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Waldmann V, Bessière F, Gardey K, Hascoët S, Henaine R, Iserin L, Ladouceur M, Bonnet D, Marijon E, Maltret A, Combes N, de Groot N. Catheter ablation of atrial tachyarrhythmias in patients with atrioventricular septal defect. Europace 2023; 25:euad275. [PMID: 37695311 PMCID: PMC10516589 DOI: 10.1093/europace/euad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
AIMS The incidence of atrial tachyarrhythmias is high in patients with atrioventricular septal defect (AVSD). No specific data on catheter ablation have been reported so far in this population. We aimed to describe the main mechanisms of atrial tachyarrhythmias in patients with AVSD and to analyse outcomes after catheter ablation. METHODS AND RESULTS This observational multi-centric cohort study enrolled all patients with AVSD referred for catheter ablation of an atrial tachyarrhythmia at six tertiary centres from 2004 to 2022. The mechanisms of the different tachyarrhythmias targeted were described and outcomes were analysed. Overall, 56 patients (38.1 ± 17.4 years, 55.4% females) were included. A total of 87 atrial tachyarrhythmias were targeted (mean number of 1.6 per patient). Regarding main circuits involved, a cavo-annular isthmus-dependent intra-atrial re-entrant tachycardia (IART) was observed in 41 (73.2%) patients and an IART involving the right lateral atriotomy in 10 (17.9%) patients. Other tachyarrhythmias with heterogeneous circuits were observed in 13 (23.2%) patients including 11 left-sided and 4 right-sided tachyarrhythmias. Overall, an acute success was achieved in 54 (96.4%) patients, and no complication was reported. During a mean follow-up of 2.8 ± 3.8 years, 22 (39.3%) patients had at least one recurrence. Freedom from atrial tachyarrhythmia recurrences was 77.5% at 1 year. Among 15 (26.8%) patients who underwent repeated ablation procedures, heterogeneous circuits including bi-atrial and left-sided tachyarrhythmias were more frequent. CONCLUSION In patients with AVSD, most circuits involve the cavo-annular isthmus, but complex mechanisms are frequently encountered in patients with repeated procedures. The acute success rate is excellent, although recurrences remain common during follow-up.
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Affiliation(s)
- Victor Waldmann
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, 149 rue de Sèvres, 75015 Paris, France
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Francis Bessière
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Kevin Gardey
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Sébastien Hascoët
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
| | - Roland Henaine
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Magalie Ladouceur
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Damien Bonnet
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, 149 rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Alice Maltret
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
| | - Nicolas Combes
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
- Electrophysiology Unit, Pasteur Clinic, 45 avenue de Lombez, 31300 Toulouse, France
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Waldmann V, Bessière F, Gardey K, Bakloul M, Belli E, Bonnet D, Chaussade AS, Cohen S, Delasnerie H, Dib N, Di Filippo S, Dulac A, Hascoët S, Henaine R, Iserin L, Karsenty C, Ladouceur M, Legendre A, Malekzadeh-Milani S, Mostefa Kara M, Radojevic J, Ratsimandresy M, Marijon E, Maltret A, Khairy P, Combes N. Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study. Circ Arrhythm Electrophysiol 2023:e011745. [PMID: 37170812 DOI: 10.1161/circep.122.011745] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Ventricular arrhythmias and sudden death are recognized complications in tetralogy of Fallot. Electrophysiological studies (EPS) before pulmonary valve replacement (PVR), the most common reintervention in tetralogy of Fallot, could potentially inform therapy to improve arrhythmic outcomes. METHODS A prospective multicenter study was conducted to systematically assess EPS with programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR from January 2020 to December 2021. A standardized stimulation protocol was used across all centers. RESULTS A total of 120 patients were enrolled, mean age 39.2±14.5 years, 53.3% males. Sustained ventricular tachycardia was induced in 27 (22.5%) patients. When identifiable, the critical isthmus most commonly implicated (ie, in 90.0%) was between the ventricular septal defect patch and pulmonary annulus. Factors independently associated with inducible ventricular tachycardia were history of atrial arrhythmia (OR, 8.56 [95% CI, 2.43-34.73]) and pulmonary annulus diameter >26 mm (OR, 5.05 [95% CI, 1.47-21.69]). The EPS led to a substantial change in management in 23 (19.2%) cases: 18 (15.0%) had catheter ablation, 3 (2.5%) surgical cryoablation during PVR, and 9 (7.5%) defibrillator implantation. Repeat EPS 5.1 (4.8-6.2) months after PVR was negative in 8 of 9 (88.9%) patients. No patient experienced a sustained ventricular arrhythmia during 13 (6.1-20.1) months of follow-up. CONCLUSIONS Systematically performing programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR yields a high rate of inducible ventricular tachycardia and carries the potential to alter management. It remains to be determined whether a standardized treatment approach based on the results of EPS will translate into improved outcomes. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04205461.
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Affiliation(s)
- Victor Waldmann
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France (V.W., E.M.)
| | - Francis Bessière
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Kevin Gardey
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Mohamed Bakloul
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Emre Belli
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Anne-Solène Chaussade
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Sarah Cohen
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Hubert Delasnerie
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
| | - Nabil Dib
- Pasteur Clinic, Toulouse, France (H.D., C.K., M.R., N.C.)
| | - Sylvie Di Filippo
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Arnaud Dulac
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Sébastien Hascoët
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Roland Henaine
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Clément Karsenty
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
| | - Magalie Ladouceur
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Antoine Legendre
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Mansour Mostefa Kara
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Jelena Radojevic
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | | | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France (V.W., E.M.)
| | - Alice Maltret
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Paul Khairy
- Pasteur Clinic, Toulouse, France (H.D., C.K., M.R., N.C.)
| | - Nicolas Combes
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
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Vasse S, Martin-Bonnet C, Henaine R. Surgical reinterventions after arterial switch operation for transposition of the great arteries. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Biot T, Fieux M, Henaine R, Truy E, Coudert A, Ayari-Khalfallah S. Long term outcome of laryngeal mobility disorder and quality of life after pediatric cardiac surgery. Int J Pediatr Otorhinolaryngol 2022; 158:111142. [PMID: 35580383 DOI: 10.1016/j.ijporl.2022.111142] [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: 10/20/2021] [Revised: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Laryngeal mobility disorder after a pediatric heart surgery is common (between 5 and 10% of cases), and has important consequences on swallowing, breathing and speaking. After reviewing the literature, the recovery rate is variable and the postoperative follow-up is often done on a short time frame. The primary objective of the study is to describe the recovery from laryngeal mobility disorder with a follow-up time of at least 5 years. The secondary objective is to describe of the quality of life of the child in terms of phonation and swallowing, and to identify potential risk factors for a lasting laryngeal mobility disorder. METHODS We collected data (morphological characteristics and details of the procedures and medical care) on children who had undergone a heart surgery with risks of complications, between 2010 and 2015, and with a laryngeal mobility disorder detected after the surgery through nasal flexible laryngoscopy. During a follow-up consultation, carried at least 5 years after the surgery, we performed a nasal flexible laryngoscopy to assess whether or not the patient had recovered a full mobility of the larynx. Two questionnaires were also given to the patients, the pVHI and the PEDI EAT-10, to assess respectively the quality of their speech and of their swallowing function. RESULTS The recovery rate for a laryngeal mobility disorder more than 5 years after surgery was found to be 65% (9 children out of the 14 included in the study). We identified a risk factor for the persistence of a laryngeal mobility disorder after surgery: the presence of an associated genetic syndrome, p = 0.025. Children with persistent laryngeal mobility disorder have an impaired quality of life score, using the pVHI scale, which correlates well with the flexible laryngoscopy findings, p = 0.033. CONCLUSION Children with a lasting laryngeal mobility disorder have disabling respiratory and vocal symptoms in their daily lives. Nasal flexible laryngoscopy should therefore be systematically performed postoperatively after a surgery carrying risks. For improved patient management, early detection of these disorders by pharyngolaryngeal nasal flexible laryngoscopy in the aftermath of high-risk cardiac surgery is strongly advised, with prolonged follow-up.
