille (APHM), CHU Henri Mondor [Créteil], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), 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)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Rouen, Normandie Université (NU), 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), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (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), 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), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Pontchaillou [Rennes], Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie [CHRU Nancy], University of Ottawa [Ottawa], CHU Henri Mondor, 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 de Rangueil, CHU Toulouse [Toulouse], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques
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Adult ,medicine.medical_specialty ,Ventricular Dysfunction, Right ,Regurgitation (circulation) ,Tricuspid regurgitation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Tricuspid Valve Insufficiency ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Statistical significance ,Medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Outcome ,Prothrombin time ,Heart Valve Prosthesis Implantation ,Tricuspid valve ,medicine.diagnostic_test ,business.industry ,medicine.disease ,3. Good health ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Heart failure ,Infective endocarditis ,Etiology ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims The aim of this study was to identify determinants of in-hospital and mid-term outcomes after isolated tricuspid valve surgery (ITVS) and more specifically the impact of tricuspid regurgitation (TR) mechanism and clinical presentation. Methods and results Among 5661 consecutive adult patients who underwent a tricuspid valve (TV) surgery at 12 French tertiary centres in 2007–2017 collected from a mandatory administrative database, we identified 466 patients (8% of all tricuspid surgeries) who underwent an ITVS. Most patients presented with advanced disease [47% in New York Heart Association (NYHA) III/IV, 57% with right-sided heart failure (HF) signs]. Tricuspid regurgitation was functional in 49% (22% with prior left-sided heart valve surgery and 27% isolated) and organic in 51% (infective endocarditis in 31% and other causes in 20%). In-hospital mortality and major complications rates were 10% and 31%, respectively. Rates of survival and survival free of HF readmission were 75% and 62% at 5 years. Patients with functional TR incurred a worse in-hospital mortality than those with organic TR (14% vs. 6%, P = 0.004), but presentation was more severe. Independent determinants of outcomes were NYHA Class III/IV [odd ratios (OR) = 2.7 (1.2–6.1), P = 0.01], moderate/severe right ventricular dysfunction [OR = 2.6 (1.2–5.8), P = 0.02], lower prothrombin time [OR = 0.98 (0.96–0.99), P = 0.008], and with borderline statistical significance, right-sided HF signs [OR = 2.4 (0.9–6.5), P = 0.06] while TR mechanism was not [OR = 0.7 (0.3–1.8), P = 0.88]. Conclusion Isolated TV surgery was associated with high mortality and morbidity, both in hospital and during follow-up, predicted by the severity of the presentation but not by TR mechanism. Our results suggest that TV intervention should be performed earlier in the course of the disease.
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- 2020
15. Cardiopulmonary bypass increases endothelial dysfunction after pulmonary ischaemia-reperfusion in an animal model
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Emmanuel Besnier, Paul Mulder, Anaïs Dumesnil, Damien Genty, Benoit Veber, Thomas Clavier, Sylvanie Renet, Zoubir Djerada, Laurence Chevalier, Vincent Richard, Jean Selim, Fabien Doguet, Nicolas Piton, Jean-Marc Baste, Fabienne Tamion, Mouad Hamzaoui, and Inès Boukhalfa
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Endothelium ,medicine.medical_treatment ,Primary Graft Dysfunction ,030204 cardiovascular system & hematology ,law.invention ,Nitric oxide ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Reperfusion therapy ,law ,Ischemia ,Internal medicine ,medicine ,Cardiopulmonary bypass ,Lung transplantation ,Animals ,Endothelial dysfunction ,Lung ,Cardiopulmonary Bypass ,business.industry ,General Medicine ,medicine.disease ,Rats ,surgical procedures, operative ,medicine.anatomical_structure ,030228 respiratory system ,chemistry ,Reperfusion ,Cardiology ,Surgery ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
OBJECTIVES Endothelial dysfunction during ischaemia-reperfusion (IR) is a major cause of primary graft dysfunction during lung transplantation. The routine use of cardiopulmonary bypass (CPB) during lung transplantation remains controversial. However, the contribution of CPB to pulmonary endothelial dysfunction remains unclear. The objective was to investigate the impact of CPB on endothelial dysfunction in a lung IR rat model. METHODS Rats were allocated to 4 groups: (i) Sham, (ii) IR, (iii) CPB and (iv) IR-CPB. The primary outcome was the study of pulmonary vascular reactivity by wire myograph. We also assessed glycocalyx degradation by enzyme-linked immunosorbent assay and electron microscopy and both systemic and pulmonary inflammation by enzyme-linked immunosorbent assay and immunohistochemistry. Rats were exposed to 45 min of CPB and IR. We used a CPB model allowing femoro-femoral support with left pulmonary hilum ischaemia for IR. RESULTS Pulmonary endothelium-dependent relaxation to acetylcholine was markedly reduced in the IR-CPB group (10.7 ± 9.1%) compared to the IR group (50.5 ± 5.2%, P CONCLUSIONS CPB significantly increased the IR-mediated effects on pulmonary endothelial dysfunction. Therefore, the use of CPB during lung transplantation could be deleterious, by increasing endothelial dysfunction.
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- 2020
16. Isolated tricuspid valve surgery–impact of etiology and clinical presentation on outcomes
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David Messika-Zeitoun, Martin Nicol, Jean-François Obadia, Christine Selton-Suty, Y. Bohbot, Christophe Tribouilloy, Virginia Nguyen, Erwan Donal, Bernard Iung, Yoan Lavie-Badie, T. Le Tourneau, Baptiste Bazire, Michele Flagiello, Fabien Doguet, Augustin Coisne, Florence Viau, Elisabeth Riant, J. Dreyfus, Gilbert Habib, and Y. Mbaki Mampuya
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Prothrombin time ,medicine.medical_specialty ,Tricuspid valve ,medicine.diagnostic_test ,business.industry ,Disease ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Heart failure ,Statistical significance ,Infective endocarditis ,medicine ,Etiology ,Presentation (obstetrics) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims To identify determinants of in-hospital and mid-term outcomes after isolated tricuspid valve surgery (ITVS) as little is known regarding the impact of tricuspid regurgitation (TR) mechanism and clinical presentation. Methods and results Among 5661 consecutive adult patients who underwent a tricuspid valve surgery at 12 French tertiary centers in 2007-2017 collected from a mandatory administrative database, we identified 466 patients (8% of all tricuspid surgeries) who underwent an ITVS. Most patients presented with advanced disease (47% in NYHA III/IV, 57% with right-sided heart failure (HF) signs). TR was functional in 49% (22% with prior left-sided heart valve surgery and 27% isolated) and organic in 51% (infective endocarditis in 31% and other causes in 20%). In-hospital mortality and major complications rates were 10% and 31% respectively. Rates of survival and survival free of HF readmission were 75% and 62% at 5 years. Patients with functional TR incurred a worse in-hospital mortality than those with organic TR (14.4% vs. 6.3%, P = 0.004) but presentation was more severe. Independent determinants of outcomes were NYHA class III/IV (OR = 2.7[1.2–6.1], P = 0.01), moderate/severe right ventricular dysfunction (OR = 2.6[1.2–5.8], P = 0.02), lower prothrombin time (OR = 0.98[0.96–0.99], P = 0.008) and with borderline statistical significance, right-sided HF signs (OR = 2.4[0.9–6.5], P = 0.06) while TR mechanism was not (OR = 0.7[0.3–1.8], P = 0.88). Conclusion ITVS was associated with high mortality and morbidity, both in-hospital and during follow-up, predicted by the severity of the presentation but not by TR mechanism. Our results suggest that TV intervention should be performed earlier in the course of the disease.
