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Mezier A, Motreff P, Clerc JM, Bar O, Deballon R, Demicheli T, Dechery T, Souteyrand G, Py A, Lhoest N, Lhermusier T, Honton B, Gommeaux A, Jeanneteau J, Deharo P, Benamer H, Cayla G, Koning R, Pereira B, Collet JP, Rangé G. Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014-2019). Front Cardiovasc Med 2023; 10:1106503. [PMID: 37034332 PMCID: PMC10080068 DOI: 10.3389/fcvm.2023.1106503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background while the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in France. Aim To analyze the real duration of DAPT post coronary angioplasty in CCS, as well as the factors affecting this duration. Methods Between 2014 and 2019, 8.836 percutaneous coronary interventions for CCS from the France-PCI registry were evaluated, with 1 year follow up, after exclusion of patients receiving oral anticoagulants, procedures performed within one year of an acute coronary syndrome, and repeat angioplasty. Results Post-percutaneous coronary intervention (PCI) DAPT duration was > 12 months for 53.1% of patients treated for CCS; 30.5% had a DAPT between 7 and 12 months, and 16.4% a DAPT ≤ 6 months. Patients with L-DAPT (>12 months) were at higher ischemic risk [25.0% of DAPT score ≥2 vs. 18.8% DAPT score ≥2 in S&I-DAPT group (≤12 months)]. The most commonly used P2Y12 inhibitor was clopidogrel (82.2%). The prescription of ticagrelor increased over the period. Conclusions post-PCI DAPT duration in CCS was higher than international recommendations in the France PCI registry between 2014 and 2019. More than half of the angioplasty performed for CCS are followed by a DAPT > 12 months. Ischemic risk assessment influences the duration of DAPT. This risk is probably overestimated nowadays, leading to a prolongation of DAPT beyond the recommended durations, thus increasing the bleeding risk.
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Affiliation(s)
- A. Mezier
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- Correspondence: A. Mezier
| | - P. Motreff
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - J. M. Clerc
- Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France
| | - O. Bar
- Cardiology Department, Nouvelle Clinique Tourangelle, Saint-Cyr-sur-Loire, France
| | - R. Deballon
- Cardiology Department, Clinique Oréliance, Orléans, France
| | - T. Demicheli
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
| | - T. Dechery
- Cardiology Department, Centre Hospitalier Jacques Coeur, Bourges, France
| | - G. Souteyrand
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - A. Py
- Cardiology Department, Clinique de l’Europe, Amiens, France
| | - N. Lhoest
- Cardiology Departemnt, Clinique Rhéna, Strasbourg, France
| | - T. Lhermusier
- Cardiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - B. Honton
- Cardiology Department, Clinique Pasteur, Toulouse, France
| | - A. Gommeaux
- Cardiology Department, Hôpital Privé de Bois-Bernard, Bois-Bernard, France
| | - J. Jeanneteau
- Cardiology Department, Clinique Saint Joseph, Trelaze, France
| | - P. Deharo
- Cardiology Department, Centre Hospitalier Universitaire de la Timone, Marseille, France
| | - H. Benamer
- Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France
| | - G. Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - R. Koning
- Cardiology Department, Clinique Saint Hilaire, Rouen, France
| | - B. Pereira
- Clinical Research and Innovation Direction, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - J. P. Collet
- Cardiology Institute, Hôpital Pitié-Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - G. Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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Massoullié G, Ploux S, Mondoly P, Souteyrand G, Pereira B, Jean F, Amabile N, Irles D, Mansourati J, Combaret N, Mechulan X, Badoz M, Da Costa A, Defaye P, Clerfond G, Bordachar P, Eschalier R. Occurrence of high-grade conduction disorder after the onset of left bundle branch block in post-TAVI. The French multicenter LBBB-TAVI study. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rangé G, Hakim R, Etienne CS, Deballon R, Dechery T, Souteyrand G, Bar O, Albert F, Canville A, Gamet A, Beygui F, Viallard L, Bonnet P, Durand E, Lesault PF, Boiffard E, Koning R, Benamer H, Commeau P, Cayla G, Motreff P. [stent thrombosis : A won battle ? (data from the France PCI registry)]. Ann Cardiol Angeiol (Paris) 2021; 70:388-394. [PMID: 34686307 DOI: 10.1016/j.ancard.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
GOAL The aim of the study is to assess the incidence, risk factors and prognosis of definite stent thrombosis (ST) at 1 year in the France PCI multicenter prospective registry. PATIENTS AND METHODS Only patients who underwent coronary angioplasty with at least one stent implantation between 1st January 2014 and 31 December 2019 were included. The population was separated into 2 groups: the "ST" group with stent thrombosis and the "control" group without stent thrombosis. RESULTS 35,435 patients were included. 256 patients (0.72%) presented a ST at 1 year. The rate of ST decreased significantly in acute coronary syndrome (1.5% in 2014 vs. 0.73% in 2019; p = 0.05) but not in chronic coronary syndrome (0.46% in 2014 vs 0.40%; p = 0.98). The risk factors are young age (65.8 years vs 68.2; p = 0.002), clinical context (35.27% vs 16.68%; p = 0.0001), diabetes (35.2 % vs 26.4%; p = 0.002), renal failure (11.7% vs 8%; p = 0.009) and history of coronary angioplasty (28.63% vs 21.86%; p = 0.009) and peripheral arterial disease (14.5% vs 10.1%; p = 0.021), LV dysfunction (37% vs 27.5%; p = 0.003), mean length (39.6 mm vs 31, 7mm; p <0.0001) and the mean number of stents per procedure (1.9 vs 1.6; p <0.0001), a TIMI flow ≤1 pre procedure (21.5% vs 12.4%; p <0.0001) and an intrastent restenosis (11% vs 6%; p <0.0001). The 1-year mortality of the ST group was significantly higher than that of the control group (19.14% vs 5.82%; p <0.0001). CONCLUSION Since 2014, the incidence of ST at 1 year has been decreasing but remains stuck at a floor level of 0.54% in 2019. The battle for ST seems to have been partly won and its risk factors well identified, but its mortality is still high.