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Affiliation(s)
- Thomas Biot
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France
| | - Maxime Fieux
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, Pierre Bénite cedex, F-69495, France; Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Université Paris Est Creteil, INSERM, IMRB, F-94010, Créteil, France; CNRS ERL 7000, F-94010, Créteil, France.
| | - Roland Henaine
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Department of Adult and Child Cardiovascular Surgery and Heart Transplantation, Louis Pradel Cardiologic Hospital, Bron, France
| | - Eric Truy
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France; Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Inserm U1028, Lyon Neuroscience Research Center, Equipe IMPACT, Lyon, France; Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
| | - Aurelie Coudert
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France; Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
| | - Sonia Ayari-Khalfallah
- Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
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Torfs A, Chardonnal L, Meunier S, Désage S, Henaine R, Lilot M. Perioperative hemostatic management of a newborn with hereditary hemophilia A and emergent surgery for dextro-transposition of the great arteries. J Cardiothorac Vasc Anesth 2022; 36:3855-3858. [DOI: 10.1053/j.jvca.2022.06.018] [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: 02/17/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
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Cantrelle C, Jasseron C, Legeai C, Henaine R, Garaix F, Houyel L, Filippo SD, Kerbaul F, Dorent R. The New French Heart Allocation System Has Improved Access to Transplantation in Adolescents. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jacquemart E, Bessière F, Combes N, Ladouceur M, Iserin L, Gardey K, Henaine R, Dulac A, Cohen S, Belli E, Jannot AS, Chevalier P, Ly R, Clavier S, Legendre A, Petit J, Maltret A, Di Filippo S, Hascoët S, Marijon E, Waldmann V. Incidence, Risk Factors, and Outcomes of Atrial Arrhythmias in Adult Patients With Atrioventricular Septal Defect. JACC Clin Electrophysiol 2022; 8:331-340. [PMID: 35331427 DOI: 10.1016/j.jacep.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/06/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to assess the incidence, associated factors, and outcomes of atrial arrhythmias in adults with atrioventricular septal defect (AVSD). BACKGROUND Data regarding atrial arrhythmias in adults with AVSD are particularly scarce. METHODS Data were analyzed from a multicentric cohort of adult patients with AVSD. Lifetime cumulative incidences of atrial arrhythmias were studied. Multiple logistic regression models were used to identify risk factors. RESULTS A total of 391 patients (61.6% women) were enrolled with a mean age of 36.3 ± 16.3 years and a mean follow-up of 17.3 ± 14.2 years after initial surgical repair. Overall, 98 patients (25.1%) developed at least 1 episode of atrial arrhythmia at a mean age of 39.2 ± 17.2 years. The mean ages of patients at first episode of intra-atrial re-entrant tachycardia (IART)/ focal atrial tachycardia (FAT) and atrial fibrillation were 33.7 ± 15.3 and 44.3 ± 16.5 years, respectively. The lifetime risks for developing atrial arrhythmia to ages 20, 40, and 60 years were 3.7%, 17.8%, and 55.3%, respectively. IART/FAT was the leading arrhythmia until the age of 45, then atrial fibrillation surpassed IART/FAT. Age (odds ratio [OR]: 1.4; 95% confidence interval [CI]: 1.2-1.6), number of cardiac surgeries (OR: 4.1; 95% CI: 2.5-6.9), left atrial dilatation (OR: 3.1; 95% CI: 1.4-6.8), right atrial dilatation (OR: 4.1; 95% CI: 1.7-10.3), and moderate or severe left atrioventricular valve regurgitation (OR: 3.7; 95% CI: 1.2-11.7) were independently associated with a higher risk of atrial arrhythmias, whereas the type of AVSD and the age at repair were not. The occurrence of atrial arrhythmias was associated with pacemaker implantation (41.8% vs. 8.5%; P < 0.001), heart failure (24.5% vs. 1.0%; P < 0.001), and cerebrovascular accidents (11.2% vs. 3.4%; P = 0.007). CONCLUSIONS The lifetime risk of atrial arrhythmias in patients with AVSD is considerable with more than half of patients developing ≥1 atrial arrhythmia by the age of 60 and is associated with a significant morbidity. The risk in partial/intermediate AVSD is as high as in complete AVSD and is not impacted by age at repair.
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Affiliation(s)
- Etienne Jacquemart
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | | | - Nicolas Combes
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France; Pasteur Clinic, Toulouse, France
| | - Magalie Ladouceur
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | - Sarah Cohen
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Emre Belli
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Anne-Sophie Jannot
- Department of Medical Informatics and Public Health, European Georges Pompidou Hospital, Paris, France
| | | | - Reaksmei Ly
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Sandra Clavier
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Antoine Legendre
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Jérôme Petit
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Alice Maltret
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | | | - Sébastien Hascoët
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Eloi Marijon
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | - Victor Waldmann
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France.
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Amadou D, Mitchell J, Bulescu C, Metton O, Henaine R, Ninet J. Direct Reimplantation Procedure in Anomalous Aortic Origin of the Right Coronary Artery: Long-Term Single Center Outcomes. World J Pediatr Congenit Heart Surg 2021; 12:693-699. [PMID: 34846970 DOI: 10.1177/21501351211027478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Anomalous aortic origin of the right coronary artery is known to be a cause of sudden cardiac death in athletes. There are no specific guidelines concerning treatment strategy in the literature. The aim of this study is to describe and report our experience of direct reimplantation technique in the treatment of this anomaly. METHODS This was a retrospective single center study of 30 patients who underwent surgery in the congenital heart disease unit of Louis Pradel Heart and Lung Hospital between January 2003 and December 2016. The mean follow-up was seven years (3 months-17 years). RESULTS Thirty patients underwent surgery. The median age was 17 years (0.2-52 years). There were 24 males. The median weight was 58 kg (3.6-118 kg). Fourteen patients were actively engaged in sports. Twenty-six patients had exertional chest pain or syncope. The median time lapse between diagnosis and intervention was 4.5 months (0.5-179 months). Twenty-seven (90%) patients underwent reimplantation of the anomalous coronary artery without transverse aortotomy, while in 3 (10%) patients transverse aortotomy was used to facilitate reimplantation to avoid tension at the anastomosis. There was no early death; one late death occurred in the third postoperative month. At the last follow-up, all patients had returned to normal physical activity without evidence of ischemia. CONCLUSIONS Direct reimplantation allows for a complete restoration of the coronary anatomy and enables patients to return to normal physical activity. Our study shows encouraging results using a direct reimplantation technique without aortotomy.
