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1. Characteristics and outcome of ambulatory heart failure patients receiving a left ventricular assist device

Author: Guillaume Baudry, Nicolas Nesseler, Erwan Flecher, André Vincentelli, Céline Goeminne, Clément Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Tam Hoang Minh, Philippe Rouvière, Philippe Gaudard, Magali Michel, Thomas Senage, Aude Boignard, Olivier Chavanon, Marylou Para, Constance Verdonk, Edeline Pelcé, Vlad Gariboldi, Frederic Anselme, Pierre‐Yves Litzler, Katrien Blanchart, Gerard Babatasi, Marie Bielefeld, Olivier Bouchot, David Hamon, Nicolas Lellouche, Xavier Bailleul, Thibaud Genet, Romain Eschalier, Nicolas d'Ostrevy, Marie‐Cécile Bories, Ramzi Abi Akar, Hugues Blangy, Fabrice Vanhuyse, Jean François Obadia, Vincent Galand, and Matteo Pozzi
Subjects: Advanced heart failure, Heart failure medications, Mechanical circulatory support, Left ventricular assist device, Outcome measures, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims Despite regularly updated guidelines, there is still a delay in referral of advanced heart failure patients to mechanical circulatory support and transplant centres. We aimed to analyse characteristics and outcome of non‐inotrope‐dependent patients implanted with a left ventricular assist device (LVAD). Methods and results The ASSIST‐ICD registry collected LVAD data in 19 centres in France between February 2006 and December 2016. We used data of patients in Interagency Registry for Mechanically Assisted Circulatory Support Classes 4–7. The primary endpoint was survival analysis. Predictors of mortality were searched with multivariable analyses. A total of 303 patients (mean age 61.0 ± 9.9 years, male sex 86.8%) were included in the present analysis. Ischaemic cardiomyopathy was the leading heart failure aetiology (64%), and bridge to transplantation was the main implantation strategy (56.1%). The overall likelihood of being alive while on LVAD support or having a transplant at 1, 2, 3, and 5 years was 66%, 61.7%, 58.7%, and 55.1%, respectively. Age [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.00–1.05; P = 0.02], a concomitant procedure (HR 2.32, 95% CI 1.52–3.53; P
Published: 2021
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2. Association between pulmonary artery pulsatility and mortality after implantation of left ventricular assist device

Author: Ali Akamkam, Vincent Galand, Marie Jungling, Clément Delmas, Camille Dambrin, Mathieu Pernot, Michel Kindo, Philippe Gaudard, Philippe Rouviere, Thomas Senage, Olivier Chavanon, Marylou Para, Vlad Gariboldi, Matteo Pozzi, Pierre‐Yves Litzler, Gerard Babatasi, Olivier Bouchot, Costin Radu, Thierry Bourguignon, Nicolas D'Ostrevy, Ramzi Abi Akar, Fabrice Vanhuyse, Maïra Gaillard, Gilles Chatelier, Audrey Fels, Erwan Flecher, and Julien Guihaire
Subjects: Left ventricular assist device, Haemodynamics, Circulatory assist devices, Ventricle, right, Heart failure, Database, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims Right ventricular failure after left ventricular assist device (LVAD) implantation is a major concern that remains challenging to predict. We sought to investigate the relationship between preoperative pulmonary artery pulsatility index (PAPi) and mortality after LVAD implantation. Methods and results A retrospective analysis of the ASSIST‐ICD multicentre registry allowed the assessment of PAPi before LVAD according to the formula [(systolic pulmonary artery pressure − diastolic pulmonary artery pressure)/central venous pressure]. The primary endpoint was survival at 3 months, according to the threshold value of PAPi determined by the receiver operating characteristic (ROC) curve. A multivariate analysis including demographic, echographic, haemodynamic, and biological variables was performed to identify predictive factors for 2 year mortality. One hundred seventeen patients were included from 2007 to 2021. The mean age was 58.45 years (±13.16), with 15.4% of women (sex ratio 5.5). A total of 53.4% were implanted as bridge to transplant and 43.1% as destination therapy. Post‐operative right ventricular failure was observed in 57 patients (48.7%), with no significant difference between survivors and non‐survivors at 1 month (odds ratio 1.59, P = 0.30). The median PAPi for the whole study population was 2.83 [interquartile range 1.63–4.69]. The threshold value of PAPi determined by the ROC curve was 2.84. Patients with PAPi ≥ 2.84 had a higher survival rate at 3 months [PAPi
Published: 2024
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3. Current results of left ventricular assist device therapy in France: the ASSIST-ICD registry

Author: Hoang Minh Tam, Marylou Para, Olivier Chavanon, Clément Delmas, Marie Cecile Bories, Constance Verdonk, Vlad Gariboldi, Magali Michel, Fabrice Colas, Marie Bielefeld, Amedeo Anselmi, Martin Kloeckner, Jean-Philippe Verhoye, Thierry Bourguignon, André Vincentelli, Stéphane Boulé, Fabrice Vanhuyse, Michel Kindo, Julien Guihaire, Camille Dambrin, Annette Belin, Costin Radu, Nicolas D'Ostrevy, Hugues Blangy, Jérôme Jouan, Jean-François Obadia, Pierre-Yves Litzler, Vincent Galand, Gerard Babatasi, Edeline Pelcé, Laurent Barandon, Mathieu Pernot, Benjamin Duband, Philippe Rouvière, Philippe Gaudard, Nicolas Lellouche, Thomas Senage, Erwan Flecher, Aude Boignard, Fabien Garnier, Raphaël P. Martins, Matteo Pozzi, Frédéric Anselme, Thibaud Genet, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Les Hôpitaux Universitaires de Strasbourg (HUS), 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 thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, Clinique de chirurgie cardiaque, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Charles Nicolle [Rouen], Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université Paris-Sud - Paris 11 (UP11), Hôpital Henri Mondor, CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, 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 Régional Universitaire de Nancy (CHRU Nancy), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], and MORNET, Dominique
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Temporal trends, Outcomes, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Clinical endpoint, Humans, Cumulative incidence, Registries, Retrospective Studies, Heart Failure, business.industry, Cardiogenic shock, General Medicine, equipment and supplies, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Surgery, Transplantation, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Ventricular assist device, Life support, Left ventricular assist devices, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Heart-Assist Devices, Implant, Cardiology and Cardiovascular Medicine, business, Destination therapy
Abstract: OBJECTIVES Our goal was to provide a picture of left ventricular assist device (LVAD) activity in France between 2007 and 2016 based on the multicentric ASSIST-ICD registry. METHODS We retrospectively collected 136 variables including in-hospital data, follow-up survival rates and adverse events from 671 LVAD recipients at 20 out of 24 LVAD implant centres in France. The average follow-up time was 1.2 years (standard deviation: 1.4); the total follow-up time was 807.5 patient-years. RESULTS The included devices were the HeartMate II®, HeartWare LVAS® or Jarvik 2000®. The overall likelihood of being alive while on LVAD support or having a transplant (primary end point) at 1, 2, 3 and 5 years postimplantation was 65.2%, 59.7%, 55.9% and 47.7%, respectively, given a cumulative incidence of 29.2% of receiving a transplant at year 5. At implantation, 21.5% of patients were on extracorporeal life support. The overall rate of cardiogenic shock at implantation was 53%. The major complications were driveline infection (26.1%), pump pocket or cannula infection (12.6%), LVAD thrombosis (12.2%), ischaemic (12.8%) or haemorrhagic stroke (5.4%; all strokes 18.2%), non-cerebral haemorrhage (9.1%) and LVAD exchange (5.2%). The primary end point (survival) was stratified by age at surgery and by the type of device used, with inference from baseline profiles. The primary end point combined with an absence of complications (secondary end point) was also stratified by device type. CONCLUSIONS The ASSIST-ICD registry provides a real-life picture of LVAD use in 20 of the 24 implant centres in France. Despite older average age and a higher proportion of patients chosen for destination therapy, survival rates improved compared to those in previous national registry results. This LVAD registry contrasts with other international registries because patients with implants have more severe disease, and the national policy for graft attribution is distinct. We recommend referring patients for LVAD earlier and suggest a discussion of the optimal timing of a transplant for bridged patients (more dismal results after the second year of support?).
Published: 2020
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4. Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

