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1. Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study

Author

Nesseler, Nicolas, Mansour, Alexandre, Schmidt, Matthieu, Para, Marylou, Porto, Alizée, Falcoz, Pierre-Emmanuel, Mongardon, Nicolas, Fougerou, Claire, Ross, James T., Beurton, Antoine, Gaide-Chevronnay, Lucie, Guinot, Pierre-Grégoire, Lebreton, Guillaume, Flecher, Erwan, Vincentelli, André, and Massart, Nicolas

Published
2024
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2. Right Ventriculoarterial Coupling Surrogates and Long-Term Survival in LVAD Recipients: Results of the ASSIST-ICD Multicentric Registry

Author

BENEYTO, MAXIME, MARTINS, RAPHAËL, GALAND, VINCENT, KINDO, MICHEL, SCHNEIDER, CLÉMENT, SEBESTYEN, ALEXANDRE, BOIGNARD, AUDE, SEBBAG, LAURENT, POZZI, MATTEO, GENET, THIBAUD, BOURGUIGNON, THIERRY, MARTIN, ANNE-CÉLINE, ACHOUH, PAUL, VANHUYSE, FABRICE, BLANG, HUGUES, DAVID, CHARLES HENRI, MICHEL, MAGALI, ANSELME, FRÉDÉRIC, LITZLER, PIERRE-YVES, JUNGLING, MARIE, VINCENTELLI, ANDRÉ, ESCHALIER, ROMAIN, D'OSTREVY, NICOLAS, NATAF, PATRICK, PARA, MARYLOU, GARNIER, FABIEN, RAJINTHAN, PRIYANKA, PORTERIE, JEAN, FAURE, MAXIME, PICARD, FRANÇOIS, GAUDARD, PHILIPPE, ROUVIÈRE, PHILIPPE, BABATASI, GÉRARD, BLANCHART, KATRIEN, GARIBOLDI, VLAD, PORTO, ALIZÉE, FLECHER, ERWAN, and DELMAS, CLEMENT

Published
2025
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7. Right ventriculoarterial coupling surrogates and long-term survival in LVAD recipients: Results of the ASSIST-ICD multicentric registry

Author

Beneyto, Maxime, primary, Martins, Raphaël, additional, Galand, Vincent, additional, Kindo, Michel, additional, Schneider, Clément, additional, Sebestyen, Alexandre, additional, Boignard, Aude, additional, Sebbag, Laurent, additional, Pozzi, Matteo, additional, Genet, Thibaud, additional, Bourguignon, Thierry, additional, Martin, Anne-Céline, additional, Achouh, Paul, additional, Vanhuyse, Fabrice, additional, Blangy, Hugues, additional, Henri, Charles, additional, Michel, Magali, additional, Anselme, Frédéric, additional, Litzler, Pierre-Yves, additional, Jungling, Marie, additional, Vincentelli, André, additional, Eschalier, Romain, additional, D'ostrevy, Nicolas, additional, Nataf, Patrick, additional, Para, Marylou, additional, Garnier, Fabien, additional, Rajinthan, Priyanka, additional, Porterie, Jean, additional, Faure, Maxime, additional, Picard, François, additional, Gaudard, Philippe, additional, Rouvière, Philippe, additional, BABATASI, Gérard, additional, BLANCHART, Katrien, additional, GARIBOLDI, Vlad, additional, Porto, Alizée, additional, Flecher, Erwan, additional, and Delmas, Clement, additional

Published
2024
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11. Resuscitation and Forensic Factors Influencing Outcome in Penetrating Cardiac Injury.

Author

Aumaitre, Astrid, Delteil, Clémence, Tuchtan, Lucile, Piercecchi-Marti, Marie-Dominique, Gainnier, Marc, Carvelli, Julien, Boussen, Salah, Bruder, Nicolas, Heireche, Fouzia, Florant, Thibault, Gaillat, Françoise, Lagier, David, Porto, Alizée, Velly, Lionel, and Simeone, Pierre

Subjects
HEART injuries, MORTALITY risk factors, PENETRATING wounds, INTENSIVE care units, EMERGENCY medicine
Abstract

Background: Cardiac injury caused by a sharp object is a medical and surgical therapeutic challenge. Mortality risk factors have been identified but there are major discrepancies in the literature. The aim of this study was to analyse the management of victims of penetrating cardiac injuries before and after admission to hospital and the anatomical characteristics of these injuries in order to facilitate diagnosis of the most critical patients. Methods: To carry out this study, we conducted a retrospective analytical study with epidemiological data on victims of penetrating cardiac injuries. We included two types of patients, with those who underwent autopsy in our institution after death from sharp injury to the heart or great vessels and those who survived with treatment in the emergency department or intensive care unit between January 2015 and February 2022. Results: We included 30 autopsied patients and 12 survivors aged between 18 and 73 years. Higher mortality was associated with prehospital or in-hospital cardiorespiratory arrest (OR = 4, CI [1.71–9.35]), preoperative mechanical ventilation (OR = 10, CI [1.53–65.41]), preoperative catecholamines (OR = 7, CI [1.12–6.29]), preoperative and perioperative adrenaline (OR = 13, CI [1.98–85.46] and [1.98–85.46]), penetrating cardiac injury (OR = 14, CI [2.10–93.22]), multiple cardiac injuries (OR = 1.5, CI [1.05–2.22]) and an Organ Injury Scaling of the American Association for the Surgery of Trauma (AAST-OIS) score of 5 (OR = 2.9, CI [1.04–8.54]; p = 0.0329) with an AUC-ROC curve value of 0.708 (CI [0.543–0.841]). Conclusions: This study identified risk mortality factors in penetrating cardiac injury patients. These findings can help improve the diagnosis and management of these patients. The AAST-OIS score may be a good tool to diagnose critical patients. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Impact of Prone Position in COVID-19 Patients on Extracorporeal Membrane Oxygenation*

