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5. Combined Bacterial Meningitis and Infective Endocarditis: When Should We Search for the Other When Either One is Diagnosed?

Author

Béraud, Guillaume, Tubiana, Sarah, Erpelding, Marie-Line, Le Moing, Vincent, Chirouze, Catherine, Gorenne, Isabelle, Manchon, Pauline, Tattevin, Pierre, Vernet, Veronique, Varon, Emmanuelle, Hoen, Bruno, Duval, Xavier, Obadia, J., Leport, C., Poyart, C., Revest, M., Selton-Suty, C., Strady, C., Vandenesch, F., Bernard, Y., Chocron, S., Plesiat, P., Abouliatim, I., de Place, C., Donnio, P., Alla, F., Carteaux, J., Doco-Lecompte, T., Lion, C., Aissa, N., Baehrel, B., Jaussaud, R., Nazeyrollas, P., Cambau, E., Iung, B., Nataf, P., Chidiac, C., Celard, M., Delahaye, F., Aumaître, H., Frappier, J., Oziol, E., Sotto, A., Sportouch, C., Bouvet, A., Bes, M., Abassade, P., Abrial, E., Acar, C., Alexandra, J., Amireche, N., Amrein, D., Andre, P., Appriou, M., Arnould, M., Atoui, A., Aziza, F., Baille, N., Bajolle, N., Battistella, P., Baumard, S., Ben Ali, A., Bertrand, J., Bialek, S., Bois Grosse, M., Boixados, M., Borlot, F., Bouchachi, A., Bouche, O., Bouchemal, S., Bourdon, J., Brasme, L., Bruntz, J., Cailhol, J., Caplan, M.P., Carette, B., Cartry, O., Cazorla, C., Chamagne, H., Champagne, H., Chanques, G., Chevalier, B., Chometon, F., Christophe, C., Colin de Verdiere, N., Daneluzzi, V., David, L., Danchin, N., de Lentdecker, P., Delcey, V., Deleuze, P., Deroure, B., Descotes-Genon, V., Didier Petit, K., Dinh, A., Doat, V., Duchene, F., Duhoux, F., Dupont, M., Ederhy, S., Epaulard, O., Evest, M., Faucher, J., Fauveau, E., Ferry, T., Fillod, M., Floch, T., Fraisse, T., Frapier, J., Freysz, L., Fumery, B., Gachot, B., Gallien, S., Garcon, P., Gaubert, A., Genoud, J., Ghiglione, S., Godreuil, C., Gandjbakhch, I., Grentzinger, A., Groben, L., Gherissi, D., Hagege, A., Hammoudi, N., Heliot, F., Henry, P., Houriez, P., Hustache-Mathieu, L., Huttin, O., Imbert, S., Jaureguiberry, S., Kaaki, M., Konate, A., Kuhn, J., Kural Menasche, S., Lafitte, A., Lafon, B., Lanternier, F., Le Chenault, V., Lechiche, C., Lefevre Thibaut, S., Lefort, A., Lemoine, J., Lepage, L., Lepousé, C., Leroy, J., Lesprit, P., Letranchant, L., Loncar, G., Lorentz, C., Magnin-Poull, I., Makinson, A., Man, H., Mansouri, M., Marçon, O., Maroni, J., Masse, V., Maurier, F., Mechaï, F., Merceron, O., Messika-Zeitoun, D., Metref, Z., Meyssonnier, V., Mezher, C., Micheli, S., Monsigny, M., Mouly, S., Mourvillier, B., Nallet, O., Nazerollas, P., Noel, V., Payet, B., Pelletier, A., Perez, P., Petit, J., Philippart, F., Piet, E., Plainvert, C., Popovic, B., Porte, J., Pradier, P., Ramadan, R., Richemond, J., Rodermann, M., Roncato, M., Roigt, I., Ruyer, O., Saada, M., Schwartz, J., Simon, M., Simorre, B., Skalli, S., Spatz, F., Sudrial, J., Tartiere, L., Terrier de La Chaize, A., Thiercelin, M., Thomas, D., Thomas, M., Toko, L., Tournoux, F., Tristan, A., Trouillet, J., Tual, L., Verdier, F., Vernet Garnier, V., Vidal, V., Weyne, P., Wolff, M., Wynckel, A., Zannad, N., Zinzius, P., Ploy, M.-C., Caron, F., Bollaert, P.-E., Gaillot, O., Taha, M.