Author: Auriane Bidaut, Erwan Flécher, Nicolas Nesseler, Karl Bounader, André Vincentelli, Mouhammed Moussa, Clément Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Clément Schneider, Philippe Gaudard, Philippe Rouvière, Magali Michel, Thomas Sénage, Aude Boignard, Olivier Chavanon, Constance Verdonk, Marylou Para, Baptiste Maille, Vlad Gariboldi, Matteo Pozzi, Elisabeth Hugon-Vallet, Pierre-Yves Litzler, Frédéric Anselme, Katrien Blanchart, Gerard Babatasi, Marie Bielefeld, Sandrine Grosjean, Costin Radu, David Hamon, Thierry Bourguignon, Thibaud Genet, Romain Eschalier, Nicolas D’Ostrevy, Hélène Nougue, Anne Cécile Martin, Fabrice Vanhuyse, Hugues Blangy, Christophe Leclercq, Raphael P. Martins, Vincent Galand, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], 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), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)
Subjects: Heart Failure, 2. Zero hunger, [SDV]Life Sciences [q-bio], Shock, Cardiogenic, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, 3. Good health, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, Treatment Outcome, 0302 clinical medicine, 030228 respiratory system, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, Heart-Assist Devices, Retrospective Studies
Abstract: International audience; Objectives: Temporary circulatory support (TCS) as a bridge-to-left ventricular assist device (BTL) in cardiogenic shock patients has been increasing, but limited data exists on this BTL strategy. We aimed at analyzing the outcome of BTL patients in a population of cardiogenic shock patients compared with those without TCS at the time of the left ventricular assist device (LVAD) surgery and identify predictors of postoperative mortality in this specific population.Design: A multicenter retrospective observational study conducted in 19 centers from 2006 to 2016.Setting: Nineteen French centers.Patients: A total of 329 cardiogenic shock patients at the time of LVAD implantation were analyzed. Patients were divided in three groups: those under TCS at the time of LVAD implantation (n = 173), those with TCS removal before LVAD surgery (n = 24), and those who did not undergo a bridging strategy (n = 152). Primary endpoint was 30-day mortality.Interventions: None.Measurements and main results: Among the BTL group, 68 (39.3%), 18 (10.4%), and 15 (8.7%) patients were under venoarterial extracorporeal membrane oxygenation, Impella, and IABP support alone, and 72 patients (20.6%) were under multiple TCS support. BTL patients presented similar 30 days survival compared with the TCS removal and non-BTL groups. However, BTL group had a significantly longer ICU duration stay, with two-fold duration of mechanical ventilation time, but the three groups experienced similar postoperative complications. Multivariate analysis identified three independent predictors of mortality in the BTL group: combined surgery with LVAD, body mass index (BMI), and heart failure (HF) duration. BTL strategy was not an independent predictor of mortality in cardiogenic shock patients who underwent LVAD.Conclusions: BTL strategy is not associated with a lower survival among cardiogenic shock patients with LVAD implantation. Predictors of mortality are combined surgery with LVAD, higher BMI, and HF duration.
Published: 2022
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5. Comparison of Outcomes and Mortality in Patients Having Left Ventricular Assist Device Implanted Early -vs- Late After Diagnosis of Cardiomyopathy

Author: Raphaël P. Martins, Matteo Pozzi, Nicolas Lellouche, Thomas Senage, Fabrice Vanhuyse, Nicolas Nesseler, Fabien Garnier, Pierre Baudinaud, Mathieu Pernot, Olivier Chavanon, Frédéric Anselme, Michel Kindo, Philippe Rouvière, Pierre-Yves Litzler, Christophe Leclercq, Marylou Para, Hugues Blangy, Constance Verdonk, Nicolas D'Ostrevy, Guillaume Baudry, Vincent Galand, André Vincentelli, Marie Bielefeld, Magali Michel, Edeline Pelcé, Vlad Gariboldi, Philippe Gaudard, Erwan Flecher, Gerard Babatasi, Katrien Blanchart, Karine Nubret, Costin Radu, Thierry Bourguignon, Céline Goéminne, Tam Hoang Minh, Aude Boignard, Thibaud Genet, Marie-Cécile Bories, Jean Porterie, Clément Delmas, Elisabeth Chen, Romain Eschalier, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Charles Nicolle [Rouen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, 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 Régional Universitaire de Nancy (CHRU Nancy), Fédération Française de Cardiologie, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Population, Cardiomyopathy, 030204 cardiovascular system & hematology, Prosthesis Design, remotely diagnosed cardiomyopathy, survival, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Clinical endpoint, medicine, Humans, In patient, education, Aged, Retrospective Studies, education.field_of_study, Ischemic cardiomyopathy, LVAD implantation, business.industry, 030208 emergency & critical care medicine, Sudden cardiac arrest, Recently diagnosed cardiomyopathy, Middle Aged, Prognosis, medicine.disease, equipment and supplies, 3. Good health, Cardiac surgery, Survival Rate, Ventricular assist device, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Heart-Assist Devices, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; LVAD implantation in patients with a recently diagnosed cardiomyopathy has been poorly investigated. This work aims at describing the characteristics and outcomes of patients receiving a LVAD within 30 days following the diagnosis of cardiomyopathy. Patients from the ASSIST-ICD study was divided into recently and remotely diagnosed cardiomyopathy based on the time from initial diagnosis of cardiomyopathy to LVAD implantation using the cut point of 30 days. The primary end point of the study was all-cause mortality at 30-day and during follow-up. A total of 652 patients were included and followed during a median time of 9.1 (2.5 to 22.1) months. In this population, 117 (17.9%) had a recently diagnosed cardiomyopathy and had LVAD implantation after a median time of 15.0 (9.0 to 24.0) days following the diagnosis. This group of patients was significantly younger, with more ischemic cardiomyopathy, more sudden cardiac arrest (SCA) events at the time of the diagnosis and were more likely to receive temporary mechanical support before LVAD compared with the remotely diagnosed group. Postoperative in-hospital survival was similar in groups, but recently diagnosed patients had a better long-term survival after hospital discharge. SCA before LVAD and any cardiac surgery combined with LVAD implantation were identified as 2 independent predictors of postoperative mortality in recently diagnosed patients. In conclusion, rescue LVAD implantation for recently diagnosed severe cardiomyopathy is common in clinical practice. Such patients experience a relatively low postoperative mortality and have a better long-term survival compared with remotely diagnosed patients.
Published: 2021
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6. Idarucizumab (Praxbind ® ) for dabigatran reversal in patients undergoing heart transplantation: a cohort of ten patients

Author: Philippe Rouvière, Philippe Gaudard, Roland G. Demaria, Jean-Marc Frapier, Pascal Colson, Audrey Agullo, François Roubille, Marc Mourad, Fabien Huet, Eran Kalmanovich, Bernard Albat, Florence Leclercq, Pascal Battistella, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Retiveau, Nolwenn, Université de Montpellier (UM), Institut de Génomique Fonctionnelle (IGF), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_treatment, 030204 cardiovascular system & hematology, heart transplantation, Dabigatran, 03 medical and health sciences, 0302 clinical medicine, idarucizumab, Emergency surgery, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, direct oral anticoagulant (DOAC) dabigatran, medicine, In patient, 030212 general & internal medicine, Heart transplantation, business.industry, Atrial fibrillation, Idarucizumab, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Anesthesia, Cohort, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, business, Biotechnology, medicine.drug
Abstract: Background: Novel oral anticoagulants are used in atrial fibrillation. Idarucizumab has been approved for reversal of dabigatran in situations of life-threatening hemorrhage or emergency surgery. Objectives: We report a single center experience of ten patients on dabigatran therapy who were given idarucizumab prior to heart transplantation. Methods & results: The mean plasma concentration of dabigatran prior to reversal was 139 ± 89 ng/ml. Hemoglobin, hematocrit and platelet levels were decreased after surgery. Surgical procedures were successfully performed with no increased risk, especially regarding bleeding complications. All patients were alive after 90 days. Conclusion: Dabigatran reversal with idarucizumab in contexts of emergency surgery/urgent procedures is an attractive and safe option to be taken into consideration for patients with end stage heart disease awaiting transplantation and indication of anticoagulant therapy.
Published: 2021
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7. Temporary assist devices in France 2014–2018: intra-aortic balloon pump: is the technique really outdated?

Author: Thomas Gandet, Fabien Huet, Sylvain Aguilhon, P. Gaudard, Pascal Battistella, François Roubille, Florence Leclercq, Clément Delmas, E. Bonnefoy-Cudraz, A. Agullo, M. Akodad, C Duflos, Philippe Rouvière, Etienne Puymirat, and Delphine Delseny
Subjects: Patient discharge, medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, medicine, Extracorporeal membrane oxygenation, Cardiology, Implantation procedure, Intra-Aortic Balloon Pumping, Cardiology and Cardiovascular Medicine, business, Intra-aortic balloon pump
Abstract: Aims Intra-aortic balloon pump (IABP) utilization was expected to be quickly abandoned following the IABP-shock trial and its class III, level B of recommendation in the 2016 ESC guidelines. The aim of this study was to evaluate the use of IABP compared to other mechanical support devices in a nationwide approach. Methods We conducted a retrospective study based on the French national hospital discharge database. All patients implanted by an assist device either by IABP, extracorporeal membrane oxygenation (ECMO) or IMPELLA® from 2014 to 2018 (2 years before/2 years after the 2016 guidelines) were included. The primary endpoint was the incidence of IABP implantation over the years. Secondary endpoints were incidence of total assist devices implantations, ECMO and IMPELLA® implantation. Results From 2014 to 2018, a total of 18,872 patients benefited from mechanical support by IABP (n=6,637, 35.2%), ECMO (n=11,833, 62.7%) or IMPELLA® (n=402, 2.1%) in France. The incidence of total mechanical support implantations (ECMO and IABP) was constant over the years. IABP implantation decreased progressively from 1,725 implantations in 2014 to 976 in 2018 (−44%). By contrast, ECMO implantation increased progressively from 1,919 implantations in 2014 to 2,715 implantations in 2018 (+42%). IMPELLA® implantations remained stable over the years from 63 (1.7%) implantations in 2014 to 83 (2.1%) in 2018. Conclusion In this nationwide real-life study, despite a significant decline in IABP implantations over the years since the ESC guidelines, this device remained used in clinical practice with around 1,000 implantations in 2018. The size of the centers is not strictly correlated with this use, suggesting differential uses depending of the local background. Funding Acknowledgement Type of funding source: None
Published: 2020
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8. Relation of Body Mass Index to Outcomes in Patients With Heart Failure Implanted With Left Ventricular Assist Devices

