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1. Advancing paediatric cardiac imaging: a comprehensive analysis of the feasibility and accuracy of a novel 3D paediatric transoesophageal probe

Author: Clément Karsenty, Khaled Hadeed, Pierrick Pyra, Aitor Guitarte, Camelia Djeddai, Remi Vincent, Yves Dulac, Ia Silagdze, Julie Gobin, Nicolas Combes, Miarisoa Ratsimandresy, Lionel Berthomieu, Davide Calvaruso, and Philippe Acar
Subjects: congenital heart disease, 3D echocardiography, transoesophageal echocardiography, pediatric, cardiac cateterism, pediatric cardiac surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: AimsPediatric transoesophageal echocardiography (TOE) probes have remained two-dimensional (2D) limiting their use compared to adults. While critical in pediatrics for interventions and post-surgery assessments, technological advancements introduced a three-dimensional (3D) pediatric TOE probe. This study assessed the new 3D pediatric TOE probe (GE 9VT-D) for feasibility, handling, and imaging quality.Methods and resultsAt Children's Hospital of Toulouse, 2-month prospective study enrolled children undergoing TOE with the new probe. All imaging modalities were rated by 2 operators using a 5-point Likert-type scale from 1 (very poor) to 5 (very good) quality. Forty-five children, median age 3.7 (range: 2 months-14.7 years) median weight 7.8 kg (range: 4.3–48 kg) underwent 60 TOEs: 25% pre-surgery, 45% post-surgery, 28% during percutaneous procedures, and 2% in intensive care. Probe handling was “very easy” in all cases without adverse events. The median score of 2D, 2D colour, pulsed Doppler and 3D were noted 5 out of 5 and continuous Doppler and 3D colour 4 out of 5. The 3D image quality remained consistent irrespective of the patient weighing above or below 7.8 kg (p = 0.72). Postoperative TOEs identified two cases needing further interventions, emphasizing its value in evaluating surgical outcomes and also for guiding percutaneous interventions.ConclusionOur comprehensive evaluation demonstrates that the new 3D pediatric TOE probe is feasible and provides high-quality imaging in pediatric patients. The successful integration of this novel probe into clinical practice has the potential to enhance diagnostic accuracy and procedural planning, ultimately optimizing patient outcomes in pediatric cardiac care.
Published: 2023
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2. Health‐Related Quality of Life and Its Association With Outcomes in Adults With Congenital Heart Disease and Heart Failure: Insight From FRESH‐ACHD Registry

Author: Reaksmei Ly, Clément Karsenty, Pascal Amedro, Sarah Cohen, Olivia Domanski, Francois Godart, Jelena Radojevic, Guy Vaksmann, Nicole Naccache, Anissa Boubrit, Vincent Bataille, Sébastien Hascoet, and Magalie Ladouceur
Subjects: congenital heart disease, heart failure, quality of life, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background Quality of Life (QoL) is a prognostic factor in heart failure (HF) of patients with acquired cardiac disease. The aim of this study was to determine the predictive value of QoL on outcomes in adults with congenital heart disease (ACHD) and HF. Methods and Results Quality of life of 196 adults with congenital heart disease with clinical heart failure (HF) (mean age: 44.3±13.8 years; 51% male; 56% with complex congenital heart disease; 47% New York Heart Association class III/IV) included in the prospective multicentric registry FRESH‐ACHD (French Survey on Heart Failure−Adult with Congenital Heart Disease) was assessed using the 36‐Item Short Form Survey (SF‐36), a patient‐reported survey. The primary end point was defined by all‐cause death, HF‐related hospitalization, heart transplantation, and mechanical circulatory support. At 12 months, 28 (14%) patients reached the combined end point. Patients with low quality of life experienced major adverse events more frequently (logrank P=0.013). On univariate analysis, lower score at physical functioning (hazard ratio [HR], 0.98 [95% CI, 0.97–0.99]; P=0.008), role limitations related to physical health (HR, 0.98 [95% CI, 0.97–0.99]; P=0.008), and general health dimensions of the SF‐36 (HR, 0.97 [95% CI, 0.95–0.99]; P=0.002) were significantly predictive of cardiovascular events. However, after multivariable analysis, SF‐36 dimensions were no longer significantly associated with the primary end point. Conclusions Patients with congenital heart disease with HF and poor quality of life experience severe events more frequently, making quality of life assessment and rehabilitation programs essential to alter their trajectory.
Published: 2023
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3. A Modified Technique for Transcatheter Pulmonary Valve Implantation of SAPIEN 3 Valves in Large Right Ventricular Outflow Tract: A Matched Comparison Study

Author: Ali Houeijeh, Clément Karsenty, Nicolas Combes, Clément Batteux, Florence Lecerf, Frederic Remy, Estibaliz Valdeolmillos, Jérôme Petit, and Sébastien Hascoet
Subjects: pulmonary valve, infective endocarditis, melody, SAPIEN, congenital heart disease, Medicine
Abstract: Introduction: Percutaneous pulmonary valve implantation (PPVI) with a SAPIEN 3 valve is effective for treating treat right ventricle outflow (RVOT) dysfunction. A modified technique was developed without prestenting using a protective valve delivery method. We aimed to compare the procedural results of the modified technique group (MTG) to those of patients in a conventional technique group (CTG). Methods: We designed a matched before–after study. All consecutive PPVI with SAPIEN 3 performed in the MTG over 9 months were matched, based on the RVOT type and size, to consecutive procedures performed previously with SAPIEN 3. Results: A total of 54 patients were included, equally distributed in the two groups. The sizes of the SAPIEN 3 valves were 23 mm (n = 9), 26 mm (n = 9), 29 mm (n = 36). The two groups were similar regarding demographic data, RVOT type, and pre-procedure hemodynamics. PPVI was performed in a single procedure in all patients of the MTG, whereas six (22.2%) patients of the CTG group underwent prestenting as a first step and valve implantation later (p = 0.02). The procedures were successful in all cases. Stent embolization was reported in two patients (7.4%) in the CTG, which were impacted in pulmonary arteries. In one case (3.7%), in the MTG, an unstable 29 mm SAPIEN 3 valve was stabilized with two stents and additional valve-in-valve implantation. The hemodynamics results were good in all cases, without significant differences between the two groups. The procedures’ durations and fluoroscopy times were significantly reduced in the MTG (48.1 versus 82.6 min, p < 0.0001; 15.2 versus 29.8 min, p = 0.0002). During follow-up, neither stent fracture nor valve dysfunction was noticed in either group. Conclusion: PPVI without prestenting and with a protective delivery method of the SAPIEN 3 valve significantly reduces the procedure’s complexity, the duration, and the irradiation while maintaining excellent hemodynamics results in selected cases.
Published: 2023
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4. Multicentre experience with Optimus balloon-expandable cobalt–chromium stents in congenital heart disease interventions

Author: Damien Bonnet, Clément Karsenty, Caroline Ovaert, Sébastien Hascoet, Zakaria Jalal, Sophie Malekzadeh-Milani, Raymond N Haddad, Ali Houeijeh, Alban-Elouen Baruteau, and Estibaliz Valdeolmillos
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Objectives To evaluate bare-metal Optimus and polytetrafluoroethylene (PTFE)-covered Optimus-CVS balloon-expandable, cobalt–chromium, hybrid cell–designed stents in congenital heart disease (CHD) interventions.Methods Retrospective multicentre review of patients with CHD receiving Optimus stents. Stent mechanical behaviour, clinical indications and outcomes were assessed.Results 183 stents (49.2% XXL/15-ZIG, 33.3% XL/12-ZIG, 17.5% L/9-ZIG) were implanted (98.9% success rate, 2.3% serious procedural complication rate) in 170 patients (57.6% men, 64.1% adults), median age 23.6 years (IQR, 15.2–39.2) and weight 63.5 kg (IQR, 47–75.7). Indications were right ventricular outflow tract stand-alone stenting or before revalvulation (62.4%), aortic coarctation treatment (15.3%), Fontan-circuit fenestration closure (12.4%) and miscellaneous (10%). 86/170 (50.6%) patients had PTFE-covered stenting (50% prophylactic). In 86/170 (50.6%) patients with stenotic lesions, median percentage of achieved stent expansion was 93.4% (IQR, 85.5%–97.7%), median gradient decreased from 28 mm Hg (IQR, 19–41) to 5 mm Hg (IQR, 1–9) (p
Published: 2023
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5. Impact of 3D-printed models in meetings with parents of children undergoing interventional cardiac catheterisation

Author: Clément Karsenty, Khaled Hadeed, Camelia Djeddai, Julie Lateyron, Aitor Guitarte, Remi Vincent, Nathalie DeBarros, Nicolas Combes, Jerome Briot, Yves Dulac, Antoine Yrondi, and Philippe Acar
Subjects: 3D-printed model, catheterisation, anxiety, patient information, complex congenital heart disease, Pediatrics, RJ1-570
Abstract: BackgroundPaediatric interventional catheterisation has consistently improved in recent decades, with often highly successful outcomes. However, progress is still required in terms of the information delivered to parents and how parental anxiety is managed.AimTo investigate the impact of cardiac printed models on improving parental understanding and alleviating anxiety before interventional catheterisation.MethodsThe parents of children undergoing interventional cardiac catheterisation were prospectively enrolled in the study. A questionnaire highlighting knowledge and understanding of the condition and cardiac catheterisation per se was scored on a scale of 1–30. The State-Trait Anxiety Inventory (STAI), which generates current anxiety scores, was also used before and after the pre-catheterisation meeting. The “printing group” received an explanation of catheterisation using the device and a three-dimensional (3D) model, while the “control group” received an explanation using only the device and a manual drawing.ResultsIn total, 76 parents of 50 children were randomly assigned to a “control group” (n = 38) or “printing group” (n = 38). The groups were comparable at baseline. The level of understanding and knowledge improved after the “control group” and “printing group” meetings (+5.5±0.8 and +10.2±0.8; p
Published: 2023
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6. Cardiac Drugs in ACHD Cardiovascular Medicine

Author: Magalie Ladouceur, Estibaliz Valdeolmillos, Clément Karsenty, Sébastien Hascoet, Pamela Moceri, and Laurianne Le Gloan
Subjects: heart failure, trials, drug therapy, pharmacological therapy, adult congenital heart disease, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Adult congenital heart disease (ACHD) is a growing population that requires life-long care due to advances in pediatric care and surgical or catheter procedures. Despite this, drug therapy in ACHD remains largely empiric due to the lack of clinical data, and formalized guidelines on drug therapy are currently lacking. The aging ACHD population has led to an increase in late cardiovascular complications such as heart failure, arrhythmias, and pulmonary hypertension. Pharmacotherapy, with few exceptions, in ACHD is largely supportive, whereas significant structural abnormalities usually require interventional, surgical, or percutaneous treatment. Recent advances in ACHD have prolonged survival for these patients, but further research is needed to determine the most effective treatment options for these patients. A better understanding of the use of cardiac drugs in ACHD patients could lead to improved treatment outcomes and a better quality of life for these patients. This review aims to provide an overview of the current status of cardiac drugs in ACHD cardiovascular medicine, including the rationale, limited current evidence, and knowledge gaps in this growing area.
Published: 2023
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7. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile

