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Vij V, Ruf TF, Thambo JB, Vogt L, Al-Sabri SMA, Nelles D, Schrickel JW, Beiert T, Nickenig G, von Bardeleben RS, Iriart X, Sedaghat A. Contrast-free left atrial appendage occlusion in patients using the LAMBRE™ device. Int J Cardiol 2024; 405:131939. [PMID: 38458388 DOI: 10.1016/j.ijcard.2024.131939] [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] [Received: 01/24/2024] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Advances in imaging have led to procedural optimization of left atrial appendage closure (LAAC). Contrast-free approaches, guided merely by echocardiography, have been established, however data on this topic remains scarce. In this analysis, we assessed contrast-free procedural results with the LAMBRE LAAC device. METHODS The multicenter retrospective BoBoMa (Bonn/Bordeaux/Mainz)-Registry included a total of 118 patients that underwent LAAC with LAMBRE devices omitting contrast-dye. Baseline and echocardiographic characteristics as well as intra- and postprocedural complications and outcomes were assessed. RESULTS Patients were at a mean age of 77.5 ± 7.5 years with high thromboembolic and bleeding risk (CHADS-VASc-score 4.6 ± 1.4, HAS-BLED-score 3.7 ± 1.0, respectively). Renal function was impaired with a mean glomerular filtration rate (GFR) of 50 ± 22 ml/min. Mean procedural time was 47.2 ± 37.5 minutes with a mean radiation dose of 4.75 ± 5.25 Gy*cm2. Device success, defined as proper deployment in a correct position, was achieved in 97.5% (115/118) of cases with repositioning of the occluder in 7.6% (9/118) and resizing in 3.4% (4/118) of cases. No relevant peri-device leakage (>3 mm) was observed with 42% of occluders being implanted in an ostial position. Periprocedural complications occurred in 6.8% (8/118) of cases, including two cases of device embolization and one case of clinically-relevant pericardial effusion requiring surgical intervention. Other complications included pericardial effusion (2.5%, 3/118) and vascular access site complications (1.7%, 2/118). CONCLUSION Echocardiography-guided contrast-free LAAC using the LAMBRE device is safe and feasible. Further prospective studies including the direct comparison of devices as well as imaging techniques are warranted in contrast-free LAAC.
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Affiliation(s)
- Vivian Vij
- Herzzentrum Bonn, University Hospital Bonn, Germany
| | | | | | - Lara Vogt
- Herzzentrum Bonn, University Hospital Bonn, Germany
| | | | | | | | | | | | | | | | - Alexander Sedaghat
- Herzzentrum Bonn, University Hospital Bonn, Germany; RheinAhrCardio, Praxis für Kardiologie, Bad-Neuenahr Ahrweiler, Germany.
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Amedro P, Gavotto A, Huguet H, Souilla L, Huby AC, Matecki S, Cadene A, De La Villeon G, Vincenti M, Werner O, Bredy C, Lavastre K, Abassi H, Cohen S, Hascoet S, Dauphin C, Chalard A, Dulac Y, Souletie N, Bouvaist H, Douchin S, Lachaud M, Ovaert C, Soulatges C, Combes N, Thambo JB, Iriart X, Bajolle F, Bonnet D, Ansquer H, Delpey JG, Cohen L, Picot MC, Guillaumont S. Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial. Eur Heart J 2024; 45:1458-1473. [PMID: 38430485 PMCID: PMC11032713 DOI: 10.1093/eurheartj/ehae085] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND AND AIMS Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD. METHODS The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health. RESULTS The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P = .038; effect size 0.34], body mass index [mean difference -0.7 kg/m2 (95% CI -1.3; -0.1); P = .022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P = .044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P = .007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent. CONCLUSIONS This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease.
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Affiliation(s)
- Pascal Amedro
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Arthur Gavotto
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Helena Huguet
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
| | - Luc Souilla
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Anne-Cecile Huby
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Stefan Matecki
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Anne Cadene
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
| | - Gregoire De La Villeon
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Marie Vincenti
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Oscar Werner
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
| | - Charlene Bredy
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Fontfroide Cardiac Rehabilitation Center, 1800 rue de Saint-Priest, 34097 Montpellier, France
| | - Kathleen Lavastre
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Hamouda Abassi
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Sarah Cohen
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, Marie-Lannelongue Hospital, Le Plessis-Robinson, France
| | - Sebastien Hascoet
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, Marie-Lannelongue Hospital, Le Plessis-Robinson, France
| | - Claire Dauphin
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Aurelie Chalard
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Yves Dulac
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Toulouse University Hospital, Toulouse, France
| | - Nathalie Souletie
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Toulouse University Hospital, Toulouse, France
| | - Helene Bouvaist
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Stephanie Douchin
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Matthias Lachaud
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Grenoble University Hospital, Grenoble, France
| | - Caroline Ovaert
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, APHM La Timone Hospital, Marseille, France
| | - Camille Soulatges
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, APHM La Timone Hospital, Marseille, France
| | - Nicolas Combes
- Pediatric and Congenital Cardiology Department, Pasteur Clinic, Toulouse, France
| | - Jean-Benoit Thambo
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
- IHU Liryc, INSERM 1045, University of Bordeaux, Avenue du Haut-Leveque, 33600 Pessac, France
| | - Xavier Iriart
- Department of Fetal, Pediatric and Adult Congenital Cardiology, M3C National CHD Reference Centre, Bordeaux University Hospital, Haut-Leveque Hospital, Avenue de Magellan, 33604 Pessac Cedex, France
| | - Fanny Bajolle
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, APHP Necker Hospital, Paris, France
| | - Damien Bonnet
- Pediatric and Congenital Cardiology Department, M3C National Reference CHD Centre, APHP Necker Hospital, Paris, France
| | - Helene Ansquer
- Pediatric and Congenital Cardiology Department, Brest University Hospital, Brest, France
| | - Jean-Guillaume Delpey
- Pediatric and Congenital Cardiology Department, Brest University Hospital, Brest, France
| | - Laurence Cohen
- Fetal, Pediatric and Congenital Private Practice, 8 rue du Conseil de l'Europe, 91300 Massy, France
| | - Marie-Christine Picot
- Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France
- Clinical Investigation Centre, INSERM-CIC 1411, University of Montpellier, Montpellier, France
| | - Sophie Guillaumont
- Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
- Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
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Padovani P, Jalal Z, Fouilloux V, Benbrik N, Grunenwald C, Thambo JB, Aldebert P, Tagorti M, Roubertie F, Baron O, Ovaert C, Ly M, Baruteau AE. Risk of infective endocarditis after hybrid melody mitral valve replacement in infants: the French experience. Interdiscip Cardiovasc Thorac Surg 2024; 38:ivae046. [PMID: 38490258 DOI: 10.1093/icvts/ivae046] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES Surgical management of mitral valve disease is challenging in infants <1 year old. We aimed at reviewing the French experience with Melody mitral valve replacement in critically ill infants. METHODS A retrospective cohort study reporting the French experience with Melody mitral valve replacement. RESULTS Seven symptomatic infants [complete atrioventricular septal defect (n = 4, Down syndrome: n = 3), hammock valve (n = 3)] underwent Melody mitral valve replacement [age: 3 months (28 days to 8 months), weight: 4.3 kg (3.2-6.4 kg)] because of severe mitral valve regurgitation (6) or mixed valve disease (1) and 14 mm (11-16 mm) mitral valve annulus. In 2 patients whose valve was felt irreparable, Melody mitral valve replacement was performed straightaway. The others underwent 2 (1-3) previous attempts of valve repair; 3 were on extracorporeal membrane oxygenation. Melody mitral valve replacement led to competent valve and low gradient [3 mmHg, (1-4 mmHg)]. One patient died 3 days post-implant from extracorporeal membrane oxygenation-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, 1 underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical mitral valve replacement at 2 years; another is currently planned for transcatheter Melody valve dilation. CONCLUSIONS Melody mitral valve replacement may be considered in selected infants with small mitral valve annulus as an alternative to mechanical mitral valve replacement. Our experience highlights a high-risk of late infective endocarditis that deserves further consideration.
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Affiliation(s)
- Paul Padovani
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Zakaria Jalal
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Virginie Fouilloux
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
| | - Nadir Benbrik
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Céline Grunenwald
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - Jean-Benoit Thambo
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Philippe Aldebert
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
| | - Maha Tagorti
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
| | - François Roubertie
- Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France
- U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
- Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France
| | - Olivier Baron
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France
- Marseille Medical Genetics, INSERM U1251, Aix-Marseille Université, Marseille, France
| | - Mohamedou Ly
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Alban-Elouen Baruteau
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
- INSERM, Nantes Université, CHU Nantes, Nantes, France
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
- Nantes Université, INRAE, UMR 1280, PhAN, Nantes, France
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Pilard CM, Villemain O, Laforest G, Roubertie F, Thambo JB, Jalal Z. Outcomes Following Closure of Secundum Atrial Septal Defect in Children ≤ 15 kg in a French Tertiary Centre. J Clin Med 2023; 13:198. [PMID: 38202205 PMCID: PMC10780239 DOI: 10.3390/jcm13010198] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Secundum atrial septal defects (sASDs) are common congenital cardiac defects mostly treated using a transcatheter approach. However, small children (<15 kg) are still undergoing surgical sASD closure in many centres. Although both options have been proved to have excellent results in children, comparative data of the two techniques are missing for patients ≤ 15 kg. The medical records of children ≤ 15 kg who underwent sASD surgical (group A) and transcatheter (group B) closure between 2010 and 2023 were reviewed retrospectively. Twenty-five children in group A and twenty-two in group B were included (mean weight 8.9 kg in group A and 10.3 kg in group B). The main indications for closure were right heart enlargement and failure to thrive. Major complications occurred in two patients in group A and none in group B. Minor complications occurred in eight patients in group A and one in group B. At last follow-up, symptoms resolved completely or improved significantly for all infants, with the exception of failure to thrive in the sub-population of children with extra-cardiac comorbidities. sASD closure can be performed safely in symptomatic infants ≤ 15 kg, even in the presence of comorbidity, and should not be postponed. However, in patients with extra-cardiac comorbidities, the only indication of growth retardation must be carefully evaluated.
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Affiliation(s)
- Claire-Marie Pilard
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
- Plateforme Technologique d’Innovation Biomédicale, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux University, INSERM U1045, 33600 Pessac, France
| | - Olivier Villemain
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
- Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, 33600 Pessac, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, 33600 Pessac, France
| | - Gérald Laforest
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
| | - François Roubertie
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
- Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, 33600 Pessac, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, 33600 Pessac, France
| | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
- Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, 33600 Pessac, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, 33600 Pessac, France
| | - Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 36000 Pessac, France; (O.V.); (G.L.); (F.R.); (J.-B.T.); (Z.J.)
- Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, 33600 Pessac, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, 33600 Pessac, France
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Hascoet S, Baruteau AE, Jalal Z, Demkow M, de Winter R, Gaio G, Clerc JM, Sabiniewicz R, Eberli F, Santoro G, Dauphin C, Schubert S, Smolka G, Lutz M, Moreno R, Pan M, Gutierrez-Larraya F, Godart F, Carminati M, Ovaert C, Batteux C, Guerin P, Thambo JB, Ewert P. Safety and efficacy of the Amplatzer™ Trevisio™ intravascular delivery system: Post-approval study results. Arch Cardiovasc Dis 2023; 116:580-589. [PMID: 37951755 DOI: 10.1016/j.acvd.2023.10.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The Amplatzer™ Trevisio™ Intravascular Delivery System (Trevisio DS; Abbott Laboratories, Chicago, IL, USA) facilitates the delivery of Amplatzer™ Occluders and features an ultraflexible tip, which improves assessment of occluder position before release. AIMS To assess the safety and efficacy of the Trevisio DS for transcatheter closure of patent foramen ovale and atrial septal defect. METHODS The Amplatzer™ Trevisio™ Intravascular Delivery System Post-Approval Study was a prospective, postmarket, single-arm, multicentre, observational study of the Trevisio DS. Enrolled patients were indicated for transcatheter closure of patent foramen ovale or atrial septal defect. In all procedures, the Trevisio DS was used to deliver Amplatzer™ Occluders. Technical success was defined as successful deployment and release of at least one occluder. Device- or procedure-related serious adverse events were tracked until discharge or day 7, whichever occurred earlier. RESULTS The study enrolled 144 patients with patent foramen ovale and 107 patients with atrial septal defect at 22 European sites; 53 patients with atrial septal defect (49.6%) were aged<18years. The rate of technical success was 98.4% (97.2% for atrial septal defect, 99.3% for patent foramen ovale). There was one serious adverse event (0.4%), an acute periprocedural device embolization that occurred after occluder release in a patient with atrial septal defect; the device was retrieved percutaneously. This was determined by the implanter to be unrelated to the performance of the Trevisio DS. CONCLUSIONS The Trevisio DS exhibited a high rate of technical success and an excellent safety profile during transcatheter closure of patent foramen ovale and atrial septal defect.