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Affiliation(s)
- G Rangé
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray.
| | - R Hakim
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray
| | - C Saint Etienne
- Service de cardiologie, Centre Hospitalo-Universitaire de Tours, 37170 Chambray les Tours, France
| | - R Deballon
- Service de cardiologie, Pôle santé Oréliance, 45770 Saran, France
| | - T Dechery
- Service de cardiologie, Centre Hospitalier Jacques-Cœur, 18020 Bourges, France
| | - G Souteyrand
- Service de cardiologie, Centre Hospitalo-Universitaire Gabriel-Montpied, 63000 Clermont Ferrand, France
| | - O Bar
- Service de cardiologie, Nouvelle Clinique Tours Plus, 37541 Saint Cyr sur Loire, France
| | - F Albert
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray
| | - A Canville
- Service de cardiologie, Clinique Saint-Hilaire, 76000 Rouen, France
| | - A Gamet
- Service de cardiologie, Centre Hospitalier Régional d'Orléans, 45100 Orléans, France
| | - F Beygui
- Service de cardiologie, Centre Hospitalo-Universitaire de Caen, 14033 Caen, France
| | - L Viallard
- Service de cardiologie, Centre Hospitalier Henri-Mondor, 15000 Aurillac, France
| | - P Bonnet
- Service de cardiologie, Groupe Hospitalier du Havre, 76290 Montivilliers, France
| | - E Durand
- Service de cardiologie, Centre Hospitalo-Universitaire de Rouen, 76038 Rouen, France
| | - P-F Lesault
- Service de cardiologie, Hôpital Privé de l'Estuaire, 76600 Le Havre, France
| | - E Boiffard
- Service de cardiologie, Centre Hospitalier Départemental de Vendée, 85000 La Roche-Sur-Yon, France
| | - R Koning
- Service de cardiologie, Clinique Saint-Hilaire, 76000 Rouen, France
| | - H Benamer
- Service de cardiologie, ICVGVM La Roseraie, 93300 Aubervilliers, France
| | - P Commeau
- Service de cardiologie, Polyclinique des Fleurs, 83190 Ollioules, France
| | - G Cayla
- Service de cardiologie, CHU Nîmes, Université Montpellier, Nîmes, France
| | - P Motreff
- Service de cardiologie, Centre Hospitalo-Universitaire Gabriel-Montpied, 63000 Clermont Ferrand, France
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Massoulie G, Andronache M, Pastorcici A, Dauphin C, Costea A, Blendea D, Catalan PA, Lizet T, Jean F, Eschallier R, Puiu M, Rosu R, Cismaru G, Souteyrand G, Motreff PA. Catheter ablation with ethanol infusion in the vein of marshall for persistent atrial fibrillation: safety and procedure duration. Europace 2021. [DOI: 10.1093/europace/euab116.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ethanol Infusion in the Vein of Marshall (EIVOM) has been recently introduced as an efficient technique that helps achieving mitral isthmus block during ablation procedures for persistent atrial fibrillation (PAF) or peri-mitral atrial flutter.
Purpose
We have evaluated the safety of EIVOM and the duration required to perform this procedure.
Methods
We performed EIVOM in 121 patients for PAF (mean age of 65 years (range 40-83, 73% men; Mean EF 50%. The main steps of the EIVOM were as follows: the procedure commenced with catheterization of the coronary sinus, followed by the subsequent introduction of an angiography catheter that allowed for iodine contrast injection and vein of Marshall (VOM) localization, 1.5-2.5 mm angioplasty balloon over 0.014" guidewire placement and finally the ethanol injection up to 10 ml.
Results
No major complications were observed during the ablation procedure or before hospital discharge.
In 62 patients in whom procedure duration data was available the mean EIVOM procedure time was 41 min (range from 13 to 105 min).
After the first 20 procedures, where the learning curve for the operators has to be taken into consideration, a reduction in the time required to achieve EIVOM was consistently noted, with an average of less than 30 min. and for the last 20 procedures less than 20 min. Factors which increase the time required for successful EIVOM include: difficulty in visualizing the ostium of the VOM, a VOM ostium located proximally, difficulty in advancing the angioplasty wire into the VOM and balloon displacement and repositioning.
Conclusions
Ethanol infusion in the Vein of Marshall is a safe and efficient technique that can be performed in an acceptable amount of time after an initial learning curve. Abstract Figure. Image 1 VOM
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Affiliation(s)
- G Massoulie
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - M Andronache
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Pastorcici
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - C Dauphin
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Costea
- University of Cincinnati, Cincinnati, United States of America
| | - D Blendea
- County Emergency Clinical Hospital, Cluj Napoca, Romania
| | - PA Catalan
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - T Lizet
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - F Jean
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - R Eschallier
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - M Puiu
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - R Rosu
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Cismaru
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - PA Motreff
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
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Pastorcici A, Andronache M, Blendea D, Massoulie G, Dauphin C, Boudias A, Catalan PA, Jean F, Costea A, Escalier R, Mihai PA, Rosu R, Cismaru G, Souteyrand G, Motreff PA. Usefulness of the angiographic anatomy of the vein of marshall for ablation procedures for persistant atrial fibrillation. Europace 2021. [DOI: 10.1093/europace/euab116.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ethanol Infusion in the Vein of Marshall (EIVOM) was recently proposed as an efficient adjunctive technique for obtaining mitral isthmus block during catheter ablation for persistent atrial fibrillation.
