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Moussa MD, Soquet J, Robin E, Labreuche J, Rousse N, Rauch A, Loobuyck V, Leroy G, Duburcq T, Gantois G, Leroy X, Ait-Ouarab S, Lamer A, Thellier L, Lukowiak O, Schurtz G, Muller C, Juthier F, Susen S, Vincentelli A. Definitions of major bleeding for predicting mortality in critically ill adult patients who survived 24 hours while supported with peripheral veno-arterial extracorporeal membrane oxygenation for cardiogenic shock: a comparative historical cohort study. Can J Anaesth 2024; 71:523-534. [PMID: 38438682 DOI: 10.1007/s12630-024-02704-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 03/06/2024] Open
Abstract
PURPOSE The severity of bleeding events is heterogeneously defined during peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO). We studied three bleeding definitions in pVA-ECMO: the Extracorporeal Life Support Organization (ELSO)-serious bleeding, the Bleeding Academic Research Consortium (BARC), and the universal definition of postoperative bleeding (UPDB) classifications. METHODS We included consecutive adult patients supported by pVA-ECMO for refractory cardiogenic shock admitted to Lille academic hospitals between January 2013 and December 2019. We assessed the association of bleeding definitions with the primary endpoint of 28-day all-cause mortality with the use of multivariate models accounting for time-dependent and competing variables. We compared models' performances using the Harrell's C-Index and the Akaike information criteria. RESULTS Twenty-eight-day mortality occurred in 128/308 (42%) 308 patients. The ELSO-serious bleeding (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.09 to 2.56) and BARC ≥ type 2 (HR, 1.55; 95% CI, 1.01 to 2.37) were associated with 28-day mortality (Harrell's C-index, 0.69; 95% CI, 0.63 to 0.74 for both). Predictors of ELSO-serious bleeding were postcardiotomy, body mass index, baseline platelets count, fibrinogen, and hemoglobin levels. CONCLUSION Extracorporeal Life Support Organization-serious bleeding and BARC ≥ type 2 are relevant definitions of major bleeding regarding their association with mortality in critically ill patients who survived the first 24 hr while supported with pVA-ECMO for cardiogenic shock. STUDY REGISTRATION CERAR (IRB 00010254-2022-050, Paris, France); first submitted on 18 April 2022.
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Affiliation(s)
- Mouhamed D Moussa
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France.
- Pôle d'Anesthésie-Réanimation, CHU Lille, Lille, France.
- Service d'Anesthésie-Réanimation Cardiovasculaire et thoracique, Institut Cœur - Poumon, CHU Lille, 2 avenue Oscar Lambret, 59 037, Lille, France.
| | - Jérôme Soquet
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiac Surgery, CHU Lille, Lille, France
| | - Emmanuel Robin
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Pôle d'Anesthésie-Réanimation, CHU Lille, Lille, France
| | | | - Natacha Rousse
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiac Surgery, CHU Lille, Lille, France
| | - Antoine Rauch
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
| | - Valentin Loobuyck
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiac Surgery, CHU Lille, Lille, France
| | | | | | | | - Xavier Leroy
- Pôle d'Anesthésie-Réanimation, CHU Lille, Lille, France
| | | | - Antoine Lamer
- Pôle d'Anesthésie-Réanimation, CHU Lille, Lille, France
| | - Lise Thellier
- Pôle d'Anesthésie-Réanimation, CHU Lille, Lille, France
| | | | - Guillaume Schurtz
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiology, CHU Lille, Lille, France
| | | | - Francis Juthier
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiac Surgery, CHU Lille, Lille, France
| | - Sophie Susen
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
| | - André Vincentelli
- Institut Pasteur de Lille, Université de Lille, Inserm, CHU Lille, Lille, France
- Department of Cardiac Surgery, CHU Lille, Lille, France
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Bichali S, Soquet J, Bouzguenda I, Lérisson H, Ung A, Pontana F, Godart F, Le Duc K, Nuytten A, Houeijeh A. Anomalous hepatic drainage and platypnea-orthodeoxia in cyanotic children. Cardiol Young 2023; 33:2685-2689. [PMID: 37877253 DOI: 10.1017/s1047951123003712] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
The aetiology of cyanosis could be unclear in children, even for specialised paediatricians. Two cases were reported: first, a 6-year-old child with features of left isomerism and Fallot was fortuitously diagnosed with anomalous hepatic venous drainage before complete repair. Second, a newborn with an antenatal diagnosis of ductus venosus agenesis had an isolated intermittent right-to-left atrial shunt when upright, with favourable outcome, in contrast to the association with significant heart malformations including inferior caval vein interruption. Multimodality imaging and 3D printing helped to rule out extracardiac causes of persistent cyanosis and plan surgical repair.