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Affiliation(s)
- Sebastien Hascoet
- Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), BME Lab, 92350 Le Plessis-Robinson, France.
| | - Alban-Elouen Baruteau
- Nantes Université, CHU de Nantes, Department of Paediatric Cardiology and Paediatric Cardiac Surgery, FHU PRECICARE, 44000 Nantes, France; Nantes Université, CHU de Nantes, Inserm, CIC FEA 1413, 44000 Nantes, France; Nantes Université, CHU de Nantes, CNRS, Inserm, l'Institut du Thorax, 44000 Nantes, France
| | - Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, CHU de Bordeaux, 33000 Bordeaux, France; Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), 92350 Le Plessis-Robinson, France; Electrophysiology and Heart Modelling Institute, IHU Liryc, Fondation Bordeaux Université, 33000 Bordeaux, France
| | - Marcin Demkow
- The Cardinal Stefan Wyszynski Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Robbert de Winter
- Amsterdam Academic Medical Centre (AMC), 1105 AZ Amsterdam, The Netherlands
| | | | | | | | | | | | | | - Stephan Schubert
- Deutsches Herzzentrum Berlin, 13353 Berlin, Germany; Herz-und Diabetes Zentrum NRW, University Clinic of Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | | | - Matthias Lutz
- Universitätsklinikum Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
| | - Raul Moreno
- Hospital Universitario de la Paz, 28046 Madrid, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia, 14004 Cordoba, Spain
| | | | | | | | | | - Clement Batteux
- Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine Paris-Saclay, Université Paris-Saclay, Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), BME Lab, 92350 Le Plessis-Robinson, France
| | | | - Jean-Benoit Thambo
- Centre Constitutif Réseau Maladies Rares Cardiopathies Congénitales Complexes (M3C), 92350 Le Plessis-Robinson, France; Electrophysiology and Heart Modelling Institute, IHU Liryc, Fondation Bordeaux Université, 33000 Bordeaux, France
| | - Peter Ewert
- Deutsches Herzzentrum München des Freistaates Bayern, 80636 München, Germany
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Baruteau AE, Hascoet S, Malekzadeh-Milani S, Batteux C, Karsenty C, Ciobotaru V, Thambo JB, Fraisse A, Boudjemline Y, Jalal Z. Transcatheter Closure of Superior Sinus Venosus Defects. JACC Cardiovasc Interv 2023; 16:2587-2599. [PMID: 37855807 DOI: 10.1016/j.jcin.2023.07.024] [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] [Received: 02/21/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 10/20/2023]
Abstract
Superior sinus venosus defect is a communication between the right and left atrium located above the upper margin of the oval fossa, immediately inferior to the junction of the superior vena cava and the right atrium. It is systematically associated with partial anomalous pulmonary venous drainage, especially of the right upper pulmonary vein. Surgical repair has been the gold standard approach to close that defect. Introduced in 2014, percutaneous closure has gradually become a safe and effective alternative to surgery in carefully selected patients, although worldwide experience remains limited. This article provides an appraisal of the patients' selection process and a step-by-step description of the procedure as well as a comprehensive review of its outcomes.
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Affiliation(s)
- Alban-Elouen Baruteau
- Nantes Université, Centre Hospitalier Universitaire Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Nantes, France; Nantes Université, Centre Hospitalier Universitaire Nantes, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Scientifique, l'institut du thorax, Nantes, France; Nantes Université, Centre Hospitalier Universitaire Nantes, Institut National de la Santé et de la Recherche Scientifique, Centre d'Investigations Cliniques Femmes-Enfants-Adolescents 1413, Nantes, France; Nantes Université, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Unité Mixte de Recherche 1280, Physiologie des Adaptations Nutritionnelles, Nantes, France.
| | - Sébastien Hascoet
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France
| | - Sophie Malekzadeh-Milani
- Malformations Cardiaques Congénitales Complexes-Necker, Department of Congenital and Pediatric Cardiology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Clément Batteux
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France
| | - Clément Karsenty
- Department of Pediatrics, Centre Hospitalier Universitaire Toulouse, Université de Toulouse, Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Toulouse, France
| | - Vlad Ciobotaru
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France; Clinique des Franciscaines, 3Dheartmodeling, Nîmes, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France; Electrophysiology and Heart Modeling Institute, Institut Hospital-Universitaire Liryc, Fondation Bordeaux Université, Bordeaux, France
| | - Alain Fraisse
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Younes Boudjemline
- Sidra Heart Center, Sidra Medicine, Weil Cornell Medical College, Doha, Qatar
| | - Zakaria Jalal
- Department of Pediatric and Adult Congenital Cardiology, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France; Electrophysiology and Heart Modeling Institute, Institut Hospital-Universitaire Liryc, Fondation Bordeaux Université, Bordeaux, France
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Iriart X, Blanc G, Bouteiller XP, Legghe B, Bouyer B, Sridi-Cheniti S, Bustin A, Vasile C, Thambo JB, Elbaz M, Cochet H. Clinical Implications of CT-detected Hypoattenuation Thickening on Left Atrial Appendage Occlusion Devices. Radiology 2023; 308:e230462. [PMID: 37668517 DOI: 10.1148/radiol.230462] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Background At follow-up CT after left atrial appendage occlusion (LAAO), hypoattenuation thickening (HAT) on the atrial aspect of the device is a common finding but the clinical implications require further study. Purpose To assess the association of HAT grade at follow-up CT with clinical characteristics and outcomes in patients who underwent LAAO. Materials and Methods This prospective study included consecutive participants with atrial fibrillation and who were at high risk for stroke (CHA2DS2-VASc score ≥4) who underwent LAAO and were administered pacifier or nonpacifier devices at two French medical centers between January 2012 and November 2020. Postprocedure CT images were evaluated by two radiologists in consensus and device-specific interpretation algorithms were applied to classify HAT as low grade (low suspicion of thrombosis) or high grade (high suspicion of thrombosis). The association between HAT grade and clinical characteristics was assessed using multinomial logistic regression, and variables associated with risk of stroke were assessed using a Cox proportional hazard model. Results This study included 412 participants (mean age, 76 years ± 8 [SD]; 284 male participants) who underwent follow-up CT at a mean of 4.2 months ± 1.7 after LAAO. Low-grade and high-grade HAT were depicted in 98 of 412 (23.8%) and 21 of 412 (5.1%) participants, respectively. High-grade HAT was associated with higher odds of antithrombotic drug discontinuation during follow-up (odds ratio, 9.5; 95% CI: 3.1, 29.1; P < .001), whereas low-grade HAT was associated with lower odds of persisting left atrial appendage patency (odds ratio, 0.46; 95% CI: 0.27, 0.79; P = .005). During a median follow-up of 17 months (IQR, 11-41 months), stroke occurred in 24 of 412 (5.8%) participants. High-grade HAT was associated with stroke (hazard ratio, 4.6; 95% CI: 1.5, 14.0; P = .008) and low-grade HAT (P = .62) was not. Conclusion Low-grade HAT was a more common finding at CT performed after LAAO CT (24%) than was high-grade HAT (5%), but it was associated with more favorable outcomes than high-grade HAT, which was associated with higher stroke risk. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Choe in this issue.
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Affiliation(s)
- Xavier Iriart
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Gregoire Blanc
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Xavier Paul Bouteiller
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Benoit Legghe
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Benjamin Bouyer
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Soumaya Sridi-Cheniti
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Aurélien Bustin
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Corina Vasile
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Jean-Benoit Thambo
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Meyer Elbaz
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
| | - Hubert Cochet
- From the IHU Liryc, CHU/Univ Bordeaux/Inserm 1045, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Inserm U1045, Avenue de Magellan, 33604 Pessac, France (X.I., X.P.B., A.B., J.B.T., H.C.); Department of Cardiac Imaging, CHU Bordeaux, Pessac, France (B.L., S.S.C., H.C.); Department of Pediatric and Adult Congenital Heart Disease, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux-Pessac, France (X.I., B.B., C.V., J.B.T.); and Department of Cardiology, CHU de Toulouse, Toulouse, France (G.B., M.E.)
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Bouyer B, Jalal Z, Daniel Ramirez F, Derval N, Iriart X, Duchateau J, Roubertie F, Tafer N, Tixier R, Pambrun T, Cheniti G, Ascione C, Yokoyama M, Kowalewski C, Buliard S, Chauvel R, Arnaud M, Hocini M, Haïssaguerre M, Jaïs P, Cochet H, Thambo JB, Sacher F. Electrophysiological study prior to planned pulmonary valve replacement in patients with repaired tetralogy of Fallot. J Cardiovasc Electrophysiol 2023; 34:1395-1404. [PMID: 37232426 DOI: 10.1111/jce.15940] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/03/2023] [Revised: 04/27/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
AIM Ventricular arrhythmias (VAs) are the most common cause of death in patients with repaired Tetralogy of Fallot (rTOF). However, risk stratifying remains challenging. We examined outcomes following programmed ventricular stimulation (PVS) with or without subsequent ablation in patients with rTOF planned for pulmonary valve replacement (PVR). METHODS We included all consecutive patients with rTOF referred to our institution from 2010 to 2018 aged ≥18 years for PVR. Right ventricular (RV) voltage maps were acquired and PVS was performed from two different sites at baseline, and if non-inducible under isoproterenol. Catheter and/or surgical ablation was performed when patients were inducible or when slow conduction was present in anatomical isthmuses (AIs). Postablation PVS was undertaken to guide implantable cardioverter-defibrillator (ICD) implantation. RESULTS Seventy-seven patients (36.2 ± 14.3 years old, 71% male) were included. Eighteen were inducible. In 28 patients (17 inducible, 11 non-inducible but with slow conduction) ablation was performed. Five had catheter ablation, surgical cryoablation in 9, both techniques in 14. ICDs were implanted in five patients. During a follow-up of 74 ± 40 months, no sudden cardiac death occurred. Three patients experienced sustained VAs, all were inducible during the initial EP study. Two of them had an ICD (low ejection fraction for one and important risk factor for arrhythmia for the second). No VAs were reported in the non-inducible group (p < .001). CONCLUSION Preoperative EPS can help identifying patients with rTOF at risk for VAs, providing an opportunity for targeted ablation and may improve decision-making regarding ICD implantation.
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Affiliation(s)
- Benjamin Bouyer
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Zakaria Jalal
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Congenital Heart Disease, Bordeaux University Hospital (CHU), Bordeaux, France
| | | | - Nicolas Derval
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Xavier Iriart
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Congenital Heart Disease, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Josselin Duchateau
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - François Roubertie
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Congenital Heart Disease, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Nadir Tafer
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Congenital Heart Disease, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Romain Tixier
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Thomas Pambrun
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Ghassen Cheniti
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Ciro Ascione
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Masaaki Yokoyama
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Christopher Kowalewski
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Samuel Buliard
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Rémi Chauvel
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Marine Arnaud
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Mélèze Hocini
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Michel Haïssaguerre
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Pierre Jaïs
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Radiology, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Jean-Benoit Thambo
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
- Department of Congenital Heart Disease, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Frederic Sacher
- Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
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Vasile CM, Bouteiller XP, Avesani M, Velly C, Chan C, Jalal Z, Thambo JB, Iriart X. Exploring the Potential of Artificial Intelligence in Pediatric Echocardiography-Preliminary Results from the First Pediatric Study Using AI Software Developed for Adults. J Clin Med 2023; 12:3209. [PMID: 37176649 PMCID: PMC10179538 DOI: 10.3390/jcm12093209] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/19/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients' cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. (2) Aim: This study aimed to determine whether an automated software developed for adults could be effectively used for the analysis of pediatric echocardiography studies without prior training. (3) Materials and Methods: The study was conducted at the University Hospital of Bordeaux between August and September 2022 and included 45 patients with normal or near normal heart architecture who underwent a 2D TTE. We performed Spearman correlation and Bland-Altman analysis. (4) Results: The mean age of our patients at the time of evaluation was 8.2 years ± 5.7, and the main reason for referral to our service was the presence of a heart murmur. Bland-Altman analysis showed good agreement between AI and the senior physician for two parameters (aortic annulus and E wave) regardless of the age of the children included in the study. A good agreement between AI and physicians was also achieved for two other features (STJ and EF) but only for patients older than 9 years. For other features, either a good agreement was found between physicians but not with the AI, or a poor agreement was established. In the first case, maybe proper training of the AI could improve the measurement, but in the latter case, for now, it seems unrealistic to expect to reach a satisfactory accuracy. (5) Conclusion: Based on this preliminary study on a small cohort group of pediatric patients, the AI soft originally developed for the adult population, had provided promising results in the evaluation of aortic annulus, STJ, and E wave.
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Affiliation(s)
- Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
| | - Xavier Paul Bouteiller
- IHU Liryc—Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, 33600 Pessac, France
- Department of Cardiology, Rythmology, CHU of Bordeaux, 33600 Pessac, France
| | - Martina Avesani
- Department of Cardiac, Thoracic, Vascular and Public Health Sciences, University of Padua, 235122 Padova, Italy
| | - Camille Velly
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
| | - Camille Chan
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
| | - Zakaria Jalal
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France
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10
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Dib N, Iriart X, Belaroussi Y, Albadi W, Tafer N, Thambo JB, Khairy P, Roubertie F. The Ross Operation in Young Patients: A 15-Year Experience Focused on Right Ventricle to Pulmonary Artery Conduit Outcomes. CJC Pediatr Congenit Heart Dis 2023; 2:86-92. [PMID: 37970525 PMCID: PMC10642144 DOI: 10.1016/j.cjcpc.2022.12.003] [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] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/20/2022] [Indexed: 11/17/2023]
Abstract
Background Data on long-term outcomes of the Ross operation in children and young adult patients are limited. The best pulmonary valve substitute for the right ventricular outflow tract reconstruction remains uncertain. This study aimed to assess the outcomes of right ventricular outflow tract reconstruction in the Ross operation in young patients using various pulmonary valve substitutes at a single institution. In addition, a comparison of reintervention rates between patients younger than 18 years and those older than 18 years was performed. Methods The study assessed all patients (N = 110) who underwent the Ross operation at the University Hospital of Bordeaux, France, between 2004 and 2020. Results The median follow-up time was 4.2 years, and the median age at operation was 15.9 years. There was no operative mortality and 1 late noncardiac death (0.8%). The overall survival rate at 10 years was 99.2%. The need for right ventricular outflow tract reoperation was lower with the pulmonary homograft compared with the Contegra conduit and Freestyle bioprosthesis: 94.3%, 93.8%, and 80% at 5 years, respectively, and 94.3%, 72.3%, and 34.3% at 10 years, respectively (P = 0.011). The probability of reintervention was not significantly different at 10 years among children vs adults (P = 0.22). Conclusions The Ross procedure in children and young adults was associated with a lower requirement for right ventricular outflow tract reoperation when pulmonary homografts were used instead of xenografts.