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- 2021
17. Calcification of aortic valvular interstitial cells induced by endothelin receptor blockers
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Anaïs Dumesnil, B. Colleville, E. Berg, H. Messaoudi, T. Levesque, A. Herbet, Fabien Doguet, Vincent Richard, Hélène Eltchaninoff, Jeremy Bellien, D. Boquet, and Nicolas Perzo
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Pathology ,medicine.medical_specialty ,business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,Endothelin receptor ,business ,medicine.disease ,Calcification - Published
- 2021
18. A Survey of Cardiac Surgery Infections With PICO Negative Pressure Therapy in High-Risk Patients
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Alfred Tabley, Chadi Aludaat, Vincent Le Guillou, Arnaud Gay, Catherine Nafeh-Bizet, Vincent Scherrer, François Bouchart, and Fabien Doguet
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Negative-pressure wound therapy ,Surveys and Questionnaires ,Medicine ,Humans ,Surgical Wound Infection ,Cardiac Surgical Procedures ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,fungi ,Retrospective cohort study ,EuroSCORE ,Middle Aged ,medicine.disease ,Mediastinitis ,Sternotomy ,Cardiac surgery ,Surgery ,030228 respiratory system ,Incision Site ,Median sternotomy ,Female ,France ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Negative-Pressure Wound Therapy - Abstract
Background Surgical site complications represent major concerns in many surgical specialties and lead to an increased length of hospital stay and the need for additional treatments and care. This investigation aimed to report survey data from the introduction of the PICO negative pressure wound therapy system (Smith & Nephew, Hull, United Kingdom) in a single hospital in France regarding cardiac surgical procedures through standard median sternotomy. Methods The patients in this study were at high risk of developing surgical site infections. PICO was used immediately postoperatively on the closed incision sites in all patients undergoing cardiac surgical procedures. Data were compared with a retrospective cohort of patients in whom PICO had not been used postoperatively. In total, 233 anonymized patient records were reviewed, 142 of which used the PICO device and 91 of which did not. Results PICO was shown to provide both clinical and economic benefits over standard care across a range of different cardiac surgical patients. The rates of complications, including deep surgical wound infections and mediastinitis, were reduced. Conclusions As noted, PICO had advantages over standard care in these patients, and complication rates decreased. This study demonstrated cost savings and an increase in available surgical and hospital capacity related to PICO use.
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- 2019
19. Early Positive Fluid Balance is Associated with Mortality in Patients Treated with Veno-Arterial Extra Corporeal Membrane Oxygenation For Cardiogenic Shock: a Retrospective Cohort Study
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Samia Boubèche, Emmanuel Besnier, Fabienne Tamion, Thomas Clavier, Vincent Compère, Bertrand Dureuil, Benoit Veber, Benjamin Popoff, and Fabien Doguet
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Shock, Cardiogenic ,Water-Electrolyte Imbalance ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Extracorporeal Membrane Oxygenation ,Positive fluid balance ,Internal medicine ,medicine ,Humans ,In patient ,Hospital Mortality ,Retrospective Studies ,business.industry ,Cardiogenic shock ,Area under the curve ,030208 emergency & critical care medicine ,Retrospective cohort study ,Oxygenation ,Middle Aged ,Water-Electrolyte Balance ,medicine.disease ,3. Good health ,Circulatory system ,Emergency Medicine ,Cardiology ,Female ,business - Abstract
PURPOSE Veno-arterial Extracoporeal Membrane Oxygenation (VA-ECMO) provides circulatory assistance for patients in cardiogenic shock. Large quantities of fluids are often required, especially during the early stages, but can result in a potentially harmful fluid-overload. The objective was to determine the association of early fluid-balance and mortality. METHODS Retrospective single-center study in 101 VA-ECMO patients between 2013 and 2016. Daily fluid-balance and weight changes over the 5 first days were observed. Analyses between survivors and non-survivors were conducted using Mann-Whitney tests and logistic regression multivariable and Cox hazard-proportional analyses to determine any association with 28-days mortality. RESULTS Mortality was 47.5%. The fluid-balance was higher in non-survivors at day-1 (47.3[18.1-71.9] vs. 19.3[1.5-36.2] mL/kg, P
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- 2019
20. Sutureless aortic bioprosthesis valve implantation and bicuspid valve anatomy: an unsolved dilemma?
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Jean-François Fuzellier, Kasra Azarnoush M.D., Antoine Gerbay, Jean-Baptiste Guichard, Marco Vola, Amedeo Anselmi, Vito Giovani Ruggieri, Salvatore Campisi, Karl Isaaz, and Fabien Doguet
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Male ,Aortic valve ,medicine.medical_specialty ,Time Factors ,Aortic Valve Insufficiency ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Prosthesis Design ,03 medical and health sciences ,0302 clinical medicine ,Bicuspid Aortic Valve Disease ,Aortic valve replacement ,Bicuspid valve ,Internal medicine ,medicine ,Humans ,In patient ,Aged ,Retrospective Studies ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,business.industry ,Retrospective cohort study ,Aortic Valve Stenosis ,Vascular surgery ,medicine.disease ,Sutureless Surgical Procedures ,Surgery ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Aortic Valve ,Heart Valve Prosthesis ,Aortic valve stenosis ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Interest is growing in the clinical use of sutureless (SU) valves. However, indications in some anatomical sub-settings, like bicuspid aortic valves (BAV), have been so far limited. We discuss herein our initial experience with the implantation of the 3f Enable SU bioprosthesis in patients with a BAV. Patients with a BAV were selected in our unit between March 2011 and September 2014 for a SU 3f Enable valve implantation. Twenty of the 198 patients who underwent a 3f Enable valve implantation in our unit had a BAV. Procedural success was 100 %, but reclamping was necessary in one (5 %) case. Median size of implanted bioprosthesis was 23 mm. After a mean follow-up of 13.8 ± 10.7 months, survival was 100 %. Two patients (10 %) showed an immediate grade 1 paravalvular leak (PVL) that progressed to grade 2 and 3+ (moderate/severe), respectively, during follow-up. Type of bicuspidy (Sievers classification) in these two patients was 0 and intraoperatively aortic annuli admitted the 25 mm calibrator. Among the 18 patients without PVL, no one had a type 0 large BAV. At 1 year, implantation of the 3f Enable SU bioprosthesis appears to be safe in patients with BAV type I and II, while in type 0 use of the SU valve seems to be safe only if the annular diameter is
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- 2016
21. Inactivated antithombin as anticoagulant reversal in a rat model of cardiopulmonary bypass: a potent and potentially safer alternative to protamine
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Jean-Luc Plantier, Alexandre Sebestyen, Vincent Richard, Alexandre Fontayne, Toufik Abache, Fabien Doguet, Elsa P. Bianchini, Yasmine Bourti, Fabienne Tamion, Delphine Borgel, Hémostase, Inflammation, Thrombose (HITH - U1176 Inserm - CHU Bicêtre), Université Paris-Sud - Paris 11 (UP11)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche du CEA/DSV/iBiTec-S/SIMOPRO, Ingénierie des protéines de l'hémostase à potentiel thérapeutique, Université Paris-Sud - Paris 11 (UP11), LFB Biotechnologies, Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Service de soins intensifs [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), LFB Biotechnologies [Lille, France], Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Department of Hematology [Paris], Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Brakenhielm, Ebba
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Male ,0301 basic medicine ,[SDV.BIO]Life Sciences [q-bio]/Biotechnology ,[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Pharmacology ,heparin ,law.invention ,chemistry.chemical_compound ,0302 clinical medicine ,law ,Protamines ,Antidote ,biology ,medicine.diagnostic_test ,Anticoagulant ,Antithrombin ,Heparin Antagonists ,Hematology ,Heparin ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,3. Good health ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,antithrombin ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,cardiopulmonary bypass ,protamine ,Histamine ,medicine.drug ,Partial thromboplastin time ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,medicine.drug_class ,Antithrombins ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine ,Cardiopulmonary bypass ,[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Animals ,Rats, Wistar ,Hemodynamics ,Anticoagulants ,Protamine ,[SDV.BIO] Life Sciences [q-bio]/Biotechnology ,030104 developmental biology ,chemistry ,biology.protein ,antidote - Abstract
International audience; Heparin anticoagulation followed by protamine reversal is commonly used in cardiopulmonary bypass (CPB). As an alternative to protamine, a recombinant inactive antithrombin (riAT) was designed as an antidote to heparin and was previously shown to be as potent as protamine in-vitro. In the present study, riAT was assessed for its ability to neutralize heparin after CPB in a rat model. After 60 min of CPB under heparin, rats received 5 mg/kg protamine, 37.5 mg/kg riAT or phosphate buffered saline (PBS) as placebo. Residual anticoagulant activity was assessed using the activated partial thromboplastin time assay before, and 10-30 min after reversion. Haemodynamic monitoring was performed and plasma histamine concentration was also measured. In this model, riAT appeared to be as efficient as protamine in neutralizing heparin. Ten minutes after injection, riAT and protamine both decreased heparin activity, to 1.8 AE 1.3 and 4.5 AE 1.4 u/ ml, respectively (23.1 AE 5.1 u/ml in placebo group). Furthermore, evolution of mean carotid arterial pressure, heart rate and plasma histamine levels was comparable in rats treated with PBS or riAT, while protamine exhibited haemodynamic side effects and increased histamine plasma concentration. Thus, riAT could represent an advantage over protamine in CPB because it efficiently reverses heparin activity without negative effects on haemodynamic parameters and plasma histamine level.