Author: Damien Bonnet, Claire Dauphin, Stéphanie Douchin, Sarah Cohen, Estelle Rage, Clément Karsenty, Jean-Benoît Thambo, FRANCOIS GODART, Klervi Leuraud, Marie-Odile Bernier, Caroline Ovaert, Jean-François Piéchaud, Sébastien Hascoet, Kossi Dovene Abalo, Sophie Malekzadeh-Milani, Serge Dreuil, Tiphaine Feuillet, Sylvie Di Filippo, Patrice Guérin, Pauline Helms, Bruno Lefort, and Pierre Mauran
Subjects: Medicine
Abstract: Purpose The COCCINELLE study is a nationwide retrospective French cohort set up to evaluate the risk of cancer in patients who undergone cardiac catheterisation (CC) procedures for diagnosis or treatment of congenital heart disease during childhood.Participants Children who undergone CC procedures from 1 January 2000 to 31 December 2013, before the age of 16 in one of the 15 paediatric cardiology departments which perform paediatric CC in mainland France were included. The follow-up started at the date of the first recorded CC procedure until the exit date, that is, the date of death, the date of first cancer diagnosis, the date of the 18th birthday or the 31 December 2015, whichever occurred first. The cohort was linked to the National Childhood Cancer Registry to identify patients diagnosed with cancer and with the French National Directory for the Identification of Natural Persons to retrieve the patients’ vital status.Findings to date A total of 17 104 children were included in the cohort and followed for 110 335 person-years, with 22 227 CC procedures collected. Among the patients, 81.6% received only one procedure. Fifty-nine cancer cases were observed in the cohort. Standardised incidence ratios (SIRs) were increased for all-cancer (SIR=3.8, 95% CI: 2.9 to 4.9), leukaemia (SIR=3.3, 95% CI: 2.0 to 5.4), lymphoma (SIR=14.9, 95% CI: 9.9 to 22.5) and solid cancers excluding central nervous system (CNS) tumours (SIR=3.3, 95% CI: 2.0 to 5.5) compared with the general population.Future plans Dose reconstruction is currently underway to estimate individual cumulative doses absorbed to relevant organs, including red bone marrow and brain for respectively haematologic disorders and CNS tumours risk estimation. A dose–response analysis will be conducted with consideration to confounding factors such as age at exposure, gender, predisposing factors to cancer and other sources of medical diagnostic low-dose ionising radiation.
Published: 2021
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8. 3D modeling and printing in large native right ventricle outflow tract to plan complex percutaneous pulmonary valve implantation

Author: Ali Houeijeh, Jérôme Petit, Marc-Antoine Isorni, Anne Sigal-Cinqualbre, Clement Batteux, Clément Karsenty, Alain Fraisse, Emmanuelle Fournier, Vlad Ciobotaru, and Sébastien Hascoet
Subjects: 3D printing, 3D CT reconstruction, PPVI, RVOT, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Objective: Investigating accuracy of cardiac tomography (CT) derived post-processing3D reconstruction (CT-PPR) and 3D printing to predict percutaneous pulmonary valve implantation (PPVI) feasibility. Background: PPVI feasibility remains challenging in large native regurgitant right ventricle outflow tract (RVOT). Methods: Fifteen patients with large native RVOT were investigated. CT-PPR consisted in RVOT long-axis curvilinear reconstruction (LACR) to measure the landing zone (LZ), and 3D volume rendering for morphological evaluation. A STL was generated to create 3D printed model (flexible resin). Balloon sizing was subsequently performed to measure LZ diameter (3D-MBD), compared to invasive balloon diameter (IBD) during catheterization, considered as the Gold Standard. Two operators predicted the feasibility of PPVI using CT-PPR and 3D printed models independently and blinded to outcome. Results: On 3D printed models, RVOT shape was tubular in 5 patients, divergent in 5 patients, concave in 4 patients and convergent in one. Agreement with CT-PPR RVOT shape morphology assessment was observed in 93% of cases (Kappa coefficient 0.91, p
Published: 2021
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9. Case Report: Successful Cerebral Revascularization and Cardiac Transplant in a 16-Year-Old Male With Syndromic BRCC3-Related Moyamoya Angiopathy

Author: Pierrick Pyra, Jean Darcourt, Marion Aubert-Mucca, Pierre Brandicourt, Olivier Patat, Emmanuel Cheuret, Karine Brochard, Annick Sevely, Lionel Calviere, and Clément Karsenty
Subjects: moyamoya angiopathy, revascularization, BRCC3, cardiac transplant, stroke, Neurology. Diseases of the nervous system, RC346-429
Abstract: Background:BRCC3/MTCP1 deletions are associated with a rare familial moyamoya angiopathy with extracranial manifestations.Case: We report the case of an adolescent male presenting with progressive and symptomatic moyamoya angiopathy and severe dilated cardiomyopathy caused by a hemizygous deletion of BRCC3/MTCP1. He was treated for renovascular hypertension by left kidney homograft and right nephrectomy in infancy and had other syndromic features, including cryptorchidism, growth hormone deficiency, and facial dysmorphism. Due to worsening of the neurological and cardiac condition, he was treated by a direct superficial temporal artery to middle cerebral artery bypass to enable successful cardiac transplant without cerebral damage.Conclusions:BRCC3-related moyamoya is a devastating disease with severe heart and brain complications. This case shows that aggressive management with cerebral revascularization to allow cardiac transplant is feasible and efficient despite end-stage heart failure.
Published: 2021
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10. Cardiovascular Characteristics and Outcomes of Young Patients with COVID-19

Author: Antonin Trimaille, Sophie Ribeyrolles, Charles Fauvel, Corentin Chaumont, Orianne Weizman, Thibaut Pommier, Joffrey Cellier, Laura Geneste, Vassili Panagides, Wassima Marsou, Antoine Deney, Sabir Attou, Thomas Delmotte, Pascale Chemaly, Clément Karsenty, Gauthier Giordano, Alexandre Gautier, Pierre Guilleminot, Audrey Sagnard, Julie Pastier, Baptiste Duceau, Willy Sutter, Victor Waldmann, Théo Pezel, Delphine Mika, Ariel Cohen, Guillaume Bonnet, and the Critical COVID-19 France Investigators
Subjects: COVID-19, SARS-CoV-2, young, myocarditis, pericarditis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Although 18–45-year-old (y-o) patients represent a significant proportion of patients hospitalized for COVID-19, data concerning the young population remain scarce. The Critical COVID France (CCF) study was an observational study including consecutive patients hospitalized for COVID-19 in 24 centers between 26 February and 20 April 2020. The primary composite outcome included transfer to the intensive care unit (ICU) or in-hospital death. Secondary outcomes were cardiovascular (CV) complications. Among 2868 patients, 321 (11.2%) patients were in the 18–45-y-o range. In comparison with older patients, young patients were more likely to have class 2 obesity and less likely to have hypertension, diabetes and dyslipidemia. The primary outcome occurred less frequently in 18–45-y-o patients in comparison with patients > 45 years old (y/o) (16.8% vs. 30.7%, p < 0.001). The 18–45-y-o patients presented with pericarditis (2.2% vs. 0.5%, p = 0.003) and myocarditis (2.5% vs. 0.6%, p = 0.002) more frequently than patients >45 y/o. Acute heart failure occurred less frequently in 18–45-y-o patients (0.9% vs. 7.2%, p < 0.001), while thrombotic complications were similar in young and older patients. Whereas both transfer to the ICU and in-hospital death occurred less frequently in young patients, COVID-19 seemed to have a particular CV impact in this population.
Published: 2021
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11. Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study