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Affiliation(s)
- Nabil Dib
- Department of Congenital Cardiac surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Xavier Iriart
- Department of Congenital Cardiology, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Yaniss Belaroussi
- Department of Congenital Cardiac surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Waleed Albadi
- Department of Congenital Cardiac surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Nadir Tafer
- Department of Congenital Cardiac Anesthesiology, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Congenital Cardiology, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Paul Khairy
- Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
| | - François Roubertie
- Department of Congenital Cardiac surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
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11
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Thambo JB, Venet M, Kreitmann B, Love BA, Jalal Z, Iriart X, Roubertie F. RISK FACTORS FOR EARLY PULMONARY HOMOGRAFT DYSFUNCTION IN CONGENITAL HEART DISEASE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02068-5] [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: 03/06/2023]
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12
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Karsenty C, Djeddai C, Cohen A, Bonnet G, Ma I, Vignaud P, Thambo JB, Di Filippo S, Acar P, Ladouceur M. Training young cardiologists in adult congenital heart disease should be a priority: Results of a French survey. Arch Cardiovasc Dis 2023; 116:167-169. [PMID: 36639299 DOI: 10.1016/j.acvd.2022.12.001] [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] [Received: 09/02/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Clément Karsenty
- Paediatric and Adult Congenital Cardiology Unit, CHU Toulouse, 330, avenue de Grande Bretagne, 31059 Toulouse cedex 9, France; Institut des maladies métaboliques et cardiovasculaires, université de Toulouse, Inserm U1048, I2MC, 31432 Toulouse, France.
| | - Camelia Djeddai
- Paediatric and Adult Congenital Cardiology Unit, CHU Toulouse, 330, avenue de Grande Bretagne, 31059 Toulouse cedex 9, France
| | - Ariel Cohen
- Department of Cardiology, Saint-Antoine and Tenon Hospital, AP-HP, Inserm UMRS-ICAN 1166 and Sorbonne université, 75013 Paris, France
| | - Guillaume Bonnet
- Centre de recherche cardiovasculaire de Paris, Inserm U970, 75015 Paris, France
| | - Iris Ma
- Institut des cardiopathies congénitales de Tours, CHRU de Tours, centre hospitalier regional universitaire de Tours, université François-Rabelais, 37000 Tours, France
| | - Paul Vignaud
- Paediatric and Adult Congenital Cardiology Unit, CHU Toulouse, 330, avenue de Grande Bretagne, 31059 Toulouse cedex 9, France
| | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, University Hospital of Bordeaux; IHU Liryc, fondation Bordeaux université, centre de recherche cardiothoracique de Bordeaux, Inserm, 33600 Pessac, France
| | - Sylvie Di Filippo
- Service de cardiologie pédiatrique, groupe hospitalier Est, CHU de Lyon, 69677 Bron, France
| | - Philippe Acar
- Paediatric and Adult Congenital Cardiology Unit, CHU Toulouse, 330, avenue de Grande Bretagne, 31059 Toulouse cedex 9, France
| | - Magalie Ladouceur
- Centre de recherche cardiovasculaire de Paris, Inserm U970, 75015 Paris, France; Centre de référence des malformations cardiaques congénitales complexes, M3C, Adult Congenital Heart Disease Unit, hôpital européen Georges-Pompidou, AP-HP, Paris Cité University, 75015 Paris, France
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13
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Laredo M, Duthoit G, Sacher F, Anselme F, Audinet C, Bessière F, Bordachar P, Bouzeman A, Boveda S, Bun SS, Chassignolle M, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Extramiana F, Fauchier L, Hermida A, Gandjbakhch E, Garcia R, Gourraud JB, Guenancia C, Guy-Moyat B, Irles D, Iserin L, Jourda F, Koutbi L, Labombarda F, Ladouceur M, Lagrange P, Lellouche N, Mansourati J, Marquié C, Martins R, Massoulié G, Mathiron A, Maury P, Messali A, Milhem A, Mondoly P, Nguyen C, Ninni S, Pasquié JL, Pierre B, Pujadas P, Sellal JM, Thambo JB, Walton C, Winum P, Zakine C, Zhao A, Jouven X, Combes N, Marijon E, Waldmann V. Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator: Insights from the DAI-T4F nationwide registry. Heart Rhythm 2023; 20:252-260. [PMID: 36309156 DOI: 10.1016/j.hrthm.2022.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/28/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND In repaired tetralogy of Fallot (TOF), little is known about characteristics of patients with rapid ventricular tachycardia (VT). Also, whether patients with a first episode of nonrapid VT may subsequently develop rapid VT or ventricular fibrillation (VF) has not been addressed. OBJECTIVES The objectives of this study were to compare patients with rapid VT/VF with those with nonrapid VT and to assess the evolution of VT cycle lengths (VTCLs) overtime. METHODS Data were analyzed from a nationwide registry including all patients with TOF and implantable cardioverter-defibrillator (ICD) since 2000. Patients with ≥1 VT episode with VTCL ≤250 ms (240 beats/min) formed the rapid VT/VF group. RESULTS Of 144 patients (mean age 42.0 ± 12.7 years; 104 [72%] men), 61 (42%) had at least 1 VT/VF episode, including 28 patients with rapid VT/VF (46%), during a median follow-up of 6.3 years (interquartile range 2.2-10.3 years). Compared with patients in the nonrapid VT group, those in the rapid VT/VF group were significantly younger at ICD implantation (35.2 ± 12.6 years vs 41.5 ± 11.2 years; P = .04), had more frequently a history of cardiac arrest (8 [29%] vs 2 [6%]; P = .02), less frequently a history of atrial arrhythmia (11 [42%] vs 22 [69%]; P = .004), and higher right ventricular ejection fraction (43.3% ± 10.3% vs 36.6% ± 11.2%; P = .04). The median VTCL of VT/VF episodes was 325 ms (interquartile range 235-429 ms). None of the patients with a first documented nonrapid VT episode had rapid VT/VF during follow-up. CONCLUSION Patients with TOF and rapid VT/VF had distinct clinical characteristics. The relatively low variation of VTCL over time suggests a room for catheter ablation without a backup ICD in selected patients with well-tolerated VT.
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Affiliation(s)
- Mikael Laredo
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Guillaume Duthoit
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Frédéric Sacher
- LIRYC Institute, Bordeaux University Hospital, Bordeaux, France
| | | | | | | | | | | | | | | | - Morgane Chassignolle
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France
| | - Gaël Clerici
- Saint Pierre University Hospital, La Réunion, France
| | | | | | | | | | | | | | | | | | - Estelle Gandjbakhch
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | | | | | | | | | | | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | - Magalie Ladouceur
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xavier Jouven
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France
| | | | - Eloi Marijon
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France
| | - Victor Waldmann
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France.
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14
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Leroux J, Strik M, Ramirez FD, Racine HP, Ploux S, Sacristan B, Chabaneix-Thomas J, Jalal Z, Thambo JB, Bordachar P. Feasibility and Diagnostic Value of Recording Smartwatch Electrocardiograms in Neonates and Children. J Pediatr 2023; 253:40-45.e1. [PMID: 36113637 DOI: 10.1016/j.jpeds.2022.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 03/21/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the agreement of smartwatch-derived single-lead electrocardiogram (ECG) recordings with 12-lead ECGs for diagnosing electrocardiographic abnormalities. STUDY DESIGN A 12-lead ECG and an ECG using Apple Watch were obtained in 110 children (aged 1 week to 16 years) with normal (n = 75) or abnormal (n = 35) 12-lead ECGs (atrioventricular block [7], supraventricular tachycardia [SVT] {5}, bundle branch block [12], ventricular preexcitation [6], long QT [5]). In children aged <6 years, the ECG recording was performed with the active participation of an adult who applied the neonate or child's finger to the crown of the watch. In older children, tracings were obtained after brief teaching without adult guidance. All 12-lead ECGs were independently evaluated by 2 blinded cardiologists. Apple Watch ECGs were independently evaluated by another blinded cardiologist. RESULTS In 109 children (99.1%), the smartwatch tracing was of sufficient quality for evaluation. Smartwatch tracings were 84% sensitive and 100% specific for the detection of an abnormal ECG. All 75 normal tracings were correctly identified. Of the 35 children with abnormalities on 12-lead ECGs, 5 (14%) were missed, most often because of baseline wander and artifacts. Rhythm disorders (atrioventricular block or SVT) and bundle branch blocks were correctly detected in most cases (11 of 12 and 11 of 12, respectively); preexcitation and long QT was detected in 4 of 6 and 4 of 5, respectively. CONCLUSION Smartwatch ECGs recorded with parental assistance in children aged up to 6 years and independently in older children have the potential to detect clinically relevant conditions.
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Affiliation(s)
- Justine Leroux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France
| | - Marc Strik
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France.
| | - F Daniel Ramirez
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Hugo Pierre Racine
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval (IUCPQ-UL), Quebec, Canada
| | - Sylvain Ploux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Benjamin Sacristan
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Julie Chabaneix-Thomas
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Zakaria Jalal
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Jean-Benoit Thambo
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Pierre Bordachar
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Pessac- Bordeaux, France
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15
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Hascoet S, Smolka G, Brochet E, Bouisset F, Leurent G, Thambo JB, Combes N, Bauer F, Nejjari M, Pilliere R, Dauphin C, Bonnet G, Ketelers R, Champagnac D, Gerardin B. Predictors of clinical success after transcatheter para-valvular leak closure: an international prospective multicentre registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2138] [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
Prosthetic paravalvular leaks (PVLs) are associated with congestive heart failure and haemolysis, for which the standard treatment is open-heart surgery with the attendant risks to the patient. Transcatheter closure has emerged as an alternative. Patient selection criteria for the best option are needed. We aimed to identify predictors of clinical success after transcatheter PVL closure.
Purpose
We aimed to identify predictors of clinical success after transcatheter PVL closure.
Methods
Consecutive patients referred to 24 European centres for transcatheter PVL closure in 2017–2019 were included in a prospective registry (Fermeture de Fuite ParaProthétique, FFPP). Clinical success was absence of any of the following within 1 month: re-admission for heart failure, blood transfusion, open-heart valvular surgery, and death.
Results
We included 216 symptomatic patients, who underwent 238 percutaneous PVL closure procedures on the mitral (64.3%), aortic (34.0%), or tricuspid (1.7%) valve. The prosthesis was mechanical in 53.3% and biological in 45.3% of procedures. All patients were symptomatic with heart failure, haemolytic anaemia, and the association of both conditions in 48.9%, 7.8% and 43.3%. One, two and three PVL were addressed during the same procedure in 69.6%, 26.6% and 3.8% respectively. Mitral and aortic PVL were severe in 35.3% and 13.8% (p<0.001). PVL was punctiform or extended to 1/8 or 1/4 of valve circumference in 18.6%, 52.4% and 28.1% of cases. A total of 331 devices were implanted. More than one device (up to 5) was implanted in 34.2% of procedures. Vascular plug 3, muscular ventricular septal defect occluder, vascular plug 2 and paravalvular leak device were the most frequently used devices, implanted in 45.0%, 16.0%, 14.2% and 13.6%, respectively. Successful device(s) implantation(s) within the leak and leak reduction ≤ grade 2 occurred in 85.0% and 91.4% of patients with mitral and aortic procedures, respectively (p=0.164), with major intra-procedural adverse event rates of 3.3% and 1.2%, respectively (p=0.371). The clinical success rates were 77.8% and 88.9% following mitral and aortic procedures, respectively (p=0.01). By multivariate logistic regression analysis, technical failure, mechanical valve and haemolytic anaemia were independently associated with absence of clinical success (odds ratios [95% CIs]: 7.7 [2.0–25.0], p=0.002; 3.6 [1.1–11.1], p=0.036 and 3.7 [1.2–11.9], p=0.025; respectively).
Conclusion
Transcatheter PVL closure is efficient and safe in symptomatic patients but is more challenging and associated with an increased risk of clinical failure when performed in patients with hemolysis and/or on a mechanical valve.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): The study is promoted and financially supported by Groupe Hospitalier Paris Saint Joseph
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Affiliation(s)
- S Hascoet
- Marie Lannelongue Hospital , Le Plessis Robinson , France
| | - G Smolka
- School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - E Brochet
- Bichat APHP Site of Paris Nord University Hospital , Paris , France
| | - F Bouisset
- Rangueil Hospital of Toulouse , Toulouse , France
| | - G Leurent
- Hospital Pontchaillou of Rennes , Rennes , France
| | - J B Thambo
- Hospital Haut Leveque , Bordeaux , France
| | - N Combes
- Clinic Pasteur , Toulouse , France
| | - F Bauer
- Rouen University Medical School , Rouen , France
| | - M Nejjari
- centre cardiologique du nord , Saint-Denis , France
| | - R Pilliere
- Clinique Ambroise Pare , Neuilly sur Seine , France
| | - C Dauphin
- University Hospital Gabriel Montpied , Clermont-Ferrand , France
| | - G Bonnet
- APHM La Timone Hospital , Marseille , France
| | | | - D Champagnac
- Medipole Lyon-Villeurbanne , Villeurbanne , France
| | - B Gerardin
- Marie Lannelongue Hospital , Le Plessis Robinson , France
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16
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Guerin P, Jalal Z, Cueff C, Hascoet S, Bouvaist H, Levy F, Hugues N, Ladouceur M, Malekzadeh-Milani SG, Iriart X, Silini A, Karam N, Iserin L, Le Gloan L, Thambo JB. Percutaneous edge-to-edge repair for systemic tricuspid valve regurgitation in patients with congenital heart disease: the first descriptive cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1834] [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
In patients with congenital heart diseases (CHD) systemic tricuspid regurgitation (STR) is frequent.
Here, we report our experience with percutaneous edge-to-edge repair (PETER) in a series of 12 CHD patients with STR using the MitraClip system.
Twelve patients (median age = 35 years, 83% males) with severe STR (ccTGA (n=5), asTGA (n=3), SV (n=4)), at high-risk for surgical treatment, gave informed consent for treatment using PETER. The XTR MitraClip device (Abbott, Santa Clara, CA) was used. At baseline, 7/12 patients were in NYHA functional class ≥ III. Standard femoral venous access was successfully used in 10/12 patients. In SV patients, the systemic valve was accessed directly through the right atrium (n=2), after a Fontan conduit puncture (n=1), or after direct atrial surgical access (n=1). In TGA patients, either transseptal (ccTGA patients, n=4) or transbaffle (asTGA patients, n=3) puncture was performed (4).
Mitraclip devices were successfully implanted in 11/12 patients (Figure 1). One procedural complication was reported for a patient with SV in whom a septal leaflet rupture occurred following clip release, leading to severe STR; the patient died from refractory cardiac failure one week later. Peri-procedural complications included one case of left femoral vein injury and one case of atrial flutter treated by catheter ablation. After a median follow-up of 12-months (range 1–25) following device implantation, no death had occurred. The patients had significant reduction in STR (from severe to moderate in 10/11 patients) and clinically improved (10/11 patients were in NYHA class I or II).