Author

Massart, Nicolas, Guervilly, Christophe, Mansour, Alexandre, Porto, Alizée, Flécher, Erwan, Esvan, Maxime, Fougerou, Claire, Fillâtre, Pierre, Duburcq, Thibault, Lebreton, Guillaume, Para, Marylou, Stephan, François, Hraiech, Sami, Ross, James, Schmidt, Matthieu, Vincentelli, André, Nesseler, Nicolas, CHU Pontchaillou [Rennes], Hôpital Yves LE FOLL [Saint-Brieuc], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Hôpital Nord [CHU - APHM], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), 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 Lille, Université de Lille, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Marie-Lannelongue, University of California [Davis] (UC Davis), University of California (UC), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome Coronavirus 2 (ECMOSARS) Investigators: Olivier Fouquet, Marc Pierrot, Sidney Chocron, Guillaume Flicoteaux, Philippe Mauriat, Hadrien Roze, Alexandre Ouattara, Olivier Huet, Marc-Olivier Fischer, Claire Alessandri, Raphel Bellaïche, Ophélie Constant, Quentin De Roux, André Ly, Arnaud Meffert, Jean-Claude Merle, Lucile Picard, Elena Skripkina, Thierry Folliguet, Nicolas Mongardon, Antonio Fiore, Nicolas D'ostrevy, Marie-Catherine Morgan, Maxime Nguyen, Pierre-Grégoire Guinot, Lucie Gaide-Chevronnay, Nicolas Terzi, Gwenhaël Colin, Olivier Fabre, Arash Astaneh, Justin Issard, Elie Fadel, Dominique Fabre, Antoine Girault, Iolande Ion, Jean Baptiste Menager, Delphine Mitilian, Julien Guihaire, Olaf Mercier, Jacques Thes, Jerôme Jouan, Thibault Duburcq, Valentin Loobuyck, Sabrina Manganiello, Mouhammed Moussa, Agnes Mugnier, Natacha Rousse, Olivier Desebbe, Roland Henaine, Matteo Pozzi, Jean-Luc Fellahi, Jean-Christophe Richard, Zakaria Riad, Laurent Papazian, Matthias Castanier, Charles Chanavaz, Cyril Cadoz, Sebastien Gette, Guillaume Louis, Erick Portocarrero, Philippe Gaudard, Kais Brini, Nicolas Bischoff, Antoine Kimmoun, Bruno Levy, Mathieu Mattei, Pierre Perez, Alexandre Bourdiol, Yannick Hourmant, Pierre-Joachim Mahé, Bertrand Rozec, Mickaël Vourc'h, Stéphane Aubert, Florian Bazalgette, Claire Roger, Sophie Provenchere, Pierre Jaquet, Brice Lortat-Jacob, Pierre Mordant, Patrick Nataf, Juliette Patrier, Morgan Roué, Romain Sonneville, Alexy Tran-Dinh, Paul-Henri Wicky, Charles Al Zreibi, Bernard Cholley, Yannis Guyonvarch, Sophie Hamada, Claudio Barbanti, Anatole Harrois, Astrid Bertier, Jordi Matiello, Thomas Kerforne, Corentin Lacroix, Nicolas Brechot, Juliette Chommeloux, Alain Combes, Jean Michel Constantin, Cosimo D'alessandro, Pierre Demondion, Alexandre Demoule, Martin Dres, Muriel Fartoukh, Guillaume Hekimian, Charles Juvin, Pascal Leprince, Guillaume Fadel, David Levy, Charles Edouard Luyt, Marc Pineton de Chambrun, Thibaut Schoell, Roxane Nicolas, Maud Jonas, Charles Vidal, Nicolas Allou, Salvatore Muccio, Dario Di Perna, Bruno Mourvillier, Vito-Giovanni Ruggieri, Amedeo Anselmi, Karl Bounader, Yoann Launey, Thomas Lebouvier, Alessandro Parasido, Florian Reizine, Philippe Seguin, Emmanuel Besnier, Dorothée Carpentier, Thomas Clavier, Anne Olland, Pierre-Emmanuel Falcoz, Marion Villard, Fanny Bounes, François Labaste, Vincent Minville, Antoine Guillon, Yannick Fedun, and MORNET, Dominique

Subjects
[SDV] Life Sciences [q-bio], critical care, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV]Life Sciences [q-bio], prone position, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, acute respiratory distress syndrome, extracorporeal membrane oxygenation, mechanical ventilation, Critical Care and Intensive Care Medicine, mortality
Abstract

International audience; Objectives: Prone positioning and venovenous extracorporeal membrane oxygenation (ECMO) are both useful interventions in acute respiratory distress syndrome (ARDS). Combining the two therapies is feasible and safe, but the effectiveness is not known. Our objective was to evaluate the potential survival benefit of prone positioning in venovenous ECMO patients cannulated for COVID-19-related ARDS.Design: Retrospective analysis of a multicenter cohort.Patients: Patients on venovenous ECMO who tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcriptase polymerase chain reaction or with a diagnosis on chest CT were eligible.Interventions: None.Measurements and main results: All patients on venovenous ECMO for respiratory failure in whom prone position status while on ECMO and in-hospital mortality were known were included. Of 647 patients in 41 centers, 517 were included. Median age was 55 (47-61), 78% were male and 95% were proned before cannulation. After cannulation, 364 patients (70%) were proned and 153 (30%) remained in the supine position for the whole ECMO run. There were 194 (53%) and 92 (60%) deaths in the prone and the supine groups, respectively. Prone position on ECMO was independently associated with lower in-hospital mortality (odds ratio = 0.49 [0.29-0.84]; p = 0.010). In 153 propensity score-matched pairs, mortality rate was 49.7% in the prone position group versus 60.1% in the supine position group (p = 0.085). Considering only patients alive at decannulation, propensity-matched proned patients had a significantly lower mortality rate (22.4% vs 37.8%; p = 0.029) than nonproned patients.Conclusions: Prone position may be beneficial in patients supported by venovenous ECMO for COVID-19-related ARDS but more data are needed to draw definitive conclusions.