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Affiliation(s)
- Daouda Amadou
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France
| | - Julia Mitchell
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France
| | - Christian Bulescu
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France
| | - Olivier Metton
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France
| | - Roland Henaine
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France.,Université Claude Bernard, Laboratoire de Physiologie INSERM, Unité 1060, CarMen, Cardioprotection, Lyon, France
| | - Jean Ninet
- Service de Chirurgie Cardiaque Congénitale, Hôpital Louis-Pradel, Hospices Civils de Lyon, Bron, France.,Université Claude Bernard, Laboratoire de Physiologie INSERM, Unité 1060, CarMen, Cardioprotection, Lyon, France
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9
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Halley E, Giai J, Chappuis M, Tomasino A, Henaine R, Letrilliart L. Health Profile of Precarious Migrants Attending the Médecins Du Monde's Health and Social Care Centres in France: a Cross-Sectional Study. Int J Public Health 2021; 66:602394. [PMID: 34456664 PMCID: PMC8386651 DOI: 10.3389/ijph.2021.602394] [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: 09/03/2020] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The present study aimed to compare the precarious migrants' health problems managed in Médecins du Monde's health and social care centres (CASO) with those of patients attending general practice in France. Methods: We compared the most frequent health problems managed in the 19 CASO in metropolitan France with those of a national sample of usual general practice consultations, after standardisation for age and sex. Results: Precarious migrants had fewer health problems managed per consultation than other patients (mean: 1.31 vs. 2.16), and these corresponded less frequently to chronic conditions (21.3% vs. 46.8%). The overrepresented health problems among CASO consultations were mainly headache (1.11% vs. 0.45%), viral hepatitis (1.05% vs. 0.20%), type 1 diabetes (1.01% vs. 0.50%) and teeth/gum disease (1.01% vs. 0.23%). Their underrepresented health problems were mainly lipid disorder (0.39% vs. 8.20%), depressive disorder (1.36% vs. 5.28%) and hypothyroidism (0.50% vs. 3.08%). Prevention issues were nominal in precarious migrants (0.16%). Conclusion: Both chronic somatic and mental conditions of precarious migrants are presumably underdiagnosed. Their screening should be improved in primary care.
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Affiliation(s)
- Emeraude Halley
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France
| | - Joris Giai
- Service de Biostatistique-Bioinformatique, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Roland Henaine
- Unité d'enseignement Libre Médecine Humanitaire et SAMU Social, Université Claude Bernard Lyon 1, Lyon, France.,Service de chirurgie cardiaque C, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France.,Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
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10
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Beaufigeau M, Henaine R, Soldea V, Schulze O, Bakloul M, Tronc F. Persistent left superior vena cava with patent left innominate vein: Ideal anatomy for mini invasive thoracoscopic ligature. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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11
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Bulescu C, Dubois R, Hameury F, Henaine R. Excision of Wilms' Tumor With Atrial Extension Under Moderate Hypothermia and Cerebral Perfusion. In Vivo 2021; 35:2213-2216. [PMID: 34182499 DOI: 10.21873/invivo.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Wilms' tumor is the most common pediatric renal tumor. Almost half of all cases have involvement of the inferior vena cava, which must be addressed at the time of surgical excision. Further extension into the right atrium may pose an immediate vital risk and necessitates special operative techniques that employ cardiopulmonary bypass. CASE REPORT We report the case of a child with a left Wilms' tumor with inferior caval and right atrial involvement, which led to significant hemodynamic compromise and urgent surgery. A left nephrectomy and cavoatrial thrombectomy were performed via a sterno-laparotomy. Our strategy employed moderate hypothermic circulatory arrest at 26°C and antegrade cerebral perfusion in order to improve visualization and ensure complete thrombectomy and protection of the abdominal organs. CONCLUSION This case emphasizes the advantages of moderate hypothermic circulatory arrest compared to deep hypothermic circulatory arrest and normothemic cardiopulmonary bypass.
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Affiliation(s)
- Cristian Bulescu
- Department of Adult and Child Cardiovascular Surgery and Heart Transplantation, Louis Pradel Cardiologic Hospital, Bron, France;
| | - Remi Dubois
- Department of Urology, Visceral, Thoracic and Transplant Surgery, Woman-Mother-Child Hospital, Bron, France
| | - Frederic Hameury
- Department of Urology, Visceral, Thoracic and Transplant Surgery, Woman-Mother-Child Hospital, Bron, France
| | - Roland Henaine
- Department of Adult and Child Cardiovascular Surgery and Heart Transplantation, Louis Pradel Cardiologic Hospital, Bron, France
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12
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Jacquemart E, Bessiere F, Combes N, Ladouceur M, Iserin L, Gardey K, Henaine R, Chevalier P, Legendre A, Petit J, Di Filippo S, Hascoet S, Marijon E, Waldmann V. Incidence, risk factors and outcomes of atrial arrhythmias in adult patients with atrioventricular septal defect. Europace 2021. [DOI: 10.1093/europace/euab116.497] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): French Federation of Cardiology
Background
The number of adults with atrioventricular septal defects (AVSD) is growing, with however, very few data regarding the natural history of atrial arrhythmias in this specific population. We aimed to assess the incidence, associated factors and outcomes of atrial arrhythmias among adult patients with AVSD.
Methods
Multicentric retrospective cohort of patients with AVSD from 3 referral centers specialized in adult congenital heart disease. Unbalanced AVSD, univentricular hearts, and Eisenmenger syndromes were excluded. Lifetime cumulative incidences of different types of atrial arrhythmia (>30 seconds) were analyzed (atrial fibrillation [AF] and intra atrial reentrant tachycardia/focal atrial tachycardia [IART/FAT]). Multiple logistic regression models were used to identify risk factors for atrial arrhythmias.
Results
The cohort comprised of 391 patients (61.6% of women) with a mean age of 36.3 ± 16.3 years and 17.3 ± 14.2 years of follow-up after surgical repair in operated patients, including 333 (85.1%) partial/intermediate and 58 (1.0%) complete AVSD. Overall, atrial arrhythmias were documented in 98 patients (25.1%).
The lifetime risks for developing atrial arrhythmia to ages 20, 40, and 60 were 3.7%, 17.6%, and 54.8%. IART/FAT was the leading arrhythmia until the age of 45 then AF surpassed IART/FAT.
Age (OR = 1.4, 95%CI = 1.2-1.6 by 5 years increment), the number of cardiac surgeries (OR = 4.1, 95%CI = 2.5-6.9), left atrial dilatation (OR = 3.1, 95%CI = 1.4-6.8), right atrial dilatation (OR = 4.1, 95%CI = 1.7-10.3), and moderate or severe left AV valve regurgitation (OR = 3.7, 95%CI = 1.2-11.7) were independently associated with a higher risk of atrial arrhythmias. Patients with atrial arrhythmias more frequently had pacemaker implantation (41.8% vs. 8.5%, p < 0.001), heart failure (24.5% vs 1.0%, p < 0.001) and cerebrovascular accidents (11.2% vs 3.4%, p = 0.007).
