Search

Your search keyword '"Bernard, Iung"' showing total 38 results
Start Over Author "Bernard, Iung" Publication Year Range Last 3 years
38 results on '"Bernard, Iung"'

1. Transcatheter edge to edge compared with surgery in older patients with degenerative mitral valve regurgitation

Author

Gaspard Suc, Rebecca Hadjedj, Jules Mesnier, Skerdi Haviari, Marylou Para, Gregory Ducrocq, Dominique Himbert, Eric Brochet, My Lien Nguyen, Sophie Provenchere, Marina Urena, and Bernard Iung

Subjects
Degenerative valve, Mitral valve repair, Transthoracic echocardiography, Mitral regurgitation, Surgery, RD1-811, Anesthesiology, RD78.3-87.3
Abstract

Abstract Objectives Transcatheter edge-to-edge repair (TEER) is an alternative for patients with severe degenerative mitral regurgitation (MR). The objective of this study was to compare the outcomes of surgery and TEER in older patients with degenerative MR patients using real life data. Methods Consecutives older patients (≥ 65 years-old), with severe symptomatic, degenerative MR requiring surgery or TEER between 2013 and 2023 were included. Exclusion criteria were secondary MR, and active endocarditis. Primary outcome was a composite of all-cause death, hospitalization for heart failure or mitral valve intervention within one year. Results A total of 295 patients were included (203 underwent surgery and 92 underwent TEER). At 1 year, 26 (9%) patients had died, required reintervention or rehospitalization for heart failure: 8 patients in the surgery group (4%) and 18(20%) in the TEER group(p 2 (aHR 4.31 (95% CI: 1.51–12.25)), history of cardiac surgery (aHR 6.24 (95%CI: 2.16–18.05)), BMI (aHR 0.88 (95% CI: 0.77–0.98)), TR > 2 at baseline (aHR: 2.47 (95% CI: 1.03–5.91)). After adjustement on confounding factors, intervention type was not associated with the primary composite outcome (aHR: 3.41 (95% CI: 0.63–18.27)), p = 0.15). Conclusion Patients with severe primary MR treated with TEER experienced a higher rate of adverse events within one year compared to surgically managed patients. However, these differences were mainly associated to clinical characteristics and were no longer significant after adjustment on residual MR > 2. Graphical Abstract

Published
2025
Full Text
View/download PDF

2. Acute Pulmonary Edema After Double Mechanical Valve Replacement

Author

Audrey Poulat, MD, Constance Verdonk, PhD, Marylou Para, PhD, Ali Jendoubi, MD, Takoua Khzouri, MD, Jean Nicolas Senemaud, PhD, Yves Castier, PhD, Rainu Richaud, MD, Phalla Ou, PhD, Bernard Iung, PhD, and Patrick Nataf, PhD

Subjects
aortic valve, mitral valve, valve replacement, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We report a case of a 16-year-old man in cardiogenic shock secondary to On-X mitral prosthesis dysfunction due to leaflet embolization through aortic mechanical prosthesis. He underwent an emergency redo mitral valve replacement and, a few days later, leaflet removal by open aortic surgery with full recovery.

Published
2024
Full Text
View/download PDF

3. Cerebrovascular complications and outcomes of critically ill adult patients with infective endocarditis

Author

Thomas Rambaud, Etienne de Montmollin, Pierre Jaquet, Augustin Gaudemer, Eric Mariotte, Sonia Abid, Marylou Para, Claire Cimadevilla, Bernard Iung, Xavier Duval, Michel Wolff, Lila Bouadma, Jean-François Timsit, and Romain Sonneville