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Affiliation(s)
- Saïd Bichali
- Paediatric Cardiology, Univ. Lille, CHU Lille, Lille, France
| | - Jérôme Soquet
- Cardiac Surgery, Univ. Lille, CHU Lille, Lille, France
| | - Ivan Bouzguenda
- Paediatric Cardiology, Hôpital Privé de la Louvière, Lille, France
| | | | - Alexandre Ung
- Biological Engineering, Univ. Lille, CHU Lille, Lille, France
| | | | - François Godart
- Paediatric Cardiology, Univ. Lille, CHU Lille, Lille, France
| | - Kévin Le Duc
- Neonatology, Univ. Lille, CHU Lille, Lille, France
| | | | - Ali Houeijeh
- Paediatric Cardiology, Univ. Lille, CHU Lille, Lille, France
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Ninni S, Dombrowicz D, Kuznetsova T, Vicario R, Gao V, Molendi-Coste O, Haas J, Woitrain E, Coisne A, Neele AE, Prange K, Willemsen L, Aghezzaf S, Fragkogianni S, Tazibet A, Pineau L, White JR, Eeckhoute J, Koussa M, Dubrulle H, Juthier F, Soquet J, Vincentelli A, Edme JL, de Winther M, Geissmann F, Staels B, Montaigne D. Hematopoietic Somatic Mosaicism Is Associated With an Increased Risk of Postoperative Atrial Fibrillation. J Am Coll Cardiol 2023; 81:1263-1278. [PMID: 36990546 PMCID: PMC10525908 DOI: 10.1016/j.jacc.2023.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND On-pump cardiac surgery triggers sterile inflammation and postoperative complications such as postoperative atrial fibrillation (POAF). Hematopoietic somatic mosaicism (HSM) is a recently identified risk factor for cardiovascular diseases and results in a shift toward a chronic proinflammatory monocyte transcriptome and phenotype. OBJECTIVES The aim of this study was to assess the prevalence, characteristics, and impact of HSM on preoperative blood and myocardial myeloid cells as well as on outcomes after cardiac surgery. METHODS Blood DNA from 104 patients referred for surgical aortic valve replacement (AVR) was genotyped using the HemePACT panel (576 genes). Four screening methods were applied to assess HSM, and postoperative outcomes were explored. In-depth blood and myocardial leukocyte phenotyping was performed in selected patients using mass cytometry and preoperative and postoperative RNA sequencing analysis of classical monocytes. RESULTS The prevalence of HSM in the patient cohort ranged from 29%, when considering the conventional HSM panel (97 genes) with variant allelic frequencies ≥2%, to 60% when considering the full HemePACT panel and variant allelic frequencies ≥1%. Three of 4 explored HSM definitions were significantly associated with higher risk for POAF. On the basis of the most inclusive definition, HSM carriers exhibited a 3.5-fold higher risk for POAF (age-adjusted OR: 3.5; 95% CI: 1.52-8.03; P = 0.003) and an exaggerated inflammatory response following AVR. HSM carriers presented higher levels of activated CD64+CD14+CD16- circulating monocytes and inflammatory monocyte-derived macrophages in presurgery myocardium. CONCLUSIONS HSM is frequent in candidates for AVR, is associated with an enrichment of proinflammatory cardiac monocyte-derived macrophages, and predisposes to a higher incidence of POAF. HSM assessment may be useful in the personalized management of patients in the perioperative period. (Post-Operative Myocardial Incident & Atrial Fibrillation [POMI-AF]; NCT03376165).