To conclude, percutaneous edge-to-edge therapy of STR in CHD patients is feasible, safe and effective to reduce STR and SRV dilatation. This reduction is associated with a significant clinical improvement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Guerin
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - Z Jalal
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - C Cueff
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - S Hascoet
- Surgical Centre Marie Lannelongue, Departmentof Pediatric and Adult Congenital cardiology , Le Plessis Robinson , France
| | - H Bouvaist
- University Hospital of Grenoble, Interventional Cardiology , Grenoble , France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - N Hugues
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - M Ladouceur
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - S G Malekzadeh-Milani
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - X Iriart
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - A Silini
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - N Karam
- Georges Pompidou APHP Site of Paris Ouest University Hospital, Department of Cardiology , Paris , France
| | - L Iserin
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - L Le Gloan
- Hospital G.R. Laennec - University Hospital Centre of Nantes, Adult Congenital Heart Disease Unit , St Herblain , France
| | - J B Thambo
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
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17
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Clift P, Berger F, Sondergaard L, Antonova P, Disney P, Nicolarsen J, Thambo JB, Tomkiewicz Pajak L, Wang JK, Schophuus Jensen A, Burgess G, Efficace M, Friberg M, Lassen C, d'Udekem Y. The efficacy and safety of macitentan in Fontan-palliated patients: results of the 52-week randomised, placebo-controlled RUBATO trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1560] [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
The clinical utility and long-term effects of endothelin receptor antagonists (ERAs) in Fontan-palliated patients remain unclear and there are currently no approved therapies. A decline in peak VO2 between consecutive cardiopulmonary exercise tests (CPETs) is highly prognostic for death or transplant in adult Fontan patients, hence its use as a primary endpoint in clinical trials of ERAs in patients with Fontan circulation.
Purpose
The RUBATO trial aimed to assess the efficacy and safety of macitentan, an endothelin receptor antagonist, in Fontan-palliated patients over 52 weeks.
Methods
In the multicentre, double-blind, randomised, placebo-controlled, phase 3 RUBATO trial, Fontan-palliated patients were randomised 1:1 to macitentan 10 mg once-daily or placebo for 52 weeks. Eligible patients were aged ≥12 years, in New York Heart Association functional class II or III, had no limitations for CPET (including no pacemakers), had undergone lateral tunnel or extracardiac conduit Fontan (total cavopulmonary connection) >1 year before screening and showed no signs of Fontan failure or clinical deterioration within 3 months before screening. Primary efficacy endpoint was change in peak VO2 from baseline to week 16. Secondary endpoints were change in peak VO2 from baseline over 52 weeks and change in mean count per minute of daily physical activity from baseline to week 16 as measured by an accelerometer. Adverse events were also assessed.
Results
137 patients were randomised to macitentan (n=68) or placebo (n=69). 92.7% of patients completed 52 weeks of double-blind treatment: 7 and 3 patients prematurely discontinued study treatment in macitentan and placebo arms, respectively. Patient baseline characteristics are shown in Table 1. At week 16, the mean (SD) change from baseline in peak VO2 was –0.16 (2.86) with macitentan vs –0.67 (2.66) mL/kg/min with placebo (median unbiased estimate of the difference between macitentan and placebo: 0.62 mL/kg/min [99% repeated confidence interval –0.62; 1.85], p=0.1930). No treatment effect was observed in the two secondary endpoints (Table 2): mean (SD) count per minute of daily physical activity decreased from baseline to week 16 by 3.02 (92.44) with macitentan and by 14.34 (117.56) with placebo (p=0.4512). The most common AEs were headache (10.3% vs 8.7% on placebo), nasopharyngitis (5.9% vs 4.3%), and pyrexia (5.9% vs 4.3%). AEs leading to treatment discontinuation were reported in 3 (4.4%) and 1 (1.4%) of macitentan and placebo patients.
Conclusion
The 52-week RUBATO trial provides an important addition to data on the clinical utility of ERAs in Fontan-palliated patients. The primary efficacy endpoint was not met and no treatment effect was observed for the two secondary endpoints. Macitentan was well tolerated; safety findings were consistent with the known safety profile of macitentan 10 mg.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Actelion Pharmaceuticals Ltd., a Janssen pharmaceutical company of Johnson & Johnson.
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Affiliation(s)
- P Clift
- Queen Elizabeth Hospital Birmingham, Adult Congenital Heart Disease Unit , Birmingham , United Kingdom
| | - F Berger
- German Heart Center Berlin, Department of Congenital Heart Disease/Pediatric Cardiology , Berlin , Germany
| | - L Sondergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - P Antonova
- Charles University in Prague, Motol University Hospital, Department of Cardiovascular Surgery, 2nd Faculty of Medicine , Motol , Czechia
| | - P Disney
- Royal Adelaide Hospital, Department of Cardiology , Adelaide , Australia
| | - J Nicolarsen
- Providence Sacred Heart Medical Center and Children's Hospital, Providence Adult and Teen Congenital Heart Program (PATCH) , Spokane , United States of America
| | - J B Thambo
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology , Pessac , France
| | - L Tomkiewicz Pajak
- Jagiellonian University Medical College, John Paul II Hospital, Department of Cardiac and Vascular Diseases, Institute of Cardiology , Krakow , Poland
| | - J K Wang
- National Taiwan University Hospital, Department of Pediatrics , Taipei , Taiwan
| | - A Schophuus Jensen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - G Burgess
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | | | - M Friberg
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - C Lassen
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - Y d'Udekem
- Children's National Hospital, Washington , D.C. , United States of America
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Waldmann V, Marquié C, Bouzeman A, Duthoit G, Thambo JB, Koutbi L, Maltret A, Pasquié JL, Combes N, Marijon E. Subcutaneous vs Transvenous Implantable Cardioverter-Defibrillator Therapy in Patients With Tetralogy of Fallot. J Am Coll Cardiol 2022; 80:1701-1703. [DOI: 10.1016/j.jacc.2022.08.761] [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] [Received: 06/06/2022] [Revised: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
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Hascoët S, Smolka G, Blanchard D, Kloëckner M, Brochet E, Bouisset F, Leurent G, Thambo JB, Combes N, Dumonteil N, Bauer F, Nejjari M, Pillière R, Dauphin C, Bonnet G, Ciobotaru V, Kételers R, Gallet R, Hammoudi N, Mangin L, Bouvaist H, Spaulding C, Aminian A, Kilic T, Popovic B, Armero S, Champagnac D, Gérardin B. Predictors of Clinical Success After Transcatheter Paravalvular Leak Closure: An International Prospective Multicenter Registry. Circ Cardiovasc Interv 2022; 15:e012193. [PMID: 36256693 DOI: 10.1161/circinterventions.122.012193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Transcatheter closure of a symptomatic prosthetic paravalvular leak (PVL) is feasible, but there is presently no conclusive evidence to show consistent efficacy. We aimed to identify predictors of clinical success after transcatheter PVL closure. METHODS Consecutive patients referred to 24 European centers for transcatheter PVL closure in 2017 to 2019 were included in a prospective registry (Fermeture de Fuite ParaProthétique, FFPP). Clinical success was absence of any of the following within 1 month: re-admission for heart failure, blood transfusion, open-heart valvular surgery, and death. RESULTS We included 216 symptomatic patients, who underwent 238 percutaneous PVL closure procedures on the mitral (64.3%), aortic (34.0%), or tricuspid (1.7%) valve. Symptoms were heart failure, hemolytic anemia, or both in 48.9%, 7.8%, and 43.3% of patients, respectively. One, 2, and 3 leaks were treated during the same procedure in 69.6%, 26.6%, and 3.8% of patients, respectively. The PVL was pinpoint or involved 1/8 or 1/4 of the valve circumference in 18.6%, 52.4%, and 28.1% of cases, respectively. The most frequently used devices were the Vascular Plug 3, Ventricular Septal Defect Occluder, Vascular Plug 2, and Paravalvular Leak Device (45.0%, 16.6%, 14.2%, and 13.6% of cases, respectively). Successful device(s) implantation with leak reduction to ≤grade 2 was obtained in 85.0% of mitral and 91.4% of aortic procedures, respectively (P=0.164); with major periprocedural adverse event rates of 3.3% and 1.2%, respectively (P=0.371); and clinical success rates of 70.3% and 88.0%, respectively (P=0.004). By multivariate analysis, technical failure, mechanical valve, and hemolytic anemia were independently associated with absence of clinical success (odds ratios [95% CIs], 7.7 [2.0-25.0]; P=0.002; 3.6 [1.1-11.1]; P=0.036; and 3.7 [1.2-11.9]; P=0.025; respectively). CONCLUSIONS Transcatheter PVL closure is efficient and safe in symptomatic patients but is associated with a lower clinical success rate in patients with hemolysis and/or a mechanical valve. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifiers: NCT05089136.
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Affiliation(s)
- Sébastien Hascoët
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, France (S.H., D.B., M.K., B.G.)
| | | | - David Blanchard
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, France (S.H., D.B., M.K., B.G.)
| | - Martin Kloëckner
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, France (S.H., D.B., M.K., B.G.)
| | - Eric Brochet
- Hôpital Bichat AP-HP, Hôpital Bichat-Paris, Paris, France (E.B.)
| | - Frederic Bouisset
- Department of Cardiology, Toulouse Rangueil University Hospital, UMR 1295 INSERM, Hôpital Rangueil, CHU Toulouse, Toulouse, France (F.B.)
| | - Guillaume Leurent
- Department of cardiology, Université Rennes, Inserm, LTSI - UMR1099, CHU Rennes, Rennes, France (G.L.)
| | | | | | | | | | | | - Rémy Pillière
- Clinique Ambroise Paré-25-27 boulevard Victor Hugo, France (R.P.)
| | - Claire Dauphin
- Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France (C.D.)
| | - Guillaume Bonnet
- CHU Timone, Assistance Publique des Hôpitaux de Marseille, France (G.B.)
| | | | | | | | - Nadjib Hammoudi
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, and Hôpital Pitié-Salpêtrière AP-HP, Boulevard de l'Hôpital, Paris, France (N.H.)
| | - Lionel Mangin
- Hôpital d'Annecy, 1 avenue de l'Hôpital, France (L.M.)
| | - Hélène Bouvaist
- CHU Grenoble, avenue du Maquis du Grésivaudan, France (H.B.)
| | | | | | - Teoman Kilic
- Kocaeli University School of Medicine, Cardiology Department, Umuttepe, Yerteskesi, Kocaeli, Turkey (T.K.)
| | - Batric Popovic
- Lorraine University, CHRU Nancy, Cardiology department, Nancy, France (B.P.)
| | | | | | - Benoît Gérardin
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, France (S.H., D.B., M.K., B.G.)
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Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessière F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Al Arnaout A, Anselme F, Audinet C, Bernard Y, Boveda S, Bun SS, Chassignolle M, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators. JACC Clin Electrophysiol 2022; 8:1304-1314. [DOI: 10.1016/j.jacep.2022.06.024] [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: 02/22/2022] [Revised: 05/24/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
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Dubes V, Charron S, Valdeolmillos E, Schena M, Martin A, Hamrani DE, Naulin J, Michel C, Constantin M, Roubertie F, Quesson B, Bernus O, Thambo JB, Jalal Z, Benoist D. Effect of percutaneous pulmonary valve replacement on ventricular electrophysiological remodeling in a porcine model of repaired tetralogy of Fallot. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.103] [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: 10/17/2022]
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22
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Tortigue M, Nield LE, Karakachoff M, McLeod CJ, Belli E, Babu-Narayan SV, Prigent S, Boet A, Conway M, Elder RW, Ladouceur M, Khairy P, Kowalik E, Kalfa DM, Barron DJ, Mussa S, Hiippala A, Temple J, Abadir S, Le Gloan L, Lachaud M, Sanatani S, Thambo JB, Gronier CG, Amedro P, Vaksmann G, Charbonneau A, Koutbi L, Ovaert C, Houeijeh A, Combes N, Maury P, Duthoit G, Hiel B, Erickson CC, Bonnet C, Van Hare GF, Dina C, Karsenty C, Fournier E, Le Bloa M, Pass RH, Liberman L, Happonen JM, Perry JC, Romefort B, Benbrik N, Hauet Q, Fraisse A, Gatzoulis MA, Abrams DJ, Dubin AM, Ho SY, Redon R, Bacha EA, Schott JJ, Baruteau AE. Familial Recurrence Patterns in Congenitally Corrected Transposition of the Great Arteries: An International Study. Circ Genom Precis Med 2022; 15:e003464. [PMID: 35549293 DOI: 10.1161/circgen.121.003464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Congenitally corrected transposition of the great arteries (ccTGA) is a rare disease of unknown cause. We aimed to better understand familial recurrence patterns. METHODS An international, multicentre, retrospective cohort study was conducted in 29 tertiary hospitals in 6 countries between 1990 and 2018, entailing investigation of 1043 unrelated ccTGA probands. RESULTS Laterality defects and atrioventricular block at diagnosis were observed in 29.9% and 9.3%, respectively. ccTGA was associated with primary ciliary dyskinesia in 11 patients. Parental consanguinity was noted in 3.4% cases. A congenital heart defect was diagnosed in 81 relatives from 69 families, 58% of them being first-degree relatives, including 28 siblings. The most prevalent defects in relatives were dextro-transposition of the great arteries (28.4%), laterality defects (13.6%), and ccTGA (11.1%); 36 new familial clusters were described, including 8 pedigrees with concordant familial aggregation of ccTGA, 19 pedigrees with familial co-segregation of ccTGA and dextro-transposition of the great arteries, and 9 familial co-segregation of ccTGA and laterality defects. In one family co-segregation of ccTGA, dextro-transposition of the great arteries and heterotaxy syndrome in 3 distinct relatives was found. In another family, twins both displayed ccTGA and primary ciliary dyskinesia. CONCLUSIONS ccTGA is not always a sporadic congenital heart defect. Familial clusters as well as evidence of an association between ccTGA, dextro-transposition of the great arteries, laterality defects and in some cases primary ciliary dyskinesia, strongly suggest a common pathogenetic pathway involving laterality genes in the pathophysiology of ccTGA.