-K., Bonacorsi, S., Lecuit, M., Gravet, A., Frachet, B., Debroucker, T., Levy-Bruhl, D., Raffi, F., Preau, M., Anguel, N., Argaud, L., Arista, S., Armand-Lefevre, L., Balavoine, S., Baraduc, R., Barnaud, G., Bernard, L., Bernars, G., Bertei, D., Bessede, E., Billard Pomares, T., Biron, C., Bland, S., Boileau, J., Boubeau, P., Bourdon, S., Bousquet, A., Boyer, S., Bozorg-Grayeli, A., Bret, L., Bretonniere, C., Bricaire, F., Brocas, E., Brun, M., Buret, J., Burucoa, C., Cabalion, J., Cabon, M., Camuset, G., Canevet, C., Carricajo, A., Castan, B., Caumes, E., Cazanave, C., Chabrol, A., Challan-Belval, T., Chanteperdrix-Marillier, V., Chaplain, C., Charlier-Woerther, C., Chaussade, H., Clair, B., Colot, J., Conil, J.-M., Cordel, H., Cormier, P., Cousson, J., Cronier, P., Cua, E., Dao-Dubremetz, A., Dargere, S., Degand, N., Dekeyser, S., Delaune, D., Denes, E., Dequin, P.-F., Descamps, D., Descloux, E., Desmaretz, J.-L., Diehl, J.-L., Dimet, J., Escaut, L., Fabe, C., Faibis, F., Flateau, C., Fonsale, N., Forestier, E., Fortineau, N., Gagneux-Brunon, A., Garandeau, C., Garcia, M., Garot, D., Gaudry, S., Goehringer, F., Gregoire-Faucher, V., Grosset, M., Gubavu, C., Gueit, I., Guelon, D., Guimard, T., Guinard, J., Hadou, T., Helene, J.-P., Henard, S., Henry, B., Hochart, A.-C., Illes, G., Jaffuel, S., Jarrin, I., Jaureguy, F., Joseph, C., Juvin, M.-E., Kayal, S., Kerneis, S., Lacassin, F., Lamaury, I., Lanotte, P., Laurens, E., Laurichesse, H., Le Brun, C., Le Turnier, P., Lecuyer, H., Ledru, S., Legrix, C., Lemaignen, A., Lemble, C., Lemee, L., Lesens, O., Levast, M., Lhommet, C., Males, S., Malpote, E., Martin-Blondel, G., Marx, M., Masson, R., Matray, O., Mbadi, A., Mellon, G., Merens, A., Meyohas, M.-C., Michon, A., Mootien Yoganaden, J., Morquin, D., Mrozek, N., Nguyen, S., Nguyen, Y., Ogielska, M., Page, B., Patrat-Delon, S., Patry, I., Pechinot, A., Picot, S., Pierrejean, D., Piroth, L., Plassart, C., Plessis, P., Portel, L., Poubeau, P., Poupard, M., Prazuck, T., Quaesaet, L., Ramanantsoa, A., Rapp, C., Raskine, L., Raymond, J., Riche, A., Robaday-Voisin, S., Robin, F., Romaszko, J.-P., Rousseau, F., Roux, A.-L., Royer, C., Salmon, D., Saroufim, C., Schmit, J.-L., Sebire, M., Segonds, C., Sivadon-Tardy, V., Soismier, N., Son, O., Sunder, S., Suy, F., Tande, D., Tankovic, J., Valin, N., van Grunderbeeck, N., Verdon, R., Vergnaud, M., Vernet-Garnier, V., Vidal, M., Vitrat, V., Vittecoq, D., Vuotto, F., Laouenan, C., Marcault, E., Mentre, F., Pasquet, B., Roy, C., Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Université Sorbonne Paris Nord, Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), 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)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), and The AEPEI IE cohort was funded by a research grant from the French Ministry of Health (PHRC 2007), grants from the Société Française de Cardiologie, the European Society of Clinical Microbiology and Infectious Diseases, and Novartis France. The sponsor was Délégation à la Recherche Clinique et au Développement, Centre Hospitalier Universitaire de Besançon. The COMBAT cohort was funded by Assistance Publique—Hôpitaux de Paris, Inserm, The French Society of Infectious Diseases (SPILF), and Pfizer Laboratory. It was also supported by the Observatoire de la Resistance du Pneumocoque (ORP) and Santé Publique France. The sponsor of the study and the funding sources had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit it for publication. The Rapid Service Fee was funded by the University Hospital of Poitiers, to which the corresponding author is affiliated.