Conclusions
The lifetime risk of atrial arrhythmias in patients with AVSD is considerable with more than half of patients who will develop an atrial arrhythmia by the age of 60. Atrial arrhythmias are associated with a significant morbidity in this population. Abstract Figure. Central Illustration AVSD
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Affiliation(s)
- E Jacquemart
- European Hospital Georges Pompidou, Paris, France
| | - F Bessiere
- Hospital Louis Pradel of Bron, Lyon, France
| | - N Combes
- Clinic Pasteur, Toulouse, France
| | - M Ladouceur
- European Hospital Georges Pompidou, Paris, France
| | - L Iserin
- European Hospital Georges Pompidou, Paris, France
| | - K Gardey
- Hospital Louis Pradel of Bron, Lyon, France
| | - R Henaine
- Hospital Louis Pradel of Bron, Lyon, France
| | | | - A Legendre
- European Hospital Georges Pompidou, Paris, France
| | - J Petit
- Surgical Centre Marie Lannelongue, Le Plessis Robinson, France
| | | | - S Hascoet
- Surgical Centre Marie Lannelongue, Le Plessis Robinson, France
| | - E Marijon
- European Hospital Georges Pompidou, Paris, France
| | - V Waldmann
- European Hospital Georges Pompidou, Paris, France
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13
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Fouilloux V, El Louali F, Gran C, Henaine R, Roubertie F, Chenu C, Fiorini M, Le Bel S, Mauriat P, Neidecker J, Macé L, Kreitmann B, Ovaert C. Berlin Heart EXCOR Paediatric Ventricular Assist Device: Does Weight Matter? Heart Lung Circ 2020; 30:585-591. [PMID: 32972811 DOI: 10.1016/j.hlc.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 07/13/2020] [Accepted: 08/24/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Berlin Heart EXCOR (BH) ventricular assist devices provide mechanical long-term circulatory support in children with end-stage heart failure, as a bridge to transplantation or to recovery. Most studies are from large-volume paediatric cardiac centres. AIM The aim of this study was to analyse the experiences of three French centres and to compare these with available published data. METHOD We performed a retrospective observational study of three paediatric cardiac intensive care units. All children supported with BH devices were included. Morbidity and mortality data were collected and risk factors analysed. RESULTS Fifty-four (54) patients (54% male) were included. Survival rate was 73% while on a BH device. Median age at BH device implantation was 17 months (range 2-180 months). The predominant indication was dilated cardiomyopathy (61%). Bi-ventricular assist device was used in 25 (46%) cases. The total length of long-term circulatory support was 3,373 days, with a mean length per patient of 62.5 days (range 5-267 days). Thirty-two (32) patients were transplanted (59%) and seven (13%) were successfully weaned. Type and length of support did not influence morbidity. Main complications were renal dysfunction (57%), bleeding (41%), and infection (39%). In multivariate analysis, a weight <5 kg was significantly associated with higher mortality. CONCLUSIONS The weight seems to be the most important risk factor of mortality in this precarious condition.
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Affiliation(s)
- Virginie Fouilloux
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Fedoua El Louali
- Department of Paediatric and Congenital Cardiology, Timone Hospital, Marseille, France.
| | - Célia Gran
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Roland Henaine
- Congenital Cardiology Unit, Cardiologic Hospital Louis Pradel, Lyon, France
| | - François Roubertie
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, Bordeaux, France
| | - Caroline Chenu
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France
| | - Marion Fiorini
- Department of Anaesthesia and Intensive Care, Timone Children Hospital, Marseille, France
| | - Stéphane Le Bel
- Department of Anaesthesia and Intensive Care, Timone Children Hospital, Marseille, France
| | - Philippe Mauriat
- Department of Intensive Care Unit, Bordeaux Heart University Hospital, Bordeaux, France
| | - Jean Neidecker
- Department of Intensive Care Unit, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Loïc Macé
- Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Bernard Kreitmann
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, Bordeaux, France
| | - Caroline Ovaert
- Faculty of Medicine, Aix-Marseille University, Marseille, France; Department of Paediatric and Congenital Cardiology, Timone Hospital, Marseille, France
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14
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Perreux Y, Alexandre Chaix M, Kamp A, Mongeon FP, Pham M, Boussel L, Henaine R, Dore A, Mond閟ert B, Di-Filippo S, Khairy P, Bessiere F. Abnormal Coronary Anatomy in Patients with Transposition of the Great
Arteries and Atrial Switch: A Predictor of Serious Cardiac Adverse Events? CONGENIT HEART DIS 2020. [DOI: 10.32604/chd.2020.013032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Raissouni K, Henaine R, Ninet J. Congenital aortic insufficiency with ascending aortic aneurysm: Dealing with a challenging case. Progress in Pediatric Cardiology 2019. [DOI: 10.1016/j.ppedcard.2019.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Courand PY, Bozio A, Ninet J, Boussel L, Bakloul M, Perouse De Montclos T, Walton C, Metton O, Henaine R, Galoin Bertail C, Di Filippo S. P782Comparison of right coronary artery with left coronary artery arising from opposite sinus: clinical presentation and risk of suden death. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P Y Courand
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - A Bozio
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Ninet
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - L Boussel
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - M Bakloul
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | | | - C Walton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - O Metton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - R Henaine
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - C Galoin Bertail
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - S Di Filippo
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
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17
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Han Yee Yu M, Roubertie F, Henaine R, Iriart X, Jalal Z, Thambo J, Séguéla P. Surgical closure of ventricular septal defect in adults: A multicenter study. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Yee Yu MH, Roubertie F, Henaine R, Iriart X, Jalal Z, Thambo J, Séguéla P. Surgical closure of ventricular septal defect in adults: a multicenter study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30890-x] [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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19
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Makani S, Mitchell J, Metton O, Di Filippo S, Henaine R, Ninet J. Surgical repair of a pseudocoarctation with cervical aortic arch complicated by multiple aneurysms of the aorta: a case report. Pan Afr Med J 2017; 26:236. [PMID: 28690750 PMCID: PMC5491740 DOI: 10.11604/pamj.2017.26.236.11800] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 02/01/2017] [Indexed: 11/11/2022] Open
Abstract
Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and deformity of the aortic arch and is known to be associated with aneurysmal formation. Several studies unite to say it leads to a surgical sanction as soon as symptomatic or associated with aneurysms of the aortic arch. Our patient is a 12 years old boy, followed since birth for a little tight pseudocoarctation with a cervical aortic arch and transverse aortic arch hypoplasia. Close clinical and paraclinical monitoring including angioscans, showed the gradual enlargement of the superior mediastinum, in relation with the appearance of three aneurysms of the aortic arch. The intervention, performed by sternotomy, has consisted of the resection of the aneurysmal area and the interposition of a Dacron tube to repair the aortic arch and the reimplantation of the left subclavian artery into the left carotid artery. The postoperative course was uneventful. Management of pseudocoarctation associated with cervical aortic arch and aneurysms remains surgical. Close monitoring of patients with pseudocorctation, seems to be essential to avoid fatal complications such as aneurysmal rupture.