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- 2018
22. Robotic total endoscopic sutureless aortic valve replacement: proof of concept for a future surgical setting
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Fabien Doguet, Vito G. Ruggieri, Radwan Kassir, Jean-François Fuzellier, Marco Vola, Thierry Folliguet, Salvatore Campisi, Jean-Noel Albertini, and Pablo Maureira
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Aortic valve ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,0206 medical engineering ,Biophysics ,02 engineering and technology ,030204 cardiovascular system & hematology ,Prosthesis ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Cadaver ,medicine ,Robotic surgery ,business.industry ,medicine.disease ,020601 biomedical engineering ,eye diseases ,Computer Science Applications ,Surgery ,medicine.anatomical_structure ,Clamp ,Native valve ,sense organs ,Intercostal space ,business - Abstract
Background Sutureless valves have recently enabled closed chest aortic valve replacement. This paper evaluates the feasibility of a robotic telemanipulation during thoracoscopic sutureless aortic valve implantation in cadavers. Methods Cadavers were prepared with a five thoracosopic trocar setting, with a transthoracic clamp inserted in the first right intercostal space and the optics inserted in the second. Seven sutureless valve implantations were scheduled using 5 Sorin Perceval and 2 Medtronic 3f Enable valves. Results In all cases performance of pericardial suspension, aortotomy and root exposure required less than 20 min. Native valve excision and sutureless bioprosthesis implantation was technically feasible in all cases. A satisfactory prosthesis sealing was ascertained visually and the absence of paravalvular leakages was assessed with a nerve hook test around the prosthetic flange. Conclusions Closed chest and robot assisted sutureless valve implantation is feasible in cadavers. Robotic technology can enhance reproducibility of the technique. Copyright © 2015 John Wiley & Sons, Ltd.
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- 2015
23. Abnormal origin and interarterial course of coronary arteries in Marfan syndrome: CT coronary angiography features
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I. Vasies, Jean-Nicolas Dacher, B. Dubourg, Fabien Doguet, and M Lempicki
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Marfan syndrome ,Coronary angiography ,medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,General Medicine ,Iterative reconstruction ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,Coronary arteries ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Tomography x ray computed ,X ray computed ,Abnormal Origin ,medicine ,Radiology, Nuclear Medicine and imaging ,Tomography ,Radiology ,business - Published
- 2016
24. Operated descending thoracic and thoracoabdominal atherosclerotic aortic aneurysm prognosis
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Fabien Doguet, Vincent Scherrer, Bruno Pochulu, Didier Plissonnier, Antoine Monnot, and Sylvie Godier
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Male ,medicine.medical_specialty ,Population ,Context (language use) ,030204 cardiovascular system & hematology ,030230 surgery ,Atherosclerotic aneurysm ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Aneurysm ,medicine ,Humans ,education ,Aged ,Retrospective Studies ,education.field_of_study ,Aortic Aneurysm, Thoracic ,business.industry ,Retrospective cohort study ,medicine.disease ,University hospital ,Atherosclerosis ,Prognosis ,Surgery ,Survival Rate ,Etiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Summary Background The long-term survival of patients treated from descending thoracic aneurysm (DTA) is well known, more than those treated from a thoracoabdominal aortic aneurysm (TAAA). Moreover, studies are rarely focused on the aneurysmal etiology and include both degenerative and post dissecting aneurysms. The aim of this study is to compare the long-term survival of patients operated from DTA or TAAA due to degenerative atherosclerosis. Methods Thirty-nine atherosclerotic aneurysm patients were operated between January 2007 and July 2015 at Rouen University Hospital. Eighteen DTA patients were operated by TEVAR and 21 TAAA patients (8 type I and 13 type III) by open approach. The main endpoint was remote survival patients. Results Overall, the initial population was similar in the two groups. However, one third of DTA were treated in context of emergency for painful aneurysm versus 9.5% of patients with TAAA (P = 0.066). Survival median of 18 DTA was 18 months (1–68). Survival median of 21 TAAA followed was 66 months (1–91). Survival in both groups was statistically different with the log-rank test (P = 0.044). Conclusions Long-term prognosis of atherosclerotic DTA may be worse than that of TAAA's. This retrospective study reflects experience in the management of DTA and TAAA in a single-center. Prospective data in patients treated with endovascular procedures for DTA or TAAA, with fenesterated or branched endoprosthesis, are warranted to confirm these results.
- Published
- 2017
25. Position paper for the evaluation and management of oral status in patients with valvular disease: Groupe de Travail Valvulopathies de la Societe Francaise de Cardiologie, Societe Frangaise de Chinirgie Orale, Societe Frangaise de Parodontologie et d'Implantologie Orale, Societe Frangaise d'Endodontie et Societe de Pathologie Infectieuse de Langue Frangaise
- Author
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Philippe Lesclous, Sarah Millot, Marie-Laure Colombier, Philippe Tramba, Bernard Iung, Emmanuel Lansac, Clement Messeca, Mathieu Ballanger, Jean Luc Charrier, Christophe Tribouilloy, Xavier Duval, Fabien Doguet, Loredana Radoï, Stéphane Simon, Alain Berrebi, Gilbert Habib, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes - UFR Odontologie, Université de Nantes (UN), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Regenerative Medicine and Skeleton research lab (RMeS), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université Paris Descartes - Faculté de Chirurgie Dentaire (UPD5 Odontologie), Université Paris Descartes - Paris 5 (UPD5), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Oral medicine and oral surgery department, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Gynécologie‑Obstétrique, Hôpital Paule de Viguier, Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cardiologie [Amiens], CHU Amiens-Picardie, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), CIC Hôpital Bichat, AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, DHU FIRE Centre de compétence des maladies pulmonaires rares, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Nantes - UFR Odontologie (UFR Odonto), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Regenerative Medicine and Skeleton (RMeS), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Gynécologie [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and 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)-UFR de Médecine
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,valvular heart disease ,Implant failure ,Physical examination ,030206 dentistry ,General Medicine ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,3. Good health ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Acute Endocarditis ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Infective endocarditis ,medicine ,Endocarditis ,Antibiotic prophylaxis ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; Oral health is of particular importance in patients with heart valve diseases because of the risk of infective endocarditis. Recommendations for antibiotic prophylaxis before dental procedures have been restricted, but the modalities of oral evaluation and dental care are not detailed in guidelines. Therefore, a multidisciplinary working group reviewed the literature to propose detailed approaches for the evaluation and management of buccodental status in patients with valvular disease. Simple questions asked by a non-dental specialist may draw attention to buccodental diseases. Besides clinical examination, recent imaging techniques are highly sensitive for the detection of inflammatory bone destruction directly related to oral or dental infection foci. The management of buccodental disease before cardiac valvular surgery should be adapted to the timing of the intervention. Simple therapeutic principles can be applied even before urgent intervention. Restorative dentistry and endodontic and periodontal therapy can be performed before elective valvular intervention and during the follow-up of patients at high risk of endocarditis. The detection and treatment of buccodental foci of infection should follow specific rules in patients who present with acute endocarditis. Implant placement is no longer contraindicated in patients at intermediate risk of endocarditis, and can also be performed in selected high-risk patients. The decision for implant placement should follow an analysis of general and local factors increasing the risk of implant failure. The surgical and prosthetic procedures should be performed in optimal safety conditions. It is therefore now possible to safely decrease the number of contraindicated dental procedures in patients at risk of endocarditis. (C) 2017 Elsevier Masson SAS. All rights reserved.