Author: Naïm Ouldali, Haleh Bagheri, Francesco Salvo, Denise Antona, Antoine Pariente, Claire Leblanc, Martine Tebacher, Joëlle Micallef, Corinne Levy, Robert Cohen, Etienne Javouhey, Brigitte Bader-Meunier, Caroline Ovaert, Sylvain Renolleau, Veronique Hentgen, Isabelle Kone-Paut, Nina Deschamps, Loïc De Pontual, Xavier Iriart, Christelle Gras-Le Guen, François Angoulvant, Alexandre Belot, Aurelie Donzeau, Layal El Aridi, Sophie Lety, Bertrand Leboucher, Agnes Baur, Lucas Jeusset, Maelle Selegny, Cristian Fedorczuk, Marion Lajus, Philippe Bensaid, Yacine Laoudi, Charlotte Pons, Anne-Cécile Robert, Camille Beaucourt, Muriel Richard, Etienne Goisque, Olivier Brissaud, Pierre Segretin, Julie Molimard, Marie-Clothilde Orecel, Gregoire Benoit, Lucille Bongiovanni, Margaux Guerder, Robin Pouyau, Jean-Marie De Guillebon De Resnes, Ellia Mezgueldi, Fleur Cour-Andlauer, Come Horvat, Pierre Poinsot, Cecile Frachette, Antoine Ouziel, Yves Gillet, Catherine Barrey, Jacques Brouard, Florence Villedieu, Vathanaksambath Ro, Narcisse Elanga, Vincent Gajdos, Romain Basmaci, Hadile Mutar, Sébastien Rouget, Elodie Nattes, Isabelle Hau, Sandra Biscardi, Houmam El Jurdi, Camille Jung, Denis Semama, Frederic Huet, Anne-Marie Zoccarato, Mayssa Sarakbi, Guillaume Mortamet, Cécile Bost-Bru, Joachim Bassil, Caroline Vinit, Véronique Hentgen, Pascal Leroux, Valérie Bertrand, Caroline Parrod, Irina Craiu, Philippe Durand, Pierre Tissiere, Caroline Claude, Guillaume Morelle, Tamazoust Guiddir, Charlotte Borocco, Frédérique Delion, Camille Guillot, Stéphane Leteurtre, François Dubos, Mylene Jouancastay, Alain Martinot, Valentine Voeusler, Jeanne Languepin, Nathalie Garrec, Arnaud Chalvon Demersay, Aurélie Morand, Emmanuelle Bosdure, Noémie Vanel, Fabrice Ughetto, Fabrice Michel, Marie Caujolle, Renaud Blonde, Jacqueline Nguyen, Olivier Vignaud, Caroline Masserot-Lureau, François Gouraud, Carine Araujo, Tara Ingrao, Sanaa Naji, Mohammed Sehaba, Christine Roche, Aurelia Carbasse, Christophe Milesi, Mustapha Mazeghrane, Sandrine Haupt, Cyril Schweitzer, Benedicte Romefort, Elise Launay, Christèle Gras-Le Guen, Ahmed Ali, Nathalie Blot, Antoine Tran, Anne Rancurel, Mickael Afanetti, Sophie Odorico, Deborah Talmud, Anais Chosidow, Anne-Sophie Romain, Emmanuel Grimprel, Marie Pouletty, Jean Gaschignard, Olivier Corseri, Albert Faye, Isabelle Melki, Camille Ducrocq, Cherine Benzoïd, Johanna Lokmer, Stéphane Dauger, Maryline Chomton, Anna Deho, Fleur Lebourgeois, Fabrice Lesage, Florence Moulin, Laurent Dupic, Yael Pinhas, Agathe Debray, Martin Chalumeau, Véronique Abadie, Pierre Frange, Jeremie F Cohen, Slimane Allali, William Curtis, Zahra Belhadjer, Johanne Auriau, Mathilde Méot, Lucile Houyel, Damien Bonnet, Christophe Delacourt, Brigitte Bader Meunier, Pierre Quartier, Youssef Shaim, Laurence Baril, Samuel Crommelynck, Baptiste Jacquot, Philippe Blanc, Natacha Maledon, Blandine Robert, Camille Loeile, Clémence Cazau, Gauthier Loron, Simona Gaga, Cécile Vittot, Loubna El Nabhani, François Buisson, Muriel Prudent, Hugues Flodrops, Fadhila Mokraoui, Simon Escoda, Laurent Bonnemains, Sarah-Louisa Mahi, Clara Mertes, Joelle Terzic, Julie Helms, Charlotte Idier, Soraya Chenichene, Nicoleta Magdolena Ursulescu, Gladys Beaujour, Abdelhak Hakim, Alice Miquel, Agnès Rey, Arnaud Wiedermann, Anne Charbonneau, Agnès Veauvy-Juven, Alexandrine Ferry, Alexis Mandelcwajg, Alix Rousseau, Amandine Prenant, Anne-Laure Bourneuf, Anne Filleron, Audrey Robine, Arthur Félix, Aude Parizel, Aurélie Labarre, Aymeric Cantais, Barbara Ros, Basile Coulon, Blandine Biot, Bérengère Dalichoux, Benjamin Fournier, Benoit Cagnard, Blandine Vanel, David Brossier, Bruno Ménager, Bruno Ozanne, Carole Marie-Jeanne, Camille Bergerot, Camille Chavy, Camille Guidon, Candice Fabre, Caroline Galeotti, Catherine Baker, Claire Ballot-Schmit, Céline Belleau, Céline Charasse, Caroline Favel, Chadia Toumi, Charlène Ferrandiz, Charlotte Couturier, Charlotte Pouchoux, Maryline Chomton-Cailliez, Charlotte Kevorkian-Verguet, Clément Brunet, Céline Manteau, Clémence Mougey, Coline Santy, Coralie Fitament, Charlotte Petriat, Charlotte Rebelle, Cyril Charron, Maxime Dartus, David Toulorge, Cécile Guillou-Debuisson, Dorann Bartebin, Valérie Klein, E Broustal, E Desselas, Elodie Marteau, Emmanuelle Bouvrot, Elise Delacroix, Edeline Coinde, Loubna Elnabhani, Elsa Amouyal, Emilie Chaillou, Emeline Gabilly-Bernard, Emilie Ruiz, Emilie Thibault, Emilie Robin, Etienne Darrieux, Eva Blondel, Floriane Socchi, François Cazassus, Fanny Bajolle, Fatma Lacin, Fouad Madhi, Franck Zekre, François Guerin, Gerald Boussicault, Henri Ginies, Gnansounou Magloire, Guilhem Arnold, Ines Coulognon, Iona Sicard-Cras, Jean-Emmanuel Kahn, Jeanne Bordet, Jeanne-Lise Fausser, Jean-François Baleine, Josephine Brice, Julie Gendras, Kaan Pekin, Karine Norbert, Clément Karsenty, Léa Savary, Laurence Martinat, Léa Lesniewski, Lorelei Charbonnier, Louise Alexandre, Lucas Percheron, Marie Vincenti, Manon Lanzini, Margot Grisval, Marianne Mercy, Marie-Emilie Lampin, Marie Desgranges, Marie Duperril, Marie-Clothilde Orcel, Marion Audier, Marion Favier, Mathieu Carpentier, Mathilde Balcean, Mathilde Bonnet, Maurine Jouret, Marie Delattre, Michael Levy, Michael Valensi, Mickael Shum, Morgane Dumortier, Morgane Gelin, Morgane Nemmouchi, Morgane Williaume, M Sebaha, Nicoleta Genetay-Stanescu, Nathan Giroux, Nicolas Crassard, Neil Derridj, Noemie Lachaume, Oscar Werner, Olivier Guilluy, Olivier Richer, Olivier Tirel, Aurianne Pauvert, Paul Casha, Noémie Perez, Pauline Gras, Pierre-Louis Leger, Marion Pinchou, Pierre Mornand, Prisca Largo, Ramona-Christina Ibanez, Charlotte Roulland, Salam Hadah Albarazi, Said Bichali, Sarah Faton, Amandine Schott, Sébastien Walser, Severine Guillaume, Solene Vincent, Sophie Galene-Gromez, Stanislas Kozisek, Thierry Maugard, Thierry Blanc, Thierry Navarro, Thomas Lauvray, Tamas Kovacs, Valérie Launay, Véronique Despert, Victoria Lhostis, Virginie Gall, Xavier Micaelli, Yasmine Benadjaoud, Zied Matoussi, Hélène Géniaux, Anthony Facile, Tessa Pietri, Pascale Palassin, Sylvine Pinel, Laurent Chouchana, Delphine Callot, Charlène Boulay, Hôpital Robert Debré, CHU Sainte Justine [Montréal], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Santé publique France - French National Public Health Agency [Saint-Maurice, France], Les Hôptaux universitaires de Strasbourg (HUS), CHU Strasbourg, CHU Marseille, Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Créteil, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [CHU Necker] (RAISE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital de la Timone [CHU - APHM] (TIMONE), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Evaluation thérapeutique et pharmacologie périnatale et pédiatrique (EA_7323), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier de Versailles André Mignot (CHV), Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [CH Versailles] (CeRéMAIA - Hôpital André Mignot), Hôpital Bicêtre, Université Paris-Saclay, CH de Saint-Malo [Broussais], Hôpital Jean Verdier [AP-HP], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant / National Referee Centre for Rheumatic and AutoImmune and Systemic Diseases in Children [Lyon] (RAISE), European Society for Paediatric Infectious Diseases, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPC), CHU Toulouse [Toulouse], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [Paris] (Institut IMAGINE/RAISE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Imagine [Paris Necker] (2I), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE)
Subjects: Oncology, [SDV]Life Sciences [q-bio], Health Policy, Multisystem inflammatory syndrome in children, Internal Medicine, COVID-19 mRNA vaccine, BNT162b2, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, SARS-COV-2, Hyper-inflammatory syndrome, Child
Abstract: International audience; BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is the most severe clinical entity associated with pediatric SARS-CoV-2 infection with a putative role of the spike protein into the immune system activation. Whether COVID-19 mRNA vaccine can induce this complication in children is unknown. We aimed to assess the risk of hyper-inflammatory syndrome following COVID-19 mRNA vaccine in children. METHODS: We conducted a post-authorization national population-based surveillance using the French enhanced pharmacovigilance surveillance system for COVID-19 vaccines. All cases of suspected hyper-inflammatory syndrome following COVID-19 mRNA vaccine in 12-17-year-old children between June 15(th), 2021 and January 1(st), 2022, were reported. Cases were reviewed according to WHO criteria for MIS-C. The reporting rate of this syndrome was compared to the MIS-C rate per 1,000,000 12-17-year-old children infected by SARS-CoV-2. FINDINGS: Up to January 2022, 8,113,058 COVID-19 mRNA vaccine doses were administered to 4,079,234 12-17-year-old children. Among them, 12 presented a hyper-inflammatory syndrome with multisystemic involvement. Main clinical features included male predominance (10/12, 83%), cardiac involvement (10/12, 83%), digestive symptoms (10/12, 83%), coagulopathy (7/12, 58%), cytolytic hepatitis (6/12, 50%), and shock (5/12, 42%). 4/12 (33%) required intensive care unit transfer, and 3/12 (25%) hemodynamic support. All cases recovered. In eight cases, no evidence of previous SARS-CoV-2 infection was found. The reporting rate was 1.5 (95%CI [0.8; 2.6]) per 1,000,000 doses injected, i.e. 2.9 (95%CI [1.5; 5.1]) per 1,000,000 12-17-year-old vaccinated children. As a comparison, 113 MIS-C (95%CI [95; 135]) occurred per 1,000,000 12-17-year-old children infected by SARS-CoV-2. INTERPRETATION: Very few cases of hyper-inflammatory syndrome with multi-organ involvement occurred following COVID-19 mRNA vaccine in 12-17-year-old children. The low reporting rate of this syndrome, compared to the rate of post-SARS-CoV-2 MIS-C in the same age-group, largely supports the vaccination in a context of an important circulation of SARS-CoV-2. FUNDING: ESPID Fellowship Award; Grandir-Fonds de Solidarité Pour L'enfance.
Published: 2022

12. Diagnostic Value of (18)F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis

Author: Zakaria Jalal, Hélène Bouvaist, Maëlys Venet, Anne Claire Casalta, Emmanuelle Fournier, Laurianne Le Gloan, Ghoufrane Tlili, Reaksmei Ly, Fabrice Camou, Caroline Ovaert, Clément Karsenty, Yaniss Belaroussi, Maëlle Selegny, J.B. Thambo, Alban-Elouen Baruteau, Sébastien Hascoët, Stéphanie Douchin, Sophie Malekzadeh-Milani, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Chirurgical Marie Lannelongue (CCML), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CHU Amiens-Picardie, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Saint-André, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Agence Nationale de la Recherche, ANR-10-IAHU-0004,LIRYC,L'Institut de Rythmologie et modélisation Cardiaque(2010), Admin, Oskar, and Instituts Hospitalo-Universitaires - L'Institut de Rythmologie et modélisation Cardiaque - - LIRYC2010 - ANR-10-IAHU-0004 - IAHU - VALID
Subjects: medicine.diagnostic_test, business.industry, Pulmonary valve, 18F-FDG PET/CT, Computed tomography, medicine.disease, Fluorodeoxyglucose positron emission tomography, medicine.anatomical_structure, Positron emission tomography, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Infective endocarditis, medicine, Radiology, Nuclear Medicine and imaging, Fdg pet ct, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Congenital heart disease
Abstract: International audience; OBJECTIVES: The aim of this study was to assess the diagnostic performances of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) in congenital heart disease (CHD) patients with pulmonary prosthetic valve or conduit endocarditis (PPVE) suspicion. BACKGROUND: PPVE is a major issue in the growing CHD population. Diagnosis is challenging, and usual imaging tools are not always efficient or validated in this specific population. Particularly, the diagnostic yield of (18)F-FDG PET/CT remains poorly studied in PPVE. METHODS: A retrospective multicenter study was conducted in 8 French tertiary centers. Children and adult CHD patients who underwent (18)F-FDG PET/CT in the setting of PPVE suspicion between January 2010 and May 2020 were included. The cases were initially classified as definite, possible, or rejected PPVE regarding the modified Duke criteria and finally by the Endocarditis Team consensus. The result of (18)F-FDG PET/CT had been compared with final diagnosis consensus used as gold-standard in our study. RESULTS: A total of 66 cases of PPVE suspicion involving 59 patients (median age 23 years, 73% men) were included. Sensitivity, specificity, positive predictive value, and negative predictive value of (18)F-FDG PET/CT in PPVE suspicion were respectively: 79.1% (95% CI: 68.4%-91.4%), 72.7% (95% CI: 60.4%-85.0%), 91.9% (95% CI: 79.6%-100.0%), and 47.1% (95% CI: 34.8%-59.4%). (18)F-FDG PET/CT findings would help to correctly reclassify 57% (4 of 7) of possible PPVE to definite PPVE. CONCLUSIONS: Using (18)F-FDG PET/CT improves the diagnostic accuracy of the Duke criteria in CHD patients with suspected PPVE. Its high positive predictive value could be helpful in routine to shorten diagnosis and treatment delays and improve clinical outcomes.
Published: 2022