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Affiliation(s)
- Marine Tortigue
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Lynne E Nield
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | | | | | - Emre Belli
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Sonya V Babu-Narayan
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Solène Prigent
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Angèle Boet
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Miriam Conway
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Robert W Elder
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT (R.W.E.)
| | - Magalie Ladouceur
- Department of Adult Congenital Heart Diseases, M3C Hôpital Européen Georges Pompidou, Paris, France (M.L.)
| | - Paul Khairy
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
| | - Ewa Kowalik
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland (E.K.)
| | - David M Kalfa
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - David J Barron
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | - Shafi Mussa
- Department of Congenital Cardiac Surgery, University Hospitals Bristol NHS Foundation Trust, United Kingdom (S.M.)
| | - Anita Hiippala
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - Joel Temple
- Department of Pediatrics, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE (J.T.)
| | - Sylvia Abadir
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
- Division of Cardiology, CHU Mère-Enfant Sainte-Justine, University of Montreal, Quebec, Canada (S.A.)
| | - Laurianne Le Gloan
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Department of Cardiology, CHU Nantes, Nantes, France (L.L.G.)
| | | | - Shubhayan Sanatani
- Division of Cardiology, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada (S.S.)
| | | | - Céline Grunenwald Gronier
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Pascal Amedro
- Department of Cardiology, CHU Bordeaux, France (J.-B.T., P.A.)
- PhyMedExp, CNRS, INSERM, University of Montpellier, France (P.A.)
| | - Guy Vaksmann
- Department of Pediatric Cardiology, Hôpital Privé de La Louvière, Lille, France (G.V.)
| | - Anne Charbonneau
- Department of Pediatric and Congenital Cardiology, American Memorial Hospital, CHU Reims, France (A.C.)
| | - Linda Koutbi
- Department of Cardiology (L.K.), La Timone Hospital, CHU Marseille, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology (C.O.), La Timone Hospital, CHU Marseille, France
- Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, France (C.O.)
| | - Ali Houeijeh
- Department of Pediatric Cardiology, CHRU Lille, France (A.H.)
| | - Nicolas Combes
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
- Department of Cardiology, Pasteur Clinic, Toulouse, France (N.C.)
| | | | - Guillaume Duthoit
- Department of Cardiology, Groupe Hospitalier Pitié Salpétrière, Sorbonne Université, Paris, France (G.D.)
| | - Bérengère Hiel
- Department of Pediatric Cardiology, CHU Amiens, France (B.H.)
| | - Christopher C Erickson
- UDivision of Pediatric Cardiology, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE (C.C.E.)
| | | | - George F Van Hare
- Division of Pediatric Cardiology, St Louis Children's Hospital, Washington University School of Medicine (G.F.V.H.)
| | - Christian Dina
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
| | - Clément Karsenty
- Department of Pediatric and Congenital Cardiology, Children's Hospital (C.K.), CHU Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR 1048, Université de Toulouse, France (C.K.)
| | - Emmanuelle Fournier
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Switzerland (M.L.B.)
| | - Robert H Pass
- Department of Pediatric Cardiology, Mount Sinai Kravis Children's Hospital, NY (R.H.P.)
| | - Leonardo Liberman
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Juha-Matti Happonen
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - James C Perry
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego (J.C.P.)
| | - Bénédicte Romefort
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Nadir Benbrik
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Quentin Hauet
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Alain Fraisse
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Michael A Gatzoulis
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Dominic J Abrams
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, MA (D.J.A.)
| | - Anne M Dubin
- Division of Pediatric Cardiology, Stanford University, Palo Alto, CA (A.M.D.)
| | - Siew Yen Ho
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Richard Redon
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Emile A Bacha
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Jean-Jacques Schott
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Alban-Elouen Baruteau
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
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Cochet H, Legghe B, Bouyer B, Blanc G, Elbaz M, Thambo JB, Iriart X. Prevalence and outcomes of hypoattenuation defects and appendage patency on computed tomography after left atrial appendage closure. Europace 2022. [DOI: 10.1093/europace/euac053.297] [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: Public grant(s) – EU funding. Main funding source(s): European Research Council
Background
Hypoattenuation (HAT) on the atrial aspect of the device and persisting LAA patency are not uncommon on CT images after left atrial appendage closure (LAAC), but their prognostic and therapeutic implications remain unclear.
Purpose
To analyze the prevalence, aspects and outcomes of HAT and LAA patency on CT after LAAC.
Methods
Consecutive patients from 2 French centers underwent cardiac CT 3 months post-LAAC. All CTs were reviewed by 2 readers in consensus to detect LAA patency and HAT. Linear defects of less than 1mm thickness in continuity with the adjacent LA wall were not considered as HAT but rather suggestive of device endothelialization. Defects >1mm thickness were categorized as low grade HAT (if 1-3mm thick and linear/regular), or high grade HAT (if >3mm and/or nodular/irregular). Patients with HAT underwent trans-esophageal echocardiography and received anticoagulation at the discretion of the cardiologist. We analyzed the relationship between CT findings and patient outcomes at follow-up.
Results
From 2012 to 2020, 412 patients were included (age 76±8 years, 68% males, prior stroke or embolism in 39%, HASBLED 3.1±0.8, CHA2DS2-VASc 4.4±1.3). The devices were Watchman in 175 (42.5%) and Amplatzer in 237 (57.5%). On 3-month follow-up CT, LAA patency was detected in 185 (45%). It related to none of the clinical characteristics, but was more common in Amplatzer devices (52% vs. 35%, P=0.001), particularly when using large Amplatzer devices (P<0.001). HAT were detected in 117 (28%), including low grade HAT in 98 (23.8%) and high grade HAT in 19 (4.6%). Patients with high grade HAT were older (P<0.001), and showed higher CHA2DS2-VASc scores (P=0.03). No relationship was found between high grade HAT and device type (P=0.89). Over a median follow-up of 17 [Q1-Q3: 11-41] months, stroke occurred in 24 (5.8%), and death in 54 (13.1%). On survival analyses, stroke and death did not relate to LAA patency (P=0.69 and P=0.80), low grade HAT (P=0.81 and P=0.38), high grade HAT (P=0.22 and P=0.36), or device type (P=0.36 and P=0.27).
Conclusion: although relatively high rates of LAA patency and HAT are observed on post-LAAC CT studies, these do not significantly relate to adverse outcomes.
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Affiliation(s)
- H Cochet
- IHU Liryc, CHU Bordeaux, Univ. Bordeaux, Bordeaux, France
| | - B Legghe
- IHU Liryc, CHU Bordeaux, Univ. Bordeaux, Bordeaux, France
| | - B Bouyer
- IHU Liryc, CHU Bordeaux, Univ. Bordeaux, Bordeaux, France
| | - G Blanc
- University Hospital of Toulouse, Toulouse, France
| | - M Elbaz
- University Hospital of Toulouse, Toulouse, France
| | - JB Thambo
- University Hospital of Toulouse, Toulouse, France
| | - X Iriart
- University Hospital of Toulouse, Toulouse, France
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24
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Avesani M, Silini A, Valdeolmillos E, Jalal Z, Thambo JB, Iriart X. Vector flow mapping analysis in a child with a cardiac resynchronization device. Rev Esp Cardiol (Engl Ed) 2022; 75:269-271. [PMID: 34635469 DOI: 10.1016/j.rec.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Martina Avesani
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France.
| | - Alexandre Silini
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France
| | - Estibaliz Valdeolmillos
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France
| | - Zakaria Jalal
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France; Institut national de la santé et de la recherche médicale (INSERM), Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France; Institut national de la santé et de la recherche médicale (INSERM), Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France; Institut national de la santé et de la recherche médicale (INSERM), Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
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Leroux J, Strik M, Ramirez FD, Ploux S, Sacristan B, Chabaneix-Thomas J, Jalal Z, Thambo JB, Bordachar P. Using a smartwatch to record an electrocardiogram in the pediatric population. J Electrocardiol 2022; 71:25-27. [PMID: 35016137 DOI: 10.1016/j.jelectrocard.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/25/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 10/19/2022]
Abstract
The accuracy of smartwatch ECG recordings in adults has been demonstrated primarily in the automated diagnosis of atrial fibrillation. While the detection of atrial fibrillation is a priority among adults given the arrhythmia's prevalence and actionable ramifications, the potential value of smartwatch ECG recordings in children differs considerably. In this case series, we will describe some examples of smartwatch ECGs recorded in children, highlighting the feasibility and potential indications of this technology in the pediatric population.
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Affiliation(s)
- Justine Leroux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France
| | - Marc Strik
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.
| | - F Daniel Ramirez
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sylvain Ploux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
| | - Benjamin Sacristan
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
| | - Julie Chabaneix-Thomas
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
| | - Zakaria Jalal
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
| | - Jean-Benoit Thambo
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
| | - Pierre Bordachar
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, F-33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France
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26
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Jalal Z, Gewillig M, Boudjemline Y, Guérin P, Pilati M, Butera G, Malekzadeh-Milani S, Avesani M, Thambo JB. Transcatheter interventions in patients with a Fontan circulation: Current practice and future developments. Front Pediatr 2022; 10:965989. [PMID: 36110107 PMCID: PMC9468446 DOI: 10.3389/fped.2022.965989] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022] Open
Abstract
The Fontan operation represents the last of multiple steps that are offered a wide range of congenital cardiac lesions with a single ventricle (SV) physiology. Nowadays this surgical program consists of a total cavopulmonary connection (TCPC), by anastomosing systemic veins to the pulmonary arteries (PAs), excluding the right-sided circulation from the heart. As a result of imaging, surgical, percutaneous, and critical care improvements, survival in this population has steadily increased. However, the Fontan physiology chronically increases systemic venous pressure causing systemic venous congestion and decreased cardiac output, exposing patients to the failure of the Fontan circulation (FC), which is associated with a wide variety of clinical complications such as liver disease, cyanosis, thromboembolism, protein-losing enteropathy (PLE), plastic bronchitis (PB), and renal dysfunction, ultimately resulting in an increased risk of exercise intolerance, arrhythmias, and premature death. The pathophysiology of the failing Fontan is complex and multifactorial; i.e., caused by the single ventricle dysfunction (diastolic/systolic failure, arrhythmias, AV valve regurgitation, etc.) or caused by the specific circulation (conduits, pulmonary vessels, etc.). The treatment is still challenging and may include multiple options and tools. Among the possible options, today, interventional catheterization is a reliable option, through which different procedures can target various failing elements of the FC. In this review, we aim to provide an overview of indications, techniques, and results of transcatheter options to treat cavopulmonary stenosis, collaterals, impaired lymphatic drainage, and the management of the fenestration, as well as to explore the recent advancements and clinical applications of transcatheter cavopulmonary connections, percutaneous valvular treatments, and to discuss the future perspectives of percutaneous therapies in the Fontan population.
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Affiliation(s)
- Zakaria Jalal
- University Hospital of Bordeaux - Department of Pediatric and Adult Congenital Cardiology, Pessac, France.,IHU LIRYC Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Marc Gewillig
- Department of Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Patrice Guérin
- Interventional Cardiology Unit, Inserm UMR 1229, L'Institut du Thorax, University Hospital of Nantes, Nantes, France
| | - Mara Pilati
- Medical and Surgical Department of Pediatric Cardiology, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Gianfranco Butera
- Medical and Surgical Department of Pediatric Cardiology, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, Pediatric Cardiology, Paris, France
| | - Martina Avesani
- University Hospital of Bordeaux - Department of Pediatric and Adult Congenital Cardiology, Pessac, France.,IHU LIRYC Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Jean-Benoit Thambo
- University Hospital of Bordeaux - Department of Pediatric and Adult Congenital Cardiology, Pessac, France.,IHU LIRYC Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
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27
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Avesani M, Kang SL, Jalal Z, Thambo JB, Iriart X. Renaissance of Cardiac Imaging to Assist Percutaneous Interventions in Congenital Heart Diseases:The Role of Three-Dimensional Echocardiography and Multimodality Imaging. Front Pediatr 2022; 10:894472. [PMID: 35664875 PMCID: PMC9160663 DOI: 10.3389/fped.2022.894472] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022] Open
Abstract
Percutaneous interventions have completely refashioned the management of children with congenital heart diseases (CHD) and the use of non-invasive imaging has become the gold standard to plan and guide these procedures in the modern era. We are now facing a dual challenge to improve the standard of care in low-risk patients, and to shift our strategies from the classic open chest surgery to imaging-guided percutaneous interventions in high-risk patients. Such rapid evolution of ultrasound technologies over the last 20 years have permitted the integration of transthoracic, transesophageal and intracardiac echocardiography into the interventional workflow to improve image guidance and reduce radiation burden from fluoroscopy and angiography. Specifically, miniaturization of transesophageal probe and advances in three-dimensional (3D) imaging techniques have enabled real-time 3D image guidance during complex interventional procedure, In addition, multimodality and fusion imaging techniques harness the strengths of different modalities to enhance understanding of anatomical and spatial relationship between different structures, improving communication and coordination between interventionalists and imaging specialists. In this review, we aim to provide an overview of 3D imaging modalities and multimodal fusion in procedural planning and live guidance of percutaneous interventions. At the present times, 3D imaging can no longer be considered a luxury but a routine clinical tool to improve procedural success and patient outcomes.
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Affiliation(s)
- Martina Avesani
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France
| | - Sok-Leng Kang
- Department of Pediatric Cardiology, Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Zakaria Jalal
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
| | - Xavier Iriart
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
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28
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Arbic N, Venet M, Iriart X, Dragulescu A, Thambo JB, Friedberg MK, Guerra V, Morgan CT, Mertens L, Villemain O. Organization of Pediatric Echocardiography Laboratories: Impact of Sonographers on Clinical, Academic, and Financial Performance. Front Pediatr 2022; 10:891360. [PMID: 35712633 PMCID: PMC9196029 DOI: 10.3389/fped.2022.891360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Echocardiography has evolved the first-line imaging for diagnosis and management of pediatric and congenital heart disease all over the world. While it recognized as essential component of pediatric cardiac care delivery, organization of pediatric echocardiography services is very heterogeneous across the world, mainly related to significant differences in material and human resources in heterogeneous health care systems. In this paper, we focus on the role of pediatric sonographers, defined as expert technicians in pediatric echocardiography. While in some services sonographers are an essential part of the organizational structure, other laboratories operate only with physicians trained in echocardiography. The impact of sonographers on clinical, academic and financial performance will be discussed. Two organizational models (with and without sonographers) will be compared, and the advantages and disadvantages of each model will be evaluated. Different models of care provision are possible and decisions on organizational models need to be adjusted to the demands and available resources.