- Published
- 2017
26. Evolution des modèles de prophylaxie de l’endocardite Infectieuse. Point de vue d’experts sur la prise en charge bucco-dentaire des patients valvulaires
- Author
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Matthieu Balanger, S. Millot, Gilbert Habib, Alain Berrebi, Sarah Millot, Bernard Iung, Philippe Lesclous, Emmanuel Lansac, Radoi Loredana, Charrier Jean-Luc, Christophe Tribouilloy, Philippe Tramba, Xavier Duval, Marie-Laure Colombier, Stéphane Simon, Fabien Doguet, and Clement Messeca
- Published
- 2017
27. Aortic Valve Repair Improves Patient Outcomes Compared to Mechanical Valve Replacement: 4 year Results of the CAVIAAR Multicentric Trial
- Author
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Christian Latremouille, Jean Pierre Fleury, Rachid Hacini, Fabien Doguet, Alexande Lafourcade, Thierry Folliguet, Pascal Leprince, Roland G. Demaria, Emmanuel Lansac, Jérôme Jouan, Georges Fayad, Jean-François Obadia, Bernard Alba, Florence Tubach, Jean Philippe Verhoye, Mathieu Debauchez, Olivier Bouchot, Christophe Acar, Didier Chatel, Isabelle Di Centa, Stéphane Lopez, Thierry Languanay, and Eric Arnaud Crozat
- Subjects
medicine.medical_specialty ,Aortic valve repair ,business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Mechanical valve ,Surgery - Published
- 2019
28. Albumin Limits Mesenteric Endothelial Dysfunction and Inflammatory Response in Cardiopulmonary Bypass
- Author
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Michael Bubenheim, Fabien Doguet, Vincent Richard, Fabienne Tamion, Vincent Le Guillou, Jean Paul Bessou, and Christian Thuillez
- Subjects
medicine.medical_specialty ,biology ,Endothelium ,Extracorporeal circulation ,Biomedical Engineering ,Serum albumin ,Gelofusine ,Medicine (miscellaneous) ,Bioengineering ,General Medicine ,medicine.disease ,Biomaterials ,Nitric oxide synthase ,medicine.anatomical_structure ,Endocrinology ,Internal medicine ,Immunology ,biology.protein ,medicine ,Sodium nitroprusside ,Endothelial dysfunction ,Mesenteric arteries ,medicine.drug - Abstract
The aim of this study was to investigate the potential anti-inflammatory and endothelial protective properties of albumin during cardiopulmonary bypass (CPB) in an experimental porcine model. Two groups underwent CPB for 90 min (n = 7 in each group), and a baseline (BL) control group did not undergo CPB (n = 7). Priming consisted of a gelatin solution (4% gelofusine, CPBG group) or colloid solution (5% albumin, CPBA group). Mesenteric arterial segments were isolated and exposed in vitro to phenylephrine (with or without nitric oxide synthase inhibition) to assess contractility, and exposed to acetylcholine and sodium nitroprusside to assess relaxation. Plasma tumor necrosis factor (TNF)-α levels, intestinal and pulmonary TNF-α and heme oxygenase (HO)-1 mRNA expression, and organ injury were studied. Upon sacrifice, TNF-α levels were significantly higher in the CPBG group than in the CPBA and BL groups. The contractile response was significantly higher in the CPBG group, whereas the response to acetylcholine was significantly lower in the CPBG group than in the other groups. HO-1 mRNA expression was significantly higher in intestine samples in the CPBA group than in the CPBG and BL groups. HO-1 mRNA expression was significantly higher in lung samples in the CPBA group than in the CPBG group. Leukocyte infiltration was significantly higher in intestine and lung samples in the CPBG group than in the CPBA and BL groups. Albumin priming reduced CPB-induced mesenteric vascular dysfunction and prevented the development of a systemic inflammatory response by modeling HO-1 expression in target organs.
- Published
- 2012
29. Mesenteric endothelial dysfunction in a cardiopulmonary bypass rat model: The effect of diabetes
- Author
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Paul Mulder, Jean Paul Bessou, Fabienne Tamion, Vincent Le Guillou, Fabien Doguet, Isabelle Remy Jouet, and Vincent Richard
- Subjects
Male ,medicine.medical_specialty ,Necrosis ,Nitric Oxide Synthase Type III ,Endothelium ,Vasodilator Agents ,Endocrinology, Diabetes and Metabolism ,Blotting, Western ,Nitric Oxide Synthase Type II ,Diabetes Mellitus, Experimental ,law.invention ,law ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Cardiopulmonary bypass ,Animals ,Vasoconstrictor Agents ,Rats, Wistar ,Endothelial dysfunction ,Nitrites ,Cardiopulmonary Bypass ,Dose-Response Relationship, Drug ,biology ,Tumor Necrosis Factor-alpha ,business.industry ,Myography ,medicine.disease ,Mesenteric Arteries ,Rats ,Up-Regulation ,Vasodilation ,Nitric oxide synthase ,surgical procedures, operative ,Endocrinology ,medicine.anatomical_structure ,Vasoconstriction ,Anesthesia ,biology.protein ,Increased inflammatory response ,Endothelium, Vascular ,Inflammation Mediators ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology ,Artery - Abstract
Background: Diabetes is a risk factor for perioperative complications after cardiac surgery. We studied its effects on mesenteric endothelial function in a cardiopulmonary bypass (CPB) model. Methods: Forty Wistar rats were divided into four groups: sham (D-CPB-), cardiopulmonary bypass (D-CPB+), diabetic (D+CPB-) and diabetic that have undergone CPB (D+CPB+). Two samples of mesenteric artery were used for nitric oxide synthase (NOS) Western blot analysis, and two others for assessing contractile response and endothelium relaxations. Nitrite products and tumour necrosis factor-alpha (TNF-α) were assessed as markers of inflammatory response. Results: We observed an enhanced contractile response to the α-adrenergic agonist associated with impairment of mesenteric vasorelaxation in D+CPB+ rats. Western immunoblot analysis of D+CPB+ highlighted an additive effect of hyper-expression of inducible NOS. A significantly increased inflammatory response was observed after CPB in diabetic animals. Conclusions: This work confirms the potential deleterious impact of diabetes on the mesenteric endothelium during CPB in cardiac surgery.
- Published
- 2012
30. Aortic valve replacement after percutaneous valvuloplasty — an approach in otherwise inoperable patients☆
- Author
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Pierre Yves Litzler, Jean Paul Bessou, Guillaume Lebreton, Mathieu Godin, Alain Cribier, Fabien Doguet, and Hélène Eltchaninoff
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Male ,Pulmonary and Respiratory Medicine ,Aortic valve ,medicine.medical_specialty ,medicine.medical_treatment ,Catheterization ,Aortic valve replacement ,Internal medicine ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Aged ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Ejection fraction ,business.industry ,Contraindications ,Cardiogenic shock ,EuroSCORE ,Aortic Valve Stenosis ,General Medicine ,Length of Stay ,medicine.disease ,Surgery ,Aortic valvuloplasty ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,Heart Valve Prosthesis ,Aortic valve stenosis ,Cardiology ,Female ,Epidemiologic Methods ,Cardiology and Cardiovascular Medicine ,business - Abstract
Cardiac surgery can relieve symptoms and improve the prognosis of patients with aortic stenosis. However, surgery-related morbidity and mortality are high when severe cardiac or extracardiac factors co-exist. We report the outcome of percutaneous balloon aortic valvuloplasty (BAV) as a bridge to aortic valve replacement (AVR) in temporarily inoperable patients in our institution.All patients who, between January 2002 and December 2006, underwent a bridging percutaneous BAV and had an AVR performed 8-14 weeks later, were included in the study. Clinical and investigational data were collected retrospectively from the patients' files. Follow-up was performed by telephonic interview.Twenty-five patients were included in the analysis (median age 71.9 years). Operative risk decreased from 18.6% before BAV to less than 13% before AVR, according to the logistical European System for Cardiac Operative Risk Evaluation (EuroSCORE). Median ejection fraction (EF) was 40% before dilation compared with 44% after BAV. The necessity for BAV included acute pulmonary oedema (8%), cardiac failure (64%), cardiogenic shock (16%), syncope (8%) and EF10% (4%). Complications included low output (28%), renal failure (20%), septic shock (4%) and cerebrovascular accident (8%). One postoperative hospital death was observed. The median length of stay in the intensive care unit (ICU) was 44 days, and the median total hospital stay was 10 days.BAV used as a bridging procedure to improve cardiovascular function prior to AVR is an interesting therapeutic approach in patients with aortic stenosis and haemodynamic failure. The postoperative course after AVR was also improved in our patients.
- Published
- 2010
31. Robotic total endoscopic sutureless aortic valve replacement: proof of concept for a future surgical setting
- Author
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Marco, Vola, Pablo, Maureira, Radwan, Kassir, Jean-François, Fuzellier, Salvatore, Campisi, Fabien, Doguet, Jean-Noel, Albertini, Vito Giovanni, Ruggieri, and Thierry, Folliguet
- Subjects
Bioprosthesis ,Heart Valve Prosthesis Implantation ,Robotic Surgical Procedures ,Sutures ,Aortic Valve ,Humans ,Endoscopy - Abstract
Sutureless valves have recently enabled closed chest aortic valve replacement. This paper evaluates the feasibility of a robotic telemanipulation during thoracoscopic sutureless aortic valve implantation in cadavers.Cadavers were prepared with a five thoracosopic trocar setting, with a transthoracic clamp inserted in the first right intercostal space and the optics inserted in the second. Seven sutureless valve implantations were scheduled using 5 Sorin Perceval and 2 Medtronic 3f Enable valves.In all cases performance of pericardial suspension, aortotomy and root exposure required less than 20 min. Native valve excision and sutureless bioprosthesis implantation was technically feasible in all cases. A satisfactory prosthesis sealing was ascertained visually and the absence of paravalvular leakages was assessed with a nerve hook test around the prosthetic flange.Closed chest and robot assisted sutureless valve implantation is feasible in cadavers. Robotic technology can enhance reproducibility of the technique. Copyright © 2015 John WileySons, Ltd.