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Affiliation(s)
- Sandro Ninni
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France.
| | - David Dombrowicz
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Tanya Kuznetsova
- Experimental Vascular Biology, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Rocio Vicario
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Vance Gao
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Olivier Molendi-Coste
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Joel Haas
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Eloise Woitrain
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Augustin Coisne
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Annette E Neele
- Experimental Vascular Biology, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Koen Prange
- Experimental Vascular Biology, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Lisa Willemsen
- Experimental Vascular Biology, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Samy Aghezzaf
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Stamatina Fragkogianni
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Amine Tazibet
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Laurent Pineau
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | | | - Jérôme Eeckhoute
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Mohamed Koussa
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Henri Dubrulle
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Francis Juthier
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Jérôme Soquet
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - André Vincentelli
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Jean-Louis Edme
- Université de Lille, EA 4483, IMPECS: Impact of Environmental Chemicals on Human Health, CHU Lille, Lille, France
| | - Menno de Winther
- Experimental Vascular Biology, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Frederic Geissmann
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Bart Staels
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - David Montaigne
- Université de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France.
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Bichali S, Bonnet M, Lampin ME, Baudelet JB, Reumaux H, Domanski O, Rakza T, Delarue A, Recher M, Soquet J, Dubos F, Leteurtre S, Houeijeh A, Godart F. Impact of time to diagnosis on the occurrence of cardiogenic shock in MIS-C post-COVID-19 infection. World J Pediatr 2023; 19:595-604. [PMID: 36607546 PMCID: PMC9817434 DOI: 10.1007/s12519-022-00681-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND In multisystem inflammatory syndrome in children (MIS-C), diagnostic delay could be associated with severity. This study aims to measure the time to diagnosis in MIS-C, assess its impact on the occurrence of cardiogenic shock, and specify its determinants. METHODS A single-center prospective cohort observational study was conducted between May 2020 and July 2022 at a tertiary care hospital. Children meeting the World Health Organization MIS-C criteria were included. A long time to diagnosis was defined as six days or more. Data on time to diagnosis were collected by two independent physicians. The primary outcome was the occurrence of cardiogenic shock. Logistic regression and receiver operating characteristic curve analysis were used for outcomes, and a Cox proportional hazards model was used for determinants. RESULTS Totally 60 children were assessed for inclusion, and 31 were finally analyzed [52% males, median age 8.8 (5.7-10.7) years]. The median time to diagnosis was 5.3 (4.2-6.2) days. In univariable analysis, age above the median, time to diagnosis, high C-reactive protein, and high N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with cardiogenic shock [odds ratio (OR) 6.13 (1.02-36.9), 2.79 (1.15-6.74), 2.08 (1.05-4.12), and 1.70 (1.04-2.78), respectively]. In multivariable analysis, time to diagnosis ≥ 6 days was associated with cardiogenic shock [adjusted OR (aOR) 21.2 (1.98-227)]. Time to diagnosis ≥ 6 days had a sensitivity of 89% and a specificity of 77% in predicting cardiogenic shock; the addition of age > 8 years and NT-proBNP at diagnosis ≥ 11,254 ng/L increased the specificity to 91%. Independent determinants of short time to diagnosis were age < 8.8 years [aHR 0.34 (0.13-0.88)], short distance to tertiary care hospital [aHR 0.27 (0.08-0.92)], and the late period of the COVID-19 pandemic [aHR 2.48 (1.05-5.85)]. CONCLUSIONS Time to diagnosis ≥ 6 days was independently associated with cardiogenic shock in MIS-C. Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity, especially in older children.
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Affiliation(s)
- Saïd Bichali
- Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000, Lille, France.