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Affiliation(s)
- Nick Arbic
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Maelys Venet
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France.,IHU LIRYC Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
| | - Andreea Dragulescu
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France.,IHU LIRYC Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
| | - Mark K Friedberg
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Vitor Guerra
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Conall Thomas Morgan
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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29
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Avesani M, Martin A, Thomas-Chabaneix J, Thambo JB, Iriart X. A Heart Elsewhere: The Unusual Diagnosis of a Congenital Ventricular Diverticulum in the Abdomen. JACC Case Rep 2021; 3:1453-1455. [PMID: 34557691 PMCID: PMC8446024 DOI: 10.1016/j.jaccas.2021.06.028] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
Congenital left ventricular (LV) diverticulum is a rare condition characterized by the presence of a contractile appendix originating usually from the cardiac apex, but with high variability in location, dimension, and clinical presentation. We describe the diagnostic process and clinical management of an isolated apical diverticulum discovered during fetal life. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Martina Avesani
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, Pessac, France
| | - Amandine Martin
- Department of Pediatric and Adult Congenital Surgery, Bordeaux University Hospital, Pessac, France
| | - Julie Thomas-Chabaneix
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, Pessac, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, Pessac, France.,Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France.,Institut National de la Santé et de la Recherche Médicale, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, Pessac, France.,Institut Hospitalo-Universitaire Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France.,Institut National de la Santé et de la Recherche Médicale, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
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30
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Pommier V, Bredy C, Abassi H, Huguet H, Picot MC, Pierard S, Pasquet A, Iriart X, Thambo JB, Amedro P. Reliability of echocardiographic parameters of the systemic right ventricle systolic function: A prospective multicentre study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.082] [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: 10/20/2022]
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31
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Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessiere F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Anselme F, Asselin A, Audinet C, Bernard Y, Bru P, Sithikun Bun S, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Long-term follow-up of patients with tetralogy of fallot and implantable cardioverter defibrillator–The DAI-T4F nationwide registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.006] [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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32
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Leroux J, Bordachar P, Strik M, Ramirez FD, Ploux S, Chabaneix-Thomas J, Jalal Z, Thambo JB. Recording an ECG With a Smartwatch in Newborns and Young Children: Feasibility and Perspectives. Can J Cardiol 2021; 37:1877-1879. [PMID: 34371118 DOI: 10.1016/j.cjca.2021.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022] Open
Abstract
Correlating symptoms with arrhythmia in neonates and young children is often difficult because of their sporadic and unpredictable nature. We show that it is possible to register an ECG with a smartwatch in neonates and young children and provide illustrative cases of supraventricular tachycardia and complete atrioventricular block identified with this technology.
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Affiliation(s)
- Justine Leroux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France
| | - Pierre Bordachar
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Marc Strik
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France.
| | - F Daniel Ramirez
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sylvain Ploux
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Julie Chabaneix-Thomas
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Zakaria Jalal
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
| | - Jean-Benoit Thambo
- Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
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33
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Pommier V, Bredy C, Abassi H, Huguet H, Picot MC, Pierard S, Pasquet A, Iriart X, Thambo JB, Amedro P. Reliability of echocardiographic parameters of the systemic right ventricle systolic function: A prospective multicentre study. International Journal of Cardiology Congenital Heart Disease 2021. [DOI: 10.1016/j.ijcchd.2021.100139] [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] Open
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34
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Amedro P, Werner O, Abassi H, Boisson A, Souilla L, Guillaumont S, Calderon J, Requirand A, Vincenti M, Pommier V, Matecki S, De La Villeon G, Lavastre K, Lacampagne A, Picot MC, Beyler C, Delclaux C, Dulac Y, Guitarte A, Charron P, Denjoy-Urbain I, Probst V, Baruteau AE, Chevalier P, Di Filippo S, Thambo JB, Bonnet D, Pasquie JL. Health-related quality of life and physical activity in children with inherited cardiac arrhythmia or inherited cardiomyopathy: the prospective multicentre controlled QUALIMYORYTHM study rationale, design and methods. Health Qual Life Outcomes 2021; 19:187. [PMID: 34321045 PMCID: PMC8317438 DOI: 10.1186/s12955-021-01825-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/18/2021] [Indexed: 02/07/2023] Open
Abstract
Background Advances in paediatric cardiology have improved the prognosis of children with inherited cardiac disorders. However, health-related quality of life (QoL) and physical activity have been scarcely analysed in children with inherited cardiac arrhythmia or inherited cardiomyopathy. Moreover, current guidelines on the eligibility of young athletes with inherited cardiac disorders for sports participation mainly rely on expert opinions and remain controversial. Methods The QUALIMYORYTHM trial is a multicentre observational controlled study. The main objective is to compare the QoL of children aged 6 to 17 years old with inherited cardiac arrhythmia (long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, or arrhythmogenic right ventricular dysplasia), or inherited cardiomyopathy (hypertrophic, dilated, or restrictive cardiomyopathy), to that of age and gender-matched healthy subjects. The secondary objective is to assess their QoL according to the disease’s clinical and genetic characteristics, the level of physical activity and motivation for sports, the exercise capacity, and the socio-demographic data. Participants will wear a fitness tracker (ActiGraph GT3X accelerometer) for 2 weeks. A total of 214 children are required to observe a significant difference of 7 ± 15 points in the PedsQL, with a power of 90% and an alpha risk of 5%. Discussion After focusing on the survival in children with inherited cardiac disorders, current research is expanding to patient-reported outcomes and secondary prevention. The QUALIMYORYTHM trial intends to improve the level of evidence for future guidelines on sports eligibility in this population. Trial registration ClinicalTrials.gov Identifier: NCT04712136, registered on January 15th, 2021 (https://clinicaltrials.gov/ct2/show/NCT04712136).
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Affiliation(s)
- Pascal Amedro
- Department of Paediatric and Adult Congenital Cardiology, M3C National Reference Centre, Haut-Lévêque Cardiology Hospital, Bordeaux University Hospital, Avenue de Magellan, 33604, Pessac Cedex, France. .,INSERM, Bordeaux Cardio-Thoracic Research Centre, U1045, University of Bordeaux, Pessac, France. .,IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, Pessac, France.
| | - Oscar Werner
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Hamouda Abassi
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Aymeric Boisson
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Luc Souilla
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Sophie Guillaumont
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France
| | - Johanna Calderon
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Anne Requirand
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Marie Vincenti
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Victor Pommier
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France
| | - Stefan Matecki
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Gregoire De La Villeon
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France
| | - Kathleen Lavastre
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Montpellier University Hospital, Montpellier, France
| | - Alain Lacampagne
- PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
| | - Marie-Christine Picot
- Epidemiology and Clinical Research Department, Montpellier University Hospital, Montpellier, France
| | - Constance Beyler
- Paediatric Cardiology and Physiology Department, Robert Debré University Hospital, University of Paris, AP-HP, Paris, France
| | - Christophe Delclaux
- Paediatric Cardiology and Physiology Department, Robert Debré University Hospital, University of Paris, AP-HP, Paris, France
| | - Yves Dulac
- Paediatric Cardiology Department, M3C Regional Reference Centre, Toulouse University Hospital, Toulouse, France
| | - Aitor Guitarte
- Paediatric Cardiology Department, M3C Regional Reference Centre, Toulouse University Hospital, Toulouse, France
| | - Philippe Charron
- Department of Cardiology, National Reference Centre for Inherited Cardiomyopathy, University of Paris, AP-HP, Paris, France
| | - Isabelle Denjoy-Urbain
- Department of Cardiology, National Reference Centre for Inherited Cardiomyopathy, University of Paris, AP-HP, Paris, France
| | - Vincent Probst
- Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France
| | - Alban-Elouen Baruteau
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, L'Institut du Thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France
| | - Philippe Chevalier
- Department of Congenital Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, University of Lyon, Lyon University Hospital, Lyon, France
| | - Sylvie Di Filippo
- Department of Congenital Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, University of Lyon, Lyon University Hospital, Lyon, France
| | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, M3C National Reference Centre, Haut-Lévêque Cardiology Hospital, Bordeaux University Hospital, Avenue de Magellan, 33604, Pessac Cedex, France.,INSERM, Bordeaux Cardio-Thoracic Research Centre, U1045, University of Bordeaux, Pessac, France.,IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, Pessac, France
| | - Damien Bonnet
- Paediatric Cardiology Department, Necker-Enfants malades, M3C National Reference Centre, University of Paris, AP-HP, Paris, France
| | - Jean-Luc Pasquie
- Cardiology Department of Cardiology, Regional Reference Centre for Inherited Cardiac Arrhythmia, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, University of Montpellier, Montpellier, France
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Avesani M, Degrelle B, Di Salvo G, Thambo JB, Iriart X. Vector flow mapping: A review from theory to practice. Echocardiography 2021; 38:1405-1413. [PMID: 34259359 DOI: 10.1111/echo.15154] [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] [Received: 02/15/2021] [Revised: 06/19/2021] [Accepted: 07/01/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The interest in intra-cardiac blood flow analysis is rapidly growing, and it has encouraged the development of different non-invasive imaging techniques. Among these, Vector Flow Mapping (VFM), combing Color-Doppler imaging and speckle tracking data, seems to be a promising approach, feasible in adult and children population. AIM OF THE REVIEW The aim of this review is to give a historical perspective on the development of VFM method and a summary of the current algorithms and parameters potentially evaluable. Then, we will present the current state-of-the-art of VFM with an overview of clinical studies and applications of this technique.
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Affiliation(s)
- Martina Avesani
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France.,Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Bastien Degrelle
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France
| | - Giovanni Di Salvo
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France.,Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France.,Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, Bordeaux, France
| | - Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France.,Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France.,Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, Bordeaux, France
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Iriart X, Guérin P, Jalal Z, Thambo JB. Edge to edge repair using a MitraClip for severe tricuspid valve regurgitation after a Mustard operation. Catheter Cardiovasc Interv 2021; 98:E108-E114. [PMID: 33793055 DOI: 10.1002/ccd.29681] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 11/11/2022]
Abstract
A 48-year-old who underwent a Mustard operation in 1972 followed by a second cardiac intervention in 1996 for pulmonary venous baffle enlargement and residual baffle leak closure, complicated by recurrent atrial flutter, was admitted to our institution for severe systemic atrio-ventricular valve regurgitation (SAVVR) associated with severely impaired systemic right ventricular (RV) function. After careful preoperative anatomic assessment including three-dimensional transesophageal echocardiography (3DTEE) to define the clipping strategy and computed tomography to optimize the transvenous baffle puncture site, the intervention was performed under general anesthesia, fluoroscopic, and 3DTEE guidance. One XTR MitraClip was successfully implanted, achieving a significant reduction in regurgitation and immediate clinical improvement. The transbaffle puncture was closed using an 8 mm atrial septal defect (ASD) device without residual shunt or obstruction of the venous baffle. Post-operative clinical evaluation showed immediate improvement in the NYHA functional class (from III to II), but the patient presented with recurrent flutter at 1 week after the procedure, which was successfully treated by catheter ablation with another transbaffle approach next to the ASD device. Clinical improvement was maintained at 1- and 6-month follow-up with significant reduction in SAVVR, reduced systemic RV volumes and improved RV ejection fraction. This case demonstrates the feasibility of percutaneous treatment of systemic SAVV in patients with systemic RV after atrial redirection.
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Affiliation(s)
- Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Patrice Guérin
- Department of congenital heart disease, University hospital of Nantes, Nantes, France
| | - Zakaria Jalal
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Spaulding C, Armero S, Champagnac D, Bhugaloo H, Ternacle J, Lellouche N, Audureau E, Le Corvoisier P. Left atrial appendage closure for stroke prevention in atrial fibrillation: Final report from the French left atrial appendage closure registry. Catheter Cardiovasc Interv 2021; 98:788-799. [PMID: 34051135 DOI: 10.1002/ccd.29795] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The French left atrial appendage (LAA) closure registry (FLAAC) aimed to assess the safety and efficacy of LAA closure in daily practice. BACKGROUND LAA closure has emerged as an alternative for preventing thromboembolic events (TE) in patients with non-valvular atrial fibrillation (NVAF). Clinical data in this field remains limited and few investigator-initiated, real-world registries have been reported. METHODS This nationwide, prospective study was performed in 36 French centers. The primary endpoint was the TE rate after successful LAA closure. RESULTS The FLAAC registry included 816 patients with a mean age of 75.5 ± 0.3 years, mean follow-up of 16.0 ± 0.3 months, high TE (CHA2 DS2 -VASc score: 4.6 ± 0.1) and bleeding risks (HAS-BLED score: 3.2 ± 0.05) and common contraindications to long-term anticoagulation (95.7%). Procedure or device-related serious adverse events occurred in 49 (6.0%) patients. The annual rate of ischemic stroke/systemic embolism was 3.3% (2.4-4.6). This suggests a relative 57% reduction compared to the risk of stroke in historical NVAF populations without antithrombotic therapy. By multivariate analysis, history of TE was the only factor associated with stroke/systemic embolism during follow-up (HR, 3.3 [1.58-6.89], p = 0.001). The annual mortality rate was 10.2% (8.4-12.3). Most of the deaths were due to comorbidities or underlying cardiovascular diseases and unrelated to the device or to TE. CONCLUSIONS Our study suggests that LAA closure can be an option in patients with NVAF. Long-term follow-up mortality was high, mostly due to comorbidities and underlying cardiovascular diseases, highlighting the importance of multidisciplinary management after LAA closure. REGISTRATION NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France
| | - Pascal Defaye
- Department of Rhythmology, University Hospital of Grenoble-Alpes, Grenoble, France
| | | | - Sélim Abbey
- Interventional Cardiology Unit, Hôpital Prive du Confluent, Nantes, France
| | - Didier Klug
- Department of Electrophysiology, Lille University Hospital, Lille, France
| | - Jean-Michel Juliard
- Département de Cardiologie, Hôpital Bichat, Université Paris-Diderot, Inserm U-1148, AP-HP, Paris, France
| | - Christian Spaulding
- Department of Cardiology, European Hospital Georges Pompidou, AP-HP, Paris Descartes University, INSERM U 970, Sudden Cardiac Death Expert Center, Paris, France
| | | | | | - Hamza Bhugaloo
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France
| | - Julien Ternacle
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Nicolas Lellouche
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Etienne Audureau
- Public Health Department, Hôpital Henri Mondor, Créteil, France.,U955-IMRB, Equipe CEpiA, Inserm, UPEC, Créteil, France
| | - Philippe Le Corvoisier
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France.,U955-IMRB, Equipe 03, Inserm, UPEC, Ecole Nationale Vétérinaire d'Alfort, Créteil, France
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Iriart X, Metras A, Coiffic A, Thambo JB. Late device-related thrombus after left atrial appendage closure: never let your guard down. Eur Heart J 2021; 42:1050. [PMID: 33180918 DOI: 10.1093/eurheartj/ehaa907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Xavier Iriart
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac 33600, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux 33600, France
- Department of Cardiovascular Surgery, Bordeaux University Hospital, France
| | - Alexandre Metras
- Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), Hôpital cardiologique Haut Lévêque, Bordeaux University Hospital, Pessac 33604, France
| | - Alain Coiffic
- Department of Cardiovascular Anesthesiology, University Hospital of Bordeaux, Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac 33600, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux 33600, France
- Department of Cardiovascular Surgery, Bordeaux University Hospital, France
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Jalal Z, Valdeolmillos E, Malekzadeh-Milani S, Eicken A, Georgiev S, Hofbeck M, Sieverding L, Gewillig M, Ovaert C, Bouvaist H, Pillois X, Thambo JB, Boudjemline Y. Mid-Term Outcomes Following Percutaneous Pulmonary Valve Implantation Using the "Folded Melody Valve" Technique. Circ Cardiovasc Interv 2021; 14:e009707. [PMID: 33726503 PMCID: PMC8055198 DOI: 10.1161/circinterventions.120.009707] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The folded valve is a manual shortening of the Melody device, which has been validated as a valuable therapeutic option for the management of dysfunctional right ventricular outflow tracts needing a short valved stent. In this article, we aimed to evaluate, in a multicenter cohort, the mid-term outcomes of patients in whom a percutaneous pulmonary valve implantation was performed using the folded valve technique. Methods: A 2012 to 2018 retrospective multicenter study was performed in 7 European institutions. All patients who benefit from percutaneous pulmonary valve implantation with a folded Melody valve were included. Results: A total of 49 patients (median age, 19 years [range 4–56], 63% male) were included. The primary percutaneous pulmonary valve implantation indication was right ventricular outflow tract stenosis (n=19; 39%), patched native right ventricular outflow tracts were the most common substrate (n=15; 31%). The folded technique was mostly used in short right ventricular outflow tracts (n=28; 57%). Procedural success was 100%. After a median follow-up of 28 months (range, 4–80), folded Melody valve function was comparable to the immediate postimplantation period (mean transvalvular peak velocity=2.6±0.6 versus 2.4±0.6 m/s, P>0.1; only 2 patients had mild pulmonary regurgitation). Incidence rate of valve-related reinterventions was 2.1% per person per year (95% CI, 0.1%–3.9%). The probability of survival without valve-related reinterventions at 36 months was 90% (95% CI, 76%–100%). Conclusions: The folded Melody valve is a safe technique with favorable mid-term outcomes up to 6.5 years after implantation, comparable with the usual Melody valve implantation procedure. Complications and reinterventions rates were low, making this technique relevant in selected patients.