- Published
- 2015
32. Standardized approach to valve repair using an expansible aortic ring versus mechanical Bentall: early outcomes of the CAVIAAR multicentric prospective cohort study
- Author
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Didier Chatel, Isabelle Di Centa, Rachid Hacini, Fabien Doguet, Georges Fayad, Thierry Folliguet, Emmanuel Lansac, Oliver Jegaden, Jean-Noël Fabiani, Blandine Pasquet, Eric Arnaud Crozat, Olivier Bouchot, Roland G. Demaria, Jean Paul Bessou, Christophe Acar, Jérôme Jouan, Bernard Albat, Alain Leguerrier, Christian Latremouille, Mathieu Debauchez, Stéphane Lopez, Jean Pierre Fleury, Pascal Leprince, Florence Tubach, Thierry Langanay, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), and Université de Montpellier (UM)-Université Montpellier 1 (UM1)
- Subjects
Male ,Time Factors ,[SDV]Life Sciences [q-bio] ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Aortic valve repair ,Postoperative Complications ,Bicuspid Aortic Valve Disease ,Interquartile range ,Risk Factors ,Odds Ratio ,80 and over ,Prospective Studies ,Prospective cohort study ,Heart Valve Prosthesis ,Heart Valve Diseases/diagnosis/mortality/*surgery ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Patient Preference ,Middle Aged ,Cardiac Valve Annuloplasty/adverse effects/mortality ,Aortic Aneurysm ,Heart Valve Prosthesis Implantation/adverse effects/*instrumentation/mortality ,Treatment Outcome ,Aortic Valve ,Cardiology ,Female ,France ,Cardiology and Cardiovascular Medicine ,Pulmonary and Respiratory Medicine ,Adult ,Reoperation ,medicine.medical_specialty ,Blood Vessel Prosthesis Implantation/adverse effects/mortality ,Prosthesis Design ,Cardiac Valve Annuloplasty ,Disease-Free Survival ,Postoperative Complications/mortality/surgery ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,Young Adult ,Internal medicine ,medicine ,Humans ,Aortic Aneurysm/diagnosis/mortality/*surgery ,Propensity Score ,Aged ,Chi-Square Distribution ,business.industry ,Odds ratio ,medicine.disease ,Confidence interval ,Surgery ,Logistic Models ,030228 respiratory system ,Heart failure ,Propensity score matching ,Multivariate Analysis ,Aortic Valve/*abnormalities/surgery ,business ,Chi-squared distribution - Abstract
International audience; OBJECTIVE: The study objective was to compare the 30-day outcomes of a standardized aortic valve repair technique (REPAIR group) associating root remodeling with an expansible aortic ring annuloplasty versus mechanical composite valve and graft (CVG group) replacement in treating aortic root aneurysms. METHODS: A total of 261 consecutive patients with aortic root aneurysm were enrolled in this multicentric prospective cohort (131 in the CVG group, 130 in the REPAIR group) in 20 centers. The main end point is a composite criterion including mortality; reoperation; thromboembolic, hemorrhagic, or infectious events; and heart failure. Secondary end points were major adverse valve-related events. Crude and propensity score adjusted estimates are provided. RESULTS: The mean age was 56.1 years, and the valve was bicuspid in 115 patients (44.7%). The median (interquartile range) preoperative aortic insufficiency grade was 2.0 (1.0-3.0) in the REPAIR group and 3.0 (2.0-3.0) in the CVG group (P = .0002). Thirty-day mortality was 3.8% (n = 5) in both groups (P = 1.00). Despite a learning curve and longer crossclamp times for valve repair (147.7 vs 99.8 minutes, P \textless .0001), the 2 groups did not differ significantly for the main criterion (odds ratio, 1.31; 95% confidence interval, 0.72-2.40; P = .38) or 30-day mortality (odds ratio, 0.99; 95% confidence interval, 0.28-3053; P = .99), with a trend toward more frequent major adverse valve-related events in the CVG group (odds ratio, 2.52; 95% confidence interval, 0.86-7.40; P = .09). At discharge, 121 patients (96.8%) in the REPAIR group had grade 0 or 1 aortic insufficiency. CONCLUSIONS: A new standardized approach to valve repair, combining an expansible aortic annuloplasty ring with the remodeling technique, presented similar 30-day results to mechanical CVG with a trend toward reducing major adverse valve-related events. Analysis of late outcomes is in process for 3- and 10-year follow-ups.
- Published
- 2015
33. Cardiac surgery and repair of pectus deformities: When and how?
- Author
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Francis Juthier, André Vincentelli, Fabien Doguet, Alain Wurtz, Jean-Marc Frapier, Lotfi Benhamed, Carlo Banfi, Alain Prat, Natacha Rousse, Ilir Hysi, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département de Chirurgie Thoracique, 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), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Interface sang vaisseaux et réparation cardiovasculaire, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and MORNET, Dominique
- Subjects
Marfan syndrome ,Adult ,Male ,medicine.medical_specialty ,Thoracic Surgical Procedure ,Adolescent ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,education ,030204 cardiovascular system & hematology ,Echocardiography/methods ,Cardiac Surgical Procedures/methods ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Pectus excavatum ,law ,Funnel Chest/surgery/ultrasonography ,medicine ,Cardiopulmonary bypass ,Humans ,Cardiac Surgical Procedures ,Retrospective Studies ,ddc:617 ,business.industry ,Pectus deformities ,Perioperative ,Thoracic Surgical Procedures ,Cardiac surgery ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,[SDV] Life Sciences [q-bio] ,Treatment Outcome ,030228 respiratory system ,Median sternotomy ,Echocardiography ,Concomitant ,Funnel Chest ,Female ,Thoracic Surgical Procedures/methods ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Objectives There is currently a lack of recommendations about patients with pectus deformities requiring cardiac surgery. This study reports the results of our surgical strategy on this issue. Methods Eleven patients, from three centers treated over a 9-year period were included in this study. Pectus deformities were operated with a modified Ravitch procedure. In the case of pectus excavatum repair and concomitant cardiac surgery, subperichondrial resection of abnormal rib cartilages was always performed before the sternotomy and an easily removable retrosternal metallic strut was inserted at the end of the procedure ensuring anterior chest wall stability. During follow-up patients had to estimate their current appearance with a numeric scale ranging from 0 to 100. Results Mean age was 27±9.4years. Pectus excavatum was present in 8 patients and pectus arcuatum in 3. There were 6 Marfan syndrome patients. Nine patients had concomitant surgery and, 2 underwent pectus repair after a history of cardiac surgery. There was no operative mortality. In the case of concomitant surgery, heart exposure through median sternotomy was facilitated by abnormal rib cartilage resection. Median follow-up was 54months (range 16.7–119.7). Mean cosmetic result evaluated by the patients was 97.3 (±2.5). Conclusions In adults, concomitant scheduled surgery is reliable and offers excellent long-term cosmetic results. Moreover, it allows a better thoracic exposition with no added perioperative risk. The modified Ravitch technique seems more adequate in these patients as it can be used in all types of pectus deformities.