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Affiliation(s)
- Said Makani
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Julia Mitchell
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Olivier Metton
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Sylvie Di Filippo
- Department of Paediatric and Congenital Cardiology, Louis Pradel Hospital, Bron, Lyon, France
| | - Roland Henaine
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Jean Ninet
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
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Veyrier M, Ducreux C, Henaine R, Ninet J, Bertail-Galoin C, Bakloul M, Di Filippo S. Heart transplantation in infants and children on mechanical ventricular support. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30348-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Walton C, Veyrier M, Ducreux C, Henaine R, Di Filippo S. Acute myocarditis in very young children: single center experience. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30341-5] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Pozzi M, Mitchell J, Henaine AM, Hanna N, Safi O, Henaine R. International normalized ratio self-testing and self-management: improving patient outcomes. Vasc Health Risk Manag 2016; 12:387-392. [PMID: 27785043 PMCID: PMC5066985 DOI: 10.2147/vhrm.s85031] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Long term oral anti-coagulation with vitamin K antagonists is a risk factor of hemorrhagic or thromebomlic complications. Periodic laboratory testing of international normalized ratio (INR) and a subsequent dose adjustment are therefore mandatory. The use of home testing devices to measure INR has been suggested as a potential way to improve the comfort and compliance of the patients and their families, the frequency of monitoring and, finally, the management and safety of long-term oral anticoagulation. In pediatric patients, increased doses to obtain and maintain the therapeutic target INR, more frequent adjustments and INR testing, multiple medication, inconstant nutritional intake, difficult venepunctures, and the need to go to the laboratory for testing (interruption of school and parents’ work attendance) highlight those difficulties. After reviewing the most relevant published studies of self-testing and self-management of INR for adult patients and children on oral anticoagulation, it seems that these are valuable and effective strategies of INR control. Despite an unclear relationship between INR control and clinical effects, these self-strategies provide a better control of the anticoagulant effect, improve patients and their family quality of life, and are an appealing solution in term of cost-effectiveness. Structured education and knowledge evaluation by trained health care professionals is required for children, to be able to adjust their dose treatment safely and accurately. However, further data are necessary in order to best define those patients who might better benefit from this multidisciplinary approach.
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Affiliation(s)
- Matteo Pozzi
- Department of Adult Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
| | - Julia Mitchell
- Department of Congenital Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
| | | | - Najib Hanna
- Pediatric Unit, "Hotel Dieu de France" Hospital, Saint Joseph University, Beirut, Lebanon
| | - Ola Safi
- Pediatric Unit, "Hotel Dieu de France" Hospital, Saint Joseph University, Beirut, Lebanon
| | - Roland Henaine
- Department of Congenital Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
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Veyrier M, Ducreux C, Bastien O, Henaine R, Neidecker J, Ninet J, Galoin-Bertail C, Bakloul M, Filippo SD. Heart transplantation in infants and children on mechanical ventricular support. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30574-2] [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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24
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Fiorini M, Aldebert P, Macé L, Henaine R, Roubertie F, Paut O, Mauriat P, Neidecker J, Ovaert C, Kreitmann B. Experience with Berlin-heart Excor® devices in children in south of France. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Meurgey A, Henaine R, Bouvagnet P, Chalabreysse L. [About a case of a recurrent glandular cardiac myxoma in a child]. Ann Pathol 2016; 36:214-7. [PMID: 27234518 DOI: 10.1016/j.annpat.2016.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/21/2015] [Accepted: 01/31/2016] [Indexed: 10/21/2022]
Abstract
Primary cardiac tumors are extremely rare and mainly benign. The majority of these are myxomas (40%). Myxoma are generally sporadic tumors which occur most commonly in adult females between 30 and 40 years, and are seldom found in the paediatric population (5%). Seven percent are associated with igenetic diseases. We report the case of an eight-year-old boy presenting a recurrent glandular cardiac myxoma. In 2011, he presented a deterioration of the general state. An echocardiography highlighted a left atrial mass on the interatrial septum, with a pedicular insertion. On the microscope, it consisted of a proliferation of stellate cells isolated or clustered in rudimentary vessels in a myxoid stroma presenting haemorrhage changes. These cells expressed CD34 and calretinine. Glandular elements without atypia were clustered within the myxomatous proliferation. They expressed cytokeratin (CK) 7. Surgical resection was macroscopically complete. In 2014, the boy had a sudden neurological deficit during a football match. An echocardiography revealed a recurrence at the same location. The lesion was excised and addressed in several fragments. Classical myxoma was associated with glands without atypia. This last component expressed CKAE1/AE3 and CK7. Ki67 index of proliferation was low. The surgical reintervention was macroscopically complete. The final diagnosis was glandular cardiac myxoma. A genetic survey was conducted, showing the presence of Carney complex. This is the first description in the litterature of a recurrent glandular cardiac myxoma occuring in a child.
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Affiliation(s)
- Alexandra Meurgey
- Service d'anatomie et cytologie pathologique, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon, France
| | - Roland Henaine
- Unité médico-chirurgicale des cardiopathies congénitales adultes et enfants, groupement hospitalier Est, hospices civils de Lyon, 69677 Lyon, France
| | - Patrice Bouvagnet
- EA 4173, laboratoire cardiogénétique, groupement hospitalier Est, hospices civils de Lyon, université Lyon 1 et hôpital Nord Ouest, 69677 Lyon, France
| | - Lara Chalabreysse
- Service d'anatomie et cytologie pathologique, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon, France.
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Baptiste Duclos J, Bastien O, Desebbe O, Ninet J, Metton O, Henaine R, Veyrier M, Bakloul M, Ducreux C, Di Filippo S. 0533: Sildenafil in the postoperative course after surgery in children with congenital heart disease. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71806-9] [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: 10/24/2022]
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Pozzi M, Generali T, Henaine R, Mitchell J, Lemaire A, Chiari P, Fran J, Obadia JF. Could anterior papillary muscle partial necrosis explain early mitral valve repair failure? J Heart Valve Dis 2014; 23:598-600. [PMID: 25799709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Standardized techniques of mitral valve repair (MVR) have recently witnessed the introduction of a 'respect rather than resect' concept, the strategy of which involves the use of artificial chordae. MVR displays several advantages over mitral valve replacement in degenerative mitral regurgitation (MR), but the risk of reoperation for MVR failure must be taken into account. Different mechanisms could be advocated as the leading cause of MVR failure; procedure-related mechanisms are usually involved in early MVR failure, while valve-related mechanisms are common in late failure. Here, the case is reported of an early failure of MVR using artificial chordae that could be explained by an unusual procedure-related mechanism, namely anterior papillary muscle necrosis. MVR failure is a well-known complication after surgical repair of degenerative MR, but anterior papillary muscle partial necrosis might also be considered a possible mechanism of procedure-related MVR failure, especially when considering the increasing use of artificial chordae. Owing to the encouraging results obtained, mitral valve re-repair might be considered a viable solution, but must be selected after only a meticulous evaluation of the underlying mechanism of MVR failure.