Subjects
Microbiology (medical), Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Echocardiography, Austrian syndrome, Staphylococcus, [SDV]Life Sciences [q-bio], Bacterial meningitis, Streptococcus, Infective endocarditis
Abstract

International audience; Introduction: We aimed to describe patients with coexisting infective endocarditis (IE) and bacterial meningitis (BM).Methods: We merged two large prospective cohorts, an IE cohort and a BM cohort, with only cases of definite IE and community-acquired meningitis. We compared patients who had IE and BM concurrently to patients with IE only and BM only.Results: Among the 1030 included patients, we identified 42 patients with IE-BM (4.1%). Baseline characteristics of patients with IE-BM were mostly similar to those of patients with IE, but meningitis was the predominant presentation at admission (39/42, 92.3%). Causative pathogens were predominantly Streptococcus pneumoniae (18/42, 42.9%) and Staphylococcus aureus (14/42, 33.3%). All pneumococcal IE were associated with BM (18/18). BM due to oral and group D streptococci, Streptococcus agalactiae, and S. aureus were frequently associated with IE (14/30, 46.7%). Three-month mortality was 28.6% in patients with IE-BM, 20.5% in patients with IE, and 16.6% in patients with BM.Conclusions: Patients with pneumococcal IE or altered mental status during IE must be investigated for BM. Patients with S. aureus, oral and group D streptococcal or enterococcal BM, or unfavorable outcome in pneumococcal meningitis would benefit from an echocardiography. Patients with the dual infection have the worst prognosis. Their identification is mandatory to initiate appropriate treatment.

Published
2022
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10. Heart transplantation — Status in Europe

Author

Cabrol, C., Gandjbakhch, I., Pavie, A., Bors, V., Cabrol, A., Leger, P., Levasseur, J. P., Vaissier, E., Petrie, J., Szefner, J., Desruennes, M., Chomette, G., Jault, F., Aupetit, B., Kawaguchi, A., Akutsu, Tetsuzo, editor, Koyanagi, Hitoshi, editor, Anderson, James M., editor, Cohn, Lawrence H., editor, Frommer, Peter L., editor, Hachida, Mitsuhiro, editor, Kataoka, Kazunori, editor, Nitta, Shin-ichi, editor, Nojiri, Chisato, editor, Olsen, Donald B., editor, Pennington, D. Glenn, editor, Takatani, Setsuo, editor, and Yozu, Ryohei, editor

Published
1991
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34. Posttransplant lymphoproliferative disorders not associated with Epstein-Barr virus: a distinct entity?

Author

Laurent Sutton, Gandjbakhch I, Richard Dorent, Veronique Leblond, J. L. Binet, M O Bitker, Frédéric Charlotte, Martine Raphael, and Frederic Davi

Subjects
Adult, Male, Herpesvirus 4, Human, Cancer Research, medicine.medical_specialty, Pathology, Adolescent, medicine.medical_treatment, Receptors, Antigen, T-Cell, Immunoglobulins, Lymphoproliferative disorders, medicine.disease_cause, Herpesviridae, Virus, Organ transplantation, hemic and lymphatic diseases, medicine, Humans, Lymphocytes, RNA, Messenger, In Situ Hybridization, Aged, Immunosuppression Therapy, business.industry, Immunosuppression, Organ Transplantation, Middle Aged, medicine.disease, Immunohistochemistry, Epstein–Barr virus, Lymphoproliferative Disorders, Lymphoma, Survival Rate, Transplantation, Blotting, Southern, Oncology, RNA, Viral, Female, business
Abstract