| | - Mathilde Bonnet
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Marie-Emilie Lampin
- grid.503422.20000 0001 2242 6780Pediatric Intensive Care, Univ. Lille, CHU Lille, 59000 Lille, France ,grid.503422.20000 0001 2242 6780ULR 2694 - Metrics: Évaluation des Technologies de Santé et des Pratiques Médicales, Univ. Lille, 59000 Lille, France
| | - Jean-Benoit Baudelet
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Héloïse Reumaux
- grid.503422.20000 0001 2242 6780Pediatric Rhumatology, Univ. Lille, CHU Lille, 59000 Lille, France
| | - Olivia Domanski
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Thameur Rakza
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Alexandre Delarue
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Morgan Recher
- grid.503422.20000 0001 2242 6780Pediatric Intensive Care, Univ. Lille, CHU Lille, 59000 Lille, France ,grid.503422.20000 0001 2242 6780ULR 2694 - Metrics: Évaluation des Technologies de Santé et des Pratiques Médicales, Univ. Lille, 59000 Lille, France
| | - Jérôme Soquet
- grid.503422.20000 0001 2242 6780Cardiac Surgery, Univ. Lille, CHU Lille, 59000 Lille, France
| | - Francois Dubos
- grid.503422.20000 0001 2242 6780Pediatric Emergency, Univ. Lille, CHU Lille, 59000 Lille, France
| | - Stéphane Leteurtre
- grid.503422.20000 0001 2242 6780Pediatric Intensive Care, Univ. Lille, CHU Lille, 59000 Lille, France ,grid.503422.20000 0001 2242 6780ULR 2694 - Metrics: Évaluation des Technologies de Santé et des Pratiques Médicales, Univ. Lille, 59000 Lille, France
| | - Ali Houeijeh
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
| | - Francois Godart
- grid.503422.20000 0001 2242 6780Pediatric Cardiology, Univ. Lille, CHU Lille, 2 Avenue Oscar Lambret, 59000 Lille, France
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Soquet J, Domanski O, Récher M, Dubernet M, Baudelet J, Guillot C, Renard J, Houeijeh A, Rousseaux J, Canavese M, Ricciardi G, Godart F, Juthier F, Rakza T. Initiation of a pediatric cardiac surgery program in 2020. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.069] [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: 10/14/2022]
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Moussa MD, Soquet J, Lamer A, Labreuche J, Gantois G, Dupont A, Abou-Arab O, Rousse N, Liu V, Brandt C, Foulon V, Leroy G, Schurtz G, Jeanpierre E, Duhamel A, Susen S, Vincentelli A, Robin E. Evaluation of Anti-Activated Factor X Activity and Activated Partial Thromboplastin Time Relations and Their Association with Bleeding and Thrombosis during Veno-Arterial ECMO Support: A Retrospective Study. J Clin Med 2021; 10:jcm10102158. [PMID: 34067573 PMCID: PMC8156165 DOI: 10.3390/jcm10102158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to investigate the relationship between anti-activated Factor X (anti-FXa) and activated Partial Thromboplastin Time (aPTT), and its modulation by other haemostasis co-variables during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. We further investigated their association with serious bleeding and thrombotic complications. METHODS This retrospective single-center study included 265 adults supported by VA-ECMO for refractory cardiogenic shock from January 2015 to June 2019. The concordance of anti-FXa and aPTT and their correlations were assessed in 1699 paired samples. Their independent associations with serious bleeding or thrombotic complications were also analysed in multivariate analysis. RESULTS The concordance rate of aPTT with anti-FXa values was 50.7%, with 39.3% subtherapeutic aPTT values. However, anti-FXa and aPTT remained associated (β = 0.43 (95% CI 0.4-0.45) 10-2 IU/mL, p < 0.001), with a significant modulation by several biological co-variables. There was no association between anti-FXa nor aPTT values with serious bleeding or with thrombotic complications. CONCLUSION During VA-ECMO, although anti-FXa and aPTT were significantly associated, their values were highly discordant with marked sub-therapeutic aPTT values. These results should favour the use of anti-FXa. The effect of biological co-variables and the failure of anti-FXa and aPTT to predict bleeding and thrombotic complications underline the complexity of VA-ECMO-related coagulopathy.
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Affiliation(s)
- Mouhamed Djahoum Moussa
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
- Correspondence: ; Tel.: +33-320-445-962
| | - Jérôme Soquet
- CHU Lille, Service de Chirurgie Cardiaque, 59000 Lille, France; (J.S.); (N.R.); (A.V.)
| | - Antoine Lamer
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
- Univ. Lille, INSERM, CHU Lille, CIC-IT 1403, 59000 Lille, France
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; (J.L.); (A.D.)
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; (J.L.); (A.D.)
- CHU Lille, Department of Biostatistics, 59000 Lille, France
| | - Guillaume Gantois
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
| | - Annabelle Dupont
- CHU Lille, Pôle d’Hématologie-Transfusion, Centre de Biologie Pathologie Génétique, 59000 Lille, France; (A.D.); (E.J.); (S.S.)