13. Myocarditis and Pericarditis in Adolescents after First and Second doses of mRNA COVID-19 Vaccines

Author: Déborah Foltran, Clément Karsenty, François Montastruc, Clara Flumian, Pierre De Paoli, Sophie Gautier, Clément Delmas, Francesco Salvo, Milou-Daniel Drici, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], CHU Lille, Université de Lille, Hôpital Pasteur [Nice] (CHU), Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANR-21-CO17-0001,Vigi-Drugs COVID-19,Identification précoce du risque associé aux médicaments utilisés dans le cadre de COVID-19 : analyse des données mondiales de pharmacovigilance(2021), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), and Admin, Oskar
Subjects: Male, Myocarditis, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Adolescent, MEDLINE, Pericarditis, medicine, Humans, AcademicSubjects/MED00200, RNA, Messenger, Child, ComputingMilieux_MISCELLANEOUS, Messenger RNA, business.industry, SARS-CoV-2, Health Policy, Adolescent RNA messenger, COVID-19, medicine.disease, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Original Article, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Aims While some concerns about vaccination-related pericarditis and/or myocarditis have been raised, no published data are available on pericarditis and/or myocarditis with mRNA COVID-19 vaccines in the age group of adolescents, particularly 12–15 years. The objective of this study was to determine whether the risk of reporting pericarditis and/or myocarditis with mRNA COVID-19 vaccines varied according to dose of vaccination, age, sex, and type of pericarditis and/or myocarditis in adolescents between 12 and 17 years. Methods and results We performed an observational study reviewing all reports of adolescents vaccinated with mRNA COVID-19 vaccines and recorded in VigiBase®, the World Health Organization global database of individual case safety reports. We included all reports registered between 1 January 2021 and 14 September 2021. Reporting odds ratios (RORs) with their 95% confidence interval (CI) were calculated to estimate the risk of reporting pericarditis and/or myocarditis. Among 4942 reports with mRNA COVID-19 vaccines in adolescents, we identified 242 pericarditis and/or myocarditis. Compared with the first dose of mRNA COVID-19 vaccines, the second dose was associated with an increased risk of reporting pericarditis and/or myocarditis (ROR 4.95; 95% CI 3.14, 7.89). The risk of reporting pericarditis and/or myocarditis was 10 times higher in boys than in girls and no difference between the two types of vaccines could be demonstrated. Conclusion This investigation including only adolescent data suggests for the first time that the second dose of mRNA COVID-19 vaccines increases the risk of reporting myocarditis/pericarditis compared with the first dose particularly in boys without significant difference between tozinameran and elasomeran.
Published: 2021

14. The usefulness of 3D printed heart models for medical student education in congenital heart disease

Author: Clément Karsenty, Philippe Acar, Benoit Delepaul, Camelia Djeddai, Aitor Guitarte, Khaled Hadeed, Jerome Briot, Yves Dulac, Paul Vignaud, Remi Vincent, Sébastien Hascoët, CHU Toulouse [Toulouse], Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre chirurgical Marie Lannelongue, Malbec, Odile, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Centre Chirurgical Marie Lannelongue (CCML)
Subjects: Heart Defects, Congenital, Models, Anatomic, 2d images, 3d printed, medicine.medical_specialty, Students, Medical, Heart disease, 3D printing model, [SDV]Life Sciences [q-bio], education, 030204 cardiovascular system & hematology, Education, 03 medical and health sciences, 0302 clinical medicine, Undergraduate medical students, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Tetralogy of Fallot, Congenital heart disease, Objective knowledge, Medical education, LC8-6691, business.industry, Research, Teaching, General Medicine, medicine.disease, Special aspects of education, Student education, [SDV] Life Sciences [q-bio], Printing, Three-Dimensional, Physical therapy, Medicine, business
Abstract: Background Three-dimensional (3D) printing technology enables the translation of 2-dimensional (2D) medical imaging into a physical replica of a patient’s individual anatomy and may enhance the understanding of congenital heart defects (CHD). We aimed to evaluate the usefulness of a spectrum of 3D-printed models in teaching CHD to medical students. Results We performed a prospective, randomized educational procedure to teach fifth year medical students four CHDs (atrial septal defect (ASD, n = 74), ventricular septal defect (VSD, n = 50), coarctation of aorta (CoA, n = 118) and tetralogy of Fallot (ToF, n = 105)). Students were randomized into printing groups or control groups. All students received the same 20 min lecture with projected digital 2D images. The printing groups also manipulated 3D printed models during the lecture. Both groups answered an objective survey (Multiple-choice questionnaire) twice, pre- and post-test, and completed a post-lecture subjective survey. Three hundred forty-seven students were included and both teaching groups for each CHD were comparable in age, sex and pre-test score. Overall, objective knowledge improved after the lecture and was higher in the printing group compared to the control group (16.3 ± 2.6 vs 14.8 ± 2.8 out of 20, p p = 0.0001 ASD group; p = 0.002 VSD group; p = 0.0005 CoA group; p = 0.003 ToF group). Students’ opinion of their understanding of CHDs was higher in the printing group compared to the control group (respectively 4.2 ± 0.5 vs 3.8 ± 0.4 out of 5, p Conclusion The use of 3D printed models in CHD lectures improve both objective knowledge and learner satisfaction for medical students. The practice should be mainstreamed.
Published: 2021

15. 3D modeling and printing in large native right ventricle outflow tract to plan complex percutaneous pulmonary valve implantation

Author: Vlad Ciobotaru, Anne Sigal-Cinqualbre, Emmanuelle Fournier, Jérôme Petit, Marc-Antoine Isorni, Clément Karsenty, Sébastien Hascoët, Alain Fraisse, Ali Houeijeh, and Clément Batteux
Subjects: 3d printed, business.industry, Balloon sizing, 3D printing, RVOT, PPVI, 3D modeling, Balloon, Landing zone, Cardiac tomography, RC666-701, Percutaneous pulmonary valve implantation, Medicine, Diseases of the circulatory (Cardiovascular) system, 3D CT reconstruction, business, Nuclear medicine, Right ventricle outflow tract
Abstract: Objective: Investigating accuracy of cardiac tomography (CT) derived post-processing3D reconstruction (CT-PPR) and 3D printing to predict percutaneous pulmonary valve implantation (PPVI) feasibility. Background: PPVI feasibility remains challenging in large native regurgitant right ventricle outflow tract (RVOT). Methods: Fifteen patients with large native RVOT were investigated. CT-PPR consisted in RVOT long-axis curvilinear reconstruction (LACR) to measure the landing zone (LZ), and 3D volume rendering for morphological evaluation. A STL was generated to create 3D printed model (flexible resin). Balloon sizing was subsequently performed to measure LZ diameter (3D-MBD), compared to invasive balloon diameter (IBD) during catheterization, considered as the Gold Standard. Two operators predicted the feasibility of PPVI using CT-PPR and 3D printed models independently and blinded to outcome. Results: On 3D printed models, RVOT shape was tubular in 5 patients, divergent in 5 patients, concave in 4 patients and convergent in one. Agreement with CT-PPR RVOT shape morphology assessment was observed in 93% of cases (Kappa coefficient 0.91, p
Published: 2021

16. History of heart failure in patients with coronavirus disease 2019: Insights from a French registry

Author: Iris Ma, Orianne Weizman, Thibaut Pommier, Cyril Zakine, A. Darmon, Melchior Jonveaux, Nacim Ezzouhairi, Théo Pezel, Wassima Marsou, Laura Geneste, Delphine Mika, C Fauvel, Antoine Deney, Thomas Delmotte, Baptiste Duceau, Vassili Panagides, Thomas Levasseur, Julien Ternacle, Clément Karsenty, Guillaume Bonnet, Victor Waldmann, Flavien Vincent, Marine Mevelec, Sabir Attou, Joffrey Cellier, Ariel Cohen, Antonin Trimaille, Diane Chavignier, Willy Sutter, Nathalie Noirclerc, Benjamin Perin, Hôpital Nord [CHU - APHM], CHU Lille, Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 (EGID), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Henri Mondor, Nouvel Hôpital Civil de Strasbourg, CHU Strasbourg, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Amiens-Picardie, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Rouen, Normandie Université (NU), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université de Bordeaux (UB), Clinique Saint Gatien, Centre Hospitalier Intercommunal Fréjus - St Raphaël (CHI Fréjus - St Raphaël), Centre Hospitalier Régional d'Orléans (CHRO), Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Signalisation et physiopathologie cardiovasculaire (UMRS1180), Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Lariboisière-Fernand-Widal [APHP], Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval [Québec] (ULaval), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires [RNMCD - U1011], CHRU de Nancy, Paris-Centre de Recherche Cardiovasculaire [PARCC (UMR_S 970/ U970)], Hôpital Européen Georges Pompidou [APHP] [HEGP], Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL], Centre Hospitalier Universitaire de Toulouse [CHU Toulouse], Centre Hospitalier Universitaire de Reims [CHU Reims], Université de Bordeaux [UB], Centre Hospitalier Intercommunal Fréjus - St Raphaël [CHI Fréjus - St Raphaël], Centre Hospitalier Régional d'Orléans [CHRO], and Signalisation et physiopathologie cardiovasculaire [UMRS1180]
Subjects: Male, qSOFA, quick sequential organ failure assessment, [SDV]Life Sciences [q-bio], CHF, chronic heart failure, Comorbidity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, HF, heart failure, 0302 clinical medicine, RAAS, renin-angiotensin-aldosterone system, Risk Factors, LVEF, left ventricular ejection fraction, Clinical endpoint, 030212 general & internal medicine, Hospital Mortality, Registries, Résultats, COVID-19, coronavirus disease 2019, Ejection fraction, Incidence, Hazard ratio, Confounding Factors, Epidemiologic, General Medicine, Stroke volume, Middle Aged, Treatment Outcome, Cardiology, Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, HFpEF, heart failure with preserved ejection fraction, RT-PCR, real-time reverse transcriptase polymerase chain reaction, Heart failure, ACE2, angiotensin-converting enzyme 2, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, 03 medical and health sciences, Facteurs de risque, Clinical Research, COVID-19, Femme, HFpEF, HFrEF, RAAS inhibitors, SARS-COV 2, Internal medicine, medicine, Intubation, Intratracheal, Humans, HFrEF, heart failure with reduced ejection fraction, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Retrospective cohort study, Stroke Volume, medicine.disease, business, Heart failure with preserved ejection fraction, Procedures and Techniques Utilization
Abstract: Summary Background Although cardiovascular comorbidities seem to be strongly associated with worse outcomes in patients with coronavirus disease 2019 (COVID-19), data regarding patients with preexisting heart failure are limited. Aims To investigate the incidence, characteristics and clinical outcomes of patients with COVID-19 with a history of heart failure with preserved or reduced ejection fraction. Methods We performed an observational multicentre study including all patients hospitalized for COVID-19 across 24 centres in France from 26 February to 20 April 2020. The primary endpoint was a composite of in-hospital death or need for orotracheal intubation. Results Overall, 2809 patients (mean age 66.4 ± 16.9 years) were included. Three hundred and seventeen patients (11.2%) had a history of heart failure; among them, 49.2% had heart failure with reduced ejection fraction and 50.8% had heart failure with preserved ejection fraction. COVID-19 severity at admission, defined by a quick sequential organ failure assessment score > 1, was similar in patients with versus without a history of heart failure. Before and after adjustment for age, male sex, cardiovascular comorbidities and quick sequential organ failure assessment score, history of heart failure was associated with the primary endpoint (hazard ratio [HR]: 1.41, 95% confidence interval [CI]: 1.06–1.90; P = 0.02). This result seemed to be mainly driven by a history of heart failure with preserved ejection fraction (HR: 1.61, 95% CI: 1.13–2.27; P = 0.01) rather than heart failure with reduced ejection fraction (HR: 1.19, 95% CI: 0.79–1.81; P = 0.41). Conclusions History of heart failure in patients with COVID-19 was associated with a higher risk of in-hospital death or orotracheal intubation. These findings suggest that patients with a history of heart failure, particularly heart failure with preserved ejection fraction, should be considered at high risk of clinical deterioration.
Published: 2021