PURPOSE Organ recipients are at a high risk of posttransplant lymphoproliferative disorders (PTLD) as a result of immunosuppressive therapy. Most B-cell lymphomas are associated with Epstein-Barr virus (EBV) infection. We describe a morphologically and clinically distinct group of PTLD in 11 patients that occurred late after organ transplantation and were not associated with EBV. PATIENTS AND METHODS There were seven kidney, three heart, and one liver transplant recipients (group I). The clinical manifestations, pathologic findings, treatment, and outcome were compared with those in 21 patients with EBV-associated PTLD treated in our institution (group II). EBV was detected with at least two techniques: Epstein-Barr-encoded RNA (EBER) in situ hybridization with EBER 1 + 2 probes, Southern blotting, and detection of latent membrane protein 1 (LMP1) expression by immunohistochemistry. RESULTS The time between transplantation and the diagnosis of lymphoma ranged from 180 to 10,220 days in group I (mean, 2,234; median, 1,800) and from 60 to 2,100 days in group II (mean, 546; median, 180), and was significantly shorter in group II (P = .02). Among 19 tumors diagnosed within 2 years after the graft, 16 were associated with EBV; among 13 tumors diagnosed after more than 2 years, only five were associated with EBV. All of the B-cell PTLDs in group I were classified as monomorphic, meeting the criteria of B diffuse large-cell lymphoma (B-DLCL) with a component of immunoblasts, and genotyping confirmed their monoclonality. Three tumors were T-cell pleomorphic lymphomas. Tumor sites were mainly bone marrow and lymph nodes. Overall median survival was 1 month in group I and 37 months in group II, with two patients still alive in group I and nine in group II. The survival time was significantly longer in group II (P < .01). CONCLUSION EBV-negative PTLD may be a late serious complication of organ transplantation. Half the tumors observed after kidney transplantation in our center were not associated with EBV and emerged after more than 5 years, which suggests the number of EBV-negative PTLDs in organ recipients might increase with time.

Published
1998
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35. Long-term use of cyclosporine in cardiac transplantation: the Pitié experience

Author

J.J Ghossoub, R Dorent, J.P. Levasseur, P. Leger, Gandjbakhch I, N. Lendvai, S Tezenas, A Pavie, E. Vaissier, and M. Eslami

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, Time Factors, Adolescent, medicine.medical_treatment, medicine, Humans, Lung transplantation, Intensive care medicine, Probability, Retrospective Studies, Heart transplantation, Transplantation, Chemotherapy, business.industry, Graft Survival, Retrospective cohort study, Middle Aged, Ciclosporin, Calcineurin, Cyclosporine, Heart Transplantation, Female, Surgery, France, Cardiomyopathies, Complication, business, Immunosuppressive Agents, Follow-Up Studies, medicine.drug
Abstract

WITH the introduction of new immunosuppressive drugs, the place that calcineurin inhibitors currently occupy in the treatment of cardiac transplant recipients will be questioned. The introduction of cyclosporine after cardiac transplantation to prevent acute rejection has been associated with a dramatic improvement in short-term survival. However, little is known about long-term outcome in heart transplant recipients. None of the centers has reported its experience with the use of calcineurin inhibitors in patients transplanted 15 years ago. The Registry of the International Society for Heart and Lung Transplantation has provided no data regarding long-term morbidity. Knowledge of long-term advantages and disadvantages of the current immunosuppressive regimens is necessary to develop new drugs. In the present study we describe complications associated with long-term cyclosporine treatment of heart transplant recipients.

Published
2002
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36. Lung cancer in heart transplant patients: a 16-year survey

Author

A Pavie, E. Vaissier, G. Silvaggio, Pascal Leprince, P. Leger, Gandjbakhch I, J.J Ghossoub, R Dorent, Siamak Mohammadi, M. Riquet, F Carnot, and S Tezenas

Subjects
Adult, Male, medicine.medical_specialty, Lung Neoplasms, Postoperative Complications, Internal medicine, Humans, Medicine, Risk factor, Lung cancer, Aged, Retrospective Studies, Transplantation, Lung, business.industry, Incidence, Respiratory disease, Middle Aged, medicine.disease, Surgery, Survival Rate, medicine.anatomical_structure, Lung disease, Circulatory system, Heart Transplantation, Female, Transplant patient, business
Published
2000
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37. Current Problems in Cardiac Transplantation

Author

Pavie, A., primary, Cabrol, C., additional, Gandjbakhch, I., additional, Bors, V., additional, Dallous, P., additional, Cabrol, A., additional, Leger, P., additional, Vaissier, E., additional, Levasseur, J. P., additional, Chomette, G., additional, and Aupetit, D., additional

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40. [Pericardial and myocardial adiastole in rheumatoid polyarthritis]

Author

Erciyes D, Mousseaux E, Cabanes L, Dougados M, Vincent Mallet, Erlinger S, Gandjbakhch I, Duboc D, and Fouchard J