Author: Céline Chabanne, Romain Eschalier, Marylou Para, Marion Charton, Edeline Pelcé, Fabrice Vanhuyse, Michel Kindo, Raphaël P. Martins, Matteo Pozzi, Thierry Bourguignon, E. Varlet, Nicolas Sadoul, Bernard Lelong, David Hamon, Tam Hoang Minh, Fabien Garnier, Mathieu Pernot, Céline Goéminne, Vlad Gariboldi, Philippe Rouvière, Jean Porterie, Pierre-Yves Litzler, Constance Verdonk, Thibaud Genet, Christophe Leclercq, Magali Michel, Philippe Gaudard, Marie-Cécile Bories, Marie Bielefeld, Katrien Blanchart, Clément Delmas, Olivier Chavanon, Thomas Senage, Costin Radu, Erwan Flecher, Karine Nubret, Nicolas D'Ostrevy, Frédéric Anselme, Vincent Galand, Aude Boignard, Gerard Babatasi, André Vincentelli, Jean-François Obadia, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Lapeyronie [Montpellier] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Institut d'Aménagement et d'Urbanisme de la Région d'Ile-de-France (IAU Île-de-France), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHI Créteil, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, 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 Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], The French Federation of Cardiology, 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), and Jonchère, Laurent
Subjects: Male, medicine.medical_specialty, Population, Left ventricular assist device, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Thinness, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, Humans, Medicine, Obesity, education, Body mass index, Aged, Retrospective Studies, Heart Failure, 2. Zero hunger, education.field_of_study, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, mortality, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Cardiac surgery, Survival Rate, Treatment Outcome, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Heart failure, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Underweight, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Destination therapy
Abstract: International audience; We aimed at characterizing the impact of low and high body mass index (BMI) on outcomes after left-ventricular assist device (LVAD) surgery and define the predictors of mortality in patients with abnormal BMI (low/high). This study was conducted in 19 centers from 2006 to 2016. Patients were divided based on their baseline BMI into 3 groups of BMI: low (BMI ≤18.5 kg/m²); normal (BMI = 18.5 to 24.99 kg/m²) and high (BMI ≥25 kg/m²) (including overweight (BMI = 25 to 29.99 kg/m²), and obesity (BMI ≥30 Kg/m²)). Among 652 patients, 29 (4.4%), 279 (42.8%) and 344 (52.8%) had a low-, normal-, and high BMI, respectively. Patients with high BMI were significantly more likely men, with more co-morbidities and more history of ventricular/supra-ventricular arrhythmias before LVAD implantation. Patients with abnormal BMI had significantly lower survival than those with normal BMI. Notably, those with low BMI experienced the worst survival whereas overweight or obese patients had similar survival. Four predictors of mortality for LVAD candidates with abnormal BMI were defined: total bilirubin ≥16 µmol/L before LVAD, hypertension, destination therapy, and cardiac surgery with LVAD. Depending on the number of predictor per patients, those with abnormal BMI may be divided in 3 groups of 1-year mortality risk, i.e., low (0 to 1 predictor: 29% and 31%), intermediate (2 to 3 predictors, 51% and 52%, respectively), and high (4 predictors: 83%). In conclusion, LVAD recipients with abnormal BMI experience lower survival, especially underweight patients. Four predictors of mortality have been identified for LVAD population with abnormal BMI, differentiating those a low-, intermediate-, and high risks of death.
Published: 2020
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9. Outcomes of Left Ventricular Assist Device Implantation in Patients With Uncommon Etiology Cardiomyopathy

Author: Romain Eschalier, Marie Bielefeld, Nicolas D'Ostrevy, Philippe Rouvière, Aude Boignard, Vincent Galand, Olivier Chavanon, François Picard, Céline Chabanne, Fabien Garnier, Frédéric Anselme, Jérôme Jouan, Katrien Blanchart, Erwan Flecher, Camille Dambrin, Hugues Blangy, Fabrice Vanhuyse, Gerard Babatasi, Edeline Pelcé, Walid Ghodhbane, Tam Hoang Minh, Céline Goéminne, Thierry Bourguignon, Raphaël P. Martins, Matteo Pozzi, Pierre-Yvesl Litzler, Frederic Sacher, Philippe Gaudard, E. Varlet, Constance Verdonk, Nicolas Lellouche, Thomas Senage, Magali Michel, Vlad Gariboldi, Bernard Lelong, Thibaud Genet, Michel Kindo, Christophe Leclercq, David Hamon, Jean-François Obadia, Clément Delmas, André Vincentelli, 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 chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, 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 thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Carnegie Mellon University [Pittsburgh] (CMU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), 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)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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 Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Fédération Française de Cardiologie, Rennes University Hospital, 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), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Henri Mondor, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre de recherches (CRT), Société Lafarge, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Nouvel Hôpital Civil, Strasbourg, France., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital Bichat Paris, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), 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), Centre Hospitalier Régional Universitaire de Caen (CHRU Caen), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie et maladies vasculaires, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and MORNET, Dominique
Subjects: Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Myocarditis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cardiomyopathy, Myocardial Ischemia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Idiopathic dilated cardiomyopathy, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Mortality rate, valvular heart disease, Hypertrophic cardiomyopathy, Cardiomyopathy, Hypertrophic, Middle Aged, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Ventricular assist device, Etiology, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; The impact of uncommon etiology cardiomyopathies on Left-ventricular assist device (LVAD)-recipient outcomes is not very well known. This study aimed to characterize patients with uncommon cardiomyopathy etiologies and examine the outcomes between uncommon and ischemic/idiopathic dilated cardiomyopathy. This observational study was conducted in 19 centers between 2006 and 2016. Baseline characteristics and outcomes of patients with uncommon etiology were compared to patients with idiopathic dilated/ischemic cardiomyopathies. Among 652 LVAD-recipients included, a total of 590 (90.5%) patients were classified as ischemic/idiopathic and 62 (9.5%) patients were classified in the "uncommon etiologies" group. Main uncommon etiologies were: hypertrophic (n = 12(19%)); cancer therapeutics-related cardiac dysfunction (CTRCD) (n = 12(19%)); myocarditis (n = 11(18%)); valvulopathy (n = 9(15%)) and others (n = 18(29%)). Patients with uncommon etiologies were significantly younger with more female and presented less co-morbidities. Additionally, patients with uncommon cardiomyopathies were less implanted as destination therapy compared with ischemic/idiopathic group (29% vs 38.8%). During a follow-up period of 9.1 months, both groups experienced similar survival. However, subgroup of hypertrophic/valvular cardiomyopathies and CTRCD had significantly higher mortality compared to the ischemic/idiopathic or myocarditis/others cardiomyopathies. Conversely, patients with myocarditis/others etiologies experienced a better survival. Indeed, the 12-months survival in the myocarditis/others; ischemic/idiopathic and hypertrophic/CTRCD/valvulopathy group were 77%; 65%, and 46% respectively. In conclusion, LVAD-recipients with hypertrophic cardiomyopathy, valvular heart disease and CTRCD experienced the higher mortality rate.
Published: 2020
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10. Ruptured right valsalva sinus into the right atrium due to infective endocarditis: a case report

Author: Philippe Rouvière, Ayoub Abetti, Audrey Agullo, Thomas Gandet, Roland G. Demaria, Bernard Albat, Alexandra Meilhac, Abdul Aziz Al Amri, Marouane Ouazzani Ibrahimi, Jean Marc Frapier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Cardiovascular Surgery, Mohammed VI university medical center, Mohammed the first university Oujda, Morocco, Biomécanique des Interactions et de l'Organisation des Tissus et des Cellules (BIOTIC), Laboratoire de Mécanique et Génie Civil (LMGC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), 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 MORNET, Dominique
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030231 tropical medicine, Case Report, Chest pain, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, Medicine, 030212 general & internal medicine, cardiovascular diseases, Rupture, Surgical repair, Valsalva sinus aneurysm, infective endocarditis, business.industry, Mortality rate, General Medicine, Emergency department, right Valsalva sinus, medicine.disease, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], body regions, medicine.anatomical_structure, Infective endocarditis, cardiovascular system, Right atrium, medicine.symptom, business, Complication
Abstract: International audience; Rupture of Valsalva sinus remains a very rare and deadly complication of Valsalva sinus aneurysm with a high mortality rate. We report here the case of a 47-year-old man who presented to the emergency department with acute exercise-induced dyspnea, chest pain, and fever. Transthoracic (TTE) and transesophageal echocardiography (TEE) highlighted a rupture of the right Valsalva sinus in the right atrium due to infective endocarditis. After stabilization of the patient, a successful surgical repair with double pericardial patches was performed.
Published: 2020
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11. Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality

Author: Vincent Auffret, Walid Ghodbane, Stéphane Boulé, Annette Belin, Michel Kindo, Nicolas Jacob, Romain Eschalier, Gerard Babatasi, Mathieu Pernot, Philippe Rouvière, Fabien Garnier, Frédéric Anselme, Christophe Leclercq, Anne Rollin, Philippe Gaudard, Edeline Pelcé, David Hamon, Nicolas Lellouche, Thomas Senage, Jean-François Obadia, Nicolas D'Ostrevy, Arnaud Savouré, André Vincentelli, Olivier Chavanon, Marie-Cécile Bories, Vincent Galand, Vlad Gariboldi, Raphaël P. Martins, Matteo Pozzi, Erwan Flecher, Laurent Barandon, Pascal Defaye, Jean-Philippe Verhoye, Thierry Bourguignon, Camille Pichard, Hugues Blangy, Constance Verdonk, Thomas Cardi, Bertrand Pierre, Eloi Marijon, Fabrice Vanhuyse, Marie Bielefeld, Pierre Mondoly, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Rennes, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Department of Cardiology and Cardiac Surgery, CHU Lille, Institut Coeur-Poumons, Lille, France, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France, Department of Cardiovascular Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), 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 thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Department of Anesthesiology and Critical Care Medicine, Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiac Stimulation and Rhythmology, CHU Grenoble, Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France, Hospital Bichat Paris, Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France, Hôpital de la Timone [CHU - APHM] (TIMONE), Department of Cardiac Surgery, 'Louis Pradel' Cardiologic Hospital, Lyon, France, Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, 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), Cardiology Department, European Georges Pompidou Hospital, Paris, France, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, 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), Department of Cardiology, Department of Cardiac Surgery, CHU de Toulouse, Toulouse, France, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], Discharged alive, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, left ventricular assist device, Humans, Post operative mortality, Clinical significance, 030212 general & internal medicine, post-operative mortality, Aged, Retrospective Studies, ventricular arrhythmia, Heart Failure, Ejection fraction, business.industry, Incidence (epidemiology), Arrhythmias, Cardiac, Middle Aged, medicine.disease, 3. Good health, Heart failure, Ventricular assist device, Ventricular fibrillation, Cardiology, Female, Heart-Assist Devices, business
Abstract: International audience; Objectives - This study aimed to evaluate incidence, clinical significance, and predictors of early ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients. Background - LVAD implantation is increasingly used in patients with end-stage heart failure. Early VAs may occur during the 30-day post-operative period, but many questions remain unanswered regarding their incidence and clinical impact. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Early VAs were defined as sustained ventricular tachycardia and/or ventricular fibrillation occurring
Published: 2019
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12. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study