Purpose
Given these considerations the objective of this research was to delineate the angiographic anatomy of the Vein of Marshall (VOM).
Methods
Fluoroscopy images were obtained retrospectively in 124 patients with persistent atrial fibrillation who underwent coronary sinus angiography for EIVOM (96 patients) or cardiac resynchronization implant (18 patients). The measurements were performed using Osirix DICOM reader using the known diameter of the angiographic catheter for calibration. The distance between the ostium of the coronary sinus (CS) and the ostium of the VOM was measured in the anteroposterior view. Additionally, the angle at which the ostium of VOM opens in the CS was obtained.
Results
The diameter of the VOM ostium was 1.8 ± 0.6mm. The length of the VOM was 18.6 ± 9.1mm. The distancebetween the CS ostium and VOM ostium was as follows: less than 10mm for 1 patient (1%), between 11-20mm for 10 patients (10.41%), between 21-30mm for 38 patients (39.58%), 31-40mm for 31 patients (32.29%), between 41-50mm for 15 patients (15.62%) and >50mm for 1 patients (1%) (53mm).
The average takeoff angleof the VOM from the CS between the main branch of the VOM and the CS was measured at 140 degrees (range 90-175 degrees). No correlation could be made between the takeoff angle and the distance between CS ostium and VOM ostium.
In the group of patients undergoing cardiac resynchronization the takeoff angle from the CS was 153°±17° and it correlated significantly with the left ventricular systolic diameter and the left ventricular ejection fraction determined by echocardiography(r = 0.52; p = 0.008 and respectively r = 0.50; p = 0.009).
Conclusions
Understanding the anatomy of the Vein of Marshall (VOM) is crucial in helping operators efficiently exploit the therapeutic potential of ethanol injection after accurate localization of such an important branch of the left atrial venous system. Abstract Figure. 1 Fig 1 Angle CS-VOM
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Affiliation(s)
- A Pastorcici
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - M Andronache
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - D Blendea
- County Emergency Clinical Hospital, Cluj Napoca, Romania
| | - G Massoulie
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - C Dauphin
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Boudias
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - PA Catalan
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - F Jean
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Costea
- University of Cincinnati, Cincinnati, United States of America
| | - R Escalier
- University of Cincinnati, Cincinnati, United States of America
| | - PA Mihai
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - R Rosu
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Cismaru
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - PA Motreff
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
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Andronache M, Pastorcici A, Massoulie G, Blendea D, Boudias A, Catalan PA, Jean F, Dauphin C, Eschalier R, Costea A, Rosu R, Cismaru G, Puiu M, Souteyrand G, Motreff P. Achieving acute mitral isthmus block with catheter ablation with vein of marshall ethanol infusion. Europace 2021. [DOI: 10.1093/europace/euab116.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Achieving bidirectional mitral isthmus block during radiofrequency (RF) ablation for persistent atrial fibrillation (AF) is still challenging. The conventional ablation method involves RF applications on the endocardial aspect of the Mitral Isthmus (MI), and for a majority of patients, in the distal coronary sinus (CS).
Purpose
We have evaluated the acute success of obtaining mitral isthmus block by adding another epicardial component using ethanol infusion in the vein of Marshall (EIVOM) in addition to endocardial MI and epicardial CS ablation.
Methods
We studied 121 patients (pts.) with a mean age of 65 years (range 40-83) 73% men; 119 with longstanding persistent AF (98%) and 2 with perimitral flutter (2%). The mean duration of AF was 53 months (12-244 months). In the majority of patients, additional endocardial (on the ventricular aspect of the MI) and/or epicardial (distal CS) (RF) ablation was performed in order to achieve MIB. The ablation procedure was performed under general anesthesia (GA) for 81 pts (67%). EIVOM was perform with a mean 6 ml ethanol (range 2-10ml)
Results
Bidirectional MIB was obtained in 114 pts. (94,2%). The 7 patients without MIB were scheduled for another ablation procedure (4 pts under GA during the first procedure). The average RF delivery time to block was 160 seconds (range 42-480 seconds) for the endocardial MI RF ablation (point-by-point application with a power of 50W and an Ablation Index of 450-500, contact force 10-20g) and 156 seconds (range 55-438) for the epicardial MI RF ablation (applications with a power of 20W). Bidirectional endocardial and epicardial MIB was confirmed by conventional pacing maneuvers performed in sinus rhythm. No major complications were observed. The parameters associated with failure for MIB were AF duration, Left Atrial dilatation >200 ml, MI thickness (epicardial endocardial distance on the CARTO maps >15mm).
Conclusion
Ethanol infusion in the vein of Marshall is a safe approach and is associated with a higher success rate of obtaining acute bidirectional endocardial and epicardial mitral isthmus block when compared with the conventional method. Abstract Figure. Bloc Mitral Endo; Bloc Mitral Epi;
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Affiliation(s)
- M Andronache
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Pastorcici
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - G Massoulie
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - D Blendea
- County Emergency Clinical Hospital, Cluj Napoca, Romania
| | - A Boudias
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - PA Catalan
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - F Jean
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - C Dauphin
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - R Eschalier
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - A Costea
- University of Cincinnati, Cincinnati, United States of America
| | - R Rosu
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Cismaru
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - M Puiu
- CARDIOTEAM MONZAARES HOSPITAL, Cluj Napoca, Romania
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - P Motreff
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
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Didier R, Le Ven F, Eltchaninoff H, Nasr B, Lefevre T, Fajadet J, Teiger E, Carrie D, Meneveau N, Ghostine S, Souteyrand G, Cuisset T, Le Breton H, Inug B, Gilard M. High post-procedural transvalvular gradient or delayed gradient increase after transcatheter aortic valve implantation: the FRANCE-2 registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Mean gradient (MG) elevation can be detected immediately post-procedure or secondarily during follow-up. Comparison between these two parameters and impact on outcomes has not previously been investigated.