Subjects
Endocarditis, Stroke, Thoracic surgery, Neuro-critical care, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Neurological complications are associated with poor outcome in patients with infective endocarditis (IE). Although guidelines recommend systematic brain imaging in the evaluation of IE patients, the association between early brain imaging findings and outcomes has never been evaluated in critically ill patients. We aimed to assess the association of CT-defined neurological complications with functional outcomes of critically ill IE patients. Methods This retrospective cohort study included consecutive patients with severe, left-sided IE hospitalized in the medical ICU of a tertiary care hospital. Patients with no baseline brain CT were excluded. Baseline CT-scans were classified in five mutually exclusive categories (normal, moderate-to-severe ischemic stroke, minor ischemic stroke, intracranial hemorrhage, other abnormal CT). The primary endpoint was 1-year favorable outcome, defined by a modified Rankin Scale score of 0–3. Results Between 06/01/2011 and 07/31/2018, 156 patients were included. Among them, 87/156 (56%) had a CT-defined neurological complication, including moderate-to-severe ischemic stroke (n = 33/156, 21%), intracranial hemorrhage (n = 24/156, 15%), minor ischemic stroke (n = 29/156, 19%), other (n = 3/156, 2%). At one year, 69 (45%) patients had a favorable outcome. Factors negatively associated with favorable outcome in multivariable analysis were moderate-to-severe ischemic stroke (OR 0.37, 95%CI 0.14 − 0.95) and age (OR 0.94, 95%CI 0.91–0.97). By contrast, the score on the Glasgow Coma Scale was positively associated with favorable outcome (per 1-point increment, OR 1.23, 95%CI 1.08–1.42). Sensitivity analyses conducted in operated patients revealed similar findings. Compared to normal CT, only moderate-to-severe ischemic stroke was associated with more frequent post-operative neurological complications (n = 8/23 (35%) vs n = 1/46 (2%), p

Published
2022
Full Text
View/download PDF

4. Impact of Antibiotic Prophylaxis on Surgical Site Infections in Cardiac Surgery

Author

Christian de Tymowski, Tarek Sahnoun, Sophie Provenchere, Marylou Para, Nicolas Derre, Pierre Mutuon, Xavier Duval, Nathalie Grall, Bernard Iung, Solen Kernéis, Jean-Christophe Lucet, and Philippe Montravers

Subjects
antibiotic prophylaxis, vancomycin, gentamicin, cephalosporins, surgical site infection, cardiac surgery, Therapeutics. Pharmacology, RM1-950
Abstract

(1) Background: Cephalosporins (CA) are the first-line antibiotic prophylaxis recommended to prevent surgical site infection (SSI) after cardiac surgery. The combination of vancomycin/gentamicin (VGA) might represent a good alternative, but few studies have evaluated its efficacy in SSI prevention. (2) Methods: A single-centre retrospective study was conducted over a 13-year period in all consecutive adult patients undergoing elective cardiac surgery. Patients were stratified according to the type of antibiotic prophylaxis. CA served as the first-line prophylaxis, and VGA was used as the second-line prophylaxis. The primary endpoint was SSI occurrence at 90 days, which was defined as the need for reoperation due to SSI. (3) Results: In total, 14,960 adult patients treated consecutively from 2006 to 2019 were included in this study, of whom 1774 (12%) received VGA and 540 (3.7%) developed SSI. VGA patients had higher severity with increased 90-day mortality. Nevertheless, the frequency of SSI was similar between CA and VGA patients. However, the microbiological aetiologies were different, with more Gram-negative bacteria noted in the VGA group. (4) Conclusions: VGA seems to be as effective as CA in preventing SSI.

Published
2023
Full Text
View/download PDF

6. Indoxyl-sulfate activation of the AhR- NF-κB pathway promotes interleukin-6 secretion and the subsequent osteogenic differentiation of human valvular interstitial cells from the aortic valve

Author

Alexandre Candellier, Nervana Issa, Maria Grissi, Théo Brouette, Carine Avondo, Cathy Gomila, Gérémy Blot, Brigitte Gubler, Gilles Touati, Youssef Bennis, Thierry Caus, Michel Brazier, Gabriel Choukroun, Christophe Tribouilloy, Saïd Kamel, Cédric Boudot, Lucie Hénaut, Hélène Eltchaninoff, Jérémy Bellien, Benjamin Bertrand, Farzin Beygui, Delphine Béziau-Gasnier, Ebba Brakenhielm, Giuseppina Caligiuri, Karine Chevreul, Frédérique Debroucker, Eric Durand, Christophe Fraschini, Martine Gilard, Bernard Iung, Said Kamel, Jamila Laschet, Alain Manrique, Emmanuel Messas, David Messika-Zeitoun, Florence Pinet, Vincent Richard, Eric Saloux, Martin Thoenes, and Claire Vézier

Subjects
Cardiology and Cardiovascular Medicine, Molecular Biology
Published
2023
Full Text
View/download PDF

8. Unmet needs in valvular heart disease

Author

David Messika-Zeitoun, Helmut Baumgartner, Ian G Burwash, Alec Vahanian, Jeroen Bax, Philippe Pibarot, Vince Chan, Martin Leon, Maurice Enriquez-Sarano, Thierry Mesana, and Bernard Iung

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Valvular heart disease (VHD) is the next epidemic in the cardiovascular field, affecting millions of people worldwide and having a major impact on health care systems. With aging of the population, the incidence and prevalence of VHD will continue to increase. However, VHD has not received the attention it deserves from both the public and policymakers. Despite important advances in the pathophysiology, natural history, management, and treatment of VHD including the development of transcatheter therapies, VHD remains underdiagnosed, identified late, and often undertreated with inequality in access to care and treatment options, and there is no medication that can prevent disease progression. The present review article discusses these gaps in the management of VHD and potential actions to undertake to improve the outcome of patients with VHD.