Author: Caroline Kerneis, Nicolas D'Ostrevy, Fabien Garnier, Frédéric Anselme, Edeline Pelcé, Magali Michel, Pierre Mondoly, Erwan Flecher, Pierre-Yves Litzler, Christophe Leclercq, Romain Eschallier, Fabrice Vanhuyse, Vincent Galand, Raphaël P. Martins, Matteo Pozzi, Jean-Baptiste Gourraud, Pascal Defaye, Nicolas Sadoul, Frederic Sacher, Marie Bielefeld, Nicolas Lellouche, Hamed Bourenane, Vincent Auffret, Pierre Bordachar, Stéphane Boulé, Michel Kindo, Valentin Loobuyck, Jérôme Jouan, Gerard Babatasi, Philippe Rouvière, Thierry Bourguignon, Olivier Chavanon, Philippe Gaudard, Annette Belin, David Hamon, Camille Dambrin, Walid Ghodhbane, Marie-Cécile Bories, Vlad Gariboldi, Thomas Cardi, Bertrand Pierre, Daniel Grinberg, CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Université de Bordeaux (UB), Université de Strasbourg (UNISTRA), CHU Strasbourg, 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 thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Rouen, Normandie Université (NU), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, 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 Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rennes (UR), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Radiofrequency ablation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Left ventricular assist device, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular tachycardia, law.invention, Cohort Studies, Postoperative Complications, 0302 clinical medicine, law, Interquartile range, 030212 general & internal medicine, Incidence, Incidence (epidemiology), Age Factors, Middle Aged, Markov Chains, 3. Good health, Survival Rate, Cardiology, Female, ventricular tachycardia, Cardiology and Cardiovascular Medicine, electrical storm, Adult, medicine.medical_specialty, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, Physiology (medical), Internal medicine, medicine, Humans, Survival rate, Aged, Proportional Hazards Models, Retrospective Studies, ventricular arrhythmia, Heart Failure, business.industry, medicine.disease, ventricular fibrillation, mortality, Ventricular assist device, Heart failure, Ventricular fibrillation, Tachycardia, Ventricular, Heart-Assist Devices, business
Abstract: International audience; Background - Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. Objective - We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients. Methods - Patients analyzed were those included in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval. Results - Of 652 patients with an LVAD, 61 (9%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (63%). The incidence then tended to decrease during the initial years of follow-up and increased again after the third year post LVAD implantation. History of VAs before LVAD implantation and heart failure duration > 84 months were independent predictors of ES. The occurrence of ES was associated with an increased early mortality since 20 patients (33%) died within the first 2 weeks of ES. Twenty-two patients (36.1%) presented at least 1 recurrence of ES, occurring 43.0 (IQR 8.0-69.0) days after the initial ES. Patients experiencing ES had a significantly lower 1-year survival rate than did those free from ES (log-rank, P = .039). Conclusion - There is a significant incidence of ES in patients with an LVAD. The short-term mortality after ES is high, and one-third of patients will die within 15 days. Whether radiofrequency ablation of arrhythmias improves outcomes would require further studies.
Published: 2019
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13. Risk factors and prognostic impact of left ventricular assist device–associated infections

Author: Marylou Para, Vincent Veniard, Louis Bernard, Vincent Auffret, Stéphane Boulé, Constance Verdonk, Laurent Barandon, Michel Kindo, Thierry Bourguignon, Pascal Defaye, Marie Bielefeld, David Hamon, Edeline Pelcé, Pierre Tattevin, Jérôme Jouan, Fabien Garnier, Philippe Gaudard, Pierre-Yves Litzler, Christophe Leclercq, Fabrice Vanhuyse, Nicolas Lellouche, Thomas Senage, Clément Delmas, Emilie Varlet, Thomas Cardi, Vlad Gariboldi, Daniel Grinberg, André Vincentelli, Arnaud Savouré, Erwan Flecher, Annette Belin, Nicolas Jacob, Gerard Babatasi, Philippe Rouvière, Romain Eschalier, Olivier Chavanon, Hugues Blangy, Camille Dambrin, Raphaël P. Martins, Matteo Pozzi, Nicolas D'Ostrevy, Vincent Galand, MORNET, Dominique, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Universitaire de Lille (CHU de Lille), Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Equipe 'Obésité et insuffisance cardiaque: approches moléculaires et cliniques ', 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)-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), Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Bordeaux II, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), 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), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Michallon, Hospital Bichat Paris, Hospital,Bichat- Paris, Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Chirurgie Cardiaque [Hôpital de la Timone - APHM], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French Federation of Cardiology, 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), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN)
Subjects: Male, medicine.medical_specialty, Percutaneous, Prosthesis-Related Infections, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Device Removal, Retrospective Studies, Heartmate ii, Pseudomonas aeruginosa, business.industry, Retrospective cohort study, Middle Aged, Prognosis, equipment and supplies, Cannula, 3. Good health, Icd implantation, Defibrillators, Implantable, [SDV] Life Sciences [q-bio], Staphylococcus aureus, Ventricular assist device, Catheter-Related Infections, Multivariate Analysis, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections. Methods - Patients included in the ASSIST-ICD study (19 centers) were enrolled. The main outcome was the occurrence of LVAD-associated infection (driveline infection, pocket infection, or pump/cannula infection) during follow-up. Results - Of the 652 patients enrolled, 201 (30.1%) presented a total of 248 LVAD infections diagnosed 6.5 months after implantation, including 171 (26.2%), 51 (7.8%), and 26 (4.0%) percutaneous driveline infection, pocket infection, or pump/cannula infection, respectively. Patients with infections were aged 58.7 years, and most received HeartMate II (82.1%) or HeartWare (13.4%). Most patients (62%) had implantable cardioverter-defibrillators (ICDs) before LVAD, and 104 (16.0%) had ICD implantation, extraction, or replacement after the LVAD surgery. Main pathogens found among the 248 infections were Staphylococcus aureus (n = 113' 45.4%), Enterobacteriaceae (n = 61; 24.6%), Pseudomonas aeruginosa (n = 34; 13.7%), coagulase-negative staphylococci (n = 13; 5.2%), and Candida species (n = 13; 5.2%). In multivariable analysis, HeartMate II (subhazard ratio, 1.56; 95% CI, 1.03 to 2.36; P = .031) and ICD-related procedures post-LVAD (subhazard ratio, 1.43; 95% CI, 1.03-1.98; P = .031) were significantly associated with LVAD infections. Infections had no detrimental impact on survival. Conclusions - Left ventricular assist device-associated infections affect one-third of LVAD recipients, mostly related to skin pathogens and gram-negative bacilli, with increased risk with HeartMate II as compared with HeartWare, and in patients who required ICD-related procedures post-LVAD. This is a plea to better select patients needing ICD implantation/replacement after LVAD implantation.
Published: 2019
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14. Management of advanced heart failure: a review

Author: Marc Mourad, Pascal Colson, Mariama Akodad, Eran Kalmanovich, Jean-Etienne Ricci, François Roubille, Y. Audurier, Philippe Gaudard, Bernard Albat, Pascal Battistella, Audrey Agullo, Philippe Rouvière, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Advanced Heart failure, Mechanical Circulatory assist devices, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Percutaneous Mechanical circulatory devices, Intensive care medicine, Heart Failure, business.industry, Cardiogenic shock, cardiogenic shock, General Medicine, medicine.disease, 3. Good health, Heart failure, Quality of Life, Heart Transplantation, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Heart failure (HF) has become a global pandemic. Despite recent developments in both medical and device treatments, HF incidences continues to increase. The current definition of HF restricts itself to stages at which clinical symptoms are apparent. In advanced heart failure (AdHF), it is universally accepted that all patients are refractory to traditional therapies. As the number of HF patients increase, so does the need for additional treatments, with an increased proportion of patients requiring advanced therapies. Areas covered: This review discusses extensive evidence for the effect of medical treatment on HF, although the data on the effect on AdHF is scare. Authors review the relevant literature for treating AdHF patients. Furthermore, mechanical circulatory devices (MCD) have emerged as an alternative to heart transplantation and have been shown to enhance quality of life and reduce mortality therefore authors also review the current literature on the different MCD and technologies. Expert commentary: More patients will need advanced therapies, as the access to heart transplantation is limited by the number of available donors. AdHF patients should be identified timely since the window of opportunities for advanced therapy is narrow as their morbidity is progressive and survival is often short.
Published: 2018
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15. Predictors and Clinical Impact of Late Ventricular Arrhythmias in Patients With Continuous-Flow Left Ventricular Assist Devices