Objectives
The study aimed to identify incidence, influence on prognosis and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (DMGI), in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry.
Methods
The registry includes all consecutive symptomatic patients with severe aortic stenosis. Three groups were analyzed: 1) PPMG <20mmHg without DMGI >10 mmHg (control); 2) PPMG <20mmHg with DMGI >10 mmHg (group 1); 3) PPMG ≥20 mmHg (group 2).
Results
From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. The control group comprised 2078 patients; the group 1, 131 patients; and the group 2, 144 patients. DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-year mortality than in control group (32.6% vs. 40.1%, p=0.27, respectively). PPMG was at least 20 mmHg in 6.1%, and was associated with higher 4-year mortality than in control group (48.7% versus 40.1%, p=0.005, respectively) (Figure 1). Two-thirds of patients with initial PPMG ≥20 mmHg had finally a MG <20 mmHg at 1 year, with mortality similar to controls (39.2% vs. 40.1%, p=0.73).
Conclusions
Patients with PPMG >20 mmHg 1 year post-TAVI had higher 4-year mortality than the general population of the registry, unlike patients with MG normalization at 1 year.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): French National Society of Cardiology
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Affiliation(s)
- R Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - F Le Ven
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | | | - B Nasr
- Hospital Cavale Blanche, Vascular Surgery, Brest, France
| | - T Lefevre
- Jacques Cartier Private Hospital, Massy, France
| | | | - E Teiger
- Henri Mondor University Hospital Chenevier APHP, Creteil, France
| | - D Carrie
- Rangueil Hospital of Toulouse, Toulouse, France
| | - N Meneveau
- University of Besançon, Besancon, France
| | - S Ghostine
- Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - T Cuisset
- Hospital La Timone of Marseille, Marseille, France
| | - H Le Breton
- Hospital Pontchaillou of Rennes, Rennes, France
| | - B Inug
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T, Paris, France
| | - M Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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Eschalier R, Massoullie G, Nahli Y, Jean F, Combaret N, Ploux S, Souteyrand G, Chabin X, Bosle R, Lambert C, Chazot E, Bordachar P, Motreff P, Pereira B, Clerfond G. New-Onset Left bundle branch block after TAVI has a deleterious impact on left ventricular systolic function. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Harbaoui B, Souteyrand G, Lefevre T, Durand E, Liebgott H, Ghigo N, Bonnet M, Bècle C, Eltchaninoff H, Lantelme P. Low gradient aortic stenosis and TAVI: The differential prognostic value of valvular and aortic calcifications may traduce a particular pathophysiology. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Duband B, Harbaoui B, Bècle C, Souteyrand G, Courand P, Eltchaninoff H, Durand E, Boussel L, Lefèvre T, Motreff P, Lantelme P. Mitral annular calcification volume predicts one year all-cause mortality after transcatheter aortic-valve implantation. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eschalier R, Clerfond G, Boirie Y, Pailleret T, Mulliez A, Combaret N, Souteyrand G, Pereira B, Jean F, Citron B, Richard R, Motreff P, Rossignol P, Massoullie G. Sarcopenia represents a very frequent comorbity in TAVI patients. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Bècle C, Riche B, Rabilloud M, Eltchaninoff H, Souteyrand G, Dupré M, Bonnet M, Durand E, Boussel L, Lefevre T, Courand P, Harbaoui B, Lantelme P. Long-term outcome after TAVI: The valve is cured but the vessels remain harmful! Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Harbaoui B, Souteyrand G, Lefevre T, Liebgott H, Courand PY, Durand E, Becle C, Eltchaninoff H, Lantelme P. P907Respective pronostic value of the valvular aortic calcifications and the thoracic aorta calcifications in patients with and without low gradient aortic stenosis after TAVI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Both the valvular aortic calcifications (VAC) and the thoracic aorta calcifications (TAC) have a prognostic impact in patients with aortic stenosis. Their respective prognostic values in patients with and without low gradient aortic stenosis (LGAS) remain unknown after TAVI.
Objectives
To assess the prognostic significance of VAC and TAC in patients with and without LGAS regarding cardiovascular mortality after 3 years follow-up.
Methods
The CAPRI-LGAS is an ancillary study of the C4CAPRI trial (NCT02935491) including 1282 consecutive TAVI patients. Calcifications were measured on pre-TAVI CT. The primary outcome was defined as cardiovascular mortality 3 years after TAVI.