17. Characteristics and impact of cardiovascular comorbidities on coronavirus disease 2019 in women: A multicentre cohort study

Author: Delphine Mika, Sabir Attou, Théo Pezel, Gauthier Giordano, Vassili Panagides, Willy Sutter, Julie Pastier, Thomas Delmotte, C Fauvel, Antoine Deney, Alexandre Gautier, Guillaume Bonnet, Joffrey Cellier, Antonin Trimaille, Victor Waldmann, Pierre Guilleminot, Baptiste Duceau, Pascale Chemaly, Clément Karsenty, Sophie Ribeyrolles, Orianne Weizman, Thibaut Pommier, C. Chaumont, Wassima Marsou, Ariel Cohen, Audrey Sagnard, and Laura Geneste
Subjects: Male, Comorbidity, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, law, Natriuretic Peptide, Brain, 030212 general & internal medicine, Hospital Mortality, Résultats, COVID-19, coronavirus disease 2019, education.field_of_study, Smoking, General Medicine, Middle Aged, Intensive care unit, ICU, intensive care unit, Troponin, Intensive Care Units, Cardiovascular Diseases, Female, France, Cardiology and Cardiovascular Medicine, Risk assessment, Cohort study, medicine.medical_specialty, Population, Outcomes, Lower risk, Risk Assessment, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, Article, 03 medical and health sciences, Facteurs de risque, Internal medicine, medicine, Diabetes Mellitus, Humans, Women, Sex Distribution, education, BNP, B-type natriuretic peptide, Aged, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, SARS-CoV-2, NT-proBNP, N-terminal prohormone of B-type natriuretic peptide, COVID-19, Retrospective cohort study, Length of Stay, medicine.disease, HR, hazard ratio, Asthma, Peptide Fragments, CI, confidence interval, Risk factors, Femmes, business, Biomarkers
Abstract: Background. – Although women account for up to half of patients hospitalized for coronavirus disease 2019 (COVID-19), no specific data have been reported in this population. Aims. − To assess the burden and impact of cardiovascular comorbidities in women with COVID-19. Methods. − All consecutive patients hospitalized for COVID-19 across 24 hospitals from 26 February to 20 April 2020 were included. The primary composite outcome was transfer to an intensive care unit or in-hospital death. Results. − Among 2878 patients, 1212 (42.1%) were women. Women were older (68.3 ± 18.0 vs 65.4 ± 16.0 years; P < 0.001), but had less prevalent cardiovascular comorbidities than men. Among women, 276 (22.8%) experienced the primary outcome, including 161 (13.3%) transfers to an intensive care unit and 115 (9.5%) deaths without transfer to intensive care unit. The rate of in-hospital death or transfer to an intensive care unit was lower in women versus men (crude hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.53–0.72). Age (adjusted HR 1.05 per 5-year increase, 95% CI 1.01–1.10), body mass index (adjusted HR 1.06 per 2-unit increase, 95% CI 1.02–1.10), chronic kidney disease (adjusted HR 1.57, 95% CI 1.11–2.22) and heart failure (adjusted HR 1.52, 95% CI 1.04–2.22) were independently associated with the primary outcome in women. Elevated B-type natriuretic peptide/N-terminal prohormone of B-type natriuretic peptide (adjusted HR 2.41, 95% CI 1.70–3.44) and troponin (adjusted HR 2.00, 95% CI 1.39–2.88) concentrations at admission were also associated with the primary outcome, even in women free of previous coronary artery disease or heart failure. Conclusions. – Although female sex was associated with a lower risk of transfer to an intensive care unit or in-hospital death, COVID-19 remained associated with considerable morbimortality in women, especially in those with cardiovascular diseases.
Published: 2021

18. Cardiovascular events in perimembranous ventricular septal defect with left ventricular volume overload: a French prospective cohort study (FRANCISCO)

Author: Damien Bonnet, Ali Houeijeh, Gilles Bosser, Clément Karsenty, Pamela Moceri, Pauline Helms, Lisa Guirgis, Elise Barre, Quentin Hauet, Sébastien Hascoët, Khaled Hadeed, Virginie Lambert, Xavier Iriart, Nicolas Pangaud, Bérangère Urbina-Hiel, Meriem Mostefa-Kara, Charlotte Denis, Eric Hery, Zakaria Jalal, Nadir Benbrik, Pierre Mauran, Pascale Maragnes, Hugues Lucron, Pascal Amedro, Céline Gronier, Francisco investigators, Magalie Ladouceur, Stéphanie Douchin, François Godart, Bruno Lefort, Karine Warin Fresse, Jean Benoit Thambo, Maurice Guirgis, Diala Khraiche, Adeline Basquin, Daniela Laux, Ronan Bonefoy, Estibaliz Valdeolmillos, Ivan Bouzguenda, Caroline Ovaert, Antoine Legendre, Laurence Iserin, Samir Harchaoui, Laurence Cohen, Jean Marc Lupoglazoff, Bertrand Leobon, Anne-Sophie Leborgne, Carine Vastel, Aurélie Chalard, Nicolas Combes, Alban-Elouen Baruteau, Hélène Ansquer, Guy Vaksmann, Lucile Houyel, Claire Bertail, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Heart Septal Defects, Ventricular, Cardiac Catheterization, medicine.medical_specialty, Septal Occluder Device, Heart Ventricles, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Volume overload, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Ventricular outflow tract, Prospective Studies, 030212 general & internal medicine, Child, Prospective cohort study, Stroke, Heart Failure, business.industry, General Medicine, medicine.disease, Haemolysis, 3. Good health, Observational Studies as Topic, Treatment Outcome, Child, Preschool, Heart failure, Pediatrics, Perinatology and Child Health, Cardiology, Cardiology and Cardiovascular Medicine, business, Watchful waiting, Cohort study
Abstract: The long-term prospective multi-centre nationwide (French) observational study FRANCISCO will provide new information on perimembranous ventricular septal defect with left ventricular overload but no pulmonary hypertension in children older than 1 year. Outcomes will be compared according to treatment strategy (watchful waiting, surgical closure, or percutaneous closure) and anatomic features of the defect. The results are expected to provide additional guidance about the optimal treatment of this specific population, which is unclear at present. Background The management of paediatric isolated perimembranous ventricular septal defect (pmVSD) with left ventricle (LV) volume overload but no pulmonary arterial hypertension (PAH) remains controversial. Three therapeutic approaches are considered: watchful waiting, surgical closure, and percutaneous closure. We aim to investigate the long-term outcomes of these patients according to anatomic pmVSD characteristics and treatment strategy. Methods The Filiale de Cardiologie Pediatrique et Congenitale (FCPC) designed the FRANCISCO registry, a long-term prospective nationwide multi-centre observational cohort study sponsored by the French Society of Cardiology, which enrolled, over 2 years (2018–2020), patients older than 1 year who had isolated pmVSD with LV volume overload. Prevalent complications related to pmVSD at baseline were exclusion criteria. Clinical, echocardiographic, and functional data will be collected at inclusion then after 1, 5, and 10 years. A core lab will analyse all baseline echocardiographic data to depict anatomical pmVSD features. The primary outcome is the 5-year incidence of cardiovascular events (infective endocarditis, sub-aortic stenosis, aortic regurgitation, right ventricular outflow tract stenosis, tricuspid regurgitation, PAH, arrhythmia, stroke, haemolysis, heart failure, or death from a cardiovascular event). We plan to enrol 200 patients, given the 10% estimated 5-year incidence of cardiovascular events with a 95% confidence interval of ±5%. Associations linking anatomical pmVSD features and treatment strategy to the incidence of complications will be assessed. Conclusions The FRANSCICO study will provide the long-term incidence of complications in patients older than 1 year with pmVSD and LV volume overload. The results are expected to improve guidance for treatment decisions.
Published: 2021

19. Exposure to low-dose ionizing radiation from cardiac catheterization and risk of cancer: the COCCINELLE study

Author: Sophie Malekzadeh-Milani, Jean-Benoit Thambo, Marie-Odile Bernier, S. Dreuil, Clément Karsenty, François Godart, Estelle Rage, Caroline Ovaert, Sylvie Di Filippo, Kossi Abalo, Claire Dauphin, Jean-François Piéchaud, Klervi Leuraud, Patrice Guerin, Sébastien Hascoët, Stéphanie Douchin, Sarah S. Cohen, Tiphaine Feuillet, Damien Bonnet, Pauline Helms, Pierre Mauran, Bruno Lefort, PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 2.M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France, 3.Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France, PSE-SANTE/SER/UEM, Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France, Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Paediatric and Congential Cardiology Department, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France., Cardiopédiatrie, hôpital couple enfant, CHU Grenoble Alpes, 38043 Grenoble cedex 9, France, Service de Cardiologie Infantile et Congénitale, Institut Cœur Poumon, 59037 Lille Cedex France, CHU Nantes, INSERM, Nantes Université, Clinique Cardiologique et des Maladies Vasculaires, CIC 1413, Institut du Thorax, Nantes, France., Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France, Institut des Cardiopathies Congénitales, CHRU Tours, 49 boulevard Béranger, 37000 Tours, France, Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, 51092 Reims Cedex, France, Cardiologie pédiatrique et congénitale, Timone enfants, AP-HM et INSERM 1251, Aix-Marseille Université, Marseille France, Institut Hospitalier Jacques-Cartier, 91300 Massy, France, Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33600 Pessac, France, M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Unité d'expertise en radioprotection médicale (IRSN/PSE-SANTE/SER/UEM), Service d'études et d'expertise en radioprotection (IRSN/PSE-SANTE/SER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), and Hospices Civils de Lyon (HCL)
Subjects: medicine.medical_specialty, education.field_of_study, Childhood Cancer Registry, business.industry, medicine.medical_treatment, Incidence (epidemiology), [SDV]Life Sciences [q-bio], Population, Cancer, Immunosuppression, medicine.disease, Confidence interval, 030218 nuclear medicine & medical imaging, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, Cohort, medicine, Cardiology and Cardiovascular Medicine, business, education, Cardiac catheterization
Abstract: International audience; Background The COCCINELLE study is a nationwide retrospective French cohort set up to evaluate the risk of radiation associated cancer in patients who undergone cardiac catheterization (CC) procedures for diagnosis or treatment of congenital heart disease during childhood [1].Material and methods Children who undergone CC procedures from 01/01/2000 to 31/12/2013 before the age of 16 in one of the 15 pediatric cardiology departments which perform pediatric CC in mainland France were included. The follow-up started at the date of the first recorded CC procedure until the exit date, i.e. the date of death, the date of first cancer diagnosis, the date of the 18th birthday, or the 31/12/2015, whichever occurred first. The cohort was linked to the National Childhood Cancer Registry to identify patients diagnosed with cancer and with the French National Directory for the Identification of Natural Persons to retrieve the patients’ vital status. An external comparison was conducted using standardized incidence ratios (SIR). Breslow and Day’s approximation was used to estimate 95% confidence intervals (CI) for the SIRs [2]. Results A total of 17,104 children were included in the cohort and followed for 110,335 person-years, with 22,227 CC procedures collected. Among the patients, 81.6 % received only one procedure. Fifty-nine cancer cases were observed in the cohort. SIRs were increased for all-cancer (SIR = 3.8, 95% CI 2.9, 4.9), leukemia (SIR = 3.3, 95% CI 2.0, 5.4), lymphoma (SIR = 14.9, 95% CI 9.9, 22.5) and solid cancers excluding central nervous system tumors (SIR = 3.3, 95% CI 2.0, 5.5) compared with the general population. Conclusion Increased risks of cancer were observed. Potential explanations include shared genetic or environmental factors, immunosuppression drugs, and exposure to medical ionizing radiation procedures. The dose-response analysis between ionizing radiation doses received during CCs and cancer occurrence will allow to address this question.Keywords: Ionizing radiation, cardiac catheterization, congenital heart disease, cancerCompeting interestsThe authors declare that they have no competing of interest.References1.Baysson H, Nkoumazok B, Barnaoui S, Réhel J, Girodon B, Milani G, Boudjemline Y, Bonnet D, Laurier D, Bernier M (2015) Follow-up of children exposed to ionising radiation from cardiac catheterisation: the Coccinelle study. Radiation protection dosimetry 165:13–162.Breslow NE, Day NE (1987) Statistical Methods in Cancer Research Volume II: The Design and Analysis of Cohort Studies, IARC Scientific Publication. IARC Scientific Publication No. 82, Lyon, France: International Agency for Research on Cancer.NotesCOCCINELLE: French acronym for COhorte sur le risque de Cancer après Cardiologie INterventionnELLECC: Cardiac CatheterizationSIR: Standardized Incidence Ratios CI: Confidence IntervalsCNS: Central Nervous System
Published: 2021