Author: Walid Ghodbane, Raphaël P. Martins, Matteo Pozzi, Vincent Auffret, Assist-Icd Investigators, David Hamon, Philippe Rouvière, Stéphane Boulé, Michel Kindo, Romain Eschalier, Pierre-Yves Litzler, Thierry Bourguignon, Olivier Chavanon, Christophe Leclercq, Camille Dambrin, Bertrand Pierre, Marie Bielefeld, Magali Michel, Hugues Blangy, Pierre Mondoly, Marie-Cécile Bories, Thomas Cardi, Jean-François Obadia, Pascal Defaye, Edeline Pelcé, Frederic Sacher, Costin Radu, Constance Verdonk, Annette Belin, Vlad Gariboldi, Erwan Flecher, Nicolas D'Ostrevy, Vincent Galand, Karine Nubret, Philippe Gaudard, Fabien Garnier, Frédéric Anselme, Gerard Babatasi, Fabrice Vanhuyse, Jean-Baptiste Gourraud, Eloi Marijon, André Vincentelli, Jean-Philippe Verhoye, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], 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 thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Cardiac Stimulation and Rhythmology, CHU Grenoble, Hôpital Michallon, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carnegie Mellon University [Pittsburgh] (CMU), Service de chirurgie cardiaque, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Département Matériaux (LCPC/MAT), Laboratoire Central des Ponts et Chaussées (LCPC)-PRES Université Nantes Angers Le Mans (UNAM), Griset SA, Diehl - Griset, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service chirurgie cardio-vasculaire, Centre Hospitalier Universitaire de Clermont-Ferrand, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Unité de recherche de l'institut du thorax (ITX-lab), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), 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), CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and 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)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Cardiomyopathy, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, implantable cardioverter-defibrillator, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, left ventricular assist device, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Fibrillation, Ejection fraction, business.industry, ventricular arrhythmias, Arrhythmias, Cardiac, Atrial fibrillation, Middle Aged, Implantable cardioverter-defibrillator, medicine.disease, equipment and supplies, Defibrillators, Implantable, 3. Good health, Ventricular assist device, Heart failure, Etiology, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, medicine.symptom, business
Abstract: International audience; Objectives - This study aimed to evaluate the incidence, clinical impact, and predictors of late ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients aiming to clarify implantable cardioverter-defibrillator (ICD) indications. Background - The arrhythmic risk and need for ICD in patients implanted with an LVAD are not very well known. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Late VAs were defined as sustained ventricular tachycardia or fibrillation occurring >30 days post-LVAD implantation, without acute reversible cause and requiring appropriate ICD therapy, external electrical shock, or medical therapy. Results - Among 659 LVAD recipients, 494 (median 58.9 years of age; mean left ventricular ejection fraction 20.7 ± 7.4%; 73.1% HeartMate II, 18.6% HeartWare, 8.3% Jarvik 2000) were discharged alive from hospital and included in the final analysis. Late VAs occurred in 133 (26.9%) patients. Multivariable analysis identified 6 independent predictors of late VAs: VAs before LVAD implantation, atrial fibrillation before LVAD implantation, idiopathic etiology of the cardiomyopathy, heart failure duration >12 months, early VAs (
Published: 2018
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16. Circulatory Support with Extracorporeal Membrane Oxygenation and/or Impella for Cardiogenic Shock During Myocardial Infarction

Author: Philippe Gaudard, François Roubille, Marc Mourad, Pablo De La Arena, Pascal Colson, Norddine Zeroual, Philippe Rouvière, Jacob Eliet, Bernard Albat, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Shock, Cardiogenic, Biomedical Engineering, Biophysics, Hemodynamics, Bioengineering, 030204 cardiovascular system & hematology, Biomaterials, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, Percutaneous Coronary Intervention, 0302 clinical medicine, Internal medicine, medicine, Extracorporeal membrane oxygenation, Humans, 030212 general & internal medicine, Myocardial infarction, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Impella, Retrospective Studies, business.industry, Cardiogenic shock, fungi, General Medicine, Middle Aged, medicine.disease, 3. Good health, surgical procedures, operative, Shock (circulatory), Conventional PCI, Cardiology, Myocardial infarction complications, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, medicine.symptom, business
Abstract: International audience; Temporary mechanical circulatory support (TCS) is recommended for patients with profound cardiogenic shock (CS). Extracorporeal membrane oxygenation (ECMO) and Impella are possible TCS devices, but the device choice and the implantation timing are not definitely established, specifically during acute myocardial infarction. We have analyzed the respective use of ECMO or Impella (2.5, CP, or 5.0) for CS following acute myocardial infarction , from a cohort of patients who underwent TCS within 72 hours after admission for emergency percutaneous coronary intervention (PCI) from January 2009 to April 2015. Among 88 TCS-treated patients, 42 had early TCS: 23 ECMO and 19 Impella. Cardiac management, including PCI, was similar between the two groups, but ECMO patients were sicker than Impella patients (higher blood lactate level at ICU admission, higher vasoactive-inotroic and ENCOURAGE scores before TCS implantation, p ≤ 0.02). Three patients (7%) have had TCS implantation before admission, but TCS was implanted mostly in cathlab (43%, 1 during PCI, 13 just after PCI) or soon after ICU admission (50%, n = 21). Modification of the initial TCS choice was required in 10 cases (24%) for assistance upgrading in case of Impella (n = 4) or for left ventricle unloading in case of ECMO (n = 6). Extracorporeal membrane oxygenation is the technique of choice in case of profound CS, whereas Impella devices seem more appropriate for less severe hemodynamic compromise. Interestingly, the combination of both techniques may help to overcome the limits inherent to each device.
Published: 2017
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17. Effect of Impella During Veno-Arterial Extracorporeal Membrane Oxygenation on Pulmonary Artery Flow as Assessed by End-Tidal Carbon Dioxide

Author: Marc Mourad, Norddine Zeroual, Philippe Gaudard, Pascal Colson, Philippe Rouvière, Bernard Albat, Jacob Eliet, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, medicine.medical_specialty, Pulmonary Circulation, medicine.medical_treatment, Biomedical Engineering, Biophysics, Diastole, Bioengineering, 030204 cardiovascular system & hematology, Pulmonary Artery, Biomaterials, 03 medical and health sciences, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, Afterload, Internal medicine, medicine.artery, Extracorporeal membrane oxygenation, medicine, Humans, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Impella, Heart Failure, business.industry, 030208 emergency & critical care medicine, General Medicine, Carbon Dioxide, Middle Aged, End tidal, Preload, medicine.anatomical_structure, Ventricle, Pulmonary artery, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, business
Abstract: International audience; Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) exposes the patient to a pulmonary blood flow bypass and a left ventricle afterload increase. Impella, a catheter-mounted microaxial rotary pump, has been proposed for left ventricle (LV) unloading in combination with VA ECMO. In order to assess the effect of Impella on pulmonary flow and LV preload, we checked Doppler pulmonary artery velocity-time integral (pVTI) and LV diastolic diameter (LVED) by transesophageal echocardiography and end-tidal carbon dioxide (EtCO2) during a step-by-step increase in Impella flow (Impella ramp test). From 134 patients on VA ECMO retrieved from our database, 27 (20%) have benefited secondary Impella implantation, out of which 11 patients had available EtCO2, pVTI, and LVED measurements at various levels of Impella speeds. We observed a proportional increases in pVTI and EtCO2 and decrease in LVED (p ≤ 0.001) during Impella flow increase. There was a significant correlation between EtCO2 and ITV pulm (Pearson correlation coefficient 0.64; p = 0.006). The study shows that Impella improves pulmonary flow, an effect that can be easily measured by EtCO2 monitoring, and ensures LV discharge, allowing adapting Impella flow adequately to patient's individual needs.
Published: 2017
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18. State-of-the-Art of Left Ventricular Assist Device use in France: the ASSIST-ICD registry

Author: Stéphane Boulé, Michel Kindo, Hugues Blangy, André Vincentelli, M. Pozzi, C V Verdonk, Rosana de Carvalho Cristo Martins, Laurent Fauchier, Jean-François Obadia, M. Michel, A. Belin, Olivier Bouchot, F. Sacher, P.Y. Litlzer, Vincent Galand, Erwan Flecher, Jean-Claude Deharo, Philippe Rouvière, G. Babatasi, Jean-Christian Roussel, Laurent Barandon, Romain Eschalier, E. Marijon, Christophe Leclercq, Pascal Defaye, Pierre Mondoly, Gabriel Laurent, Vlad Gariboldi, Thierry Bourguignon, Nicolas Lellouche, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Charles Sadron (ICS), Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Cardiac Stimulation and Rhythmology, CHU Grenoble, Univers, Transport, Interfaces, Nanostructures, Atmosphère et environnement, Molécules (UMR 6213) (UTINAM), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), 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) (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), LyRe, Lyonnaise des Eaux, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et nanosciences d'Alsace, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and 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)
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Ventricular assist device, Internal medicine, medicine, Cardiology, 030212 general & internal medicine, State (computer science), Medical emergency, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2017
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19. Description des deux techniques de revascularisation myocardique chirurgicale

Author: Philippe Rouvière, Jean Claude Sinquet, Roland G. Demaria, Marouane Ouazzani, Jean Marc Frapier, and Bernard Albat
Subjects: medicine.medical_specialty, business.industry, Myocardial revascularisation, General Medicine, medicine.disease, law.invention, medicine.anatomical_structure, law, Internal medicine, Cardiopulmonary bypass, medicine, Cardiology, Myocardial infarction, business, General Nursing, Artery
Abstract: A coronary artery bypass involves taking blood vessels from another part of the patient's body to bypass one or several major coronary stenoses. Coronary artery bypass using cardiopulmonary bypass and off-pump coronary artery bypass are the two methods used to revascularise the heart after a myocardial infarction.
Published: 2015
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20. Chirurgie mitrale mini-invasive vidéo-assistée : le point de vue des Ibode