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France;
- MP3CV, EA7517, CURS, Jules Verne University of Picardie, 80054 Amiens, France
| | - Natacha Rousse
- CHU Lille, Service de Chirurgie Cardiaque, 59000 Lille, France; (J.S.); (N.R.); (A.V.)
| | - Vincent Liu
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
| | - Caroline Brandt
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
| | - Valentin Foulon
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
| | - Guillaume Leroy
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
| | | | - Emmanuel Jeanpierre
- CHU Lille, Pôle d’Hématologie-Transfusion, Centre de Biologie Pathologie Génétique, 59000 Lille, France; (A.D.); (E.J.); (S.S.)
| | - Alain Duhamel
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; (J.L.); (A.D.)
- CHU Lille, Department of Biostatistics, 59000 Lille, France
| | - Sophie Susen
- CHU Lille, Pôle d’Hématologie-Transfusion, Centre de Biologie Pathologie Génétique, 59000 Lille, France; (A.D.); (E.J.); (S.S.)
| | - André Vincentelli
- CHU Lille, Service de Chirurgie Cardiaque, 59000 Lille, France; (J.S.); (N.R.); (A.V.)
| | - Emmanuel Robin
- CHU Lille, Pôle d’Anesthésie-Réanimation, 59000 Lille, France; (A.L.); (G.G.); (V.L.); (C.B.); (V.F.); (G.L.); (E.R.)
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Vincentelli A, Soquet J, Deblauwe D, Rousse N, Loobuyck V, Goeminne C, Mugnier A, Gantois G, Bical A, Moussa M, Robin E, Juthier F. Organ Care System for High Risk Transplantation: A New Paradigm. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Richardson M, Raad N, Coisne A, Ridon H, Polge AS, Mouton S, Silvestri V, Pagniez J, Longere B, Modine T, Soquet J, Juthier F, Montaigne D, Pontana F. Assessment of aortic regurgitation mechanism with cardiac magnetic resonance: an echocardiography comparative study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.069] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Aortic regurgitation (AR) quantification still remains challenging and requires an integrated approach. AR mechanism is one key parameter to take into account to assess its severity and repairability, and thus help to guide surgical decision. Although Cardiac Magnetic Resonance (CMR) has a growing interest in AR quantification, its performance to identify aortic AR mechanism has never been studied.
Purpose
We intended to define CMR Performance in this setting, by using echocardiography as reference.
Methods
AR mechanism was systematically evaluated in sixty-seven patients (81% male, mean age 46 ± 20 years) with chronic AR using CMR, and compared to transthoracic (TTE) and transesophageal (TEE) echocardiography as gold standard. AR were categorized as follows: type 1, aortic dilatation; type 2, Cusp prolapse; type 3, restrictive cusp motion. Jet direction, number of cusps and calcification (1 = no calcification, 2 = spots, 3 = big calcification interfering with cusp motion and 4 = Extensive with restricted cusp motion) were also evaluated.
Results
At TTE/TEE, mechanisms of AR were type 1 in 56 (83.5%), type 2 in 33 (49.2%), type 3 in 24 (35%). Agreement between TTE/TEE and CMR was modest, with respectively 74.6% (k= 0.4), 79.1% (k = 0.58) and 74.6% (k = 0.44). Bicuspid aortic valve was found in 44 (65.7%) patients at TTE/TEE, agreement with CMR was excellent, 98.5% (k = 0.97). Jet was directed to the mitral valve in 42 (62.7%), at the inter ventricular septum in 12 (17.9%), and central in 13 (19.4%). Agreement with CMR was correct, respectively 80% (k = 0,6), 88% (k = 0.62) and 83.5% (K= 0.52). Calcification extension was 1 in 26 (38.8%), 2 in 25 (37.3%), 3 in 11 (16.4%) and 4 in 5 (7.5%). Agreement with CMR was poor, 44.7% (K= 0.28).
Conclusion
Accuracy between CMR and TTE/TEE to evaluate chronic AR mechanism and repairability was modest, with lower performance to define calcification extension.