Published
2022
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15. Reintervention of Residual Aortic Dissection after Type A Aortic Repair: Results of a Prospective Follow-Up at 5 Years

Author

Porto, Alizée, primary, Omnes, Virgile, additional, Bartoli, Michel A., additional, Azogui, Ron, additional, Resseguier, Noémie, additional, De Masi, Mariangela, additional, Bal, Laurence, additional, Imbert, Laura, additional, Jaussaud, Nicolas, additional, Morera, Pierre, additional, Jacquier, Alexis, additional, Barral, Pierre-Antoine, additional, Gariboldi, Vlad, additional, and Gaudry, Marine, additional

Published
2023
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16. Feasibility of Non-Invasive Coronary Artery Disease Screening with Coronary CT Angiography before Transcatheter Aortic Valve Implantation

Author

Boyer, Jérémy, primary, Bartoli, Axel, additional, Deharo, Pierre, additional, Vaillier, Antoine, additional, Ferrara, Jérôme, additional, Barral, Pierre-Antoine, additional, Jaussaud, Nicolas, additional, Morera, Pierre, additional, Porto, Alizée, additional, Collart, Frédéric, additional, Jacquier, Alexis, additional, and Cuisset, Thomas, additional

Published
2023
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17. Prognostic value of forward flow indices in primary mitral regurgitation due to mitral valve prolapse

Author

Petolat, Elisabeth, Theron, Alexis, Resseguier, Noemie, Fabre, Cyprien, Norscini, Giulia, Badaoui, Rita, Habib, Gilbert, Collart, Frederic, Zaffran, Stéphane, Porto, Alizée, Avierinos, Jean-François, Hôpital de la Timone [CHU - APHM] (TIMONE), Aix Marseille Université (AMU), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Cardiologie [Hôpital de la Timone - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)

Subjects
left ventricular dysfunction, mitral repair surgery, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, stroke volume, mitral regurgitation, mitral valve prolapse, Cardiology and Cardiovascular Medicine
Abstract

BackgroundDegenerative mitral regurgitation (DMR) due to mitral valve prolapse (MVP) is a common valve disease associated with significant morbidity and mortality. Timing for surgery is debated for asymptomatic patients without Class I indication, prompting the search for novel parameters of early left ventricular (LV) systolic dysfunction.AimsTo evaluate the prognostic impact of preoperative forward flow indices on the occurrence of post-operative LV systolic dysfunction.MethodsWe retrospectively included all consecutive patients with severe DMR due to MVP who underwent mitral valve repair between 2014 and 2019. LVOTTVI, forward stroke volume index, and forward LVEF were assessed as potential risk factors for LVEF ResultsA total of 198 patients were included: 154 patients (78%) were asymptomatic, and 46 patients (23%) had hypertension. The mean preoperative LVEF was 69 ± 9%. 35 patients (18%) had LVEF ≤ 60%, and 61 patients (31%) had LVESD ≥40 mm. The mean post-operative LVEF was 59 ± 9%, and 21 patients (11%) had post-operative LVEFTVI was the strongest independent predictor of post-operative LV dysfunction after adjustment for age, sex, symptoms, LVEF, LV end systolic diameter, atrial fibrillation and left atrial volume index (0.75 [0.62–0.91], p < 0.01). The best sensitivity (81%) and specificity (63%) was obtained with LVOTTVI ≤15 cm based on ROC curve analysis.ConclusionLVOTTVI represents an independent marker of myocardial performance impairment in the presence of severe DMR. LVOTTVI could be an earlier marker than traditional echo parameters and aids in the optimization of the timing of surgery.

Published
2023
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18. Veno-Arterial Extracorporeal Membrane Oxygenation for Circulatory Failure in COVID-19 Patients: Insights from the ECMOSARS Registry