Author: Ana Guerra, Gianluca Samarani, Bernard Albat, Patricia Hey, Roland G. Demaria, Jean-Claude Sinquet, Philippe Rouvière, and Andrée Llorens
Subjects: Medical–Surgical Nursing
Published: 2014
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21. 1074Predictors and clinical impact of late ventricular arrhythmias in patients with continuous-flow left ventricular assist devices

Author: Vincent Galand, R E Eschallier, Jean-Baptiste Gourraud, M K Kindo, Stéphane Boulé, R Martins, Frédéric Anselme, E. Marijon, Pierre Mondoly, Christophe Leclercq, Bertrand Pierre, Philippe Rouvière, Pascal Defaye, and F. Sacher
Subjects: medicine.medical_specialty, Continuous flow, business.industry, Physiology (medical), Ventricular assist device, medicine.medical_treatment, Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business
Published: 2018
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22. 223Early post-operative ventricular arrhythmias increase mortality in patient with continuous-flow left ventricular assist device

Author: Vincent Galand, Stéphane Boulé, Pierre Mondoly, M K Kindo, Christophe Leclercq, R E Eschallier, C V Verdonk, F. Sacher, Frédéric Anselme, Jean-Baptiste Gourraud, Pascal Defaye, Philippe Rouvière, Bertrand Pierre, R Martins, and E. Marijon
Subjects: medicine.medical_specialty, business.industry, Continuous flow, Physiology (medical), Internal medicine, Ventricular assist device, medicine.medical_treatment, medicine, Cardiology, In patient, Post operative, Cardiology and Cardiovascular Medicine, business
Published: 2018
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23. Les anévrismes des artères digestives. À propos d'un cas clinique de localisation anévrismale multiple et revue de la littérature

Author: E. Raad, Philippe Rouvière, Roland G. Demaria, Michel Prudhomme, Jean-Marc Frapier, Bernard Albat, and Michel Dauzat
Subjects: medicine.medical_specialty, Common hepatic artery, medicine.diagnostic_test, business.industry, Vascular disease, Splenic artery, Anastomosis, medicine.disease, Asymptomatic, Surgery, Celiac artery, Blood vessel prosthesis, medicine.artery, Angiography, Medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Visceral artery aneurysms constitute a rare vascular disease, with a risk of rupture associated to a high mortality. Often asymptomatic, they are discovered following a routine radiological examination. We present the case of a 71-year-old patient with multiple aneurysms involving the celiac trunk, the splenic artery, and the common hepatic artery. The surgical treatment consisted of an aortohepatic bypass using polytetrafluoroethylene prosthesis, after exclusion of all the aneurysms. The angiography and postoperative angioscan demonstrated the perfect patency of the prosthesis, totally excluding the aneurysms. Given the variety of presentations and the absence of precise predictive factors, there is no therapeutic consensus so far. Surgery is the first therapeutic choice. Endovascular treatment by angioembolization must be reserved for particular conditions. The purpose of this article is to propose the best therapeutic approach on the basis of evidence in the literature.
Published: 2007
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24. Management and outcome of patients supported with Impella 5.0 for refractory cardiogenic shock

Author: Philippe Gaudard, Géraldine Culas, Jacob Eliet, Pascal Colson, Norddine Zeroual, Philippe Rouvière, Marc Mourad, Bernard Albat, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Arnaud de Villeneuve-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Université de Montpellier (UM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), and Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM)
Subjects: Male, Inotrope, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Shock, Cardiogenic, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Myocardial infarction, Impella, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Ejection fraction, [ SDV ] Life Sciences [q-bio], business.industry, Research, Cardiogenic shock, Stroke Volume, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Echocardiography, Shock (circulatory), Ventricular assist device, Cardiology, Female, SOFA score, Heart-Assist Devices, medicine.symptom, business
Abstract: IntroductionCardiogenic shock refractory to standard therapy with inotropes and/or intra-aortic balloon pump is accompanied with an unacceptable high mortality. Percutaneous left ventricular assist devices may provide a survival benefit for these very sick patients. In this study, we describe our experience with the Impella 5.0 device used in the setting of refractory cardiogenic shock.MethodsIn this observational, retrospective, single-center study we included all the consecutive patients supported with Impella 5.0, between May 2008 and December 2013, for refractory cardiogenic shock. Patients’ baseline and procedural characteristics, hemodynamics and outcome to the first 48 h of support, to ICU discharge and day-28 visit were collected.ResultsA total of 40 patients were included in the study. Median age was 57 years and 87.5 % were male. Cardiogenic shock resulted from acute myocardial infarction in 17 patients (43 %), dilated cardiomyopathy in 12 (30 %) and postcardiotomy cardiac failure in 7 (18 %). In 15 patients Impella 5.0 was added to an ECMO to unload the left ventricle. The median SOFA score for the entire cohort prior to circulatory support was 12 [10–14] and the duration of Impella support was 7 [5–10] days. We observed a significant decrease of the inotrope score (10 [1–17] vs. 1 [0–9];p = 0.04) and the lactate values (3.8 [1.7–5.9] mmol/L vs. 2.5 [1.5–3.4] mmol/L;p = 0.01) after 6 h of support with Impella 5.0. Furthermore, at Impella removal the patients’ left ventricular ejection fraction improved significantly (p p = 0.02).ConclusionsImpella 5.0 allowed fast weaning of inotropes and might facilitate myocardial recovery. Despite high severity scores at admission, day-28 mortality rate was better than predicated.
Published: 2015
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25. Mitral valve repair by Alfieri's technique does not limit exercise tolerance more than Carpentier's correction☆

Author: Jean-Marc Frapier, Catherine Sportouch, Jean-Marc Davy, Bernard Albat, Philippe Rouvière, Valerie Rauzy, Stéphane Cade, and Demaria R
Subjects: Male, Reoperation, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Blood Pressure, Physical exercise, Oxygen Consumption, Mitral valve, Internal medicine, Humans, Medicine, Outpatient clinic, Aged, Ultrasonography, Aged, 80 and over, Mitral valve repair, Exercise Tolerance, business.industry, Mitral Valve Insufficiency, VO2 max, Stroke Volume, Cardiorespiratory fitness, General Medicine, Stroke volume, Middle Aged, medicine.disease, Survival Analysis, Treatment Outcome, medicine.anatomical_structure, Exercise Test, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Mitral valve regurgitation, Follow-Up Studies
Abstract: Objective:The main goal of this study was to evaluate if the edge-to-edge mitral repair could be a limiting factor for exercise tolerance and to compare these results to those of classical techniques. Methods: Between 2000 and 2002, 54 consecutive patients were operated on for mitral valve regurgitation (MR). Twenty-five patients were operated with Alfieri’s technique (group A) and 29 patients with Carpentier’s technique (group C). The mean age was 63.9 years in group A and 63.8 years in group C (p = 0.98). After a mean follow-up of 16.2 12 months, survivor patients were seen at the outpatient clinic, by the same physician for a clinical evaluation, an echocardiogram at rest and at peak exercise, and received a cardiorespiratory exercise testing with maximal oxygen uptake (VO2 max) recording. Results: Clinical status improved with 0% of the patients in class NYHA III or IV in either group postoperatively versus 77% preoperatively. There was no significant MR in 80% of cases in group A versus 89.6% in group C (p = 0.54). The mean mitral valve area was 2.5 and 2.9 cm 2 in groups A and C, respectively (p = 0.018). The mitral gradient at rest was 3.8 and 3.3 mmHg (p = 0.31) and the mitral gradient at peak exercise was 8.5 and 9.7 mmHg (p = 0.22) in groups A and C, respectively. Cardiorespiratory exercise testing showed a mean VO2 max of 73.7 15% of normal value in group A versus 79.6 13.1% in group C (p = 0.18). Conclusion: Alfieri’s technique has the same efficiency on improvement of MR and clinical status than classical repair. Despite a higher restriction of mitral valve area at rest in group A, gradient and mean VO2 max at peak exercise were similar in both groups.
Published: 2006
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26. Long-Term Outcomes After Cryoablation for Ventricular Tachycardia During Surgical Treatment of Anterior Ventricular Aneurysms

Author: Jean-Marc Frapier, Beatrice Celton, Bernard Albat, Eric Barbotte, Mirdavron Mukaddirov, Philippe Rouvière, and Roland G. Demaria
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Heart Ventricles, medicine.medical_treatment, Implantable defibrillator, Ventricular tachycardia, Cryosurgery, Sudden death, Intraoperative Period, Postoperative Complications, Internal medicine, medicine, Humans, Myocardial infarction, Heart Aneurysm, Aged, Retrospective Studies, Ejection fraction, business.industry, Cryoablation, General Medicine, Middle Aged, medicine.disease, Ventricular aneurysm, Surgery, Treatment Outcome, Left Ventricular Aneurysm, Tachycardia, Ventricular, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Intraoperative map-guided procedures have been widely advocated as the best surgical strategy for the treatment of ventricular tachycardia (VT), though favorable results have been reported with subendocardial resection without mapping. This study examined the very long-term results of encircling cryoablation without mapping during surgery for anterior left ventricular aneurysm complicated by VT. Between 1985 and 2003, this procedure was performed in 52 patients, 7 of whom (13.7%) were operated within 1 month of anterior myocardial infarction. Their mean age was 64.4 +/- 8.3 years and mean left ventricular ejection fraction was 31.7%+/- 9.5%. The overall hospital mortality was 1.9%. At 14 years, 86% of patients (95% CI: 75.4-96.6) were free from VT or sudden death. An implantable defibrillator was implanted in five patients (9.6%) during follow-up. The 14-year overall survival was 51.4% (95% CI: 33.8-72.4), and two patients (3.8%) underwent cardiac transplantation during follow-up. The main cause of late death was congestive heart failure in eight patients (40.0%). Favorable long-term results can be achieved with encircling cryoablation without mapping in patients undergoing surgery for anterior left ventricular aneurysm complicated by VT.
Published: 2005
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27. Late results of double-valve replacement with biologic or mechanical prostheses