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Di Filippo S, Henaine R, Veyrier M, Ducreux C, Ninet J, Sebbag L, Boissonnat P, Roussoulières A. Long-term experience with heart transplantation in children and patients with congenital heart disease. Arch Cardiovasc Dis 2014. [DOI: 10.1016/j.acvd.2014.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mitchell J, Lemaire A, Henaine R, Metton O, Ninet J. Reimplantation of left coronary artery from pulmonary artery in a 65-year-old. Asian Cardiovasc Thorac Ann 2014; 24:69-71. [PMID: 24948780 DOI: 10.1177/0218492314539953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anomalous left coronary artery to the pulmonary artery is a rare pathology with a mortality rate of 90% in the first year of life, directly related to left ventricular function and coronary perfusion, although several adult cases have been reported. Surgical correction consists of ligation of the anomalous left coronary artery associated with coronary artery bypass grafting. We describe the exceptional case of a 65-year-old woman who underwent reimplantation of the left coronary artery in the anatomical position without bridging.
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Affiliation(s)
- Julia Mitchell
- Cardio-Pediatric and Congenital Medico-Surgical Department C, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Anaïs Lemaire
- Cardio-Pediatric and Congenital Medico-Surgical Department C, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Roland Henaine
- Cardio-Pediatric and Congenital Medico-Surgical Department C, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Olivier Metton
- Cardio-Pediatric and Congenital Medico-Surgical Department C, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Jean Ninet
- Cardio-Pediatric and Congenital Medico-Surgical Department C, Cardiologic Hospital Louis Pradel, Lyon, France
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Desebbe O, Faulcon C, Henaine R, Tran L, Koffel C, Delannoy B, Lehot JJ, Bastien O, Maucort-Boulch D. Tissue Hemoglobin Monitoring Is Unable to Follow Variations of Arterial Hemoglobin During Transitions From Pulsatile to Constant Flow in Cardiac Surgery. J Cardiothorac Vasc Anesth 2014; 28:668-73. [DOI: 10.1053/j.jvca.2013.06.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Indexed: 11/11/2022]
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Roubertie F, Henaine R, Roques X, Thambo JB. Left posterolateral thoracotomy: an alternative approach for pulmonary valve replacement. Ann Thorac Surg 2014; 97:691-3. [PMID: 24484812 DOI: 10.1016/j.athoracsur.2013.05.113] [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: 03/21/2013] [Revised: 05/03/2013] [Accepted: 05/15/2013] [Indexed: 10/25/2022]
Abstract
Pulmonary valve replacement in adults who have a repaired tetralogy of Fallot is realized through a redo median sternotomy. A dilated ascending aorta is often present and adherent to the sternum and can be injured during sternum reentry, with dramatic consequences. We report on an adult patient with a corrected tetralogy of Fallot who underwent pulmonary valve replacement, thick transannular patch excision, and left pulmonary artery enlargement. Surgery was performed through a left posterolateral thoracotomy. This surgical approach was safe and efficient and, compared with the left anterior thoracotomy approach, offered many more possibilities.
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Affiliation(s)
- François Roubertie
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France.
| | - Roland Henaine
- Department of Cardiac Surgery, Cardiologic Hospital Louis Pradel, Lyon, France
| | - Xavier Roques
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
| | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Heart Disease, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France
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Pozzi M, Henaine R, Grinberg D, Robin J, Saroul C, Delannoy B, Desebbe O, Obadia JF. Total percutaneous femoral vessels cannulation for minimally invasive mitral valve surgery. Ann Cardiothorac Surg 2013; 2:739-43. [PMID: 24349975 DOI: 10.3978/j.issn.2225-319x.2013.08.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 08/30/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Minimally invasive mitral valve surgery (MIMVS) has experienced several technological changes in the last two decades. Our aim was to describe one of the most recent improvements, the utilization of a total percutaneous femoral vessels cannulation technique during MIMVS. METHODS We performed a retrospective observational analysis of this technique among 300 consecutive MIMVS patients, with particular focus on cannulation aspects of MIMVS, its success rate and potential complications. RESULTS From October 2008 to December 2012, 300 patients (60% males) were operated on. Mean age was 62.9±16.4 years. Indications for operation included mitral valve repair (93%) and mitral valve replacement (7%). Two femoral arterial catheterizations failed and required conversion to sternotomy. The complications on the arterial side were: 5 (1.6%) cases of bleeding during the introduction of Prostar leading to a preoperative surgical hemostasis; 2 (0.6%) retroperitoneal bleeds during cardiopulmonary bypass requiring difficult surgical control but with an uneventful follow-up; 6 (2%) bleeding episodes after removal of the arterial cannula easily controlled by direct surgical revision; 1 (0.3%) arterio-venous fistula requiring a surgical correction on postoperative day 32; 1 (0.3%) patient had a transitory claudication due to a superficial femoral artery thrombosis progressively compensated by the collateral circulation. There were no postoperative bleeding complications. There were no other complications linked to the femoral cannulations or to the groin occurred during the follow-up. The percentage of uneventful arterial cannulations was 80% among the first 50 patients (N=10 out of 50) and 98.8% thereafter (N=3 out of 250). CONCLUSIONS Total percutaneous femoral vessels cannulation technique is particularly suitable for MIMVS with a high success rate and few complications after a short learning curve. With the advent of the percutaneous approach, the traditional complications of the groin incision have completely disappeared in modern operations with no groin infection, hematoma or lymphocele.
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Affiliation(s)
- Matteo Pozzi
- Department of Cardiac Surgery, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France; ; Ph.D. School in Cardiovascular Science, Cardiovascular Surgery Unit, University of Verona Medical School, Verona, Italy
| | - Roland Henaine
- Department of Cardiac Surgery, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Daniel Grinberg
- Department of Cardiac Surgery, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Jacques Robin
- Department of Cardiac Surgery, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Christine Saroul
- Department of Anesthesia-Reanimation, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Bertrand Delannoy
- Department of Anesthesia-Reanimation, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Olivier Desebbe
- Department of Anesthesia-Reanimation, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
| | - Jean-François Obadia
- Department of Cardiac Surgery, "Cardiothoracic Hospital Louis Pradel", Hospices Civils de Lyon, "Claude Bernard" University, Lyon, France
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Henaine R, Chevalier P, Henaine AM, Motreff P, Pozzi M, Armoiry X. Self-testing of the International Normalized Ratio in adults with a mechanical heart valve: patient education and cost matter. Thromb Res 2013; 133:129-30. [PMID: 24331210 DOI: 10.1016/j.thromres.2013.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/26/2013] [Accepted: 11/26/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Roland Henaine
- Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Bron ,France; Inserm U1060, UCBL1, CarMeN, N°5, Cardioprotection Lyon, France.