Published
2023
Full Text
View/download PDF

10. Predictive value of the TRI-SCORE for in-hospital mortality after redo isolated tricuspid valve surgery

Author

Julien Dreyfus, Yohann Bohbot, Augustin Coisne, Yoan Lavie-Badie, Michele Flagiello, Baptiste Bazire, Florian Eggenspieler, Florence Viau, Elisabeth Riant, Yannick Mbaki, Damien Eyharts, Thomas Sénage, Thomas Modine, Martin Nicol, Fabien Doguet, Thierry Le Tourneau, Christophe Tribouilloy, Erwan Donal, Jacques Tomasi, Gilbert Habib, Christine Selton-Suty, Costin Radu, Pascal Lim, Richard Raffoul, Bernard Iung, Jean-Francois Obadia, Etienne Audureau, David Messika-Zeitoun, Centre cardiologique du Nord (CCN), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU 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), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance Publique - Hôpitaux de Marseille (APHM), 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 hospitalier universitaire de Nantes (CHU Nantes), Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Lariboisière-Fernand-Widal [APHP], CHU Rouen, Normandie Université (NU), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Cardiologie [Hôpital de la Timone - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)

Subjects
tricuspid valve insufficiency, Cardiology and Cardiovascular Medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

ObjectivesThe TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.MethodsUsing a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017. Baseline characteristics and outcomes were collected from chart review and surgical scores were calculated.ResultsWe identified 70 patients who underwent a redo ITVS (54±15 years, 63% female). Prior intervention was a tricuspid valve repair in 51% and a replacement in 49%, and was combined with another surgery in 41%. A tricuspid valve replacement was performed in all patients for the redo surgery. Overall, in-hospital mortality and major postoperative complication rates were 10% and 34%, respectively. The TRI-SCORE was the only surgical risk score associated with in-hospital mortality (p=0.005). The area under the receiver operating characteristic curve for the TRI-SCORE was 0.83, much higher than for the logistic EuroSCORE (0.58) or EuroSCORE II (0.61). The TRI-SCORE was also associated with major postoperative complication rates and survival free of readmissions for heart failure.ConclusionRedo ITVS was rarely performed and was associated with an overall high in-hospital mortality and morbidity, but hiding important individual disparities. The TRI-SCORE accurately predicted in-hospital mortality after redo ITVS and may guide clinical decision-making process (www.tri-score.com).

Published
2023
Full Text
View/download PDF

11. Myocardial Work Predicts Outcome in Asymptomatic Severe Aortic Stenosis

Author

Marko Banovic, Niya Mileva, Ana Moya, Pasquale Paolisso, Monika Beles, Nikola Boskovic, Miodrag Jovanovic, Ivana Nedeljkovic, Anja Radunovic, Marija Radjenovic, Mina Raznatovic, Milica Bojanic, Andrea Manojlovic, Martin Kotrc, Radka Kockova, Guy Van Camp, Marc Vanderheyden, Svetozar Putnik, Bernard Iung, Jozef Bartunek, and Martin Penicka

Subjects
Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine
Published
2023
Full Text
View/download PDF

13. One-Year Outcome After Cardiac Surgery for Patients With Cancer: An Observational Monocentric Retrospective Study

Author

Hadrien Portefaix, Sophie Provenchère, Bernard Iung, Dan Longrois, Grégory Papin, Philippe Montravers, and Elie Kantor

Subjects
medicine.medical_specialty, law.invention, Postoperative Complications, Risk Factors, law, Neoplasms, Internal medicine, Cardiopulmonary bypass, medicine, Humans, Prospective Studies, Cardiac Surgical Procedures, Retrospective Studies, Cardiopulmonary Bypass, Proportional hazards model, business.industry, Mortality rate, Cancer, Retrospective cohort study, medicine.disease, Cardiac surgery, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Observational study, Cardiology and Cardiovascular Medicine, business, Artery
Abstract