Author: Annick Mouly-Bandini, Philippe Rouvière, Thierry Caus, Thierry G. Mesana, Jean-Raoul Monties, and Frederic Collart
Subjects: Male, Reoperation, Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, medicine.medical_treatment, Prosthesis Design, Prosthesis, Postoperative Complications, Valve replacement, Mitral valve, medicine, Humans, Aged, Bioprosthesis, business.industry, Mortality rate, Incidence (epidemiology), Middle Aged, Survival Analysis, Surgery, Equipment Failure Analysis, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, Complication, business, Double valve replacement, Follow-Up Studies
Abstract: Background . We previously showed that the risk of reoperation for structural degeneration of bioprostheses was higher in cases involving patients older than 65 years ( p = 0.003) and double-valve replacement ( p = 0.02). The purpose of this study was to compare late outcome of mitral-aortic valve replacement using bioprostheses or mechanical valves. Methods . The bioprosthesis group included all mainland France residents (n = 48) between 55 and 65 years old operated on between 1980 and 1995 for mitral-aortic valve replacement using bioprostheses. The mechanical valve group was obtained by matching each of these patients with a patient operated on using mechanical valves at approximately the same time during the study. Results . In the bioprosthesis group, 10-year survival was 45% ± 8% versus 62% ± 7% in the mechanical valve group (not significant). The linearized reoperation rate was 6.8 per patient-year versus 1.1 per patient-year ( p = 0.001), and the linearized reoperative mortality rate was 1.8 per patient-year and 0.7 per patient-year (not significant), respectively. Conclusions . The reoperative mortality risk after mitral-aortic valve replacement using two bioprostheses does not significantly decrease overall survival after age 65 years.
Published: 2001
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28. Impact of learning curve on outcome of left ventricular assist device (LVAD) implantation in a monocentric cohort

Author: Jacob Eliet, Marc Mourad, Norddine Zeroual, Philippe Rouvière, Pascal Colson, Philippe Gaudard, and Remy Coves
Subjects: medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Internal medicine, Ventricular assist device, medicine.medical_treatment, Cohort, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Outcome (game theory), Surgery
Published: 2016
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29. Cryosurgery for Ventricular Tachycardia

Author: Roland G. Demaria, Philippe Rouvière, Mirdavron Mukaddirov, Bernard Albat, Guillaume Maxant, and Jean-Marc Frapier
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Internal medicine, medicine, Cardiology, Ventricular tachycardia, medicine.disease, business, Cryosurgery
Published: 2011
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30. Pericardial exploration by pericardioscopy during a surgical sub xyphoid approach

Author: Roland G, Demaria, Marco, Piciché, Pascal, Battistella, Philippe, Rouvière, Jean-Marc, Frapier, and Bernard, Albat
Subjects: Sternum, Treatment Outcome, Thoracotomy, Feasibility Studies, Humans, Endoscopy, Pericardiocentesis, Pericardial Effusion
Abstract: This clinical feasibility study was planned to evaluate pericardioscopy as a means of control of the pericardial cavity during drainage for pericardial effusion by a surgical sub xyphoid approach. Seventeen patients who underwent an operation for surgical drainage of the pericardium (11 medical and 6 postoperative pericardial effusions) benefited from a pericardial exploration with a mediastinoscope or rigid thoracoscope (Karl Storz, Germany). In 7 of the 11 medical cases, a severe inflammation of the pericardium associated with false membranes was visualized; in 3 cases, the pericardium was considered as normal; and in 1 case, pericardial metastases were visualized. In the 6 postoperative cases, clots were visualized with a venous bypass graft and the pulmonary cannula of a right ventricular assist device (Thoratec, USA) was also perfectly controlled. The cause of bleeding was reported in one case and suspected in another, but required total sternotomy for repair in both cases. No mortality or morbidity was reported to be directly due to the technique. The peroperative assessment of pericardial cavity is possible by use of pericardioscopy with a satisfactory resolution, but visualization of the left lateral part of the heart remains difficult. The possibility exists to partially remove clots and false membranes, obtain various samples, and control the position of the drains. Improvement in the optic device with the possibility of a flexible device that has a tip protector for optimal visualization, may improve both the technique and results.
Published: 2006

31. Internal thoracic arterial grafts evaluation by multislice CT scan: a preliminary study

Author: Jean-Marc Frapier, Marco Picichè, Pascal Battistella, Roland G. Demaria, Philippe Rouvière, H. Vernhet, and Bernard Albat
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Internal thoracic artery, Anastomosis, Severity of Illness Index, Imaging, Three-Dimensional, medicine.artery, medicine, Vascular Patency, Humans, Multislice ct, Saphenous Vein, Prospective Studies, Coronary Artery Bypass, Mammary Arteries, business.industry, Anastomosis, Surgical, Coronary Stenosis, Arterial grafts, medicine.anatomical_structure, Treatment Outcome, Light speed, Surgery, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Surgical Clips, Artery
Abstract: Background and aim The internal thoracic artery (ITA) has a better long-term patency than saphenous veins, and anastomosis between ITA and the left anterior descending artery (LAD) represents the "gold-standard" of surgical myocardial revascularization. The aim of this study is to evaluate the multidetector multislice CT Scan (MCTS) as a means of postoperative evaluation of ITA coronary artery bypass grafts. Methods Twenty-eight patients having been operated on for coronary artery bypass with ITA during a 6-months period, benefited, 7 days after surgery, from a patency and anastomotic site control of ITA with a MCTS associated with cardiac gating (Light Speed, General Electric, USA). Results Internal thoracic artery bypasses are visualized perfectly on all their courses, with possibility of 3D reconstructions, showing the relationship between cardiac cavities and the arterial bypasses. The anastomotic site on the LAD was, in selected cases, perfectly visualized. Sequential bypasses with left ITA are well visualized as well as T or Y right-to-left ITA grafts. However, surgical clips create some image artefacts. Conclusions The postoperative control of ITAs are possible by MCTS with a satisfactory resolution. This makes it possible to check the patency of ITAs, their course on the heart surface, and the location and quality of anastomosis with a noninvasive reproductive method.
Published: 2004

32. Off-Pump Coronary Artery Bypass Grafts Assessment by Multislice Computed Tomography

Author: Roland G., Demaria, Helene, Vernhet, Pascal, Battistella, Jean-Marc, Frapier, Philippe, Rouvière, and Bernard, Albat
Abstract: Background: Selective coronary angiography is the standard but invasive procedure for postoperative assessment of coronary artery bypass graft patency. The aim of this prospective study is to evaluate the multislice computed tomography (CT) as a means of postoperative patency assessment and anastomotic site control of arterial and venous coronary bypass grafts performed with off-pump coronary artery bypass techniques. Methods: Over a 6-month period, 20 patients underwent isolated coronary artery bypass (beating heart technique) and benefited, 7 days later, from a patency and anastomotic site control by multidetector angio multislice CT with cardiac gating. Results: Whole internal thoracic artery bypasses and venous grafts were visualized perfectly on their entire length, including the anastomotic site, and 3-dimensional reconstruction was possible. The relationship between cardiac cavities and the bypasses were well visualized, allowing quantification of bypass stenosis ensured by software analysis. Conclusions: Postoperative control of coronary bypasses is possible by multislice CT with a very satisfactory resolution, thus making it possible to check the patency of coronary bypasses and the quality of anastomosis with a noninvasive method. Three-dimensional reconstructions are very useful in the event of redo surgery.
Published: 2004

33. 0403: One-year survival among patients supported with a ventricular assist device: results of the hospital of Montpellier about 29 implantations

Author: Philippe Gaudart, Nordine Zeroual, Marc Mourad, Philippe Rouvière, François Roubille, and Pascal Battistella
Subjects: Mechanical ventilation, Inotrope, medicine.medical_specialty, business.industry, medicine.medical_treatment, Levosimendan, medicine.disease, Transplantation, Ventricular assist device, Internal medicine, Heart failure, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Impella, Destination therapy, medicine.drug
Abstract: Ventricular assist devices (VADs) are used to bridge the patient with end-stage heart failure to cardiac transplantation (BTT) or to destination therapy (DT). Since 2003 in the Montpellier’s hospital, 29 VADs have been implanted (8 to DT). In the majority of cases, the VAD was used in acute end-stage of heart failure; one-year mortality was 45%. Unlike inotropic agents, levosimendan, a new calcium senziter, enhances myocardial contractility without increasing myocardial oxygen consumption. 15 out of 29 patients were on the Intermacs classification level 1, on a scale of 1 to 7, 9 received levosimendan and 6 did not. 9 of 29 patients were undergoing to levosimendan infusion to prevent right ventricular failure; 5 were under mechanical ventilation and 5 under Extra-corporal membran oxygenation (ECMO) or trans-aortic left ventricular discharge by Impella 5.0 (Abiomed) before LVAD. 7 out of 29 patients (77.8%) were alive one year later, among who one died from cancer. 2 patients were under ECMO after LVAD. In contrast, only 6 patients out of 29 patients (20,7%) without levosimendan are alive after one year. Multivariate analysis demonstrated a significant independant effect of levosimendan infusion on one year mortality in this retrospective study.
Published: 2015
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34. Influence of patient-prosthesis mismatch on long-term results after aortic valve replacement with a stented bioprosthesis