| | - Philippe Chevalier
- Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiologic and Rhytmology Unit, Bron, France
| | | | - Pascal Motreff
- CHU de Clermont-Ferrand, Service de cardiologie, Clermont-Ferrand, France
| | - Matteo Pozzi
- Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Bron ,France
| | - Xavier Armoiry
- Université Claude Bernard Lyon 1, UMR-CNRS 5510/MATEIS, France; Hospices Civils de Lyon, Groupement Hospitalier Est, Service pharmaceutique, Bron, France; Hospices Civils De Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation, France
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Desebbe O, Henaine R, Keller G, Koffel C, Garcia H, Rosamel P, Obadia JF, Bastien O, Lehot JJ, Haftek M, Critchley LA. Ability of the Third-Generation FloTrac/Vigileo Software to Track Changes in Cardiac Output in Cardiac Surgery Patients: A Polar Plot Approach. J Cardiothorac Vasc Anesth 2013; 27:1122-7. [DOI: 10.1053/j.jvca.2013.03.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Indexed: 11/11/2022]
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Morillon-Lutun S, Maucort-Boulch D, Mewton N, Farhat F, Bresson D, Girerd N, Desebbe O, Henaine R, Kirkorian G, Bonnefoy-Cudraz E. Therapeutic management changes and mortality rates over 30 years in ventricular septal rupture complicating acute myocardial infarction. Am J Cardiol 2013; 112:1273-8. [PMID: 23866732 DOI: 10.1016/j.amjcard.2013.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/16/2013] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
Abstract
Recent studies have shown that the decrease in ventricular septal rupture (VSR) incidence after acute myocardial infarction is related to the improvement of reperfusion strategies. Our main objective was to explore the influence of therapeutic management changes on post-infarct VSR patient outcomes in a single reference center over a period of 30 years. We analyzed therapeutic management strategies and mortality rates in 228 patients with VSR after acute myocardial infarction admitted from 1981 to 2010. Patients were classified in 3 successive decades. There were no significant differences in clinical characteristics of patients with VSR at admission among those decades. Overall, surgery was performed in 159 patients (71.9%), primary transcatheter VSR closure was attempted in 5 patients (2.2%), and 64 patients (27.6%) were managed medically. Independent predictors of in-hospital mortality were VSR surgical repair (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.1 to 0.7, p = 0.008), cardiogenic shock (OR 6.06, 95% CI 2.8 to 13.1, p <0.0001), and Killip class on admission (OR 1.75, 95% CI 1.1 to 9.9, p = 0.02). We found a significant 1-year mortality reduction between the first and second decades (hazard ratio 0.48, 95% CI 0.28 to 0.80; p = 0.005), with no significant change in the last decade (p = 0.2). This change was related to a systematic referral to surgical repair and shorter delays to VSR surgery (5.2 ± 6.3 vs 1.9 ± 3.2 days from first to second decade; p = 0.012). In conclusion, surgical repair remains the only significant efficient therapy to reduce mortality in patients with VSR (p <10(-3)). In-hospital prognosis remains disappointing. This contrasts with the favorable long-term outcome of patients who survive the perioperative period and are discharged from hospital.
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Pozzi M, Rioufol G, Delannoy B, Lienhart-Robert A, Henaine R, Finet G, Obadia J. The “PAC-MAN” sign: An insidious complication after transcatheter aortic valve deployment. Int J Cardiol 2013; 167:e192-4. [DOI: 10.1016/j.ijcard.2013.04.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/06/2013] [Indexed: 11/26/2022]
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Veyrier M, Ducreux C, Henaine R, Ninet J, Bozio A, Sassolas F, Di Filippo S. Long term follow-up after heart transplantation in very young children. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chalard A, Sanchez I, Gouton M, Henaine R, Salami FA, Ninet J, Douek PC, Di Filippo S, Boussel L. Effect of pulmonary valve replacement on left ventricular fucntion in patients with tetralogy of fallot. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Joly H, Soufi A, Henaine R, Sassolas F, Ninet J, Bozio A, Metton O, Di Filippo S. Long-term survival and functional status of adult patient with Eisenmenger syndrome. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Soufi A, Veyrier M, Ducreux C, Sassolas F, Henaine R, Metton O, Ninet J, Joly H, Bozio A, Di Filippo S. Infective endocarditis in adults with congenital heart disease. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Joly H, Soufi A, Bozio A, Sassolas F, Henaine R, Metton O, Ninet J, Di Filippo S. Long-term survival and functional status of adult patients with Eisenmenger Syndrome. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Veyrier M, Ducreux C, Henaine R, Bozio A, Sassolas F, Ninet J, Di Filippo S. Long-term follow-up after heart transplantation in very young children. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Filippini S, Desebbe O, Gamondes D, Henaine R. Synergy between stents and extracorporeal membrane oxygenation in multitrauma patients with inferior vena cava injury. Eur J Cardiothorac Surg 2013; 44:1140-2. [DOI: 10.1093/ejcts/ezt203] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Desebbe O, Rosamel P, Henaine R, Vergnat M, Farhat F, Dubien PY, Bastien O. [Interhospital transport with extracorporeal life support: results and perspectives after 5 years experience]. ACTA ACUST UNITED AC 2013; 32:225-30. [PMID: 23499393 DOI: 10.1016/j.annfar.2013.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 02/04/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Describing the experience of a referral center for interhospital patients transport treated with extracorporeal circulatory or respiratory support (ECLS), the difficulties encountered and the results obtained. STUDY DESIGN Retrospective and observational study. PATIENTS AND METHODS All patients with respiratory or circulatory failure accepted for extracorporeal assistance for which routine medical transport was life threatening. STATISTICAL ANALYSIS A descriptive analysis was performed (median and interquartile deviation). Comparison of biological data was performed using a non-parametric Wilcoxon test and 5 years overall survival was determined by a Kaplan-Meier analysis. RESULTS Over a 55-month period, 29 patients were selected for transportation under ECMO or ECLS. Indication was respiratory failure in 38 % of cases, hemodynamic instability in 52 % of cases and combined symptoms in 10 % of cases. Average duration of transportation was 40 km (9-64 km). No complication related to transport was observed. Incidence of intrahospital death was 57 %. There was no correlation between death and indication of ECLS. Five-year survival was 55 % and 39 % for venovenous and arteriovenous ECLS, respectively. CONCLUSION In our experience, interhospital transport of patients under ECMO is feasible in satisfactory conditions of safety with trained team and standard procedures.
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Affiliation(s)
- O Desebbe
- Service d'anesthésie-réanimation, hôpital cardiovasculaire et pneumologique Louis-Pradel, hospices civils de Lyon, 28, avenue du Doyen-Lépine, 69677 Bron cedex, France
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Courand PY, Bozio A, Ninet J, Henaine R, Veyrier M, Bakloul M, Boussel L, Di Filippo S. Focus on echocardiographic and Doppler analysis of coronary artery abnormal origin from the pulmonary trunk with mild myocardial dysfunction. Echocardiography 2013. [PMID: 23347291 DOI: 10.1111/echo.12124.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Late presentation of abnormal origin of coronary artery from the pulmonary artery (ACAPA) is uncommon compared with early presentation, which usually induces extended myocardial necrosis and severe heart failure. The late presentation is characterized by abundant development of intercoronary collaterals resulting in mild and rare symptoms, but nevertheless can cause sudden cardiac death. Our objective was to describe presentation, cardiovascular imaging methods for diagnosis and outcomes of patients with late presentation of ACAP. METHODS The study is a retrospective review of a single-center database to identify all patients diagnosed with ACAPA beyond the first year of life. RESULTS From 1976 to 2011, 10 patients were identified with ACAPA at the age of 1.1-64 years: 6 with left coronary artery from the pulmonary artery (ALCAPA) and 4 with right coronary artery from the pulmonary artery (ARCAPA). Echocardiography and Doppler imaging evidenced: (1) direct signs: the abnormal coronary ostium arising from the pulmonary trunk with retrograde coronary artery flow and (2) indirect signs: abundant intercoronary septal collaterals with anterograde flow (ARCAPA) or retrograde flow (ALCAPA) and dilatation of the controlateral normally originated coronary artery. Nine patients underwent surgical implantation of the ACAPA into the ascending aorta. After 7.9 years mean follow-up, all were asymptomatic except one who required a second surgery. CONCLUSIONS Noninvasive cardiovascular imaging, namely transthoracic echocardiography and Doppler specific parameters, can reach diagnosis of late presentation of ACAPA. Direct aortic implantation is a reliable and effective to establish dual coronary artery circulation and prevent risks due to myocardial ischemia.