Subjects
Arthritis, Rheumatoid, Male, Diastole, Echocardiography, Hypertension, Humans, Pericarditis, Arrhythmias, Cardiac, Middle Aged, Pericardial Effusion
Abstract

The authors describe a case of clinical, echocardiographic and haemodynamic adiastole in a man with severe rheumatoid arthritis with a previous history of pericardial effusion. The adiastole was mixed, fibrous pericarditis, confirmed by ultra fast CT scan and at surgery; myocardial adiastole was suspected on finding thickening of the ventricular walls (in the absence of hypertension and coronary artery disease) and, unfortunately, confirmed by the persistence of adiastole despite very satisfactory pericardectomy. The authors underline the involvement of the three cardiac tunics in rheumatoid arthritis and the value of different diagnostic methods in the differentiation between constrictive pericarditis and restrictive cardiomyopathy.

Published
1999

41. European Multicenter Tacrolimus (FK506) Heart Pilot Study: one-year results--European Tacrolimus Multicenter Heart Study Group

Author

Reichart, B., Meiser, B., Vigano, M., Mauro Rinaldi, Martinelli, L., Yacoub, M., Banner, N. R., Gandjbakhch, I., Dorent, R., Hetzer, R., and Hummel, M.

Subjects
Adult, Blood Glucose, Graft Rejection, Male, Adolescent, Administration, Oral, Graft vs Host Disease, Pilot Projects, Middle Aged, Kidney Function Tests, Tacrolimus, Heart Transplantation, Humans, Insulin, Female, Immunosuppressive Agents, Aged
Abstract

Tacrolimus (FK506) may represent a major advance in the management of allograft rejection after solid organ transplantation. In August 1994 a European heart transplantation pilot study was initiated to assess the efficacy and safety of tacrolimus when administered exclusively through an oral route.Eighty-two heart transplant recipients were randomized to treatment (2:1 ratio) with either tacrolimus- (n=54) or cyclosporine-based therapy (n=28).No significant differences were evident between the two treatment groups in either rejection or survival rates at 1 year. Kaplan-Meier estimates of the freedom from rejection were 26.3% and 18.5%, respectively, for the tacrolimus and cyclosporine treatment groups (p=.444). Survival rates were 79.6% and 92.9% (p=.125). At 3 of the 5 centers, patients received antithymocyte globulin during the immediate postoperative period and fared better than those who did not (with acute rejection-free rates of 49.2% and 26.7% for tacrolimus and cyclosporine, respectively [p=.080], as opposed to 7.1% and 8.3% [p=.965]; patient survival rates of 84.6% and 93.3% [p=.382] vs 75.0% and 92.3% [p=.243]). The overall rates of infection, impaired renal function (31.5% vs 21.4%), and glucose intolerance (7.0% vs 4.3%) did not differ significantly between the tacrolimus and cyclosporine treatment groups. Tacrolimus seemed to possess an advantage with regard to a reduced requirement for antihypertensive therapy (59.5% vs 87.5%, p=.025).Immunosuppression with oral tacrolimus provides a viable alternative to treatment with cyclosporine, particularly when administered in conjunction with antibody therapy. Further studies are warranted to optimize the administration of tacrolimus in this indication.

Published
1998

42. Left centrifugal pump cardiac assist with transseptal percutaneous left atrial cannula

Author

P Léger, Vaissier E, A Nzomvuama, Gandjbakhch I, Alain Pavie, Meredith M. Regan, and J Szefner

Subjects
Male, medicine.medical_specialty, Cardiac output, Cardiac Catheterization, medicine.medical_treatment, Aortic Valve Insufficiency, Biomedical Engineering, Femoral vein, Cardiac Output, Low, Myocardial Infarction, Medicine (miscellaneous), Bioengineering, Femoral artery, Prosthesis Design, Catheterization, Biomaterials, Aortic valve replacement, Internal medicine, medicine.artery, medicine, Heart Septum, Humans, Myocardial infarction, Heart Atria, Coronary Artery Bypass, Ultrasonography, Interventional, Heart Valve Prosthesis Implantation, business.industry, Mitral valve replacement, Mitral Valve Insufficiency, General Medicine, Aortic Valve Stenosis, Femoral Vein, Middle Aged, medicine.disease, Cannula, Surgery, Descending aorta, cardiovascular system, Cardiology, Heart-Assist Devices, business, Blood Flow Velocity, Echocardiography, Transesophageal
Abstract