20. Position paper concerning the competence, performance and environment required for the practice of ablation in children and in congenital heart disease

Author: Jérôme Lacotte, Fanny Bajolle, Karine Warin-Fresse, Nicolas Combes, Olivier Piot, Magalie Ladouceur, Jérôme Taieb, Guillaume Duthoit, Philippe Acar, Frederic Anselm, Jacques Mansourati, Jean Benoit Thambo, Daniel Gras, Clément Karsenty, Sylvie Di Filippo, Estelle Gandjbakhch, Serge Boveda, Pascal Defaye, Frederic Sacher, Pierre Bordachar, Pascal Amedro, Céline Gronier, Eloi Marijon, Emre Belli, Gabriel Laurent, Linda Koutbi, Alice Maltret, Adeline Basquin, Victor Waldmann, Nicolas Derval, Didier Klug, Daniela Laux, Sébastien Hascoët, Philippe Maury, Caroline Ovaert, Nicolas Sadoul, Laurent Fauchier, Clinical sciences, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre de Référence Maladies Cardiaques Héréditaires, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Pasteur [Toulouse], Hôpital Marie-Lannelongue, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CHU Rouen, Normandie Université (NU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nouvelles Cliniques Nantaises - NCN [Nantes], Clinique De L' Orangerie - ELSAN [Strasbourg] (CDOS), CHU Lille, Hôpital de la Timone [CHU - APHM] (TIMONE), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Privé Jacques Cartier [Massy], Institut Cardiovasculaire Paris Sud [Massy] (ICPS), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Centre cardiologique du Nord (CCN), CHU Toulouse [Toulouse], CHU Pessac, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Congenital Heart Disease Service, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, France., Department of Cardiology, Georges Pompidou European Hospital and Necker-Enfants Malades Hospital, AP-HP, Adult Congenital Heart Disease Unit, Centre de Référence des Malformations Cardiaques Congénitales Complexes (M3C), 75015 Paris, France, Inserm U970, PARCC, 75015 Paris, France., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France, Pôle des Cardiopathies Congénitales, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Cardiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de Cardiologie Pédiatrique, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cardiopathies et mort subite [ERL 3147], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes (UN), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut Cardiovasculaire Paris Sud, Jacques Cartier Private Hospital, 91300 Massy, Service de Cardiologie [CHU de Dijon], Centre chirurgical Marie Lannelongue, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de Cardiologie [CHRU Nancy], Centre Hospitalier du Pays d'Aix, Department of Cardiology, Brest University Hospital, 29200 Brest, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cardiac Stimulation and Rhythmology, Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Chirurgical Marie Lannelongue (CCML), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)
Subjects: Heart disease, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Cryosurgery, 0302 clinical medicine, Cardiologists, heart rate, risk factors, 030212 general & internal medicine, Child, ComputingMilieux_MISCELLANEOUS, education.field_of_study, Cardiac electrophysiology, Paediatric cardiology, Age Factors, Arrhythmias, Cardiac/diagnosis, Cardiology Service, Hospital/standards, survivors, General Medicine, 3. Good health, Cardiac Surgical Procedures/adverse effects, Catheter, Treatment Outcome, Catheter Ablation, Electrophysiologic Techniques, Cardiac/standards, young adult, Cardiology Service, Hospital, Clinical Competence, Electrophysiologic Techniques, Cardiac, Cardiology and Cardiovascular Medicine, Heart Defects, Congenital, Adult, medicine.medical_specialty, Consensus, Adolescent, Child, preschool, Population, Catheter Ablation/adverse effects, Catheter ablation, Ablation procedures, Clinical Competence/standards, Competence (law), 03 medical and health sciences, Cardiologists/standards, Intensive care, medicine, Humans, cardiovascular diseases, Cardiac Surgical Procedures, education, Intensive care medicine, Congenital heart disease, Cryosurgery/adverse effects, Heart Defects, Congenital/diagnostic imaging, business.industry, Infant, Newborn, Infant, Arrhythmias, Cardiac, medicine.disease, Position paper, business
Abstract: International audience; The population of patients with congenital heart disease (CHD) is continuously increasing, and a significant proportion of these patients will experience arrhythmias because of the underlying congenital heart defect itself or as a consequence of interventional or surgical treatment. Arrhythmias are a leading cause of mortality, morbidity and impaired quality of life in adults with CHD. Arrhythmias may also occur in children with or without CHD. In light of the unique issues, challenges and considerations involved in managing arrhythmias in this growing, ageing and heterogeneous patient population and in children, it appears both timely and essential to critically appraise and synthesize optimal treatment strategies. The introduction of catheter ablation techniques has greatly improved the treatment of cardiac arrhythmias. However, catheter ablation in adults or children with CHD and in children without CHD is more technically demanding, potentially causing various complications, and thus requires a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding required technical competence and equipment are lacking in this situation, the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Affiliate Group of Paediatric and Adult Congenital Cardiology have decided to produce a common position paper compiled from expert opinions from cardiac electrophysiology and paediatric cardiology. The paper details the features of an interventional cardiac electrophysiology centre that are required for ablation procedures in adults with CHD and in children, the importance of being able to diagnose, monitor and manage complications associated with ablations in these patients and the supplemental hospital-based resources required, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Lastly, the need for quality evaluations and French registries of ablations in these populations is discussed. The purpose of this consensus statement is therefore to define optimal conditions for the delivery of invasive care regarding ablation of arrhythmias in adults with CHD and in children, and to provide expert and - when possible - evidence-based recommendations on best practice for catheter-based ablation procedures in these specific populations.
Published: 2020

21. Impact of Sophrology on cardiopulmonary fitness in teenagers and young adults with a congenital heart disease: The SOPHROCARE study rationale, design and methods

Author: Damien Bonnet, Pierre-Emmanuel Séguéla, Clément Karsenty, Xavier Iriart, Khaled Hadeed, Pascal Amedro, Kathleen Lavastre, Thibault Mura, Jean-Benoit-Thambo, Aitor Guitarte, Oscar Werner, Laurence Negre-Pages, Françoise Charbonnier, Gregoire De La Villeon, Philippe Acar, Annie Auer, Anne Requirand, Julie Thomas, Fanny Bajolle, Huguette Romieu, Nathalie Souletie, Maria Mounier, Charlene Bredy, Johan Moreau, Stefan Matecki, Yves Dulac, Sophie Guillaumont, Hamouda Abassi, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Paediatric Cardiology and Pulmonology Department, M3C Regional Reference Centre, Montpellier University Hospital, Montpellier, Paediatric Cardiology and Rehabilitation Centre, Institut-Saint-Pierre, Palavas-Les-Flots, France, Self-perceived Health Assessment Research Unit, EA3279, Public Health Department, Mediterranean Medical School, Marseille, France, CHU Toulouse [Toulouse], Paediatric and Congenital Cardiology Department, M3C Regional Reference Centre, Toulouse University Hospital, Toulouse, France, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidemiology and Clinical Research Department, Montpellier University Hospital, Montpellier, France, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Paediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France
Subjects: lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Relaxation, Heart disease, Health-related quality of life, [SDV]Life Sciences [q-bio], Oxygen pulse, Sophrology, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Exercise capacity, cardiovascular diseases, 030212 general & internal medicine, Young adult, Original Paper, business.industry, Congenital heart defect, VO2 max, medicine.disease, 3. Good health, lcsh:RC666-701, Physical therapy, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Anaerobic exercise, Hypercapnia, VO2max
Abstract: Highlights • Exercise capacity in patients with CHD is lower than in the general population. • Non-invasive relaxation therapy may be effective in patients with dyspnoea. • Evidence based-medicine on relaxation therapy in the CHD population is poor. • This trial will assess the impact of Sophrology on exercise capacity in CHD patients., Background Recent advances in the field of congenital heart disease (CHD) have significantly improved the overall prognosis. Now more attention is being given to health-related quality of life (HRQoL) and promotion of physical activity. Non-invasive relaxation therapy may be effective in cardiac patients concerned with exercise-induced dyspnoea. The SOPHROCARE randomised trial aims to assess the impact of Caycedian Sophrology on cardiopulmonary fitness in adolescents and young adults with CHD. Methods The SOPHROCARE trial is a nationwide, multicentre, randomised, controlled study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (8 Sophrology group sessions vs. no intervention). The primary outcome is the change in percent predicted maximum oxygen uptake (VO2max) between baseline and 12-month follow-up. A total of 94 patients in each group is required to observe a significant increase of 10% in VO2max with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (VE/VCO2 slope, ventilatory anaerobic threshold, oxygen pulse, respiratory response to hypercapnia), health-related quality of life score (PedsQL), physical and psychological status. Conclusion After focusing on the survival in CHD, current research is opening on secondary prevention and patient-related outcomes. We sought to assess in the SOPHROCARE trial, if a Sophrology program, could improve exercise capacity and quality of life in youth with CHD. Trial registration Clinicaltrials.gov (NCT03999320).
Published: 2020

22. Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV‐INHIBITION study design