Cardiac surgery increasingly is being performed in patients with a history of or with active cancer. The aim of this study was to analyze the association between a history of cancer and 1-year mortality after cardiac surgery with cardiopulmonary bypass (CPB).An observational monocentric study, with data collected from a prospective institutional database was conducted.A single academic center.All consecutive patients undergoing cardiac surgery with CPB between 2005 and 2017.None.A history of cancer was preoperatively identified. Mortality rates were estimated by the Kaplan-Meier method. The 1-year mortality risk of patients with and without cancer was compared using a multivariate Cox model.During the study period, 12,143 patients underwent cardiac surgery with CPB, including 4,681 (39%) isolated coronary artery bypass surgeries. Their median EuroSCORE II was 3.1, interquartile range 1.5-to-6.4. Nine hundred thirty patients (8%) had a diagnosis of cancer, out of whom 469 (50%) were diagnosed ≤5 years before the index surgery; 103 (11%) patients had hemopathy, and 825 (89%) had solid cancers. The estimated unadjusted 1-year mortality was significantly higher among patients with cancer, 11% (95% confidence interval [CI] 10-14) versus 8% (95%CI 7-9) p0.01. After adjustment, a diagnosis of cancer was not associated with the risk of 1-year mortality (adjusted hazard ratio = 1.17 [95%CI 0.96-1.43]; p = 0.13).In a large cohort of patients undergoing cardiac surgery with CPB, cancer was not independently associated with 1-year mortality. An isolated cancer history should not lead to denial of cardiac surgery. The impact of cancer on complications and long-term survival after cardiac surgery requires further research.

Published
2022
Full Text
View/download PDF

14. Cost-Effectiveness Analysis of SAPIEN 3 Transcatheter Aortic Valve Implantation Procedure Compared With Surgery in Patients With Severe Aortic Stenosis at Low Risk of Surgical Mortality in France

Author

Gérard de Pouvourville, Christian Spaulding, Nicolas Dumonteil, Pierre Mutuon, Thierry Lefèvre, Christophe Roussel, Hélène Eltchaninoff, Bernard Iung, Pascal Candolfi, Michelle Green, Martine Gilard, and Judith Shore

Subjects
Clinical Trials as Topic, medicine.medical_specialty, education.field_of_study, Transcatheter aortic, business.industry, Cost-Benefit Analysis, Health Policy, Population, Public Health, Environmental and Occupational Health, Surgical mortality, Aortic Valve Stenosis, Cost-effectiveness analysis, medicine.disease, Surgery, Transcatheter Aortic Valve Replacement, Stenosis, Quality of life, Aortic valve replacement, Quality of Life, medicine, Humans, Adverse effect, education, business
Abstract

Objectives The clinical and cost-saving benefits of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis who are at high or intermediate risk of surgical mortality are supported by a growing evidence base. The PARTNER 3 trial (Placement of AoRTic TraNscathetER Valve Trial) demonstrated clinical benefits with SAPIEN 3 TAVI compared with SAVR in selected patients at low risk of surgical mortality. This study uses PARTNER 3 outcomes in combination with a French national hospital claim database to inform a cost-utility model and examine the cost implications of TAVI over SAVR in a low-risk population. Methods A 2-stage cost-utility analysis was developed to estimate changes in both direct healthcare costs and health-related quality of life using TAVI with SAPIEN 3 compared with SAVR. Early adverse events associated with TAVI were captured using the PARTNER 3 data set. These data fed into a Markov model that captured longer-term outcomes of patients, after TAVI or SAVR intervention. Results TAVI with SAPIEN 3 offers meaningful benefits over SAVR in providing both cost saving (€12 742 per patient) and generating greater quality-adjusted life-years (0.89 per patient). These results are robust with TAVI with SAPIEN 3 remaining dominant across several scenarios and deterministic and probabilistic sensitivity analyses. Conclusions This model demonstrated that TAVI with SAPIEN 3 was dominant compared with SAVR in the treatment of patients with severe symptomatic aortic stenosis who are at low risk of surgical mortality. These findings should help policy makers in developing informed approaches to intervention selection for this patient population.