Results
Among the 1282 patients, 397 (31%) had a LGAS. Compared to the other patients, LGAS patients were more prone to be men, younger, with atrial fibrillation, and lower left ventricular ejection fraction (LVEF), p<0.05 for all. No statistically significant difference was noticed for pulmonary systolic pressures, history of diabetes, chronic respiratory disease, renal insufficiency or peripheral vascular disease. VAC was lower in LGAS compared to non-LGAS patients (1.05 cm3±0.7 vs 0.75 cm3±0.5), p<0.001, the contrary was noticed for TAC, (3.1 cm3±3 vs 3.7 cm3±3.7), p=0.011. After 3 years follow-up, 227 (17.7%) patients died from cardiovascular causes; respectively 85 (21.4%) and 142 (16.1%) patients with and without LGAS, p=0.02. In univariate analysis, in LGAS patients each increase of 1cm3 TAC was associated with cardiovascular mortality while VAC was not, respectively Hazard Ratio (HR) 1.07 and confidence interval (CI) (1.023–1.119) p=0.003, and HR 0.822 CI (0.523–1.292), p=0.39. In patients without LGAS both TAC and VAC were associated with mortality, respectively HR 1.054 CI (1.006–1.104), p=0.028 and HR 1.363 CI (1.092–1.701), p=0.006. Multivariate analysis was adjusted for TAC, VAC, age, gender, atrial fibrillation, and LVEF. In LGAS patients TAC but not VAC was still a predictor of cardiovascular mortality, respectively HR 1.092 CI (1.031–1.158), p=0.003, and HR 0.743 CI (0.464–1.191), p=0.21. In patients without LGAS TAC was no more associated with cardiovascular mortality while VAC was, respectively HR 1.306 CI (1.024–1.666), p=0.031, and HR 1.038 CI (0.985–1.094), p=0.161. When further adjusting on pulmonary systolic pressures, history of diabetes, chronic respiratory disease, renal insufficiency and peripheral vascular disease, the results remained similar ie in LGAS patients, TAC HR 1.090 CI (1.022–1.162), p=0.009 while in patients without LGAS VAC HR 1.377 CI (1.049–1.809), p=0.021.
Conclusions
The present study shows that VAC and TAC involve different prognostic information in patients with and without LGAS after TAVI. While VAC may be a marker of early and periprocedural mortality and aortic regurgitation in non-LGAS patients, TAC may continue to be harmful and increase afterload in patients with LGAS whom LVEF is often impaired.
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Affiliation(s)
- B Harbaoui
- Civils Hospices of Lyon, cardiology, Lyon, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - T Lefevre
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - H Liebgott
- University Claude Bernard of Lyon, CREATIS, Lyon, France
| | - P Y Courand
- Civils Hospices of Lyon, cardiology, Lyon, France
| | - E Durand
- University Hospital of Rouen, Rouen, France
| | - C Becle
- Civils Hospices of Lyon, cardiology, Lyon, France
| | | | - P Lantelme
- Civils Hospices of Lyon, cardiology, Lyon, France
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Bouajila S, Combaret N, Souteyrand G, Spaulding C, Benamer H, Manzo-Silberman S, Cassagnes L, Bouatia-Naji N, Motreff P. P3647Spontaneous coronary artery dissection: new insights on presentation, clinical and angiographic characteristics from the French multicenter registry DISCO study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Spontaneous coronary artery dissection (SCAD) is an underdiagnosed and poorly understood cause of acute coronary syndrome (ACS). Clinical, angiographic features and management remain to be better defined in large cohorts.
Purpose
The aim of this study was to evaluate clinical, angiographic characteristics, treatment modalities and prognosis of patients with SCAD from a multicenter national registry.
Methods
From 2016 to 2018, SCAD patients were enrolled retrospectively and prospectively in the French multicenter regristry DISCO study in 61 cardiology interventional centers. All coronary angiograms were reviewed by 2 experienced cardiologists for diagnosis confirmation and classified according to current angiographic SCAD classification.
Results
A total of 373 confirmed SCAD patients were included, 45.6% prospectively, 54.4% retrospectively. Mean age was 51.5±10.3 years, with 90.6% women of whom 51.2% were postmenauposal. Ninety percent of patients had ≤2 cardiovascular risk factors, 96.2% presented with ACS, with a positive troponin in 95.4%, and ST-segment elevation in 45.0%. Precipitating emotional stress factors were reported in 46.0% and a physical trigger in 12.4%. Systemic inflammatory disease was present in 5 patients (1.4%). Peripartum SCAD accounted for only 4.4% of cases. The majority of patients (75.1%) had type 2 angiographic SCAD (diffuse long smooth tubular lesions due to intramural hematoma), with only 13.8% and 8.9% having type 1 (longitudinal filling defect) and type 3 (multiple focal tubular lesions due to intramural hematoma) respectively. Multivessel SCAD occurred in 6.2%. While 84.2% of SCAD patients were initially treated conservatively, 15.5% underwent percutaneous coronary intervention as the initial strategy and 1 patient (0.3%) required surgical implantation of a left ventricular assist device. Repeat angiogram was conducted in 288 patients (median 38 [8–70] days) showing improvement of the culprit lesion in 81.9%. At 1 year follow-up, recurrent SCAD occurred in 2.5%, major adverse cardiac events (stroke, myocardial infarction, and revascularization) in 7.7%, and all patients survived.
Conclusion
Our study confirms that SCAD predominantly affects early middle-aged women with few cardiovascular risk factors, with peripartum SCAD accounting for a minority of cases. Type 2 angiographic SCAD which is difficult to recognize was the most frequent angiographic appearance. This may contribute to the underestimation of SCAD in clinical practice. The majority of patients were treated conservatively with favorable outcomes. Longer-term follow-up of this large cohort and further investigations on physiopathology are warranted to improve management and risk stratification of patients.