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Affiliation(s)
- Zakaria Jalal
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Estíbaliz Valdeolmillos
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, Pediatric Cardiology, France (S.M.-M.)
| | - Andreas Eicken
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the TU Munich, Germany (A.E., S.G.)
| | - Stanimir Georgiev
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the TU Munich, Germany (A.E., S.G.)
| | - Michael Hofbeck
- Department of Pediatric Cardiology, University Children's Hospital, Tuebingen, Germany (M.H., L.S.)
| | - Ludger Sieverding
- Department of Pediatric Cardiology, University Children's Hospital, Tuebingen, Germany (M.H., L.S.)
| | - Marc Gewillig
- Department of Pediatric Cardiology, University Hospitals Leuven, Belgium (M.G.)
| | - Caroline Ovaert
- Department of Pediatric Cardiology and Congenital Heart Disease, AP-HM, Timone enfants, Hopital de la Timone, Provence-Alpes-Côte d'Azur, France (C.O.)
| | | | - Xavier Pillois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Jean-Benoit Thambo
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology, Pessac, France (Z.J., E.V., J.-B.T.).,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France (Z.J., E.V., X.P., J.-B.T.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, France (Z.J., E.V., X.P., J.-B.T.)
| | - Younes Boudjemline
- Cardiac Catheterization Laboratories, Sidra Heart Center, Sidra Medicine, Doha, Qatar (Y.B.)
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Perdreau E, Jalal Z, Walton R, Sigler M, Cochet H, Naulin J, Quesson B, Bernus O, Thambo JB. Non-invasive assessment of cardiac percutaneous occluders healing process using computed tomography imaging: a proof of concept study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.246] [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: Other. Main funding source(s): National Research Agency (ANR) French Federation of Cardiology : “Aide à la recherche par équipe 2018, Cardiopathies de l’enfant”
Introduction
After percutaneous implantation of an atrial septal defect (ASD) occluder device, a complex healing process leads to the device coverage within several months. However, an unexplained incomplete device coverage is at risk of complications such as thrombosis or infectious endocarditis.
Purpose
The aim of the study was to assess the device coverage process of ASD occluder devices in a chronic sheep model using micro-CT technology.
Methods
After percutaneous creation of an ASD by catheterization, 8 ewes (mean age 5.4 ± 0.7 yo and mean weight 55.6 ± 7.9 kg) were implanted with a 16-mm Nit-Occlud ASD-R occluder (PFM medical, Cologne, Germany) and were followed for 1 month (N = 3) and 3 months (N =5). After heart explantation, a iodine contrast agent was used to enhance the tissue signal. The device coverage was then assessed by micro-CT and the results were compared to histology, used as the gold standard for healing evaluation. The micro-CT image resolution was 41.7 µm. Reconstruction was performed in 2D and 3D with Amira® software, allowing to obtain images that were exploited by a code to measure the surface for each disk of the analyzed devices. Histological study was performed after resin embedding and Richardson blue staining was used. The pathologist was blinded to the duration of animals’ follow-up and micro-CT results.
Results
ASD creation and device closure was successful in 100% animals without complications. Following heart explantation, macroscopic assessment of devices showed that the coverage was complete for the left-side disk regardless of the duration of the follow-up and variable for the right-side disk, depending of the protrusion of this disk. 2D and 3D micro-CT analysis allowed an accurate evaluation of device coverage of each disk and was overall well correlated to histology slices (cf Figure). Surface calculation from micro-CT images showed that the median surface of coverage was 93 ± 8% for the left-side disk and 55 ± 31% for the right-side disk.
Conclusion
This preliminary study made the proof of concept that micro-CT is a reliable tool to assess the coverage of intra-cardiac occluders in vitro. The translation to clinical practice is challenging but would allow an individual follow-up, to avoid thrombotic or infective complications.
Abstract Figure.
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Affiliation(s)
| | | | | | - M Sigler
- Georg-August University, Pediatric Cardiology and Intensive Care Medicine, Gottingen, Germany
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41
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d'Udekem Y, Thambo JB, Iyengar AJ, Rychik J. Are we getting closer to identifying the best follow-up and management after Fontan completion? J Thorac Cardiovasc Surg 2020; 162:222-227. [PMID: 32763048 DOI: 10.1016/j.jtcvs.2020.03.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Yves d'Udekem
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Jean-Benoit Thambo
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France; IHU Lyric, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, Pessac, France
| | - Ajay J Iyengar
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jack Rychik
- Division of Pediatric Cardiology, and Cardiac Center at The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
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Miton N, Godart F, Milani G, Jalal Z, Karsenty C, Baruteau AE, Gronier C, Aldebert P, Douchin S, Lucron H, Chalard A, Houeijeh A, Petit J, Hascoet S, Thambo JB, Dauphin C. Patent foramen ovale closure in children without cardiopathy: Child-PFO study. Arch Cardiovasc Dis 2020; 113:513-524. [PMID: 32680737 DOI: 10.1016/j.acvd.2020.03.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Closure of patent foramen ovale is well-managed in adults, but is performed less frequently in children. AIM To analyse all patent foramen ovale closures performed in the past 20 years in French paediatric centres. METHODS Retrospective study of patent foramen ovale closures in children without cardiopathy in nine centres between 2000 and 2019. RESULTS Forty-one procedures were carried out in children (median age: 14.9 years). Thirty-one patent foramen ovales were closed after a transient ischaemic attack or stroke, six for a left-to-right shunt and four for other reasons. Transthoracic echocardiography was used for 72.2% of the diagnoses and transoesophageal echocardiography for 27.8%. A substantial degree of shunting was found in 42.9% of patients and an atrial septal aneurysm in 56.2%. General anaesthesia with transoesophageal echocardiography guidance was performed in 68.3% of the procedures; local anaesthesia and transthoracic echocardiography or intracardiac echocardiography was performed in 31.7%. The success rate was 100%. The median fluoroscopy time was 4.14minutes: 3.55minutes with transoesophageal echocardiography; and 4.38minutes with transthoracic echocardiography (P=0.67). There was only one periprocedural complication (2.4%). Postoperatively, 80,5% of patients were treated with aspirin and 12,2% with an anticoagulant. The rate of complete occlusion was 56.8% immediately after the procedure, 68.6% at 1 year and 92.3% at the last follow-up. There were no delayed complications or cases of recurrent stroke during follow-up (median follow-up: 568 days). CONCLUSION Closure of patent foramen ovale in children appears to be safe and effective, as we noted a low rate of immediate complications, no delayed complications and no stroke recurrence in this indication.
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Affiliation(s)
- Noelie Miton
- Department of Cardiology, M3C Regional Reference CHD Centre, Gabriel Montpied University Hospital, 63000 Clermont-Ferrand, France
| | - François Godart
- Paediatric Cardiology and Congenital Heart Disease, Institut Coeur Poumon, Lille University, 59000 Lille, France
| | - Guiti Milani
- Paediatric Cardiology Department, Necker-Enfants Malades Hospital, AP-HP, M3C National Reference CHD Centre, Paris Descartes University, Sorbonne Paris, 75015 Paris, France
| | - Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33604 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, 33600 Pessac, France; Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, 33600 Pessac, France
| | - Clément Karsenty
- Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse University, 31432 Toulouse, France; Paediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse University, 31300 Toulouse, France
| | - Alban-Elouen Baruteau
- L'institut du Thorax, INSERM, CNRS, Nantes University, CHU Nantes, 44007 Nantes, France; Department of Congenital Cardiology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| | - Céline Gronier
- Groupe d'Exploration Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, France
| | - Philippe Aldebert
- Paediatric and Congenital Medico-Surgical Cardiology Department, M3C Regional Reference CHD Centre, AP-HM, La Timone University Hospital, 13005 Marseille, France
| | - Stéphanie Douchin
- Department of Cardiology, M3C Regional Reference CHD Centre, CHU Grenoble, 38700 La Tronche, France
| | - Hugues Lucron
- Paediatric Cardiology, M3C Antilles-Guyane Centre, University Hospital (CHU de Martinique), 97200 Fort-de-France, France
| | - Aurélie Chalard
- Department of Cardiology, M3C Regional Reference CHD Centre, Gabriel Montpied University Hospital, 63000 Clermont-Ferrand, France
| | - Ali Houeijeh
- Paediatric Cardiology and Congenital Heart Disease, Institut Coeur Poumon, Lille University, 59000 Lille, France
| | - Jérome Petit
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference CHD Centre, Paris-Sud University, Paris-Saclay University, 92350 Le Plessis-Robinson, France
| | - Sébastien Hascoet
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference CHD Centre, Paris-Sud University, Paris-Saclay University, 92350 Le Plessis-Robinson, France
| | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33604 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, 33600 Pessac, France; Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, 33600 Pessac, France
| | - Claire Dauphin
- Department of Cardiology, M3C Regional Reference CHD Centre, Gabriel Montpied University Hospital, 63000 Clermont-Ferrand, France.
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43
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Jakamy R, Séguéla PE, Jalal Z, de Guillebon M, Thambo JB. An Unusual Cause of Neonatal Heart Failure. Can J Cardiol 2020; 36:1831.e5-1831.e6. [PMID: 32497582 DOI: 10.1016/j.cjca.2020.05.036] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/11/2020] [Accepted: 05/28/2020] [Indexed: 11/17/2022] Open
Abstract
Hypertension is an important and under-recognized cause of acquired cardiomyopathy in newborns. Half the etiologies of neonatal hypertension are undetermined. We present a rare case of severe neonatal hypertension with ventricular dysfunction secondary to substance exposure during pregnancy. This case report emphasizes the importance of a well-focused prenatal history on maternal medications and substance use.
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Affiliation(s)
- Réda Jakamy
- Pediatric and Congenital Cardiology Department, Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France.
| | - Pierre-Emmanuel Séguéla
- Pediatric and Congenital Cardiology Department, Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France
| | - Zakaria Jalal
- Pediatric and Congenital Cardiology Department, Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France
| | | | - Jean-Benoit Thambo
- Pediatric and Congenital Cardiology Department, Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France
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44
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Amedro P, Gavotto A, Abassi H, Picot MC, Matecki S, Malekzadeh-Milani S, Levy M, Ladouceur M, Ovaert C, Aldebert P, Thambo JB, Fraisse A, Humbert M, Cohen S, Baruteau AE, Karsenty C, Bonnet D, Hascoet S. Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV-INHIBITION study design. ESC Heart Fail 2020; 7:747-756. [PMID: 32147955 PMCID: PMC7160497 DOI: 10.1002/ehf2.12630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/04/2020] [Accepted: 01/12/2020] [Indexed: 12/14/2022] Open
Abstract
Aims In univentricular hearts, selective lung vasodilators such as phosphodiesterase type 5 (PDE5) inhibitors would decrease pulmonary resistance and improve exercise tolerance. However, the level of evidence for the use of PDE5 inhibitors in patients with a single ventricle (SV) remains limited. We present the SV‐INHIBITION study rationale, design, and methods. Methods and results The SV‐INHIBITION trial is a nationwide multicentre, randomized, double blind, placebo‐controlled, Phase III study, aiming to evaluate the efficacy of sildenafil on the ventilatory efficiency during exercise, in teenagers and adult patients (>15 years old) with an SV. Patients with a mean pulmonary arterial pressure >15 mmHg and a trans‐pulmonary gradient >5 mmHg, measured by cardiac catheterization, will be eligible. The primary outcome is the variation of the VE/VCO2 slope, measured by a cardiopulmonary exercise test, between baseline and 6 months of treatment. A total of 50 patients are required to observe a decrease of 5 ± 5 points in the VE/VCO2 slope, with a power of 90% and an alpha risk of 5%. The secondary outcomes are clinical outcomes, oxygen saturation, 6 min walk test, SV function, NT‐proBNP, peak VO2, stroke volume, mean pulmonary arterial pressure, trans‐pulmonary gradient, SF36 quality of life score, safety, and acceptability. Conclusions The SV‐INHIBITION study aims to answer the question whether PDE5 inhibitors should be prescribed in patients with an SV. This trial has been built focusing on the three levels of research defined by the World Health Organization: disability (exercise tolerance), deficit (SV function), and handicap (quality of life).