- Published
- 2015
34. Changes in mesenteric vascular reactivity and inflammatory response after cardiopulmonary bypass in a rat model
- Author
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Jean Paul Bessou, Fabien Doguet, Pierre-Yves Litzler, François Bouchart, Marie-France Hellot, A Tabley, Christian Thuillez, Vincent Richard, and Fabienne Tamion
- Subjects
Male ,Nitroprusside ,Pulmonary and Respiratory Medicine ,Hemodynamics ,In Vitro Techniques ,Nitroarginine ,law.invention ,Phenylephrine ,Ileum ,law ,Mesenteric Vascular Occlusion ,medicine ,Cardiopulmonary bypass ,Animals ,Vasoconstrictor Agents ,Splanchnic Circulation ,Rats, Wistar ,Mesenteric arteries ,Cardiopulmonary Bypass ,Tumor Necrosis Factor-alpha ,business.industry ,medicine.disease ,Acetylcholine ,Systemic Inflammatory Response Syndrome ,Mesenteric Arteries ,Rats ,Vasodilation ,Arterioles ,medicine.anatomical_structure ,Vasoconstriction ,Mesenteric ischemia ,Anesthesia ,Circulatory system ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Myograph ,medicine.drug ,Blood vessel - Abstract
Background Mesenteric ischemia and acidosis leading to intestinal ischemia has been observed during cardiopulmonary bypass (CPB) despite normal flow in the mesenteric vessels. The aim of this study was to assess mesenteric endothelium-dependent reactivity and vasoconstrictor responses of small mesenteric arteries in a rat model of CPB without aortic cross-clamping. Methods After femoral cannulation a partial 90 minutes CPB was performed with hemodynamics and blood gas parameters monitoring. Blood samples and segments of small mesenteric arteries were obtained in rats sacrificed 2.5 hours (CPBH2.5) or 6 hours (CPBH6) after femoral cannulation. Sham surgery (sham H2.5, sham H6) was performed with femoral cannulation only. Segments of small mesenteric arteries were placed in a myograph in order to assess the contractile response to phenylephrine (with or without NO synthase inhibitor) or the endothelium-dependent relaxation to acetylcholine. Systemic inflammation was evaluated by measuring plasma concentrations of TNFα. Pulmonary and intestinal infiltration of activated leukocytes was assessed by immunohistochemistry. Results CPB induced increased contractile response to phenylephrine which persisted after blockade of NO synthesis as well as transient impairment of endothelium-dependent relaxations. CPB also led to early and marked release of TNFα. Conclusions CPB was responsible for mesenteric endothelial dysfunction and direct increase in the contractile response to α1-adrenergic agonist with increased systemic inflammatory response. This phenomenon might contribute to an increase in the risk of mesenteric ischemic events during cardiac surgery especially when vasopressor agents are used.
- Published
- 2004
35. Isolation of the Phrenic Nerve to Suppress Diaphragmatic Contraction Induced by Cardiac Resynchronization
- Author
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Bénédicte Godin, Fabien Doguet, Charlotte Honoré, and Frédéric Anselme
- Subjects
Male ,medicine.medical_specialty ,Contraction (grammar) ,medicine.medical_treatment ,Bundle-Branch Block ,Diaphragm ,Cardiac resynchronization therapy ,Diaphragmatic breathing ,Cardiac Resynchronization Therapy ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Cardiac Resynchronization Therapy Devices ,Coronary sinus ,Phrenic nerve ,business.industry ,Thoracoscopy ,Equipment Design ,Middle Aged ,Implantable cardioverter-defibrillator ,Phrenic Nerve ,Treatment Outcome ,Anesthesia ,Cardiac resynchronization ,Cardiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Muscle Contraction ,circulatory and respiratory physiology - Abstract
Phrenic Nerve Isolation in Cardiac Resynchronization. Left phrenic nerve stimulation is a well-known complication of cardiac resynchronization therapy (CRT). We report a case where electronic or anatomical repositioning of the left ventricular (LV) electrode (within the coronary sinus tributaries) was not feasible/effective. Surgical graft interpositioning was performed to successfully isolate the phrenic nerve from the previously implanted coronary sinus epicardial LV lead. (J Cardiovasc Electrophysiol, Vol. 23, pp. 778-780, July 2012)
- Published
- 2012
36. Cardiopulmonary bypass model in the rat: a new minimal invasive model with a low flow volume
- Author
-
Fabienne Tamion, Jean-Paul Bessou, Fabien Doguet, and Guillaume Lebreton
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Time Factors ,Blood Pressure ,Blood volume ,law.invention ,Heart Rate ,law ,Cardiopulmonary bypass ,Animals ,Medicine ,Rats, Wistar ,Blood Volume ,Cardiopulmonary Bypass ,Surgical approach ,Tumor Necrosis Factor-alpha ,business.industry ,Extracorporeal circulation ,Equipment Design ,Femoral Vein ,Rats ,Femoral Artery ,surgical procedures, operative ,Anesthesia ,Models, Animal ,Surgery ,Brief Communications ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,circulatory and respiratory physiology - Abstract
Numerous cardiopulmonary bypass (CPB) models in the rat have already been described, but these models often have an important mortality and differ a lot from human clinical conditions thus making them hardly usable. The CPB model in the rat we describe allows a femoro-femoral support CPB with a low priming volume, minimal surgical approach and excellent peroperative survival. This CPB model in the rat allows evaluating extracorporeal circulation effects.
- Published
- 2012
37. Repair of Intraoperative Aortic Dissection Associated with Malperfusion Syndrome Using a Combination of Open and Endovascular Techniques
- Author
-
Roland Benichou, Guillaume Lebreton, Alexandre Canville, Erick Clavier, Jean Paul Bessou, and Fabien Doguet
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aortography ,Myocardial Ischemia ,Diagnosis, Differential ,Aortic aneurysm ,Aneurysm ,medicine.artery ,medicine ,Humans ,cardiovascular diseases ,Intraoperative Complications ,Aged ,Aortic dissection ,Aorta ,Cardiopulmonary Bypass ,Aortic Aneurysm, Thoracic ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,medicine.disease ,Cardiac surgery ,Surgery ,Aortic Dissection ,Cardiothoracic surgery ,cardiovascular system ,Female ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Echocardiography, Transesophageal ,Follow-Up Studies - Abstract
Intraoperative aortic dissection is a rare but potentially fatal complication of cardiac surgery. In this report, we present a case of intraoperative aortic dissection that was complicated by intestinal ischaemia. The aorta was successfully repaired using both open and endovascular techniques.
- Published
- 2011
38. Vascular steal from right ventricular metastasis of renal tumor: Insight from single source dual energy cardiac CT
- Author
-
Fabien Doguet, Jean-Nicolas Dacher, C. Lemarignier, B. Dubourg, C. Hauville, Hélène Eltchaninoff, and J. Caudron
- Subjects
Cardiac tumor ,medicine.medical_specialty ,Iodinated contrast medium ,Heart Ventricles ,Metastasis ,Heart Neoplasms ,Radiography, Dual-Energy Scanned Projection ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,Cardiac Tumors ,Radiological and Ultrasound Technology ,Dual energy ,business.industry ,Dual energy cardiac CT ,General Medicine ,Middle Aged ,Renal tumor ,medicine.disease ,Kidney Neoplasms ,Cardiac Imaging Techniques ,Female ,Radiology ,Tomography, X-Ray Computed ,Nuclear medicine ,business - Published
- 2015
39. Favorable evolution of a 43-year-old Starr-Edwards valve in the tricuspid position
- Author
-
Chadi, Aludaat, Arnaud, Gay, Amina, Guetlin, Catherine, Nafeh-Bizet, Jean-Paul, Bessou, and Fabien, Doguet
- Subjects
Adult ,Ebstein Anomaly ,Heart Valve Prosthesis Implantation ,Reoperation ,Heart Valve Prosthesis ,Humans ,Mitral Valve ,Female ,Tricuspid Valve ,Aged - Abstract
The durability of a Starr-Edwards valve implanted in the tricuspid position in 1967 to treat Ebstein's disease with tricuspid valve regurgitation. At surgery, cardiac permanent pacing for postoperative complete atrioventricular block was achieved using a nuclear-powered pacemaker (NP). Although the 43rd year of cardiologic follow up was free from complications, the patient--a 74-year-old woman--suffered symptomatic mitral regurgitation and underwent a redo mitral valve replacement, during which the Starr-Edwards valve and NP were left in place.
- Published
- 2012
40. Albumin limits mesenteric endothelial dysfunction and inflammatory response in cardiopulmonary bypass
- Author
-
Fabien, Doguet, Fabienne, Tamion, Vincent, Le Guillou, Michael, Bubenheim, Christian, Thuillez, Vincent, Richard, and Jean Paul, Bessou
- Subjects
Cardiopulmonary Bypass ,Swine ,Tumor Necrosis Factor-alpha ,Anti-Inflammatory Agents ,Gene Expression ,Mesenteric Arteries ,Intestines ,Vasoconstriction ,Animals ,Humans ,Endothelium, Vascular ,RNA, Messenger ,Intestinal Mucosa ,Lung ,Heme Oxygenase-1 ,Serum Albumin - Abstract
The aim of this study was to investigate the potential anti-inflammatory and endothelial protective properties of albumin during cardiopulmonary bypass (CPB) in an experimental porcine model. Two groups underwent CPB for 90 min (n = 7 in each group), and a baseline (BL) control group did not undergo CPB (n = 7). Priming consisted of a gelatin solution (4% gelofusine, CPBG group) or colloid solution (5% albumin, CPBA group). Mesenteric arterial segments were isolated and exposed in vitro to phenylephrine (with or without nitric oxide synthase inhibition) to assess contractility, and exposed to acetylcholine and sodium nitroprusside to assess relaxation. Plasma tumor necrosis factor (TNF)-α levels, intestinal and pulmonary TNF-α and heme oxygenase (HO)-1 mRNA expression, and organ injury were studied. Upon sacrifice, TNF-α levels were significantly higher in the CPBG group than in the CPBA and BL groups. The contractile response was significantly higher in the CPBG group, whereas the response to acetylcholine was significantly lower in the CPBG group than in the other groups. HO-1 mRNA expression was significantly higher in intestine samples in the CPBA group than in the CPBG and BL groups. HO-1 mRNA expression was significantly higher in lung samples in the CPBA group than in the CPBG group. Leukocyte infiltration was significantly higher in intestine and lung samples in the CPBG group than in the CPBA and BL groups. Albumin priming reduced CPB-induced mesenteric vascular dysfunction and prevented the development of a systemic inflammatory response by modeling HO-1 expression in target organs.