Acknowledgement/Funding
Fondation Coeur et Recherche, French Coronary Atheroma and Interventional Cardiology Group, French Society of Cardiology
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Affiliation(s)
- S Bouajila
- Hospital Lariboisiere, Department of Cardiology, Paris, France
| | - N Combaret
- University Hospital Gabriel Montpied, Department of Cardiology, Clermont-Ferrand, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Department of Cardiology, Clermont-Ferrand, France
| | - C Spaulding
- European Hospital Georges Pompidou, Department of Cardiology, Paris, France
| | - H Benamer
- Institut Cardiovasculaire Paris Sud, Department of Cardiology, Paris, France
| | | | - L Cassagnes
- University Hospital Gabriel Montpied, Department of Radiology, Clermont-Ferrand, France
| | - N Bouatia-Naji
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - P Motreff
- University Hospital Gabriel Montpied, Department of Cardiology, Clermont-Ferrand, France
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15
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Harbaoui B, Eltchaninoff H, Rabilloud M, Souteyrand G, Durand E, Boussel L, Lefevre T, Lantelme P. Development of a dedicated TAVR risk score based on aorta calcification; 4 cities for assessing calcification prognostic impact: the C4CAPRI trial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Harbaoui B, Durand E, Dupré M, Rabilloud M, Loic B, Souteyrand G, Courand P, Lefevre T, Eltchaninoff H, Lantelme P. Significance of the CAPRI score to predict heart failure recurrence after TAVI: The CAPRI-HF study. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Faurie B, Lefevre T, Souteyrand G, Staat P, Godin M, Caussin C, Abdellaoui M, Mangin L, Van Belle E, Drogoul L, Dumonteil N, Monsegu J. Direct left ventricular rapid pacing via the valve delivery guide wire in TAVI: A randomized study (EASY TAVI). Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Lattuca B, Cayla G, Silvain J, Cuisset T, Leclercq F, Manzo-Silberman S, Saint-Étienne C, Delarche N, El Mahmoud R, Carrie D, Souteyrand G, Diallo A, Collet J, Vicaut E, Montalescot G. Impact and predictive factors of bleeding complications in elderly patients admitted for an acute coronary syndrome: Insights from the ANTARCTIC trial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Derimay F, Rioufol G, Cellier G, Souteyrand G, Finet G. Benefits of final proximal optimisation technique (POT) in provisional stenting. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Yahia MC, Braik N, Amabile N, Souteyrand G, Ohlmann P, Lefrançois Y, Silvain J, Schiele F, Meneveau N. Intracoronary thrombus by Optical Coherence Tomography (OCT): Characterization, quantification and prognostic impact in patients with non-ST-elevation acute coronary syndrome. A DOCTORS substudy. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Derimay F, Maillard L, Rioufol G, Souteyrand G, Aminian A, Guérin P, Finet G. Sequential techniques of provisional stenting in coronary bifurcation with the Xposition S™ self-apposing nitinol stent. A comparative bench study. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Meneveau N, Yahia M, Braik N, Bonnet B, Chopard R, Amabile N, Souteyrand G, Ohlmann P, Lefrancois Y, Silvain J, Schiele F. P825Evaluation of intracoronary thrombus by optical coherence tomography: characterization, quantification, prognostic impact in patients with non-ST-elevation acute coronary syndrome. A DOCTORS substudy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Meneveau
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
| | - M Yahia
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
| | - N Braik
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
| | - B Bonnet
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
| | - R Chopard
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
| | - N Amabile
- Institut Mutualiste Montsouris, Paris, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | | | - J Silvain
- Hospital Pitie-Salpetriere, Paris, France
| | - F Schiele
- University Hospital of Besancon - Hospital Jean Minjoz, Besancon, France
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23
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Lattuca B, Cayla G, Silvain J, Cuisset T, Leclercq F, Manzo-Silberman S, Saint-Etienne C, Delarche N, El Mahmoud R, Carrie D, Souteyrand G, Diallo A, Collet JP, Vicaut E, Montalescot G. P2245Impact and predictive factors of bleeding complications in elderly patients admitted for an acute coronary syndrome: insights from the ANTARCTIC trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Lattuca
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - G Cayla
- University Hospital of Nimes, Cardiology, Nimes, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - T Cuisset
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - F Leclercq
- Hospital Regional University of Montpellier, Montpellier, France
| | | | | | - N Delarche
- Hospital Center of Pau, Cardiology, Pau, France
| | - R El Mahmoud
- University Hospital Ambroise Pare, Cardiology, Boulogne-Billancourt, France
| | - D Carrie
- University Hospital of Toulouse, Cardiology, Toulouse, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Cardiology, Clermont-Ferrand, France
| | - A Diallo
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
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24
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Massoullié G, Chouki C, Mulliez A, Rossignol P, Ploux S, Reuillard A, Jean F, Pereira B, Eschalier A, Andronache M, Souteyrand G, Citron B, Lusson J, Motreff P, Clerfond G, Bordachar P, Authier N, Eschalier R. Optimization of medical treatment improve long term survival of heart failure patients after ICD and CRT implantation. Insight from National French Database. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Jacquier P, Massa H, Chronopoulos A, Thumann G, Souteyrand G. Hémorragie intra-vitréenne, persistance de la vascularisation fœtale et Incontinentia Pigmenti. J Fr Ophtalmol 2017; 40:e397-e399. [DOI: 10.1016/j.jfo.2016.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/07/2016] [Accepted: 07/24/2016] [Indexed: 11/15/2022]
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26
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Reuillard A, Combaret N, Garrouste C, Azarnoush K, Aniort J, Pereira B, Innorta A, Souteyrand G. Impact sur la fonction rénale du traitement curatif d’un rétrécissement aortique serré chez les patients insuffisants rénaux chroniques. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Bechiri M, Souteyrand G, Motreff P, Mangin L, Range G, Levesque S, Meneveau N, Lefevre T, Trouillet C, Caussin C, Amabile N. P2345Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Souteyrand G, Valadier M, Amabile N, Derimay F, Harbaoui B, Leddet P, Barnay P, Malcles G, Mulliez A, Combaret N, Motreff P. P5569Diagnosis and management of spontaneously recanalized coronary thrombus guided by optical coherence tomography: lessons from lotus root French registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Cianci A, Combaret N, Souteyrand G, Malcles G, Amonchot A, Motreff P. 108Optical coherence tomography contribution in diagnosis and management in spontaneous coronary artery dissection. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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de Massougnes S, Malclès A, Souteyrand G, Massa H, Thumann G, Steffen H. [Retinal astrocytic hamartoma: Multimodal imaging]. J Fr Ophtalmol 2017; 40:84-86. [PMID: 28063619 DOI: 10.1016/j.jfo.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Affiliation(s)
- S de Massougnes
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse.