Author

Anselmi, Amedeo, Mansour, Alexandre, Para, Marylou, Mongardon, Nicolas, Porto, Alizée, Guihaire, Julien, Morgant, Marie-Catherine, Pozzi, Matteo, Cholley, Bernard, Falcoz, Pierre-Emmanuel, Gaudard, Philippe, Lebreton, Guillaume, Labaste, François, Barbanti, Claudio, Fouquet, Olivier, Chocron, Sidney, Mottard, Nicolas, Esvan, Maxime, Fougerou-Leurent, Claire, Flecher, Erwan, Vincentelli, André, Nesseler, Nicolas, Pierrot, Marc, Flicoteaux, Guillaume, Mauriat, Philippe, Ouattara, Alexandre, Roze, Hadrien, Huet, Olivier, Fischer, Marc-Olivier, Alessandri, Claire, Bellaïche, Raphel, Constant, Ophélie, Roux, Quentin, Ly, André, Meffert, Arnaud, Merle, Jean-Claude, Picard, Lucile, Skripkina, Elena, Folliguet, Thierry, Fiore, Antonio, d'Ostrevy, Nicolas, Morgan, Marie-Catherine, Guinot, Pierre-Grégoire, Nguyen, Maxime, Gaide-Chevronnay, Lucie, Terzi, Nicolas, Colin, Gwenhaël, Fabre, Olivier, Astaneh, Arash, Issard, Justin, Fadel, Elie, Fabre, Dominique, Girault, Antoine, Ion, Iolande, Menager, Jean Baptiste, Mitilian, Delphine, Mercier, Olaf, Stephan, François, Thes, Jacques, Jouan, Jerôme, Duburcq, Thibault, Loobuyck, Valentin, Moussa, Mouhammed, Mugnier, Agnes, Rousse, Natacha, Manganiello, Sabrina, Desebbe, Olivier, Fellahi, Jean-Luc, Henaine, Roland, Richard, Jean-Christophe, Riad, Zakaria, Guervilly, Christophe, Hraiech, Sami, Papazian, Laurent, Castanier, Matthias, Chanavaz, Charles, Cadoz, Cyril, Gette, Sebastien, Louis, Guillaume, Portocarrero, Erick, Brini, Kais, Bischoff, Nicolas, Levy, Bruno, Kimmoun, Antoine, Mattei, Mathieu, Perez, Pierre, Bourdiol, Alexandre, Hourmant, Yannick, Mahé, Pierre-Joachim, Rozec, Bertrand, Vourc’h, Mickaël, Aubert, Stéphane, Bazalgette, Florian, Roger, Claire, Jaquet, Pierre, Lortat-Jacob, Brice, Mordant, Pierre, Nataf, Patrick, Patrier, Juliette, Provenchere, Sophie, Roué, Morgan, Sonneville, Romain, Tran-Dinh, Alexy, Wicky, Paul-Henri, Al Zreibi, Charles, Guyonvarch, Yannis, Hamada, Sophie, Bertier, Astrid, Harrois, Anatole, Matiello, Jordi, Kerforne, Thomas, Lacroix, Corentin, Brechot, Nicolas, Combes, Alain, Schmidt, Matthieu, Chommeloux, Juliette, Constantin, Jean Michel, D’alessandro, Cosimo, Demondion, Pierre, Demoule, Alexandre, Dres, Martin, Fadel, Guillaume, Fartoukh, Muriel, Hekimian, Guillaume, Juvin, Charles, Leprince, Pascal, Levy, David, Luyt, Charles Edouard, Pineton de Chambrun, Marc, Schoell, Thibaut, Fillâtre, Pierre, Massart, Nicolas, Nicolas, Roxane, Jonas, Maud, Vidal, Charles, Allou, Nicolas, Muccio, Salvatore, Di Perna, Dario, Ruggieri, Vito-Giovanni, Mourvillier, Bruno, Bounader, Karl, Launey, Yoann, Lebouvier, Thomas, Parasido, Alessandro, Reizine, Florian, Seguin, Philippe, Besnier, Emmanuel, Carpentier, Dorothée, Clavier, Thomas, Olland, Anne, Villard, Marion, Bounes, Fanny, Minville, Vincent, Guillon, Antoine, Fedun, Yannick, Ross, James, 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], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), IMRB - PROTECT/'Pharmacologie et Technologies pour les Maladies Cardiovasculaires' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay, Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), 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), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Franco-czech Laboratory for clinical research on obesity, Charles University [Prague] (CU)-Institut National de la Santé et de la Recherche Médicale (INSERM), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Nutrition, Métabolismes et Cancer (NuMeCan), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Heart Failure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, VA-ECMO, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Outcomes, Covid-19
Abstract

International audience; Objectives: The clinical profile and outcomes of patients with Covid-19 who require veno-arterial or veno-venous-arterial extracorporeal membrane oxygenation (VA-ECMO - VAV-ECMO) are poorly understood. We aimed to describe the characteristics and outcomes of these patients and to identify predictors of both favorable and unfavorable outcomes.Methods: ECMOSARS is a multicenter, prospective, nationwide French registry enrolling patients who require VV/VA-ECMO in the context of Covid-19 infection (652 patients at 41 centers). We focused on 47 patients supported with VA- or VAV-ECMO for refractory cardiogenic shock.Results: Median age was 49. 14% of patients had a prior diagnosis of heart failure. The most common etiologies of cardiogenic shock were acute pulmonary embolism (30%), myocarditis (28%), and acute coronary syndrome (4%). E-CPR (Extracorporeal Cardiopulmonary Resuscitation) occurred in 38%. In-hospital survival was 28% in the whole cohort, and 43% when E-CPR patients were excluded. ECMO cannulation was associated with significant improvements in pH and FiO2 on day one, but non-survivors showed significantly more severe acidosis and higher FiO2 than survivors at this point (p = 0.030 and p = 0.006). Other factors associated with death were greater age (p = 0.02), higher BMI (p = 0.03), E-CPR (p = 0.001), non-myocarditis etiology (p = 0.02), higher serum lactates (p = 0.004), epinephrine (but not noradrenaline) use before initiation of ECMO (p = 0.003), hemorrhagic complications (p = 0.001), greater transfusion requirements (p = 0.001), and more severe SAVE and SAFE scores (p = 0.01 and p = 0.03).Conclusions: We report the largest focused analysis of VA- and VAV-ECMO recipients in Covid-19. Although relatively rare, the need for temporary mechanical circulatory support in these patients is associated with poor prognosis. However, VA-ECMO remains a viable solution to rescue carefully selected patients. We identified factors associated with poor prognosis and suggest that E-CPR is not a reasonable indication for VA-ECMO in this population.