Published
2022
Full Text
View/download PDF

17. Transcatheter Aortic Valve Replacement in Patients with Reduced Ejection Fraction and Nonsevere Aortic Stenosis

Author

Sebastian Ludwig, Niklas Schofer, Mohamed Abdel-Wahab, Marina Urena, Guillaume Jean, Matthias Renker, Christian W. Hamm, Holger Thiele, Bernard Iung, Joris F. Ooms, Maya Wiessman, Nils S.B. Mogensen, Benjamin Longère, Nils Perrin, Walid Ben Ali, Augustin Coisne, Jordi S. Dahl, Nicolas M. Van Mieghem, Ran Kornowski, Won-Keun Kim, Marie-Annick Clavel, and Cardiology

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Background: The potential benefit of transcatheter aortic valve replacement (TAVR) in patients with nonsevere aortic stenosis (AS) and heart failure is controversial. This study aimed to assess outcomes of patients with nonsevere low-gradient AS (LGAS) and reduced left ventricular ejection fraction undergoing TAVR or medical management. Methods: Patients undergoing TAVR for LGAS and reduced left ventricular ejection fraction ( Results: A total of 706 LGAS patients undergoing TAVR (TS-LGAS, N=527; PS-LGAS, N=179) and 470 Medical-Mod patients were included. After adjustment, both TAVR groups showed superior survival compared with Medical-Mod patients (all P P =0.96). After propensity score-matching among patients with nonsevere AS, PS-LGAS TAVR patients showed superior 2-year overall (65.4%) and cardiovascular survival (80.4%) compared with Medical-Mod patients (48.8% and 58.5%, both P ≤0.004). In a multivariable analysis including all patients with nonsevere AS, TAVR was an independent predictor of survival (hazard ratio, 0.39 [95% CI, 0.27–0.55]; P Conclusions: Among patients with nonsevere AS and reduced left ventricular ejection fraction, TAVR represents a major predictor of superior survival. These results reinforce the need for randomized-controlled trials comparing TAVR versus medical management in heart failure patients with nonsevere AS. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04914481.

Published
2023

18. Carcinoid heart disease in patients with midgut neuroendocrine tumours

Author

Clémence Delhomme, Thomas Walter, Dimitri Arangalage, Gaspard Suc, Olivia Hentic, Agnès Cachier, Soleiman Alkhoder, Laurent François, Catherine Lombard‐Bohas, Bernard Iung, Philippe Ruszniewski, and Louis de Mestier

Subjects
Cellular and Molecular Neuroscience, Endocrinology, Endocrine and Autonomic Systems, Endocrinology, Diabetes and Metabolism
Published
2023
Full Text
View/download PDF

19. Godina 2022. u kardiovaskularnoj medicini: 10 najboljih radova o bolestima srčanih zalistaka

Author

Helmut Baumgartner, Bernard Iung, and David Messika-Zeitoun

Subjects
valvular heart disease, клапни сърдечни заболявания valvular heart disease, Cardiology and Cardiovascular Medicine
Abstract

Сърдечно-съдовата медицина през 2022 г: 10-те най-добри статии за клапни сърдечни заболявания The year in cardiovascular medicine 2022: the top 10 papers in valvular heart disease

Published
2023

22. Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Author

Pierre Deharo, Lionel Leroux, Alexis Theron, Jérome Ferrara, Antoine Vaillier, Nicolas Jaussaud, Alizée Porto, Pierre Morera, Vlad Gariboldi, Bernard Iung, Thierry Lefevre, Philippe Commeau, Margaux Gouysse, Florence du Chayla, Nicolas Glatt, Guillaume Cayla, Herve Le Breton, Hakim Benamer, Sylvain Beurtheret, Jean Philippe Verhoye, Helene Eltchaninoff, Martine Gilard, Jean Philippe Collet, Nicolas Dumonteil, Frederic Collart, Thomas Modine, Thomas Cuisset, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Timone [CHU - APHM] (TIMONE), Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux], CHU Bordeaux [Bordeaux], Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Privé Jacques Cartier [Massy], Polyclinique Les Fleurs - ELSAN [Ollioules] (PLF), Clinityx, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Pontchaillou [Rennes], Hôpital Saint-Joseph [Marseille], Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), 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), CHU Pitié-Salpêtrière [AP-HP], 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Clinique Pasteur, Clinique Pasteur [Toulouse], and ANR-16-RHUS-0003,STOP-AS,STOP-AS(2016)

Subjects
TAVI, Mismatch, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, General Medicine, mismatch, paravalvular leak, Paravalvular leak
Abstract

Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.