| | - A Malclès
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse
| | - G Souteyrand
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse
| | - H Massa
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse
| | - G Thumann
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse
| | - H Steffen
- Service d'ophtalmologie, hôpitaux universitaires de Genève, 22, rue Alcide-Jentzer, 1205 Genève, Suisse
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31
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Malclès G, Souteyrand G, Motreff P. [Recent insights on spontaneous coronary artery dissection (SCAD): From diagnosis suspicion to long-term outcomes]. Ann Cardiol Angeiol (Paris) 2016; 65:451-456. [PMID: 27823678 DOI: 10.1016/j.ancard.2016.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Spontaneous coronary artery dissection (SCAD) is a poorly understood and under-diagnosed entity of acute coronary syndrome, affecting predominantly young women. Relatively large series have been published in the past five years highlighting this condition, once believed to be rare. Indeed, the pathophysiology, natural history, clinical presentation, patient profile, diagnostic modalities, management and outcomes of SCAD are becoming better understood. The aim of our review is to provide a brief "state of the art" of SCAD in 2016 to help the clinician in the management of this challenging condition.
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Affiliation(s)
- G Malclès
- Department of Cardiology, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
| | - G Souteyrand
- Department of Cardiology, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
| | - P Motreff
- Department of Cardiology, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
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32
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Gandji W, Azarnoush K, Mulliez A, Innorta A, Farhat M, Combaret N, Durel N, Souteyrand G, Lusson JR, Camilleri L. [Impact of transcatheter aortic valve implantation in the treatment of aortic valve disease after previous coronary artery bypass]. Ann Cardiol Angeiol (Paris) 2015; 65:7-14. [PMID: 25641084 DOI: 10.1016/j.ancard.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/02/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Patients with a history of coronary artery bypass and aortic valve disease constitute a high-risk group for conventional redo surgery. The transcatheter aortic valve implantation (TAVI) may be an alternative for high-risk patients. The purpose of this study is to evaluate the impact of TAVI in the treatment of aortic valve disease after previous surgical coronary artery revascularization. PATIENTS AND METHODS This is a single-center retrospective, observational study, including 87 patients undergoing surgery for surgical heart valve replacement or TAVI from January 2007 to December 2013. RESULTS The introduction of transcatheter aortic valve implantation techniques has doubled the number of redo patients treated for aortic valve disease. From 2010 to 2013, the patients treated by conventional surgery diminished by 30%, with improved postoperative outcomes. This study allowed us to notice differences in patient's in terms of operative risk factors. For the same reasons no comparison was possible between 2 subgroup of patients. Hospital mortality was 6.4% for conventional aortic surgery and 20% for transcatheter aortic valve treatment. CONCLUSION Surgery remains the standard treatment for aortic valve disease even in redo patients, but TAVI becomes a very interesting tool as it may represent a tailored approach for our patients.
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Affiliation(s)
- W Gandji
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - K Azarnoush
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France; Inra, UMR 1019 nutrition humaine, 63122 Saint-Genès-Champanelle, France.
| | - A Mulliez
- Bio-statistics unit, délégation recherche clinique & innovation. CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - A Innorta
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - M Farhat
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - N Combaret
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - N Durel
- Service de cardiologie, pôle santé république, 105, avenue de la République, 63050 Clermont-Ferrand, France
| | - G Souteyrand
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - J R Lusson
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
| | - L Camilleri
- Pôle cardiologie médicale et chirurgicale, CHU de Clermont-Ferrand, place H.-Dunant, B.P. 69, 63000 Clermont-Ferrand, France
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Amabile N, Hammas S, Fradi S, Souteyrand G, Veugeois A, Belle L, Motreff P, Caussin C. Intra-coronary thrombus evolution during acute coronary syndrome: regression assessment by serial optical coherence tomography analyses. Eur Heart J Cardiovasc Imaging 2014; 16:433-40. [DOI: 10.1093/ehjci/jeu228] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kauffmann S, Commun F, Schoeffler P, Souteyrand G, Chiambaretta F, Dewachter P. Effets indésirables cardiovasculaires des collyres à la phényléphrine en chirurgie ophtalmologique. ACTA ACUST UNITED AC 2013; 32:112-4. [DOI: 10.1016/j.annfar.2012.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 12/10/2012] [Indexed: 11/15/2022]
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Motreff P, Souteyrand G, Durel N, Lusson JR, Citron B. Recommandations européennes de prise en charge du syndrome coronarien aigu. Que doit en retenir le médecin du travail ? ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Motreff P, Souteyrand G, Dauphin C, Eschalier R, Cassagnes J, Lusson J. Management of Spontaneous Coronary Artery Dissection: Review of the Literature and Discussion Based on a Series of 12 Young Women with Acute Coronary Syndrome. Cardiology 2010; 115:10-8. [DOI: 10.1159/000244608] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Accepted: 06/28/2009] [Indexed: 11/19/2022]
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38