Abstract Figure. AR classification TTE/TEE vs CMR
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Affiliation(s)
- M Richardson
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, Lille, France
| | - N Raad
- Chru De Lille - Institut Coeur-Poumons, Department of Cardio-Vascular Radiology, Lille, France
| | - A Coisne
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, INSERM UMR 1011, EGID FR 3508, Lille, France
| | - H Ridon
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, Lille, France
| | - AS Polge
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, Lille, France
| | - S Mouton
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, Lille, France
| | - V Silvestri
- Chru De Lille - Institut Coeur-Poumons, Department of Cardio-Vascular Radiology, Lille, France
| | - J Pagniez
- Chru De Lille - Institut Coeur-Poumons, Department of Cardio-Vascular Radiology, Lille, France
| | - B Longere
- Chru De Lille - Institut Coeur-Poumons, Department of Cardio-Vascular Radiology, Lille, France
| | - T Modine
- Chru De Lille - Institut Coeur-Poumons, Department of Cardiac Surgery, Lille, France
| | - J Soquet
- Chru De Lille - Institut Coeur-Poumons, Department of Cardiac Surgery, Lille, France
| | - F Juthier
- Chru De Lille - Institut Coeur-Poumons, Department of Cardiac Surgery, Lille, France
| | - D Montaigne
- Chru De Lille - Institut Coeur-Poumons, Department of clinical physiology and echocardiography, INSERM UMR 1011, EGID FR 3508, Lille, France
| | - F Pontana
- Chru De Lille - Institut Coeur-Poumons, Department of Cardio-Vascular Radiology, INSERM UMR 1011, EGID FR 3508, Lille, France
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Delsart P, Soquet J, Ramdane N, Ramond C, Mugnier A, Rousse N, Ledieu G, Bical A, Loobuyck V, Jegou B, Modine T, Hysi I, Fabre O, Juthier F, Vincentelli A, Mounier-Vehier C. Aortic morphology post type A acute aortic syndrome: Prognosis significance and association with 24-hour blood pressure-monitoring parameters. J Card Surg 2020; 35:981-987. [PMID: 32176383 DOI: 10.1111/jocs.14512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome. METHODS The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis. RESULTS The population included 79 males, with an overall mean age of 60 ± 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg ± 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P < .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24). CONCLUSION The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
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Affiliation(s)
| | - Jérôme Soquet
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Nassima Ramdane
- METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, CHU Lille, ULR 2694, Lille, France
| | | | | | - Natacha Rousse
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | | | - Antoine Bical
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
| | - Valentin Loobuyck
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Bruno Jegou
- CHU Lille, Institut Cœur Poumon, Lille, France
| | | | - Ilir Hysi
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Olivier Fabre
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Francis Juthier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Andre Vincentelli
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Claire Mounier-Vehier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
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Soquet J, Juthier F, Richardson M, Rousse N, Mugnier A, Coisne A, Loobuyck V, Prat A, Vincentelli A. P671Impaired left ventricular systolic function in patients with stenotic bicuspid aortic valve at the time of aortic valve replacement: a single-institution cohort of 425 patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p671] [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)
- J Soquet
- Lille University Hospital, Cardiac surgery, Lille, France
| | - F Juthier
- Lille University Hospital, Cardiac surgery, Lille, France
| | - M Richardson
- Lille University Hospital, Clinical physiology and echocardiography, Heart valve clinic, Lille, France
| | - N Rousse
- Lille University Hospital, Cardiac surgery, Lille, France
| | - A Mugnier
- Lille University Hospital, Cardiac surgery, Lille, France
| | - A Coisne
- Lille University Hospital, Clinical physiology and echocardiography, Heart valve clinic, Lille, France
| | - V Loobuyck
- Lille University Hospital, Cardiac surgery, Lille, France
| | - A Prat
- Lille University Hospital, Cardiac surgery, Lille, France
| | - A Vincentelli
- Lille University Hospital, Cardiac surgery, Lille, France
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Soquet J, Mugnier A, Juthier F, Banfi C, Al Ibrahim M, Prat A, Vincentelli A. Erratum to: Prise en charge précoce des insuffisances aortique et mitrale aiguës en réanimation. Réanimation 2012. [DOI: 10.1007/s13546-012-0476-7] [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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