- Published
- 2012
41. Novel approach for atrial fibrillation ablation during open-heart surgery using cryoballoon technology
- Author
-
Aurélie Guiot, Martin Bernier, Fabien Doguet, Arnaud Savouré, and Frédéric Anselme
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cryotherapy ,Pulmonary vein ,Physiology (medical) ,Internal medicine ,Angioplasty ,Atrial Fibrillation ,medicine ,Humans ,Cardiac Surgical Procedures ,Cryoballoon ablation ,business.industry ,Atrial fibrillation ,Middle Aged ,Ablation ,medicine.disease ,Surgery ,Treatment Outcome ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,Mitral valve regurgitation ,Complication ,business ,Angioplasty, Balloon - Abstract
Background The role of cryoballoon pulmonary vein isolation for the treatment of atrial fibrillation (AF) is unclear. Methods and results In a 61-year-old man with persistent AF and severe mitral valve regurgitation, surgical cryoballoon pulmonary vein isolation was performed during open-heart surgery, without complication. Conclusion Surgical cryoballoon ablation is feasible and can effectively isolate PV.
- Published
- 2012
42. Radiofrequency ablation under extracorporeal membrane oxygenation for atrial tachycardia in postpartum
- Author
-
Arnaud Savouré, Caroline Lasgi, Sarah Hariri, Vincent Scherrer, Bertrand Dureuil, Fabienne Tamion, and Fabien Doguet
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Radiofrequency ablation ,medicine.medical_treatment ,Pregnancy Complications, Cardiovascular ,Cardiomyopathy ,Gestational Age ,Risk Assessment ,law.invention ,Electrocardiography ,Extracorporeal Membrane Oxygenation ,law ,Pregnancy ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Tachycardia, Supraventricular ,Humans ,Atrial tachycardia ,Unusual case ,business.industry ,Cesarean Section ,Cardiogenic shock ,Postpartum Period ,Pregnancy Outcome ,medicine.disease ,Combined Modality Therapy ,surgical procedures, operative ,Anesthesia ,Cardiology ,Catheter Ablation ,Surgery ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Tachycardia-mediated cardiomyopathy associated with cardiogenic shock is a rare but well-known entity. We report an unusual case of cardiogenic shock with atrial tachycardia in postpartum; the patient underwent successful radiofrequency ablation under extracorporeal membrane oxygenation (ECMO). Radiofrequency ablation is usually used to treat this clinical situation. The use of ECMO has been described only in pediatric case. (J Card Surg 2012;27:647-649)
- Published
- 2012
43. Modulation of mesenteric vasoreactivity and inflammatory response by protein undernutrition in cardiopulmonary bypass
- Author
-
Guillaume Lebreton, Jean-Paul Bessou, Moïse Coëffier, Vincent Richard, Fabien Doguet, Fabienne Tamion, and Michael Bubenheim
- Subjects
Male ,Nitroprusside ,medicine.medical_specialty ,Endothelium ,Endocrinology, Diabetes and Metabolism ,Inflammation ,law.invention ,Contractility ,Phenylephrine ,law ,Internal medicine ,Cardiopulmonary bypass ,medicine ,Animals ,Endothelial dysfunction ,Coronary Artery Bypass ,Rats, Wistar ,Mesenteric arteries ,Nutrition and Dietetics ,business.industry ,Tumor Necrosis Factor-alpha ,Malnutrition ,medicine.disease ,Acetylcholine ,Mesenteric Arteries ,Rats ,Disease Models, Animal ,surgical procedures, operative ,medicine.anatomical_structure ,Vasoconstriction ,Anesthesia ,Cardiology ,Dietary Proteins ,medicine.symptom ,business ,medicine.drug ,Artery - Abstract
Objective Cardiopulmonary bypass (CPB) is responsible for an inflammatory response that can lead to postoperative organ dysfunction. Undernutrition increases the risk of organ failure. We investigated the effect of undernutrition on the inflammatory response and mesenteric vascular reactivity induced by CPB in rats. Methods CPB was performed in Wistar rats given normal nutrition or protein undernutrition. Mesenteric artery contractility was determined in the presence of increasing concentrations of phenylephrine with or without nitric oxide synthase blockade. Relaxation was assessed in the presence of acetylcholine or sodium nitroprusside. The inflammatory response was evaluated by the measurement of systemic tumor necrosis factor-α at cannulation and after 150 min and by a histologic study of pulmonary and gut leukocyte infiltration. Results CPB and protein undernutrition induced hypercontractility to phenylephrine and early relaxation defects in the mesenteric arteries. CPB caused endothelial dysfunction with early impairment of endothelium-dependent relaxation. Protein undernutrition led to an impaired relaxation of the mesenteric arteries, which was in part endothelium independent. Concomitantly, a significant inflammatory response was observed. Conclusion CPB and undernutrition induce mesenteric hypercontractility to α1-adrenergics and impair vascular relaxation, without any additive effect of CPB on undernutrition. Undernutrition causes inflammation and a lack of vascular relaxation, probably involving smooth muscle contractile mechanisms.
- Published
- 2012
44. Isolated ventricular septal rupture secondary to blunt trauma
- Author
-
Matthieu Godin, Fabien Doguet, François Bouchart, and Marilyne Hamdan-Challe
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Poison control ,Ventricular Septum ,Wounds, Nonpenetrating ,Asymptomatic ,Ventricular Septal Rupture ,Blunt ,medicine ,Humans ,cardiovascular diseases ,Embolization ,Cardiac Surgical Procedures ,Ventricular remodeling ,Ultrasonography ,business.industry ,Suture Techniques ,Accidents, Traffic ,medicine.disease ,Surgery ,Radiography ,Treatment Outcome ,Heart Injuries ,Blunt trauma ,cardiovascular system ,Tissue Adhesives ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Pulmonary Embolism - Abstract
A ventricular septal rupture (VSR) is a rare complication of blunt chest trauma. We describe the case of a 25-year-old man who developed a VSR as a result of a high-speed road accident. The rupture was closed by left ventricular remodeling and replacement of the diseased myocardium with a Dacron patch. The patch sutures were reinforced with glue. Redo surgery was necessary at nine months due to patch detachment and embolization of the glue in the right lower lobe. The patient is asymptomatic, at 13-month follow-up. Keywords: Trauma; Blunt; Myocardial injury; Cardiac intervention; Shunts (cardiac); Wound closure. Language: en
- Published
- 2010
45. Place of extracorporeal membrane oxygenation in acute aortic dissection
- Author
-
Vincent Leguillou, Jean Paul Bessou, Caroline Vierne, and Fabien Doguet
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Dissection (medical) ,Aortography ,Extracorporeal ,Coronary artery bypass surgery ,Blood Vessel Prosthesis Implantation ,Extracorporeal Membrane Oxygenation ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Humans ,cardiovascular diseases ,Coronary Artery Bypass ,Aortic dissection ,Heart Valve Prosthesis Implantation ,Cardiopulmonary Bypass ,business.industry ,Coronary Aneurysm ,Hemodynamics ,Arrhythmias, Cardiac ,Middle Aged ,medicine.disease ,Surgery ,Aortic Aneurysm ,Aortic Dissection ,medicine.anatomical_structure ,Treatment Outcome ,Acute Disease ,Cardiology ,Heart Arrest, Induced ,Female ,Cardiology and Cardiovascular Medicine ,Cardiotomy ,business ,Tomography, X-Ray Computed ,Artery - Abstract
Coronary artery dissection (CAD) is a rare but serious complication of type A aortic dissection (AD) which may be discovered preoperatively in the presence of clinical or ECG signs of ischemia, or intraoperatively after dissection of the coronary ostium. Treatment of CAD consists of surgical repair with glue and, if necessary, coronary artery bypass graft. No case of AD with CAD complicated by major arrhythmias treated by assisted circulation has been reported in the literature. We report the first case of AD with implementation of extracorporeal membranous oxygenation following cardiotomy with a favorable outcome.