Published
2023
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22. Predictors of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion

Author

Fauchier, Grégoire, Bisson, Arnaud, Bodin, Alexandre, Herbert, Julien, Semaan, Carl, Angoulvant, Denis, Ducluzeau, Pierre Henri, Lip, Gregory, Fauchier, Laurent, Deharo, Pierre, Cuisset, Thomas, Lacour, Thibaud, Etienne, Christophe Saint, Jaussaud, Nicolas, Morera, Pierre, Spychaj, Jean-Charles, Porto, Alizée, Collart, Frederic, Theron, Alexis, Bernard, Anne, Bourguignon, Thierry, Simard, Trevor, Jung, Richard, Lehenbauer, Kyle, Piayda, Kerstin, Pracoń, Radoslaw, Jackson, Gregory, Flores-Umanzor, Eduardo, Faroux, Laurent, Korsholm, Kasper, Chun, Julian K.R., Chen, Shaojie, Maarse, Moniek, Montrella, Kristi, Chaker, Zakeih, Spoon, Jocelyn, Pastormerlo, Luigi, Meincke, Felix, Sawant, Abhishek, Moldovan, Carmen, Qintar, Mohammed, Aktas, Mehmet, Branca, Luca, Radinovic, Andrea, Ram, Pradhum, El-Zein, Rayan, Flautt, Thomas, Ding, Wern Yew, Sayegh, Bassel, Benito-González, Tomás, Lee, Oh-Hyun, Badejoko, Solomon, Paitazoglou, Christina, Karim, Nabeela, Zaghloul, Ahmed, Agrawal, Himanshu, Kaplan, Rachel, Alli, Oluseun, Ahmed, Aamir, Suradi, Hussam, Knight, Bradley, Alla, Venkata, Panaich, Sidakpal, Wong, Tom, Bergmann, Martin, Chothia, Rashaad, Kim, Jung-Sun, Pérez de Prado, Armando, Bazaz, Raveen, Gupta, Dhiraj, Valderrabano, Miguel, Sanchez, Carlos, El Chami, Mikhael, Mazzone, Patrizio, Adamo, Marianna, Ling, Fred, Wang, Dee Dee, O’neill, William, Wojakowski, Wojtek, Pershad, Ashish, Berti, Sergio, Spoon, Daniel, Kawsara, Akram, Jabbour, George, Boersma, Lucas V.A., Schmidt, Boris, Nielsen-Kudsk, Jens Erik, Rodés-Cabau, Josep, Freixa, Xavier, Ellis, Christopher, Demkow, Marcin, Sievert, Horst, Main, Michael, Hibbert, Benjamin, Holmes, David, Alkhouli, Mohamad, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Trousseau [Tours], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), University of Liverpool, Aalborg University [Denmark] (AAU), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Timone [CHU - APHM] (TIMONE), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Marseille, Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), University of Ottawa [Ottawa], Université Laval [Québec] (ULaval), National Institute for Research and Development in Microtechnologies (IMT-Bucharest), Graduate School, Cardiology, and ACS - Heart failure & arrhythmias

Subjects
Male, Cardiac Catheterization, Time Factors, Percutaneous, left atrial appendage occlusion, Septal Occluder Device, medicine.medical_treatment, Transesophageal, [SHS]Humanities and Social Sciences, Pulmonary vein, Postoperative Complications, Risk Factors, Interquartile range, Atrial Fibrillation, Registries, Embolization, ComputingMilieux_MISCELLANEOUS, Watchman, Incidence, Atrial fibrillation, Europe, Survival Rate, Treatment Outcome, Echocardiography, Cardiology, Female, Watchman FLX, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Heart Diseases, ACP, Amplatzer cardiac plug, Amulet, DRT, LAAO, device-related thrombus, Aged, Atrial Appendage, Echocardiography, Transesophageal, Follow-Up Studies, Humans, Thrombosis, Left atrial appendage occlusion, Internal medicine, medicine, Risk factor, Thrombus, business.industry, medicine.disease, business
Abstract

Background: Device-related thrombus (DRT) has been considered an Achilles’ heel of left atrial appendage occlusion (LAAO). However, data on DRT prediction remain limited. Objectives: This study constructed a DRT registry via a multicenter collaboration aimed to assess outcomes and predictors of DRT. Methods: Thirty-seven international centers contributed LAAO cases with and without DRT (device-matched and temporally related to the DRT cases). This study described the management patterns and mid-term outcomes of DRT and assessed patient and procedural predictors of DRT. Results: A total of 711 patients (237 with and 474 without DRT) were included. Follow-up duration was similar in the DRT and no-DRT groups, median 1.8 years (interquartile range: 0.9-3.0 years) versus 1.6 years (interquartile range: 1.0-2.9 years), respectively (P = 0.76). DRTs were detected between days 0 to 45, 45 to 180, 180 to 365, and >365 in 24.9%, 38.8%, 16.0%, and 20.3% of patients. DRT presence was associated with a higher risk of the composite endpoint of death, ischemic stroke, or systemic embolization (HR: 2.37; 95% CI, 1.58-3.56; P < 0.001) driven by ischemic stroke (HR: 3.49; 95% CI: 1.35-9.00; P = 0.01). At last known follow-up, 25.3% of patients had DRT. Discharge medications after LAAO did not have an impact on DRT. Multivariable analysis identified 5 DRT risk factors: hypercoagulability disorder (odds ratio [OR]: 17.50; 95% CI: 3.39-90.45), pericardial effusion (OR: 13.45; 95% CI: 1.46-123.52), renal insufficiency (OR: 4.02; 95% CI: 1.22-13.25), implantation depth >10 mm from the pulmonary vein limbus (OR: 2.41; 95% CI: 1.57-3.69), and non-paroxysmal atrial fibrillation (OR: 1.90; 95% CI: 1.22-2.97). Following conversion to risk factor points, patients with ≥2 risk points for DRT had a 2.1-fold increased risk of DRT compared with those without any risk factors. Conclusions: DRT after LAAO is associated with ischemic events. Patient- and procedure-specific factors are associated with the risk of DRT and may aid in risk stratification of patients referred for LAAO.