Left cardiac support postcardiotomy requires a second operation for removal of the atrial cannula following weaning from assistance. To avoid the risk of this procedure, we used a transseptal cannula prototype. The cannula was introduced percutaneously through the femoral vein and advanced into the left atrium guided by the finger of the surgeon. Optimal positioning of the tip of the cannula was verified by perioperative transesophageal echocardiography. A long arterial cannula was positioned in the descending aorta via the femoral artery and a Carmeda circuit with a centrifugal pump was connected to both cannulas. This procedure was used in 3 patients with low cardiac output who underwent emergency surgery, a 63-year-old patient referred for aortic and mitral valve replacement, a 54-year-old man for aortic valve replacement, and a 64-year-old patient in the acute phase of myocardial infarction after myocardial revascularization. The assistance was used systematically at the end of the operation. The assist flow was 1.2-2.6 L/min. The patients were all weaned from support between 18 h and 8 days later. No complications related to the device occurred. Both cannulas were removed surgically from the femoral vessels without reopening the chest. This new procedure is of interest for 2 reasons: the systematic implantation allows for early assistance, and the use of a percutaneous approach avoids the risk of reopening the chest. More cases are needed to confirm this initial good impression.

Published
1998

46. An immunological score for prediction of acute rejection of heart transplants

Author

Autran B, Jouveshomme S, sylvie escolano, Jl, Golmard, Dorent R, Jj, Ghoussoub, Delcourt A, Mallet A, Cabrol A, and Gandjbakhch I

Subjects
Graft Rejection, Antigens, CD, Predictive Value of Tests, Antibodies, Monoclonal, Heart Transplantation, Humans, Drug Therapy, Combination, HLA-DR Antigens, Lymphocytes, Prognosis, Immunosuppressive Agents
Published
1995

47. [Chronic constrictive pericarditis. A retrospective study of a series of 84 patients]

Author

Nataf P, Patrice Cacoub, Dorent R, Jault F, Fontanel M, Regan M, Bors V, Pavie A, Cabrol C, and Gandjbakhch I

Subjects
Adult, Male, Pericardiectomy, Chronic Disease, Pericarditis, Constrictive, Humans, Female, Middle Aged, Survival Analysis, Retrospective Studies
Abstract

Chronic constrictive pericarditis still poses diagnostic and therapeutic problems. A series of 84 cases (59 men-25 women; men age: 46 years) operated between 1979 and 1989 at the Pitié Hospital was reviewed. The majority of patients (72%) were in functional Classes III or IV; 88% had clinical signs of right ventricular failure and 18% had anasarca. The average duration of symptoms before diagnosis was 20 months. Chest X-ray showed pericardial calcification in 40% of cases. A characteristic dip-plateau pressure tracing was obtained in 76% of cases. A specific aetiology was only found in 36 cases (45%), only 12% being of tuberculous origin. A subtotal pericardectomy from phrenic to phrenic was carried out in 75 patients. The absence of planes of cleavage in 9 cases imposed a special operative technique consisting of "patchwork" sectioning of the visceral pericardium. The operative mortality was 2.3% (2 patients: pulmonary embolism and septicaemia). Non-fatal post-operative complications occurred in 8.2% of cases (7 patients). The survival rate excluding operative mortality was 94% at 3 years and 87% at 7 years. No patient was reoperated for recurrent constrictive pericarditis. At the last follow-up appointment, all patients were in functional Classes I or II. The authors conclude that the absence of specific symptoms, the low prevalence of the condition and the change in aetiology related to the decline in tuberculous infection make the diagnosis of chronic constrictive pericarditis very difficult. The diagnostic contributions of new imaging techniques such as CT and MR scanning should be assessed. This series confirms the efficacy of surgical treatment by subtotal pericardectomy.

Published
1994

49. 15: Results of a 12-Month, Multicenter, Randomized Trial of Everolimus with Reduced-Exposure Cyclosporine Versus MMF and Standard-Exposure Cyclosporine in De Novo Cardiac Transplant Recipients

Author

Lehmkuhl, H., primary, Livi, U., additional, Arizon, J., additional, Viganò, M., additional, Magelli, C., additional, Boissonnat, P., additional, Gerosa, G., additional, Musumeci, F., additional, Gandjbakhch, I., additional, Vanhaecke, J., additional, Hexham, J.M., additional, and Mange, K.C., additional

Published
2008
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