Author: Jean M, Frapier, Philippe, Rouvière, Franck, Razcka, Thierry, Aymard, Bernard, Albat, and Paul A, Chaptal
Subjects: Adult, Aged, 80 and over, Bioprosthesis, Male, Time Factors, Heart Valve Diseases, Middle Aged, Prosthesis Design, Survival Analysis, Statistics, Nonparametric, Prosthesis Failure, Postoperative Complications, Treatment Outcome, Risk Factors, Aortic Valve, Cause of Death, Heart Valve Prosthesis, Heart Function Tests, Multivariate Analysis, Humans, Female, Stents, Aged, Follow-Up Studies, Proportional Hazards Models
Abstract: The study aim was to compare long-term results of bioprostheses implanted in the aortic position, with and without patient-prosthesis mismatch (defined as effective orifice area (EOA)/body surface area (BSA)or =0.85 cm2/m2).Between 1986 and 1990, 90 consecutive patients (mean age 72.6 years; mean BSA 1.77+/-0.2 m2) each received an aortic Medtronic Intact valve (19 mm, n = 35; 21 mm, n = 29;23 mm, n = 26). Of these patients, 64 had a patient-prosthesis mismatch, and 26 had no mismatch. Median follow up was 7.3 years.At 10 years postoperatively, there was no significant inter-group difference in actuarial freedom from thromboembolism (90.7% in mismatch group, 79.6% in no-mismatch group; p = 0.16), hemorrhage (86% versus 83.3%; p = 0.59), endocarditis (98.2% versus 86.7%; p = 0.1), structural valve deterioration (97% versus 100%; p = 0.57) and reoperation (96.4% versus 94.8%; p = 0.2). At the same time, overall actuarial survival was 42.1+/-6.5% in the mismatch group and 22.6+/-8.6% in the no-mismatch group (p = 0.08). By multivariate analysis, the main risk factor for late death was a preoperative left ventricular ejection fraction (LVEF)50% (p = 0.001). Freedom from cardiac death was 70+/-6% and 35.7+/-11% in the mismatch and no-mismatch groups respectively (p = 0.005), but this was not significantly different when LVEFs were paired (LVEF50% p = 0.33, LVEF50% p = 0.28). The NYHA functional status of survivors showed 94.4% of the mismatch group and 100% of the no-mismatch group to be in NYHA classes I and II (p = 1).Within this patient population it was not possible to demonstrate any negative effects of patient-prosthesis mismatch at 10 years after Intact aortic valve replacement; the LVEF was the only predictor for late death.
Published: 2002

35. Management of descending necrotizing mediastinitis: an aggressive treatment for an aggressive disease

Author: Henri Mary, Pierre Alric, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Jean-Dominique Pegis, and Philippe Rouvière
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Sepsis, Necrosis, medicine, Humans, Thoracotomy, Drainage, Abscess, Aged, business.industry, Mortality rate, Mediastinum, Decortication, Middle Aged, medicine.disease, Mediastinitis, Surgery, medicine.anatomical_structure, Acute Disease, Female, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract: Background . Descending necrotizing mediastinitis represent a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high mortality associated with this disease. Surgical management and a particularly optimal form of mediastinal drainage remain controversial. Methods . Over a 10-year period, 12 patients were treated at our institution. Surgical treatment consisted of 1 or several cervical drainages, associated with drainage of the mediastinum through a thoracic approach in 11 patients. Thoracic procedures included radical surgical debridement of the mediastinum with complete excision of the tissue necrosis, decortication, and pleural drainage with adequate placement of chest tubes for mediastino-pleural irrigation. Transcervical mediastinal drainage was performed in only 1 patient. Results . The outcome was favorable in 10 patients, 9 of whom had mediastinal drainage through thoracotomy. Two patients were initially drained through a minor thoracic approach; the first died of tracheal fistula and the second required new drainage through a thoracotomy. The patient who had transcervical mediastinal drainage without a thoracic approach presented an abscess limited to the anterior and superior mediastinum. In 3 patients, ongoing mediastinal sepsis required a second thoracotomy. Conclusion . A stepwise approach with transcervical mediastinal drainage is first justified in patients with very limited disease to the upper mediastinum. However, ongoing mediastinal sepsis requires new drainage, through a major thoracic approach, without delay. Extensive mediastinitis can not be adequately treated without mediastinal drainage including a thoracotomy. This aggressive surgical policy has allowed us to maintain a low mortality rate (16.5%) in a series of 12 patients with this highly lethal disease.
Published: 1999

36. Anatomical findings after amplatzer occluder to treat aortic regurgitation on left ventricular assist device patient

Author: J. Eliet, R. Demaria, Catherine Sportouch, Pascal Battistella, Christophe Piot, P. Gaudard, A. Agullo, Philippe Rouvière, Bernard Albat, and J.M. Frapier
Subjects: Aortic valve, Aorta, medicine.medical_specialty, business.industry, medicine.medical_treatment, Regurgitation (circulation), Haemolysis, Surgery, Transplantation, medicine.anatomical_structure, Ventricular assist device, medicine.artery, Internal medicine, Mitral valve, cardiovascular system, Ventricular pressure, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business
Abstract: A 57-years-old woman, with HeartMate II left ventricular assist device (LVAD) as a bridge to transplant for a coronary arteries disease presented 6 months after implantation with severe haemolysis, new-onset aortic insufficiency (AI) and pulmonary oedema. On the transoesophageal echocardiography (TEE,) the aortic valve showed increased thickening, valve leaflet fusion without opening and moderate to severe central regurgitation. Despite diffuse arteriopathy, a 25-mm Amplatzer "Cribiform" septal occlude was delivered across the aortic valve via a percutaneously placed 9-F TorqVue catheter. With TEE guidance, the device was positioned across the valve, resulting in decreased AI without mitral obstruction. A transthoracic echocardiography performed two weeks later demonstrated decreased end diastolic left ventricular diameter and disappearance of aortic regurgitation. The haemolysis ceased and clinical status improved. 4 months later, the patient again developed severe haemolysis leading to global heart failure without AI. Thrombosis in the device was suspected and emergency cardiac transplantation was undertaken. During the procedure, after cardiectomy, the aortic valve was checked (figure) and found totally closed and watertight when submitted to the water test; the aortic leaflets disappeared under layers of fibrosis. The Amplatzer was complety endothelialized on both the aortic and the ventricular side without thrombus apposition or obstruction of ostial coronary arteries. The left ventricular output chamber was free without anomaly of mitral valve motion. Trans-catheter closure of the native aortic valve with an Amplatzer occluder can offer an easy way to treat new-onset severe AI on LVAD patients. ![Figure][1] Figure 1. Amplatzer on aortic valve [1]: pending:yes
Published: 2013
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37. Idarucizumab (Praxbind®) for dabigatran reversal in patients undergoing heart transplantation: a cohort of ten patients

Author: Eran Kalmanovich, Pascal Battistella, Philippe Rouviere, Bernard Albat, Jean-Marc Frapier, Roland Demaria, Fabien Huet, Audrey Agullo, Marc Mourad, Pascal Colson, Florence Leclercq, Philippe Gaudard, and François Roubille
Subjects: direct oral anticoagulant (DOAC) dabigatran, heart transplantation, idarucizumab, Medicine, Medicine (General), R5-920
Abstract: Background: Novel oral anticoagulants are used in atrial fibrillation. Idarucizumab has been approved for reversal of dabigatran in situations of life-threatening hemorrhage or emergency surgery. Objectives: We report a single center experience of ten patients on dabigatran therapy who were given idarucizumab prior to heart transplantation. Methods & results: The mean plasma concentration of dabigatran prior to reversal was 139 ± 89 ng/ml. Hemoglobin, hematocrit and platelet levels were decreased after surgery. Surgical procedures were successfully performed with no increased risk, especially regarding bleeding complications. All patients were alive after 90 days. Conclusion: Dabigatran reversal with idarucizumab in contexts of emergency surgery/urgent procedures is an attractive and safe option to be taken into consideration for patients with end stage heart disease awaiting transplantation and indication of anticoagulant therapy.
Published: 2021
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38. Ruptured right Valsalva sinus into the right atrium due to infective endocarditis: a case report

Author: Ayoub Abetti, Thomas Gandet, Abdul Aziz Al Amri, Marouane Ouazzani Ibrahimi, Philippe Rouviere, Alexandra Meilhac, Audrey Agullo, Roland Demaria, Jean Marc Frapier, and Bernard Albat
Subjects: rupture, right valsalva sinus, valsalva sinus aneurysm, infective endocarditis, Medicine
Abstract: Rupture of Valsalva sinus remains a very rare and deadly complication of Valsalva sinus aneurysm with a high mortality rate. We report here the case of a 47-year-old man who presented to the emergency department with acute exercise-induced dyspnea, chest pain, and fever. Transthoracic (TTE) and transesophageal echocardiography (TEE) highlighted a rupture of the right Valsalva sinus in the right atrium due to infective endocarditis. After stabilization of the patient, a successful surgical repair with double pericardial patches was performed.
Published: 2020
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39. 1048-138 Edge-to-edge mitral repair seems to induce functional restriction

Author: Jean-Marc Davy, Philippe Rouvière, Jean-Marc Frapier, Bernard Albat, Franck Raczka, Valerie Rauzy, and Catherine Sportouch
Subjects: business.industry, Medicine, Anatomy, ComputingMethodologies_GENERAL, Edge (geometry), business, Cardiology and Cardiovascular Medicine
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