- Published
- 2010
46. Acute aortic syndrome: a 'last glance' before incision
- Author
-
Guillaume Lebreton, Fabien Doguet, Jean-Paul Bessou, and Pierre-Yves Litzler
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Aortic Diseases ,Computed tomography ,Unnecessary Procedures ,Aortography ,Pericardial recess ,Penetrating atherosclerotic ulcer ,Predictive Value of Tests ,medicine.artery ,medicine ,Humans ,Ct diagnosis ,False Positive Reactions ,Surgical emergency ,Diagnostic Errors ,Ulcer ,Aged ,Aortic dissection ,Acute aortic syndrome ,Aorta ,Hematoma ,medicine.diagnostic_test ,business.industry ,Syndrome ,medicine.disease ,Sternotomy ,Aortic Aneurysm ,Aortic Dissection ,Acute Disease ,cardiovascular system ,Surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Vascular Surgical Procedures ,Echocardiography, Transesophageal - Abstract
Acute aortic syndrome (AAS) (aortic dissection, intramural aortic haematoma, or penetrating atherosclerotic ulcer) is a surgical emergency. Computed tomography (CT) is the reference technique for the diagnosis of this critical situation. However, a few reports of false-positive images leading to unnecessary interventions have been published. It is important to recognize and understand the pitfalls in the CT diagnosis of AAS. We describe the case of a 76-year-old man with clinical signs of AAS and a CT-scan compatible with a diagnosis of aortic intra-mural haematoma, leading to emergency surgery. The peroperative findings revealed a normal aortic wall with the presence of an unusual pericardial recess at the right side of the aorta.
- Published
- 2010
47. Right ventricular perforation due to migration of a ventricular lead
- Author
-
Jean-Paul Bessou, Arnaud Savouré, Fabien Doguet, and Jean Marc Baste
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Chest Pain ,Respiratory Distress Syndrome ,Ventricular lead ,business.industry ,Heart Ventricles ,Cardiac Pacing, Artificial ,Hemodynamics ,Middle Aged ,Sternotomy ,Defibrillators, Implantable ,Foreign-Body Migration ,Heart Injuries ,Internal medicine ,Cardiology ,Medicine ,Humans ,Surgery ,Ventricular Perforation ,Cardiology and Cardiovascular Medicine ,business - Published
- 2010
48. Coronary artery dissection after surgical cryoablation procedure
- Author
-
Pierre Yves Litzler, F. Bouchart, Vincent Le Guillou, Alain Cribier, Catherine Nafeh-Bizet, Fabien Doguet, and Jean Paul Bessou
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Dissection (medical) ,Cryosurgery ,Internal medicine ,Atrial Fibrillation ,Medicine ,Humans ,cardiovascular diseases ,Circumflex ,Aged ,medicine.diagnostic_test ,business.industry ,Vascular disease ,Atrial fibrillation ,Cryoablation ,medicine.disease ,Coronary Vessels ,Surgery ,medicine.anatomical_structure ,Angiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Cryoablation can be used to treat atrial fibrillation (AF) surgically. We describe a 71-year-old woman who underwent cryoablation after 6 months of AF. Four hours post-surgery, electrocardiographic changes were observed in the circumflex artery territory associated with hemodynamic instability, which responded to inotropic agents. Angiography revealed a diffuse circumflex artery spasm with a heterogeneous aspect of the posterior branch evoking a dissection. Platelet anti-aggregant and trinitrine therapy were started. Recovery was uneventful and the patient was discharged on day 13. Cryoablation-associated circumflex artery dissection is rare. Caution is required when locating the ablation lines to avoid coronary artery injury.
- Published
- 2008
49. 0360 : Iatrogenic circumflex artery occlusion during mitral valve surgery: a retrospective study on 8 patients and a medical review
- Author
-
Jean-Paul Bessou, Matthieu Godin, Eric Durand, Hélène Eltchaninoff, Christophe Tron, F. Bouchart, Fabien Doguet, and Grégoire Cauchois
- Subjects
medicine.medical_specialty ,Mitral valve repair ,Ejection fraction ,business.industry ,medicine.medical_treatment ,Revascularization ,medicine.disease ,Surgery ,Valve replacement ,Internal medicine ,Cardiac tamponade ,Occlusion ,cardiovascular system ,Cardiology ,Medicine ,cardiovascular diseases ,Artery occlusion ,Circumflex ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Circumflex coronary artery (CCA) injury during mitral valve surgery is a rare but serious complication whit difficult diagnosis. The aim of our study was to describe the elements of diagnosis that could allow prevention of this complication. Methods and Results From 2006 to 2013 in Rouen University Hospital, 8 patients (1.03%) among 775 undergoing mitral valve surgery (repair or replacement) presented CCA occlusion confirmed by coronary angiography. Sex ratio was 5 men for 3 women with a mean age of 54.2 years. Left main coronary dominance was present in 75%. Mitral valve repair was performed in 5 patients and valve replacement in 3. The diagnosis was suspected by ECG in 7/8 patients: 6 patients (75%) presented ST segment elevation, 1 had permanent AV block while EKG was normal in one. CCA occlusion led to a significant impairment of left ventricular function, median LVEF: decreased from 58 to 43% (p=0.04) although coronary angiography was performed within one hour in 5 patients (62.5%). Five had complete revascularization (4 of those with immediate coronary angiography), while 3 patients were treated medically. Occlusion, assessed by coronary angiography, was preferentially located on the superolateral quarter of the mitral annulus next to the anterolateral commissure predominantly on its mid portion (75%). As regards to the mechanism of CCA occlusion, 37.5% of patients had a stitch passing through the CCA, 50% had a kinking of the vessel due to a stitch located close to the CCA and one of them had a compressive hematoma Follow-up at day-7 was uneventful in 7 patients with one in-hospital death one day after the surgery (cardiac tamponade). Conclusion CCA injury is a rare but serious complication of mitral valve surgery suspected on ECG, due to a stitch always located at the same point of mitral annulus. An eventual intraoperative angiography in hybrid rooms could be a specific solution for patients at risk (large mitral ring, left main coronary dominance).
- Published
- 2015
50. 0247: Mitral valve surgery complicated by circumflex artery: a rare but serious complication
- Author
-
Christophe Tron, Grégoire Cauchois, Matthieu Godin, Eric Durand, Hélène Eltchaninoff, Fabien Doguet, Jean-Paul Bessou, and F. Bouchart
- Subjects
Mitral valve repair ,medicine.medical_specialty ,Ejection fraction ,business.industry ,medicine.medical_treatment ,medicine.disease ,Revascularization ,Surgery ,Valve replacement ,Internal medicine ,Cardiac tamponade ,Occlusion ,cardiovascular system ,medicine ,Cardiology ,cardiovascular diseases ,Circumflex ,Cardiology and Cardiovascular Medicine ,Complication ,business - Abstract
Background Circumflex coronary artery (CCA) injury during mitral valve surgery is a rare but serious complication whit difficult diagnosis. The aim of our study was to describe the elements of diagnosis that could allow prevention of this complication. Method and results From 2006 to 2013 in Rouen University Hospital, 8 patients (1.03%) among 775 undergoing mitral valve surgery (repair or replacement) presented CCA occlusion confirmed by coronary angiography. Sex ratio was 5 men for 3 women with a mean age of 54.2 years. Left main coronary dominance was present in 75%. Mitral valve repair was performed in 5 patients and valve replacement in 3. The diagnosis was suspected by ECG in 7/8 patients: 6 patients (75%) presented ST segment elevation, 1 had permanent AV block while EKG was normal in one. CCA occlusion led to a significant impairment of left ventricular function, median LVEF: decreased from 58 to 43% (p=0.04) although coronary angiography was performed within one hour in 5 patients (62.5%). Five had complete revascularization (4 of those with immediate coronary angiography), while 3 were treated medically. Occlusion, assessed by coronary angiography, was preferentially located on the superolateral quarter of the mitral annulus next to the anterolateral commissure predominantly on its mid portion (75%). As regards to the mechanism of CCA occlusion, 37.5% of patients had a stitch passing through the CCA, 50% had a kinking of the vessel due to a stitch located close to the CCA and one of them had a compressive hematoma. Follow-up at day-7 was uneventful in 7 patients with one in-hospital death one day after the surgery (cardiac tamponade). Conclusion CCA injury is a rare but serious complication of mitral valve surgery suspected on ECG, due to a stitch always located at the same point of mitral annulus. An eventual intraoperative angiography in hybrid rooms could be a specific solution for patients at risk (large mitral ring, left main coronary dominance).
- Published
- 2015
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