Author: Magalie Ladouceur, Sv-Inhibition study investigators, Marc Humbert, Hamouda Abassi, Caroline Ovaert, Alban-Elouen Baruteau, Arthur Gavotto, Jean-Benoit Thambo, Sébastien Hascoët, P. Aldebert, Alain Fraisse, Sophie Malekzadeh-Milani, Marilyne Lévy, Marie-Christine Picot, Sarah Cohen, Pascal Amedro, Clément Karsenty, Damien Bonnet, Stefan Matecki, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Paediatric and Adult Congenital Heart Disease DepartmentHôpital Cardiologique du Haut-Lévêque, M3C National Reference Centre, CHU de Bordeaux, Bordeaux, France, Royal Brompton and Harefield Hospital Trust, Service de Pneumologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Université Grenoble Alpes - UFR Pharmacie (UGA UFRP), Université Grenoble Alpes (UGA), Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, CHU Nantes, Nantes, France, CHU Toulouse [Toulouse], Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Antoine Béclère, Université Paris-Sud 11 - Faculté de médecine (UP11 UFR Médecine), and MORNET, Dominique
Subjects: Adult, Heart Defects, Congenital, medicine.medical_specialty, Heart disease, Adolescent, Sildenafil, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Study Designs, 030204 cardiovascular system & hematology, Univentricular Heart, Pulmonary hypertension, Pulmonary vasodilator, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Exercise capacity, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Cardiac catheterization, Heart Failure, Study Design, business.industry, Congenital heart defect, Stroke volume, Phosphodiesterase 5 Inhibitors, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, chemistry, Ventricle, RC666-701, Heart failure, cGMP-specific phosphodiesterase type 5, Single ventricle, Cardiology, Quality of Life, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; 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).Trial registration: ClinicalTrials.gov NCT03997097.
Published: 2020

23. Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study

Author: Xavier Iriart, Philippe Acar, Zakaria Jalal, Alban-Elouen Baruteau, Khaled Hadeed, Jean-Benoit Baudelet, Alain Fraisse, Clément Karsenty, Philippe Aldebert, François Heitz, Pierre Mauran, Lisa Guirguis, François Godart, Jean Benoit Thambo, Ender Odemis, Caroline Ovaert, Sébastien Hascoët, Ali Houeijeh, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Aortic valve, medicine.medical_specialty, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], General Medicine, 030204 cardiovascular system & hematology, Haemolysis, medicine.disease, Pulmonary hypertension, 3. Good health, Surgery, Aortic valvuloplasty, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Ventricle, Interquartile range, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Complication, business, Atrioventricular block, ComputingMilieux_MISCELLANEOUS
Abstract: Summary Background Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Le VSD coil was recently introduced in France as an alternative to occluder devices. Aims To study the safety and feasibility of pmVSD closure with the Nit-Occlud Le VSD coil. Methods All consecutives cases of pmVSD closure with the Nit-Occlud Le VSD coil in 20 tertiary French centres were included between January 2015 and December 2018. Results Among 46 procedures in five centres, indications for pmVSD closure were left ventricle overload (76.1%), exertional dyspnoea (17.4%), history of infective endocarditis (4.3%) and mild pulmonary hypertension (2.2%). The median (interquartile [IQR]) age of the patients was 13.9 (5.7–31.8) years. Aneurismal tissue was identified in 91.3% of patients. VSD median (IQR) size was 8 (7–10) mm on the left ventricle side and 5 (4–6) mm on the right ventricle side. Implantation was successful in 40 patients (87.0%; 95% confidence interval [CI] 73.7–95.1%). Severe complications occurred in six patients (13.0%, 95% CI 4.9–26.3%), mainly severe haemolysis (8.7%, 95% CI 2.4–20.8%). One aortic valve lesion required surgical aortic valvuloplasty. Occurrence of severe complications was significantly related to the presence of haemolysis (P = 0.001), residual shunt (P = 0.007) and multi-exit VSD (P = 0.005). Residual shunt was observed in 40% of cases with the implanted device shortly after closure and 15% after a median follow-up of 27 months. No immediate or delayed device embolization or complete AVB was recorded. Conclusion pmVSD closure with the Nit-Occlud Le VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Le VSD as a therapeutic strategy remains controversial and is limited to selected patients.
Published: 2020

24. Feasibility, Safety and Accuracy of Echocardiography-Fluoroscopy Imaging Fusion During Percutaneous Atrial Septal Defect Closure in Children

Author: Clément Karsenty, Alain Fraisse, Khaled Hadeed, Francoise Auriol, Nicolas Combes, Philippe Acar, François Heitz, Gerald Chausseray, Xavier Alacoque, Yves Dulac, Pascal Amedro, Sébastien Hascoët, Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Clinique Pasteur [Toulouse], CHU Toulouse, Hôpital des Enfants, Unité de Gastroentérologie, Hépatologie et Nutrition, Département de Pédiatrie, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Aix Marseille Université (AMU), Université de Toulouse (UT), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), and Service Gastroentérologie, hépatologie nutrition, diabétologie et maladies héréditaires du métabolisme pédiatrique [CHU Toulouse]
Subjects: Male, Cardiac Catheterization, Percutaneous, Adolescent, Septal Occluder Device, Pediatric cardiology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], education, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, Multimodal Imaging, Heart Septal Defects, Atrial, Congenital heart diseases, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, medicine, Fluoroscopy, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Prospective Studies, Cardiac Surgical Procedures, Child, Fluoroscopic imaging, Cardiac catheterization, 3D echocardiography, medicine.diagnostic_test, business.industry, Imaging guidance, Reproducibility of Results, Atrial septal defect closure, Echocardiography, Doppler, Color, Treatment Outcome, Surgery, Computer-Assisted, Child, Preschool, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, Fluoroscopic image, business, Nuclear medicine, EchoNavigator, Echocardiography, Transesophageal, Imaging fusion
Abstract: Imaging fusion between echocardiography and fluoroscopy was recently developed. The aim of this study was to assess its feasibility and accuracy during pediatric cardiac catheterization.Thirty-one patients (median weight, 26 kg; interquartile range [IQR], 21-37 kg) who underwent percutaneous atrial septal defect closure were prospectively included. The feasibility and accuracy of various imaging fusion modalities (live two-dimensional, live color two-dimensional, live three-dimensional and markers) with EchoNavigator software were assessed. To assess the accuracy of spatial registration of the echocardiogram on the fluoroscopic image, the occluder screw, an object that appeared on each image, was used as a reference tool, and the distance between the two when fused was measured. A distance was measured on the fusion screen between a marker positioned on the screw from the echocardiography screen and from the fluoroscopy screen (distance 1). Another distance was measured on the fusion screen between the screw visualized by three-dimensional echocardiography and by fluoroscopy (distance 2). The two distances were measured on four C-arm orientations in end-systolic and end-diastolic frames.Fusion and marker positioning were feasible in real time in all cases. On the fusion screen, median systolic and diastolic distance 1 were 0.5 mm (IQR, 0.3-1 mm) and 2 mm (IQR, 1.5-2.5 mm; P .0001), respectively. The marker positioned from the echocardiography screen was fixed on the fusion screen and did not follow the movement of the screw. Median systolic and diastolic distance 2 were 0.5 mm (IQR, 0-0.5 mm) and 2 mm (IQR, 1.5-2.5 mm; P .0001), respectively.Echocardiographic fluoroscopic imaging fusion is feasible, safe, and accurate in children weighting20 kg. This technique offers a new method of imaging guidance in the catheterization laboratory for complex procedures and training.
Published: 2018

25. Outcome of adults with Eisenmenger syndrome treated with drugs specific to pulmonary arterial hypertension: A French multicentre study

Author: Pierre Mauran, Ali Houeijeh, Elise Barre, Clément Karsenty, Hélène Bouvaist, Pamela Moceri, Xavier Iriart, Elie Fadel, Adélaïde Richard, Nathalie Souletie, Emmanuelle Fournier, Lauriane Le Gloan, Magalie Ladouceur, Xavier Jaïs, Yvette Bernard, François Godart, Jelena Radojevic, Jérôme Petit, Laurence Iserin, Damien Bonnet, Gilles Bosser, Sébastien Hascoët, Pascal Amedro, Claire Dauphin, Adeline Basquin, Olivier Sitbon, Marc Humbert, Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Centre de Référence des cardiopathies congénitales (M3C), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Saclay, Hôpital Bicêtre, Centre hospitalier universitaire de Nantes (CHU Nantes), Service de médecine interne, hôpital Gabriel-Montpied, CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Bordeaux [Bordeaux], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Hôpital Pasteur [Nice] (CHU), CHU Grenoble, Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Rouen, Normandie Université (NU), Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Pontchaillou [Rennes], CHU Necker - Enfants Malades [AP-HP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre chirurgical Marie Lannelongue, Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre chirurgical Marie Lannelongue, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and Centre chirurgical Marie Lannelongue-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Pediatrics, Time Factors, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Pulmonary arterial hypertension, Gastroenterology, Congenital heart diseases, 0302 clinical medicine, Risk Factors, Cause of Death, 030212 general & internal medicine, Longitudinal Studies, Child, Cause of death, Outcome, Cardiopathies congénitales, Age Factors, Hypertension artérielle pulmonaire, General Medicine, Middle Aged, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Syndrome d’Eisenmenger, 3. Good health, Treatment Outcome, Disease Progression, Female, France, Drug therapy, Cardiology and Cardiovascular Medicine, Cohort study, Médicament, Adult, medicine.medical_specialty, Adolescent, Hypertension, Pulmonary, Pulmonary Artery, Lower risk, Disease-Free Survival, 03 medical and health sciences, Young Adult, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Pronostic, Humans, Arterial Pressure, Antihypertensive Agents, Proportional Hazards Models, Retrospective Studies, Chi-Square Distribution, business.industry, Eisenmenger syndrome, Retrospective cohort study, Eisenmenger Complex, medicine.disease, Pulmonary hypertension, Confidence interval, Transplantation, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Background: The relationship between pulmonary arterial hypertension-specific drug therapy (PAH-SDT) and mortality in Eisenmenger syndrome (ES) is controversial.Aims: To investigate outcomes in patients with ES, and their relationship with PAH-SDT.Methods: Retrospective, observational, nationwide, multicentre cohort study.Results: We included 340 patients with ES: genetic syndrome (n = 119; 35.3%); pretricuspid defect (n = 75; 22.1%). Overall, 276 (81.2%) patients received PAH-SDT: monotherapy (endothelin receptor antagonist [ERA] or phosphodiesterase 5 inhibitor [PDE5I]) 46.7%; dual therapy (ERA + PDE5I) 40.9%; triple therapy (ERA + PDE5I + prostanoid) 9.1%. Median PAH-SDT duration was 5.5 years [3.0–9.1 years]. Events (death, lung or heart-lung transplantation) occurred in 95 (27.9%) patients at a median age of 40.5 years [29.4–47.6]. The cumulative occurrence of events was 16.7% [95% confidence interval 12.8–21.6%] and 46.4% [95% confidence interval 38.2–55.4%] at age 40 and 60 years, respectively. With age at evaluation or time since PAH diagnosis as time scales, cumulative occurrence of events was lower in patients taking one or two PAH-SDTs (P = 0.0001 and P = 0.004, respectively), with the largest differences in the post-tricuspid defect subgroup (P < 0.001 and P < 0.02, respectively) versus patients without PAH-SDT. By multivariable Cox analysis, with time since PAH diagnosis as time scale, New York Heart Association/World Health Organization functional class III/IV, lower peripheral arterial oxygen saturation and pretricuspid defect were associated with a higher risk of events (P = 0.002, P = 0.01 and P = 0.04, respectively), and one or two PAH-SDTs with a lower risk of events (P = 0.009).Conclusions: Outcomes are poor in ES, but seem better with PAH-SDT. ES with pretricuspid defects has worse outcomes despite the delayed disease onset.; Contexte: L’intérêt du traitement médical spécifique (TMS) de l’hypertension artérielle pulmonaire (HTAP) dans le syndrome d’Eisenmenger (SE) est controversé.Objectifs: Étudier le pronostic à long terme des patients ayant un SE et la relation avec le TMS.Méthodes: Une cohorte observationnelle longitudinale multicentrique rétrospective historique française de 340 SE a été constituée.Résultats: Le shunt était prétricuspide dans 75 cas (22,1 %). Au total, 276 (81,2 %) patients étaient sous TMS (monothérapie 46,7 % ; bi-thérapie 40,9 % ; tri-thérapie 9,1 %). La durée médiane de TMS était de 5,5 ans [3,0–9,1]. Un événement clinique majeur (ECM : décès, transplantation cardiopulmonaire ou bipulmonaire) a été observé dans 95 (27,9 %) cas à un âge médian de 40,5 [29,4–47,6] ans. La survenue cumulée d’un ECM était de 16,7 % [IC 95 % 12,8–21,6 %] et 46,4 % [IC 95 % 38,2–55,4 %] à l’âge de 40 et 60 ans. Avec l’âge ou le délai depuis le premier examen comme échelle temporelle, la survenue cumulée des ECM était moindre chez les patients sous un ou deux TMS (p = 0,0001 et p = 0,004), en particulier chez les patients avec un shunt post-tricuspide (p < 0,001 et p < 0,02) comparée aux patients sans TMS. Une analyse multivariée de Cox avec le délai depuis le diagnostic de l’HTAP comme échelle temporelle a montré qu’une classe fonctionnelle III ou IV de la NYHA/WHO, une saturation périphérique en oxygène basse (en variable continue), un shunt pré-tricuspide et l’absence de TMS étaient associés à un risque augmenté d’ECM (p = 0,002 ; p = 0,01 ; p = 0,04 and p = 0,009, respectivement).Conclusions: Le TMS dans le SE semble associé à un meilleur pronostic. Néanmoins, même avec un traitement médical palliatif, le pronostic du SE reste altéré. Les patients avec un shunt prétricuspide ont un profil clinique et un pronostic plus sombre malgré une survenue plus tardive de l’HTAP.
Published: 2017