Published
2021
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23. Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Author

Deharo, Pierre, primary, Leroux, Lionel, additional, Theron, Alexis, additional, Ferrara, Jérome, additional, Vaillier, Antoine, additional, Jaussaud, Nicolas, additional, Porto, Alizée, additional, Morera, Pierre, additional, Gariboldi, Vlad, additional, Iung, Bernard, additional, Lefevre, Thierry, additional, Commeau, Philippe, additional, Gouysse, Margaux, additional, du Chayla, Florence, additional, Glatt, Nicolas, additional, Cayla, Guillaume, additional, Le Breton, Herve, additional, Benamer, Hakim, additional, Beurtheret, Sylvain, additional, Verhoye, Jean Philippe, additional, Eltchaninoff, Helene, additional, Gilard, Martine, additional, Collet, Jean Philippe, additional, Dumonteil, Nicolas, additional, Collart, Frederic, additional, Modine, Thomas, additional, and Cuisset, Thomas, additional

Published
2022
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25. Analysis of the aortic volume at an early stage allows predicting the long-term evolution of the descending thoracic aorta after an operated type A dissection

Author

Gaudry, Marine, primary, Porto, Alizée, additional, Bartoli, Michel, additional, Bal, Laurence, additional, Omnes, Virgile, additional, Demasi, Mariangela, additional, Jacquier, Alexis, additional, Piquet, Philippe, additional, Delpano, Valérie, additional, and Guivier-Curien, Carine, additional

Published
2022
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28. To the Editor—Fear does not avoid the danger!

Author

Sambola, Antonia, Rello, Pau, Soriano, Toni, Bhatt, Deepak, Pasupuleti, Vinay, Cannon, Christopher, Gibson, C. Michael, Dewilde, Willem J.M., Lip, Gregory Y.H., Peterson, Eric, Airaksinen, K.E. Juhani, Kiviniemi, Tuomas, Fauchier, Laurent, Räber, Lorenz, Ruiz-Nodar, Juan, Banach, Maciej, Bueno, Héctor, Hernandez, Adrian, Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Etienne, Christophe Saint, Porto, Alizée, Theron, Alexis, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, von Tokarski, Florent, Lemaignen, Adrien, Portais, Antoine, Hennekinne, Fanny, Sautenet, Bénédicte, Halimi, Jean-Michel, Legras, Annick, Patat, Frédéric, Mirguet, Christian, Bernard, Anne, Bernard, Louis, Clementy, Nicolas, Harvard Medical School [Boston] (HMS), Baim Institute for Clinical Research Boston MA, Beth Israel Deaconess Medical Center [Boston] (BIDMC), University of Liverpool, Liverpool Heart & Chest Hospital, Aalborg University [Denmark] (AAU), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Medical University of Łódź (MUL), University of Zielona Góra, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), Instituto de Salud Carlos III [Madrid] (ISC), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital de la Timone [CHU - APHM] (TIMONE), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine Interne et Maladies Infectieuses [Tours], MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Hôpital Bretonneau, Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation cardio-vasculaire et thoracique, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Pontchaillou, Centre de référence en infections ostéo-articulaires du grand-ouest [Rennes] (CRIOGO), and CHU Pontchaillou [Rennes]

Subjects
business.industry, Physiology (medical), Medicine, Fear, Medical emergency, Cardiology and Cardiovascular Medicine, business, medicine.disease, ComputingMilieux_MISCELLANEOUS, Defibrillators, Implantable, [SHS]Humanities and Social Sciences
Abstract

International audience

Published
2021
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29. Results of a prospective follow-up study after type A aortic dissection repair: a high rate of distal aneurysmal evolution and reinterventions

Author

Gaudry, Marine, primary, Porto, Alizée, additional, Guivier-Curien, Carine, additional, Blanchard, Arnaud, additional, Bal, Laurence, additional, Resseguier, Noemie, additional, Omnes, Virgile, additional, De Masi, Mariangela, additional, Ejargue, Meghann, additional, Jacquier, Alexis, additional, Gariboldi, Vlad, additional, Deplano, Valérie, additional, and Piquet, Philippe, additional

Published
2021
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32. Prognosis of Type 2 Myocardial Infarction Patients Implanted With a Prophylactic Defibrillator (from the Very-High-Rate Registry)

Author

Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Saint Etienne, Christophe, Grammatico-Guillon, Leslie, Porto, Alizée, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, Fauchier, Laurent, Garcia, Rodrigue, Boveda, Serge, Defaye, Pascal, Sadoul, Nicolas, Narayanan, Kumar, Perier, Marie-Cécile, Klug, Didier, Leclercq, Christophe, Babuty, Dominique, Bordachar, Pierre, Gras, Daniel, Deharo, Jean-Claude, Piot, Olivier, Providencia, Rui, Marijon, Eloi, Algalarrondo, Vincent, Theron, Alexis, David, Charlotte, André, Clémentine, Pierre, Bertrand, Bernard, Anne, Angoulvant, Denis, Clementy, Nicolas, 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), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Clinique Pasteur, Clinique Pasteur [Toulouse], Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pontchaillou [Rennes], 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), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre cardiologique du Nord (CCN), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), and EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Myocardial Infarction, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, [SHS]Humanities and Social Sciences, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Registries, Aged, Retrospective Studies, Ejection fraction, business.industry, Stroke Volume, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Prognosis, Defibrillators, Implantable, Transplantation, Primary Prevention, Survival Rate, Death, Sudden, Cardiac, Treatment Outcome, Heart failure, Cardiology, Myocardial infarction complications, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices. Methods: Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France. Results: A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10–599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P =0.005), cardiovascular death (relative risk, 0.82; corrected P =0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P

Published
2020
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33. Rapid deployment versus trans‐catheter aortic valve replacement in intermediate‐risk patients: A propensity score analysis

Author

Ferrara, Jérome, primary, Deharo, Pierre, additional, Resseguier, Noémie, additional, Porto, Alizée, additional, Jaussaud, Nicolas, additional, Morera, Pierre, additional, Amanatiou, Cécile, additional, Gariboldi, Vlad, additional, Collart, Frederic, additional, Cuisset, Thomas, additional, and Theron, Alexis, additional

Published
2021
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34. A 10-Year Aortic Center Experience with Hybrid Repair of Chronic “Residual” Aortic Dissection After Type A Repair