Published
2022
Full Text
View/download PDF

23. Data standards for transcatheter aortic valve implantation: the European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart)

Author

Suleman Aktaa, Gorav Batra, Stefan K James, Daniel J Blackman, Peter F Ludman, Mamas A Mamas, Mohamed Abdel-Wahab, Gianni D Angelini, Martin Czerny, Victoria Delgado, Giuseppe De Luca, Eustachio Agricola, Dan Foldager, Christian W Hamm, Bernard Iung, Norman Mangner, Julinda Mehilli, Gavin J Murphy, Darren Mylotte, Radoslaw Parma, Anna Sonia Petronio, Bodgan A Popescu, Lars Sondergaard, Rui C Teles, Manel Sabaté, Christian J Terkelsen, Luca Testa, Jianhua Wu, Aldo P Maggioni, Lars Wallentin, Barbara Casadei, Chris P Gale, and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
TAVI, Registry, Health Policy, Data standards, Variables, EuroHeart, Quality of care, Aortic valve, Cardiology and Cardiovascular Medicine, Data definitions
Abstract

Aims Standardized data definitions are necessary for the quantification of quality of care and patient outcomes in observational studies and randomised controlled trials (RCTs). The European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart) project of the European Society of Cardiology (ESC) aims to create pan-European data standards for cardiovascular diseases and interventions, including transcatheter aortic valve implantation (TAVI). Methods and results We followed the EuroHeart methodology for cardiovascular data standard development. A Working Group of 29 members representing 12 countries was established and included a patient representative, as well as experts in the management of valvular heart disease from the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Association of Cardiovascular Imaging (EACVI) and the Working Group on Cardiovascular Surgery. We conducted a systematic review of the literature and used a modified Delphi method to reach consensus on a final set of variables. For each variable, the Working Group provided a definition, permissible values, and categorized the variable as mandatory (Level 1) or additional (Level 2) based on its clinical importance and feasibility. In total, 93 Level 1 and 113 Level 2 variables were selected, with the level 1 variables providing the dataset for registration of patients undergoing TAVI on the EuroHeart IT platform. Conclusion This document provides details of the EuroHeart data standards for TAVI processes of care and in-hospital outcomes. In the context of EuroHeart, this will facilitate quality improvement, observational research, registry-based RCTs and post-marketing surveillance of devices, and pharmacotherapies. One-sentence summary The EuroHeart data standards for transcatheter aortic valve implantation (TAVI) are a set of internationally agreed data variables and definitions that once implemented will facilitate improvement of quality of care and outcomes for patients receiving TAVI.

Published
2022
Full Text
View/download PDF

27. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery

Author

Sigrun, Halvorsen, Julinda, Mehilli, Salvatore, Cassese, Trygve S, Hall, Magdy, Abdelhamid, Emanuele, Barbato, Stefan, De Hert, Ingrid, de Laval, Tobias, Geisler, Lynne, Hinterbuchner, Borja, Ibanez, Radosław, Lenarczyk, Ulrich R, Mansmann, Paul, McGreavy, Christian, Mueller, Claudio, Muneretto, Alexander, Niessner, Tatjana S, Potpara, Arsen, Ristić, L Elif, Sade, Henrik, Schirmer, Stefanie, Schüpke, Henrik, Sillesen, Helge, Skulstad, Lucia, Torracca, Oktay, Tutarel, Peter, Van Der Meer, Wojtek, Wojakowski, Kai, Zacharowski, Juhani, Knuuti, Steen Dalby, Kristensen, Victor, Aboyans, Ingo, Ahrens, Sotiris, Antoniou, Riccardo, Asteggiano, Dan, Atar, Andreas, Baumbach, Helmut, Baumgartner, Michael, Böhm, Michael A, Borger, Hector, Bueno, Jelena, Čelutkienė, Alaide, Chieffo, Maya, Cikes, Harald, Darius, Victoria, Delgado, Philip J, Devereaux, David, Duncker, Volkmar, Falk, Laurent, Fauchier, Gilbert, Habib, David, Hasdai, Kurt, Huber, Bernard, Iung, Tiny, Jaarsma, Aleksandra, Konradi, Konstantinos C, Koskinas, Dipak, Kotecha, Ulf, Landmesser, Basil S, Lewis, Ales, Linhart, Maja Lisa, Løchen, Michael, Maeng, Stéphane, Manzo-Silberman, Richard, Mindham, Lis, Neubeck, Jens Cosedis, Nielsen, Steffen E, Petersen, Eva, Prescott, Amina, Rakisheva, Antti, Saraste, Dirk, Sibbing, Jolanta, Siller-Matula, Marta, Sitges, Ivan, Stankovic, Rob F, Storey, Jurrien, Ten Berg, Matthias, Thielmann, and Rhian M, Touyz

Subjects
Anti-thrombotic therapy, Biomarkers, Guidelines, Non-cardiac surgery, Peri-operative beta-blockers, Peri-operative cardiac management, