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1. Clinical and echocardiographic risk factors for device-related thrombus after left atrial appendage closure: an analysis from the multicenter EUROC-DRT registry

Author

Vivian Vij, Kerstin Piayda, Dominik Nelles, Steffen Gloekler, Roberto Galea, Monika Fürholz, Bernhard Meier, Marco Valgimigli, Gilles O’Hara, Dabit Arzamendi, Victor Agudelo, Lluis Asmarats, Xavier Freixa, Eduardo Flores-Umanzor, Ole De Backer, Lars Sondergaard, Luis Nombela-Franco, Angela McInerney, Kasper Korsholm, Jens Erik Nielsen-Kudsk, Shazia Afzal, Tobias Zeus, Felix Operhalski, Boris Schmidt, Gilles Montalescot, Paul Guedeney, Xavier Iriart, Noelie Miton, Jacqueline Saw, Thomas Gilhofer, Laurent Fauchier, Egzon Veliqi, Felix Meincke, Nils Petri, Peter Nordbeck, Dmitrii Ognerubov, Evgeny Merkulov, Ignacio Cruz-González, Rocio Gonzalez-Ferreiro, Deepak L. Bhatt, Alessandra Laricchia, Antonio Mangieri, Heyder Omran, Jan Wilko Schrickel, Josep Rodes-Cabau, Horst Sievert, Georg Nickenig, and Alexander Sedaghat

Subjects
Device-related thrombus, Anticoagulants, Thrombosis, Left atrial appendage closure, General Medicine, Atrial fibrillation, Stroke, Treatment Outcome, Ischemic Attack, Transient, Risk Factors, Echocardiography, Atrial Fibrillation, Humans, Atrial Appendage, Registries, Cardiology and Cardiovascular Medicine
Abstract

Background Data on Device-related Thrombus (DRT) after left atrial appendage closure (LAAC) remain scarce. This study aimed to investigate risk factors for DRT from centers reporting to the EUROC-DRT registry. Methods We included 537 patients (112 with DRT and 425 without DRT) who had undergone LAAC between 12/2008 and 04/2019. Baseline and implantation characteristics, anti-thrombotic treatment and clinical outcomes were compared between both groups in uni- and multivariate analyses. Additional propensity-score matching (PSM) was conducted to focus on the role of implantation characteristics. Results Patients with DRT showed higher rates of previous stroke/transient ischemic attack (TIA) (49.1% vs. 34.7%, p < 0.01), spontaneous echocardiographic contrast (SEC) (44.9% vs. 27.7%, p < 0.01) and lower left atrial appendage (LAA) peak emptying velocity (35.4 +/- 18.5 vs. 42.4 +/- 18.0 cm/s, p= 0.02). Occluders implanted in DRT patients were larger (25.5 +/- 3.8 vs. 24.6 +/- 3.5 mm, p =0.03) and implanted deeper in the LAA (mean depth: 7.6 +/- 4.7 vs. 5.7 +/- 4.7 mm, p

Published
2022

2. Patent foramen ovale closure in children without cardiopathy: Child-PFO study

Author

Sébastien Hascoët, Ali Houeijeh, Stéphanie Douchin, Claire Dauphin, Alban-Elouen Baruteau, Clément Karsenty, Hugues Lucron, François Godart, Zakaria Jalal, Jérôme Petit, Céline Gronier, Guiti Milani, Aurélie Chalard, Noelie Miton, Philippe Aldebert, and J.B. Thambo

Subjects
Male, Cardiac Catheterization, medicine.medical_specialty, Time Factors, Adolescent, Septal Occluder Device, medicine.drug_class, Foramen Ovale, Patent, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, medicine, Humans, Fluoroscopy, General anaesthesia, 030212 general & internal medicine, Retrospective Studies, Aspirin, medicine.diagnostic_test, business.industry, Anticoagulant, Age Factors, Retrospective cohort study, General Medicine, medicine.disease, Surgery, Stroke, Shunting, Treatment Outcome, Ischemic Attack, Transient, Patent foramen ovale, Female, France, Cardiology and Cardiovascular Medicine, business, Complication, medicine.drug
Abstract

Summary Background Closure of patent foramen ovale is well-managed in adults, but is performed less frequently in children. Aim To analyse all patent foramen ovale closures performed in the past 20 years in French paediatric centres. Methods Retrospective study of patent foramen ovale closures in children without cardiopathy in nine centres between 2000 and 2019. Results Forty-one procedures were carried out in children (median age: 14.9 years). Thirty-one patent foramen ovales were closed after a transient ischaemic attack or stroke, six for a left-to-right shunt and four for other reasons. Transthoracic echocardiography was used for 72.2% of the diagnoses and transoesophageal echocardiography for 27.8%. A substantial degree of shunting was found in 42.9% of patients and an atrial septal aneurysm in 56.2%. General anaesthesia with transoesophageal echocardiography guidance was performed in 68.3% of the procedures; local anaesthesia and transthoracic echocardiography or intracardiac echocardiography was performed in 31.7%. The success rate was 100%. The median fluoroscopy time was 4.14 minutes: 3.55 minutes with transoesophageal echocardiography; and 4.38 minutes with transthoracic echocardiography (P = 0.67). There was only one periprocedural complication (2.4%). Postoperatively, 80,5% of patients were treated with aspirin and 12,2% with an anticoagulant. The rate of complete occlusion was 56.8% immediately after the procedure, 68.6% at 1 year and 92.3% at the last follow-up. There were no delayed complications or cases of recurrent stroke during follow-up (median follow-up: 568 days). Conclusion Closure of patent foramen ovale in children appears to be safe and effective, as we noted a low rate of immediate complications, no delayed complications and no stroke recurrence in this indication.

Published
2020

3. Impact of video on the understanding and satisfaction of patients receiving informed consent before elective inpatient coronary angiography: A randomized trial

Author

Infocoro investigators, Benjamin Alos, Justine Pollet, Fiona Ecarnot, Thomas Levasseur, Anis Sfaxi, Nicolas Danchin, Mariama Akodad, Noelie Miton, Yves Juillière, Nicolas Barber-Chamoux, Claire Bouleti, Clement Servoz, Nathan Mewton, Pascal Motreff, Olivier Lairez, Damien Metz, Benoit Lattuca, Loic Belle, François Derimay, Thomas Mathivet, Philippe-Gabriel Steg, Aurélien Mulliez, Olivier Hachet, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Délégation à la Recherche Clinique et à l'Innovation (DRCI), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), CHU Gabriel Montpied [Clermont-Ferrand], Department of Earth Sciences [Oxford], University of Oxford [Oxford], Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), 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), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, University of Oxford, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées

Subjects
Coronary angiography, Male, Health Knowledge, Attitudes, Practice, Younger age, [SDV]Life Sciences [q-bio], Video Recording, 030204 cardiovascular system & hematology, Anxiety, Coronary Angiography, outcomes, law.invention, information, surgery, 0302 clinical medicine, Randomized controlled trial, Informed consent, law, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, intervention, Informed Consent, communication, of-life, Middle Aged, 3. Good health, Patient Satisfaction, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, comprehension, decision-support tool, medicine.medical_specialty, MEDLINE, artery-disease, Access to Information, 03 medical and health sciences, Patient Education as Topic, Humans, cancer, Aged, Inpatients, business.industry, Comprehension, Multicenter study, Physical therapy, Cardiovascular System & Cardiology, Educational Measurement, business
Abstract

International audience; Background: Appropriate information about the benefits and risks of invasive procedures is crucial, but limited data is available in this field. The aim of this study was to evaluate the incremental value of a short video about coronary angiography compared with standard information, in terms of patient understanding, satisfaction and anxiety. Methods: This prospective multicenter study included patients admitted for scheduled coronary angiography, who were randomized to receive either standard information or video information by watching a three-dimensional educational video. After information was delivered, patients were asked to complete a dedicated 16-point information questionnaire, as well as satisfaction and anxiety scales. Results: From 21 September to 4 October 2015, 821 consecutive patients were randomized to receive either standard information (n = 415) or standard information with an added educational video (n = 406). The information score was higher in the video information group than in the standard group (11.8 +/- 2.8 vs 9.5 +/- 3.1; P \textless .001). This result was consistent across age and education level subgroups. Self-reported satisfaction was also higher in the video information group (8.4 +/- 1.9 vs. 7.7 +/- 2.3; P \textless .001), while anxiety level did not differ between groups. The variables associated with a higher information score were the use of the educational video, younger age, higher level of education, previous follow-up by a cardiologist, prior information about coronary angiography and previous coronary angiography. Conclusions: In comparison with standard information, viewing a dedicated educational video improved patients' understanding and satisfaction before scheduled coronary angiography. These results are in favor of widespread use of this incremental information tool. (C) 2018 Elsevier Inc. All rights reserved.

Published
2018

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