Author

Gaudry, Marine, primary, Porto, Alizée, additional, Blanchard, Arnaud, additional, Chazot, Jean-Victor, additional, Bal, Laurence, additional, De Masi, Mariangela, additional, Bartoli, Axel, additional, Barral, Pierre-Antoine, additional, Jacquier, Alexis, additional, Gariboldi, Vlad, additional, Collart, Fréderic, additional, Deplano, Valérie, additional, and Piquet, Philippe, additional

Published
2021
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38. Impact of Sapien 3 Balloon-Expandable Versus Evolut R Self-Expandable Transcatheter Aortic Valve Implantation in Patients With Aortic Stenosis

Author

Saint Etienne, Christophe, Grammatico-Guillon, Leslie, Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Saint, Christophe, Porto, Alizée, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, Fauchier, Laurent, Lucas, Nelly, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance Publique - Hôpitaux de Marseille (APHM), 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), Aix-Marseille Université - Faculté de médecine (AMU MED), and Aix Marseille Université (AMU)

Subjects
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, heart valve prosthesis, transcatheter aortic valve replacement, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract

International audience; Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices.Methods:Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France.Results:A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10-599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P=0.005), cardiovascular death (relative risk, 0.82; corrected P=0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P

Published
2020
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39. Results of a prospective follow-up study after type A aortic dissection repair: a high rate of distal aneurysmal evolution and reinterventions.

Author

Gaudry, Marine, Porto, Alizée, Guivier-Curien, Carine, Blanchard, Arnaud, Bal, Laurence, Resseguier, Noemie, Omnes, Virgile, Masi, Mariangela De, Ejargue, Meghann, Jacquier, Alexis, Gariboldi, Vlad, Deplano, Valérie, and Piquet, Philippe

Subjects
*AORTIC dissection, *BRACHIOCEPHALIC trunk, *AORTIC rupture, *MITRAL valve, *LONGITUDINAL method, *AORTIC valve, *MARFAN syndrome
Abstract

Open in new tab Download slide Open in new tab Download slide OBJECTIVES We investigated the anatomical evolution of residual aortic dissection after type A repair and factors associated with poor prognosis at a high-volume aortic centre. METHODS Between 2017 and 2019, all type A aortic dissections were included for prospective follow-up. Patients without follow-up computed tomography (CT) scan available for radiological analysis and patients without residual aortic dissection were excluded from this study. The primary end point was a composite end point defined as dissection-related events including aneurysmal evolution (increased diameter > 5 mm/year), aortic reintervention for malperfusion syndrome, aortic diameter >55 mm, rapid aortic growth >10 mm/year or aortic rupture and death. The secondary end points were risk factors for dissection-related events and reintervention analysis. All immediate and last postoperative CT scans were analysed. RESULTS Among 104 patients, after a mean follow-up of 20.4 months (8–41), the risk of dissection-related events was 46.1% (48/104) and the risk of distal reintervention was 17.3% (18/104). Marfan syndrome (P  < 0.01), aortic bicuspid valve (P  = 0.038), innominate artery debranching (P  = 0.025), short aortic cross-clamp time (P  = 0.011), initial aortic diameter >40 mm (P  < 0.01) and absence of resection of the primary entry tear (P  = 0.015) were associated with an increased risk of dissection-related events or reintervention during follow-up. CONCLUSIONS Residual aortic dissection is a serious disease requiring close follow-up at an expert centre. This study shows higher reintervention and aneurysmal development rates than currently published. To improve long-term outcomes, the early demographic and anatomic poor prognostic factors identified may be used for more aggressive treatment at an early phase. [ABSTRACT FROM AUTHOR]

Published
2022
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40. Impact de la technique de réparation valvulaire sur la fonction ventriculaire gauche post opératoire dans l'insuffisance mitrale primaire par prolapsus du feuillet postérieur

Author

Porto, Alizée, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), and Alexis Theron

Subjects
Résection valvulaire, [SDV]Life Sciences [q-bio], Insuffisance mitrale primaire sévère, Néo-cordage, Réparation valvulaire mitrale, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Dysfonction ventriculaire gauche postopératoire
Abstract

Thèse présentée sous la forme d'une "thèse article"; Introduction : l’insuffisance mitrale (IM) primaire est la valvulopathie la plus fréquente dans les pays occidentaux et est associée à un pronostic défavorable sous traitement médical. Lorsque l’indication chirurgicale est posée, la réparation valvulaire est le traitement de référence et doit être effectuée avant la survenue d’une dysfonction du ventricule gauche (VG), première cause de mortalité post opératoire. L’objectif de ce présent travail est de déterminer l’impact de la technique de réparation valvulaire mitrale sur la fonction ventriculaire gauche postopératoire chez les patients opérés d’une IM primaire sévère par prolapsus du feuillet postérieur.Méthodes et résultats : il s’agissait d’une étude monocentrique rétrospective menée sur 10 ans dans le service de chirurgie cardiaque de l’hôpital de la Timone à Marseille. Trois cents trente-quatre patients atteints d’IM primaire sévère par prolapsus du feuillet postérieur ont été consécutivement inclus : 222 patients (66,5%) ont bénéficié d’une réparation valvulaire par néo-cordage (groupe N) et 112 patients (33,5%) d’une réparation valvulaire par résection (groupe R). On observait en préopératoire 30% de patients asymptomatiques et 44 % présentant une dyspnée de stade 2 NYHA, Une FA était présente chez 19 % des patients. La fraction d’éjection du VG était en moyenne à 65  8 % ; 27.80 % patients présentaient une dysfonction VG et 36.50 % une dilatation systolique ventriculaire gauche en préopératoire. L’atteinte isolée de P2 représentaient 76.40 % des lésions traitées.En analyse multivariée, par appariement par score de propension et analyse de sensibilité, la technique chirurgicale n’influençait pas la dysfonction VG en postopératoire immédiat et au 6ème mois. En postopératoire immédiat on retrouvait 29,8 % de dysfonction VG dans le groupe N contre 34 % dans le groupe R (OR 1.20 [0.64-1.94] ; p 0.68) et au 6ème mois, 15,60 % dans le groupe N contre 15,40 % dans le groupe R (OR 0.94 [0.38-2.15] ; p 0.88).La survie actuarielle à 4 ans était de 97.7 % [95.20-100] (groupe N : 99.30 % [97.80-100] ; groupe R : 96,40 % [91.70-100], p 0.47). Le taux de survie sans ré-opération à 4 ans était de 94.80 % [91.50-98.40] (groupe N : 97.70 % [95.20-100] ; groupe R : 91,40 % [85-98.30] ; p 0.21). Le taux de survie sans récidive d’IM modérée ou sévère à 4 ans était de 90,10 % [84.10-96.60] (groupe N : 93.50 % [87.10-100] ; groupe R : 86.50 % [76.60-97.60] ; p 0.36).Conclusion : la dysfonction ventriculaire gauche constitue la première cause de décès postopératoire et doit être impérativement prévenue par une prise en charge plus précoce. Le choix de la technique de réparation valvulaire ne semble pas avoir d’impact sur la fonction systolique ventriculaire gauche. La résection valvulaire et les néo-cordages présentent des résultats précoces satisfaisants et comparables.