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Affiliation(s)
- Pascal Amedro
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | - Arthur Gavotto
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France
| | - Hamouda Abassi
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France
| | | | - Stefan Matecki
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | - Sophie Malekzadeh-Milani
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Marilyne Levy
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Magalie Ladouceur
- Adult Congenital Heart Disease Unit, Department of Cardiology, M3C National Reference Centre, European Hospital Georges Pompidou, Paris, France
| | - Caroline Ovaert
- Paediatric and Congenital Medico-Surgical Cardiology Department, M3C Regional Reference Centre, AP-HM, La Timone University Hospital, Marseille, France.,Laboratory of Medical Genetics, INSERM UMR 1251, Aix-Marseille University, Marseille, France
| | - Philippe Aldebert
- Paediatric and Congenital Medico-Surgical Cardiology Department, M3C Regional Reference Centre, AP-HM, La Timone University Hospital, Marseille, France
| | - Jean-Benoit Thambo
- Paediatric and Adult Congenital Heart Disease Department, Hôpital Cardiologique du Haut-Lévêque, M3C National Reference Centre, CHU de Bordeaux, Bordeaux, France
| | - Alain Fraisse
- Pediatric Cardiology Service, Royal Brompton and Harefield Hospital Trust, London, UK
| | - Marc Humbert
- Department of Pulmonology, PH National Reference Centre, APHP, Kremlin-Bicetre, Paris, France.,Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
| | - Sarah Cohen
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
| | - Alban-Elouen Baruteau
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Nantes, Nantes, France
| | - Clement Karsenty
- Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Toulouse, Toulouse, France
| | - Damien Bonnet
- Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Sebastien Hascoet
- Paris-Sud Faculty of Medicine, INSERM U999, Marie-Lannelongue Hospital, M3C National Reference Centre, Paris-Sud University, Paris-Saclay, Le Plessis-Robinson, Paris, France
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45
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Fournier E, Séguéla PE, Sauvestre F, Jalal Z, Thomas J, Iriart X, Bonello B, Thambo JB. Imaging Aspects of Pediatric Cardiac Tumors. JACC Cardiovasc Imaging 2020; 13:2245-2253. [PMID: 31954647 DOI: 10.1016/j.jcmg.2019.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/12/2019] [Accepted: 11/21/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Emmanuelle Fournier
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France.
| | | | - Fanny Sauvestre
- Fœtopathology Unit, Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - Zakaria Jalal
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Julie Thomas
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Xavier Iriart
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Béatrice Bonello
- Cardiology Department, Great Ormond Street Hospital, London, United Kingdom
| | - Jean-Benoit Thambo
- Pediatric and Congenital Cardiology Unit, Bordeaux University Hospital, Bordeaux, France
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46
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Jakamy R, Séguéla PE, Valdeolmillos E, Mostefa Kara M, Mouton JB, Iriart X, Thambo JB. Pulmonary Atresia With Ventriculocoronary Arterial Connections and a Large Conoventricular Septal Defect. JACC Case Rep 2019; 1:545-548. [PMID: 34316875 PMCID: PMC8288796 DOI: 10.1016/j.jaccas.2019.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/25/2019] [Accepted: 09/11/2019] [Indexed: 11/28/2022]
Abstract
Ventriculocoronary arterial connections are typically found in patients with pulmonary atresia with an intact ventricular septum. This report describes a case of ventriculocoronary arterial connections in a patient with pulmonary atresia with a ventricular septal defect. Our case supports recent data suggesting a primary coronary artery developmental anomaly in pulmonary atresia. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Réda Jakamy
- Address for correspondence: Dr. Réda Jakamy, Service de cardiologie pédiatrique et congénitale, Hôpital Haut-Lévêque - groupe hospitalier SUD, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, France.
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47
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Valdeomillos E, Jalal Z, Boudjemline Y, Thambo JB. Transcatheter ductus arteriosus stenting in paediatric cardiology: Indications, results and perspectives. Arch Cardiovasc Dis 2019; 113:129-141. [PMID: 31753586 DOI: 10.1016/j.acvd.2019.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/27/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
Abstract
Stenting the arterial duct emerged in the early 1990s as an alternative to a variety of surgical interventions in neonates with a duct-dependent pulmonary or systemic circulation complex defect. Furthermore, palliative ductal stenting has been applied in older children with severe suprasystemic pulmonary arterial hypertension, as an alternative to surgical shunts, such as Potts anastomosis. Early results of this technique were discouraging, but by learning from the failures of the past, ductal stenting has become a reliable palliative therapy. In this review, we aim to describe the historical evolution of ductal stenting, its different clinical applications and outcomes, and future perspectives for this strategy in congenital cardiac catheterization.
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Affiliation(s)
- Estibaliz Valdeomillos
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), avenue Magellan, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, fondation Bordeaux université, 33600 Pessac, France; U1045, Inserm, centre de recherche cardio-thoracique de Bordeaux, 33000 Bordeaux, France.
| | - Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), avenue Magellan, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, fondation Bordeaux université, 33600 Pessac, France; U1045, Inserm, centre de recherche cardio-thoracique de Bordeaux, 33000 Bordeaux, France
| | | | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), avenue Magellan, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, fondation Bordeaux université, 33600 Pessac, France; U1045, Inserm, centre de recherche cardio-thoracique de Bordeaux, 33000 Bordeaux, France
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- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), avenue Magellan, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, fondation Bordeaux université, 33600 Pessac, France; U1045, Inserm, centre de recherche cardio-thoracique de Bordeaux, 33000 Bordeaux, France; Heart Center, Sidra Medicine, Doha, Qatar
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48
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Waldmann V, Bouzeman A, Marquie C, Labombarda F, Koutbi R, Sellal JM, Fauchier L, Mondoly P, Pasquie JL, Anselme F, Eschalier R, Iserin L, Thambo JB, Combes N, Marijon E. 2396Long-term follow-up of patients with tetralogy of Fallot and implantable cardioverter defibrillator. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0149] [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
Ventricular arrhythmias and sudden death are potential late complications in patients with tetralogy of Fallot. Data regarding the value of implantable cardioverter defibrillators (ICD) are scarce in this population.
Purpose
To assess long-term rates of appropriate ICD therapies and ICD-related complications in a large registry of ICD recipients with tetralogy of Fallot.
Methods
The DAI-T4F study is an ongoing national French registry including all patients with tetralogy of Fallot and ICD (NCT03837574). Information have been collected prospectively since 2010 with annual update. Baseline patient characteristics and clinical events during follow-up were analyzed with central adjudication. Cox proportional hazard models were used to identify factors associated with appropriate ICD therapies and complications.
Results
A total of 134 patients (median age 41.7 years, 70.7% males) were enrolled. The median (IQR) follow-up duration was 6.1 (2.7–10.2) years. ICDs were implanted for primary prevention in 47 (35.1%) patients and for secondary prevention in 87 (64.9%) patients. Overall, 14 (29.8%) and 45 (51.7%) patients received at least one appropriate ICD therapy in primary and secondary prevention, respectively, giving annual incidences of 5.5% and 7.1% (p=0.06). Patients with altered left ventricle ejection fraction (LVEF) at inclusion ≤35% experienced less appropriate ICD therapies (HR=0.31, 95% CI: 0.11–0.86, p=0.02), whereas a history of sustained or non-sustained ventricular arrhythmia (HR=2.7, 95% CI: 1.2–3.9, p=0.03) was positively associated with appropriate therapies. Fifty-seven (42.5%) patients had ICD-related complications, including 32 (24.2%) inappropriate ICD shocks, 22 (16.4%) significant lead dysfunction, 14 (10.4%) device infection, and 5 (3.7%) generator dysfunction/recall. History of supraventricular arrhythmias (HR=2.2, 95% CI: 1.2–3.7, p=0.01) and congestive heart failure (HR=2.0, 95% CI: 1.2–3.6, p=0.01) were both associated with a higher risk of complications. During follow-up, 7 (5.2%) patients underwent cardiac transplantation and 12 (9.0%) patients died, mainly from progressive heart failure (n=5). Only one sudden death due to electrical storm was recorded.
Figure 1
Conclusions
Appropriate therapies are frequent in patients with tetralogy of Fallot and ICDs, including in primary prevention. The relatively important proportion of ICD-related complication highlights the need for improving risk stratification in this population, considering associated conditions in the individual benefit-risk equation.
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Affiliation(s)
- V Waldmann
- European Hospital Georges Pompidou, Paris, France
| | - A Bouzeman
- Private Hopital of Parly II, Le Chesnay, France
| | | | | | - R Koutbi
- Hospital La Timone of Marseille, Marseille, France
| | - J M Sellal
- University Hospital of Nancy, Nancy, France
| | - L Fauchier
- University Hospital of Tours, Tours, France
| | - P Mondoly
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - J L Pasquie
- University Hospital of Montpellier, Montpellier, France
| | - F Anselme
- University Hospital of Rouen, Rouen, France
| | - R Eschalier
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - L Iserin
- European Hospital Georges Pompidou, Paris, France
| | - J B Thambo
- University Hospital of Bordeaux, Bordeaux, France
| | - N Combes
- Clinic Pasteur, Toulouse, France
| | - E Marijon
- European Hospital Georges Pompidou, Paris, France
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49
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Waldmann V, Bouzeman A, Bessiere F, Labombarda F, Ladouceur M, Marquie C, Guenancia C, Audinet C, Defaye P, Mathiron A, Iserin L, Thambo JB, Pasquie JL, Combes N, Marijon E. 5204Primary prevention of sudden cardiac death in patients with tetralogy of Fallot with implantable cardioverter defibrillator: insights from the DAI-T4F study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0062] [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
Background
Ventricular arrhythmias and sudden death are feared late complications in patients with tetralogy of Fallot. Selection of candidates for primary prevention implantable cardioverter defibrillator (ICD) remains challenging in this population. Non-sustained ventricular tachycardia (NSVT), altered left ventricular ejection fraction (LVEF), positive programmed ventricular stimulation, and enlarged QRS are currently used for risk stratification.
Purpose
To identify high-risk patients with tetralogy of Fallot in the setting of primary prevention of sudden cardiac death.
Methods
The DAI-T4F study is a large ongoing national French registry including all patients with tetralogy of Fallot and ICD (NCT03837574). Information have been collected prospectively since 2010 with annual update. Baseline patient characteristics and clinical events during the follow-up were analyzed with central adjudication. Cox proportional hazard models were used to identify factors associated with appropriate ICD therapies.
Results
Among 134 patients enrolled, 47 (35.1%) underwent ICD implantation for primary prevention (median age 49.1 years, 76.6% males). At baseline, 20 (42.6%) patients had NSVT, 17 (36.2%) had severe altered LVEF ≤35%, 16 (34.0%) had positive programmed ventricular stimulation, and 16 (34.0%) had QRS duration ≥180ms. Overall, 20 (42.6%), 15 (31.9%), and 6 (12.8%) patients had respectively one, two, or ≥ three of these risk factors. Six (12.8%) patients were implanted for other indications. During a median (IQR) follow-up duration of 5.3 (2.1–8.0) years, 14 (29.8%) patients had at least one appropriate ICD therapy. The annual incidence of appropriate ICD therapies were 2.8%, 4.6%, 6.3%, and 8.6% in patients with none, one, two, or ≥ three of these factors (p for trend = 0.145). None of predictors, considered isolated, was significantly associated with ICD appropriate therapies. Patients with non-sustained ventricular tachycardia (NSVT) and positive programmed ventricular stimulation had a significant increased risk of ICD appropriate therapies (HR=3.8, 95% CI: 1.1–14.3, p=0.035), as well as patients with NSVT and QRSd ≥180 ms (HR=7.2, 95% CI: 1.6–32.7, p=0.003). No patient with severe altered LVEF without other risk factor had appropriate ICD therapy. Patients with congestive heart failure and/or altered LVEF had a higher risk of non-sudden death or cardiac transplantation (HR=14.4, 95% CI: 1.8–112.7, p<0.001). Seventeen (36.2%) patients experienced at least one ICD-related complication.
Conclusions
Our data illustrate that specific risk stratification and primary prevention for sudden cardiac death in patients with tetralogy of Fallot may be improved. The value of a severely altered LVEF appears low in the absence of other risk factors, and combination of different predictors is essential. The high rate of complications as well as consideration of competing risk situation have to be integrated in the benefit-risk equation.
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Affiliation(s)
- V Waldmann
- European Hospital Georges Pompidou, Paris, France
| | - A Bouzeman
- Private Hopital of Parly II, Le Chesnay, France
| | - F Bessiere
- Hospital Louis Pradel of Bron, Lyon, France
| | | | - M Ladouceur
- European Hospital Georges Pompidou, Paris, France
| | | | | | - C Audinet
- Centre Hospitalier de Bretagne Sud, Lorient, France
| | - P Defaye
- University Hospital of Grenoble, Grenoble, France
| | - A Mathiron
- University Hospital of Amiens, Amiens, France
| | - L Iserin
- European Hospital Georges Pompidou, Paris, France
| | - J B Thambo
- University Hospital of Bordeaux, Bordeaux, France
| | - J L Pasquie
- University Hospital of Montpellier, Montpellier, France
| | - N Combes
- Clinic Pasteur, Toulouse, France
| | - E Marijon
- European Hospital Georges Pompidou, Paris, France
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50
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Gavotto A, Abassi H, Rola M, Serrand C, Picot MC, Iriart X, Thambo JB, Iserin L, Ladouceur M, Bredy C, Amedro P. Factors associated with exercise capacity in patients with a systemic right ventricle. Int J Cardiol 2019; 292:230-235. [DOI: 10.1016/j.ijcard.2019.06.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 11/25/2022]
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