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Affiliation(s)
- Pierre-Yves Courand
- Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
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Courand PY, Bozio A, Ninet J, Henaine R, Veyrier M, Bakloul M, Boussel L, Filippo SD. Focus on Echocardiographic and Doppler Analysis of Coronary Artery Abnormal Origin from the Pulmonary Trunk with Mild Myocardial Dysfunction. Echocardiography 2013; 30:829-36. [PMID: 23347291 DOI: 10.1111/echo.12124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
| | | | - Jean Ninet
- Department of Cardiothoracic Surgery; Louis Pradel Hospital; Hospices civils de Lyon; Lyon; France
| | - Roland Henaine
- Department of Cardiothoracic Surgery; Louis Pradel Hospital; Hospices civils de Lyon; Lyon; France
| | | | | | - Loic Boussel
- Department of Hemodynamics and Radiology; Louis Pradel Hospital; Hospices civils de Lyon; Lyon; France
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Alsohim F, Henaine R, Bastien O, Veyrier M, Ducreux C, Metton O, Ninet J, Di Filippo S. 290: Experience with levosimendan as an alternative to catecholamines in children. Archives of Cardiovascular Diseases Supplements 2013. [DOI: 10.1016/s1878-6480(13)71221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chalard A, Sanchez I, Gouton M, Henaine R, Salami FA, Ninet J, Douek PC, Di Filippo S, Boussel L. Effect of pulmonary valve replacement on left ventricular function in patients with tetralogy of Fallot. Am J Cardiol 2012; 110:1828-35. [PMID: 22980967 DOI: 10.1016/j.amjcard.2012.08.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 08/10/2012] [Accepted: 08/10/2012] [Indexed: 10/27/2022]
Abstract
Pulmonary valve regurgitation is the most common complication after complete repair of tetralogy of Fallot. The benefits of pulmonary valve replacement (PVR) on right ventricular (RV) volumes is well established. However, the effect on left ventricular (LV) function is still debated. We aimed to determine the evolution of LV function after PVR and assess the contribution of the interventricular septum (IVS) motion. A total of 21 patients (mean age 30.1 ± 14.1 years) presenting with a history of complete repair of tetralogy of Fallot and requiring PVR prospectively underwent cardiac magnetic resonance imaging before and after PVR to measure the end-diastolic volume (EDV), end systolic volume, and ejection fraction for the LV and RV chambers. Maximal excursion of the IVS was also calculated to quantify abnormal septal motion. The LV-EDV and LV-end systolic volume was 80 ± 27 and 40 ± 19.5 ml/m(2) before PVR and 81.5 ± 23 and 35 ± 14 ml/m(2) after PVR, respectively, leading to a significant increase in LV ejection fraction of 6.1 ± 4.9% (51 ± 8.2% before and 57 ± 6.8% after PVR, p = 0.0003). Also, a significant reduction in RV-EDV (p = 0.0001) and RV end-systolic volume (p = 0.0001) was seen but without improvement in the RV ejection fraction. The maximum IVS excursion decreased after PVR (9.2 ± 3.4 mm before and 6.8 ± 3.6 mm after; p = 0.002). LV ejection fraction improvement correlated with RV-EDV before PVR (ρ = 0.43; p = 0.049). The maximum IVS excursion correlated with RV-EDV before and after PVR but was independent of LV ejection fraction improvement. In conclusion, the results of the present study have demonstrated a significant improvement in LV ejection fraction after PVR that correlated with the pre-PVR RV-EDV but was independent of IVS motion improvement.
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Henaine R, Vergnat M, Bacha EA, Baudet B, Lambert V, Belli E, Serraf A. Effects of lack of pulsatility on pulmonary endothelial function in the Fontan circulation. J Thorac Cardiovasc Surg 2012; 146:522-9. [PMID: 23219498 DOI: 10.1016/j.jtcvs.2012.11.031] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [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: 09/20/2012] [Accepted: 11/09/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Continuous flow in the Fontan circulation results in impairment of pulmonary artery endothelial function, increased pulmonary arterial resistance, and, potentially, late failure of Fontan circulation. We investigated the mechanisms of vascular remodeling and altered vascular reactivity associated with chronic privation of pulsatility on pulmonary vasculature. METHODS A total of 30 pigs were evenly distributed in 3 groups: 10 underwent a sham procedure (group I) and 20 underwent a cavopulmonary shunt between the superior vena cava and right pulmonary artery--10 with complete ligation of the proximal right pulmonary artery (group II, nonpulsatile) and 10 with partial ligation (group III, micropulsatile). At 3 months postoperatively, the in vivo hemodynamics, in vitro vasomotricity (concentration response curves on pulmonary artery isolated rings), and endothelial nitric oxide synthase protein level were assessed. A comparison between group and between the right and left lung in each group was performed. RESULTS Group II developed right pulmonary hypertension and increased right pulmonary resistance. Endothelial function was altered in group II, as reflected by a decrease in the vasodilation response to acetylcholine and ionophoric calcium but preservation of the nonendothelial-dependent response to sodium nitroprusside. Group III micropulsatility attenuated pulmonary hypertension but did not prevent impairment of the endothelial-dependant relaxation response. Right lung Western blotting revealed decreased endothelial nitric oxide synthase in group II (0.941 ± 0.149 vs sham 1.536 ± 0.222, P = .045) that was preserved in group III (1.275 ± 0.236, P = .39). CONCLUSIONS In a chronic model of unilateral cavopulmonary shunt, pulsatility loss resulted in an altered endothelial-dependant vasorelaxation response of the pulmonary arteries. Micropulsatility limited the effects of pulsatility loss. These results are of importance for potential therapies against pulmonary hypertension in the nonpulsatile Fontan circulation, by retaining accessory pulmonary flow or pharmaceutical modulation of nonendothelial-dependant pulmonary vasorelaxation.
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Affiliation(s)
- Roland Henaine
- Department of Cardiothoracic Surgery, Hôpital Louis Pradel, Hospices Civils de Lyon, Claude Bernard Lyon I University, Faculté de Médecine-Laboratoire de Physiologie, Lyon, France.
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Chalard A, Gouton M, Henaine R, Ninet J, Douek P, Filippo SD, Boussel L. 336 Tetralogy of Fallot: impact of pulmonary valve replacement on the left ventricular function. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70732-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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