Published
2017

43. MYOCARDIAL REVASCULARIZATION STRATEGIES IN ST ELEVATION MYOCARDIAL INFARCTION WITHOUT URGENT REVASCULARIZATION: INSIGHT FROM A NATIONWIDE STUDY

Author

Deharo, Pierre, Porto, Alizée, Bourguignon, Thierry, Herbert, Julien, Etienne, Christophe Saint, Semaan, Carl, Genet, Thibaud, Jaussaud, Nicolas, Morera, Pierre, Theron, Alexis, Gariboldi, Vlad, Collart, Frederic, Cuisset, Thomas, and Fauchier, Laurent

Abstract

To analyse the outcomes of patients presenting with ST elevation myocardial infarction (STEMI) without early (<48h) revascularization, according to percutaneous versus surgical revascularization.

Published
2021
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44. Extracorporeal Membrane Oxygenation for Respiratory Failure Related to COVID-19: A Nationwide Cohort Study.

Author

Nesseler N, Fadel G, Mansour A, Para M, Falcoz PE, Mongardon N, Porto A, Bertier A, Levy B, Cadoz C, Guinot PG, Fouquet O, Fellahi JL, Ouattara A, Guihaire J, Ruggieri VG, Gaudard P, Labaste F, Clavier T, Brini K, Allou N, Lacroix C, Chommeloux J, Lebreton G, Matthay MA, Provenchere S, Flécher E, and Vincentelli A

Subjects
Cohort Studies, Humans, Male, Pandemics, Retrospective Studies, COVID-19 therapy, Extracorporeal Membrane Oxygenation adverse effects, Respiratory Insufficiency etiology, Respiratory Insufficiency therapy
Abstract

Background: Despite expanding use, knowledge on extracorporeal membrane oxygenation support during the COVID-19 pandemic remains limited. The objective was to report characteristics, management, and outcomes of patients receiving extracorporeal membrane oxygenation with a diagnosis of COVID-19 in France and to identify pre-extracorporeal membrane oxygenation factors associated with in-hospital mortality. A hypothesis of similar mortality rates and risk factors for COVID-19 and non-COVID-19 patients on venovenous extracorporeal membrane oxygenation was made., Methods: The Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome-Coronavirus 2 (ECMOSARS) registry included COVID-19 patients supported by extracorporeal membrane oxygenation in France. This study analyzed patients included in this registry up to October 25, 2020, and supported by venovenous extracorporeal membrane oxygenation for respiratory failure with a minimum follow-up of 28 days after cannulation. The primary outcome was in-hospital mortality. Risk factors for in-hospital mortality were analyzed., Results: Among 494 extracorporeal membrane oxygenation patients included in the registry, 429 were initially supported by venovenous extracorporeal membrane oxygenation and followed for at least 28 days. The median (interquartile range) age was 54 yr (46 to 60 yr), and 338 of 429 (79%) were men. Management before extracorporeal membrane oxygenation cannulation included prone positioning for 411 of 429 (96%), neuromuscular blockage for 419 of 427 (98%), and NO for 161 of 401 (40%). A total of 192 of 429 (45%) patients were cannulated by a mobile extracorporeal membrane oxygenation unit. In-hospital mortality was 219 of 429 (51%), with a median follow-up of 49 days (33 to 70 days). Among pre-extracorporeal membrane oxygenation modifiable exposure variables, neuromuscular blockage use (hazard ratio, 0.286; 95% CI, 0.101 to 0.81) and duration of ventilation (more than 7 days compared to less than 2 days; hazard ratio, 1.74; 95% CI, 1.07 to 2.83) were independently associated with in-hospital mortality. Both age (per 10-yr increase; hazard ratio, 1.27; 95% CI, 1.07 to 1.50) and total bilirubin at cannulation (6.0 mg/dl or more compared to less than 1.2 mg/dl; hazard ratio, 2.65; 95% CI, 1.09 to 6.5) were confounders significantly associated with in-hospital mortality., Conclusions: In-hospital mortality was higher than recently reported, but nearly half of the patients survived. A high proportion of patients were cannulated by a mobile extracorporeal membrane oxygenation unit. Several factors associated with mortality were identified. Venovenous extracorporeal membrane oxygenation support should be considered early within the first week of mechanical ventilation initiation., (Copyright © 2022, the American Society of Anesthesiologists. All Rights Reserved.)

Published
2022
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