26. Early architectural modifications in the right ventricle myocardium of children with tetralogy of Fallot: Preliminary data by morphological analysis

Author: Sébastien Hascoët, Bertrand Leobon, A. Pathak, P. Acar, Jean-Michel Senard, Céline Galés, Céline Guilbeau-Frugier, Philippe Maury, and Clément Karsenty
Subjects: medicine.medical_specialty, business.industry, General Medicine, Reentry, medicine.disease, Surgery, Stenosis, medicine.anatomical_structure, Fibrosis, Ventricle, Internal medicine, Ventricular fibrillation, Pulmonary valve stenosis, Cardiology, medicine, cardiovascular system, business, Pulmonary atresia, Cardiology and Cardiovascular Medicine, Tetralogy of Fallot
Abstract: Malignant ventricular arrhythmias (VA) may happen remote from tetralogy of Fallot (TOF) repair. Monomorphic ventricular tachycardia (VT) using surgical scar-related reentry circuits is the most common form of VA, but ventricular fibrillation (VF) unrelated to VT has been described. Right ventricular fibrosis may be part of the substrate for VF and also VT. We aimed to assess right ventricular fibrosis in young children with TOF. Methods We prospectively included 9 children requiring surgery for the management of TOF. Right ventricle tissue of the outflow tract resected during surgery was analyzed under conventional microscopy. Results Surgical indications were complete repair of TOF with pulmonary stenosis ( n = 7), complete repair with right-ventricle-to pulmonary-artery-conduit of TOF with pulmonary atresia ( n = 1) and redo surgery for outflow tract and pulmonary valve stenosis six years after the complete repair ( n = 1). Median age at complete repair was 5.5 months old (range: 3 to 75, 3 children coming from developing countries having been operated after 2 year-old). Median Sp0 2 was 85% (range: 65 to100%). Pulmonary annulus section was required in 62.5%. Morphological analysis revealed a marked sub-endocardial fibrosis, fibrosis of the interstitium and of the support vessels. Morphology of cardiomyocytes suggests that they remain immature in most cases. However, an early maturation was observed in some myocardial sectors in a 27-month-old child with cardiomyocytes exhibiting acquisition of a mature brick-wall micropattern. Cardiomyocytes are often multinucleated with some being trinucleated. MIB-1 revealed some cardiomyocytes to be in mitosis cycle. Conclusion Early fibrosis and cardiomyocytes alterations of the right ventricle outflow tract before any surgery in TOF are already present in very young children. If these early abnormalities are evolutive and if they represent a facilitating substrate for late VA remains to be demonstrated.
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27. 0500: Children with tetralogy of Fallot exhibit accelerated maturation of the cardiac tissue into adult phenotype

Author: Jean-Michel Senard, Céline Galés, Philippe Maury, Clément Karsenty, Philippe Acar, Sébastien Hascoët, Atul Pathak, and Céline Guilbeau-Frugier
Subjects: Pressure overload, Pathology, medicine.medical_specialty, business.industry, Hyperplasia, medicine.disease, Phenotype, Muscle hypertrophy, Infundibulum, medicine.anatomical_structure, Ventricle, Fibrosis, medicine, Cardiology and Cardiovascular Medicine, business, Tetralogy of Fallot
Abstract: Introduction Shortly after birth, under changes in loading conditions of the heart, a shift from predominantly hyperplasic to hypertrophic cardiac growth occurs. In rodents, at birth, neonatal proliferative cardiomyocytes (CMs) exhibit a fusiform shape and differentiated into non-proliferative rhod-shape CM around P20 defined as the mature state. In human, CM differentiation supposedly ended around 6 years old but the exact timing still remains unknown. Moreover, numerous stimuli most probably contribute to the CM maturation, including pressure. In a human model of pressure overload named tetralogy of Fallot (ToF), we thus hypothesized the occurence of an earlier maturation of the cardiac tissue. Methods we prospectively included 15 children around 6 month-old (min. 3.5 max. 27), who required surgery for the management of ToF. We assessed criteria of maturation from right ventricle tissue of infundibulum that was resected during the surgery. Results As previously described, heart sections analysis revealed a marked sub-endocardial fibrosis (473±444µm) and a significant fibrosis of the interstitium (13.0±6.3%). This criteria was correlated to the severity of the disease represented by the degree of desaturation (r=0,623; p=0,017). In all children analysed, CMs were hypertrophied but unlike healthy myocardium, CM size was heterogeneous (CV=40,4%), with alternating immature and mature area. In mature area, as expected, CMs proliferation stopped as indicated by the loss of Ki67 staining and exhibit a mature rod-shape. Ultrastructurally, CMs had structured intercalated disk and elongated contractile apparatus with an alignment of Z-strikes and apparent I-band. The lateral membrane between two CMs was compacted with periodic crests and holes. Conclusion Our data highly suggest that the increase of pressure during childhood may act as a maturation factor. Myocardium in ToF is characterized by a shortening of the hyperplasia stage and a subsequent early hypertrophy stage.
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28. 0359 : Right ventricular systolic strain evolution during peri-operative management of congenital heart diseases

Author: Philippe Acar, Gerald Chausseray, Yves Dulac, Xavier Alacoque, Bertrand Leobon, Khaled Hadeed, Sébastien Hascoët, Clément Karsenty, Sophie Breinig, Rose Fesseau, and Florent Semet
Subjects: medicine.medical_specialty, business.industry, Peak systolic strain, Perioperative, Contractility, Internal medicine, Systolic strain, 2d speckle tracking, Heart rate, medicine, Cardiology, Cardiology and Cardiovascular Medicine, Prospective cohort study, business
Abstract: BackgroundRV systolic strain evolution during peri-operative management of congenital heart diseases (CHD) is unknown.MethodsIn this prospective study, RV peak systolic strain (PSS) was measured using 2D speckle tracking echocardiography (Qlab10.0 software, Philips) in 39 children undergoing surgery of a CHD (Median age: 17 months, min 6 day-old, max 14.3 year-old). Three measures were performed the day before surgery, few hours after the surgery and before discharge and compared to conventional echocardiographic parameters of RV and left ventricular (LV) function. The relationships between the evolution of RV-PSS, peri-operative parameters and the type of CHD were assessed.ResultsMean RV-PSS at baseline was –19.5±4.8. RV-PSS was moderately correlated with the heart rate (r=0.49), the LV Tmad (r=–0.48), the TAPSE (r=–0.54) and the tricuspid S’ wave (r= –0.44)(all p
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28 results on '"Clément, Karsenty"'

1. Advancing paediatric cardiac imaging: a comprehensive analysis of the feasibility and accuracy of a novel 3D paediatric transoesophageal probe

2. Health‐Related Quality of Life and Its Association With Outcomes in Adults With Congenital Heart Disease and Heart Failure: Insight From FRESH‐ACHD Registry

3. A Modified Technique for Transcatheter Pulmonary Valve Implantation of SAPIEN 3 Valves in Large Right Ventricular Outflow Tract: A Matched Comparison Study

4. Multicentre experience with Optimus balloon-expandable cobalt–chromium stents in congenital heart disease interventions

5. Impact of 3D-printed models in meetings with parents of children undergoing interventional cardiac catheterisation

6. Cardiac Drugs in ACHD Cardiovascular Medicine

7. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile

8. 3D modeling and printing in large native right ventricle outflow tract to plan complex percutaneous pulmonary valve implantation

9. Case Report: Successful Cerebral Revascularization and Cardiac Transplant in a 16-Year-Old Male With Syndromic BRCC3-Related Moyamoya Angiopathy

10. Cardiovascular Characteristics and Outcomes of Young Patients with COVID-19

11. Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study

12. Diagnostic Value of (18)F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis

13. Myocarditis and Pericarditis in Adolescents after First and Second doses of mRNA COVID-19 Vaccines

14. The usefulness of 3D printed heart models for medical student education in congenital heart disease

15. 3D modeling and printing in large native right ventricle outflow tract to plan complex percutaneous pulmonary valve implantation

16. History of heart failure in patients with coronavirus disease 2019: Insights from a French registry

17. Characteristics and impact of cardiovascular comorbidities on coronavirus disease 2019 in women: A multicentre cohort study

18. Cardiovascular events in perimembranous ventricular septal defect with left ventricular volume overload: a French prospective cohort study (FRANCISCO)

19. Exposure to low-dose ionizing radiation from cardiac catheterization and risk of cancer: the COCCINELLE study

20. Position paper concerning the competence, performance and environment required for the practice of ablation in children and in congenital heart disease

21. Impact of Sophrology on cardiopulmonary fitness in teenagers and young adults with a congenital heart disease: The SOPHROCARE study rationale, design and methods

22. Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV‐INHIBITION study design

23. Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study

24. Feasibility, Safety and Accuracy of Echocardiography-Fluoroscopy Imaging Fusion During Percutaneous Atrial Septal Defect Closure in Children

25. Outcome of adults with Eisenmenger syndrome treated with drugs specific to pulmonary arterial hypertension: A French multicentre study

26. Early architectural modifications in the right ventricle myocardium of children with tetralogy of Fallot: Preliminary data by morphological analysis

27. 0500: Children with tetralogy of Fallot exhibit accelerated maturation of the cardiac tissue into adult phenotype

28. 0359 : Right ventricular systolic strain evolution during peri-operative management of congenital heart diseases

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