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Souteyrand G. 738 Plaie transfixiante oculaire bilatérale par accident de modélisme. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)71337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Roussi M, Viennet A, Souteyrand G, Nezzar H, Dillies J, Kemeny J, Bacin F. 778 Localisation métastatique d’un mélanome conjonctival au niveau du sac lacrymal : à propos d’un cas rare. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)71377-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Dauphin C, Motreff P, Souteyrand G, Laurichesse H, Gourdon F, Lesens O, Lamaison D, Beytout J, Cassagnes J, Lusson JR. [Kawasaki disease is also a disease of adults: report of six cases]. Arch Mal Coeur Vaiss 2007; 100:439-47. [PMID: 17646771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Kawasaki disease is an inflammatory arterial disease of unknown cause usually affecting young children, the principal complication of which is coronary artery aneurysm. Early treatment with immunoglobulins and aspirin prevents this complication. The diagnosis requires expert clinical criteria and, in atypical forms, a more recent decisional diagnostic tree has to be used. The authors report 6 cases of adult Kawasaki disease. As in the other sixty or so cases in the literature, hepatic forms were the commonest (5/6). Only three of the six cases met the classical clinical criteria and the diagnosis was made by the decisional tree or after coronary complications in the oldest subject. The five treated patients progressed favourably after a course of immunoglobulins. Echocardiography detected 100% of children with coronary disease but it was more difficult in adults in whom new non-invasive methods of coronary imaging (fast CT and MRI) and stress testing should complete the investigations. The association of prolonged pyrexia, clinical criteria and a biological inflammatory syndrome should, after exclusion of the differential diagnoses, suggest a diagnosis of Kawasaki disease in the adult as in the child. The possibility of coronary disease, even though extremely rare, should be recognised by the cardiologist and lead to diagnostic and therapeutic managements as aggressive as in children.
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Affiliation(s)
- C Dauphin
- CHU Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de cardiologie et maladies vasculaires, 63003 Clermont-Ferrand.
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Souteyrand G, Deriot J, Sillaire I, Roquet W, Bacin F. 250 Documentation par l’OCT d’une résolution spontanée d’un trou maculaire post-traumatique : à propos d’un cas. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ngoy Nkulu D, Dauphin C, Motreff P, Joly H, Souteyrand G, Lamaison D, Cassagnes J, de Riberolles C, Lusson JR. [Implantation of mechanical pulmonary and tricuspid valve prostheses at a distance from complete repair of Tetralogy of Fallot]. Arch Mal Coeur Vaiss 2006; 99:507-10. [PMID: 16802743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The authors report the case of a 39 years old woman operated for tetralogy of Fallot at the age of 6. Multiple complications due to postoperative atrioventricular block and a poor surgical result on the pulmonary outflow tract led to several reoperations. Right ventricular dysfunction with pulmonary regurgitation and mitral tricuspid valve disease in a context of endocarditis on the pacing catheter led to double pulmonary and tricuspid valve replacement with mechanical prostheses. The outcome at follow-up at 3 years is good. To the authors' knowledge, this is the first reported case of double mechanical valve replacement of the right heart after complete repair of tetralogy of Fallot.
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Affiliation(s)
- D Ngoy Nkulu
- Service de cardiologie et maladies vasculaires (Pr J Cassagnes), CHU Clermont-Ferrand, hôpital G Montpied
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Lamaison D, Motreff P, Jean F, Geoffroy E, Rodriguez R, Souteyrand G, Chanseaume S, Terrazoni S, Cassagnes J. [The place of telemedicine in rhythmology and cardiac pacing]. Arch Mal Coeur Vaiss 2004; 97:1160-4. [PMID: 15609921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Rapid advancement in telecommunication technology has made possible automatic periodic transmission of pacemaker and implantable defibrillator data to the attending physician (home monitoring). Furthermore, technology using remote control software allows, through device programmers, interrogation of the device memory, permitting remote monitoring by physicians or technical support of the manufacturer. Potential applications of these two capabilities include a close watch over the functioning of the devices, ability to obtain an earlier diagnosis (and management) of arrhythmic events, and assistance at the time of implant procedure and routine follow up. Finally these new tools raise several questions concerning safety aspects (including reliability of transmission, encrypted transfer, restricted access of the central database), economic aspects, and physician and manufacturer's liability.
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Affiliation(s)
- D Lamaison
- Service de cardiologie, hôpital G. Montpied, Clermont-Ferrand.
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Merlin E, Souteyrand G, Dauphin C, Lusson RJ, De Riberolles C, Poirier V, Foulon E, Stéphan JL. Varicelle compliquée d’une endocardite à streptocoque A : à propos d’une observation. Arch Pediatr 2004; 11:122-5. [PMID: 14761734 DOI: 10.1016/j.arcped.2003.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2003] [Accepted: 10/26/2003] [Indexed: 10/26/2022]
Abstract
Although varicella is most often a benign and self-limited disease of childhood, it can be associated with a variety of serious and potential lethal complications. Especially, the incidence of severe infectious complications caused by group A streptococci has been increasing over the last years. We report the case of a previously healthy young boy with an aortic bicuspidy who developed a varicella complicated by endocarditis due to group A streptococcus, and a haemophagocytic syndrome. A favorable outcome was obtained after an early valvular replacement and 6 weeks of intravenous antibiotics.
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Affiliation(s)
- E Merlin
- Unité d'oncohématologie pédiatrique, Hôtel-Dieu, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand, France
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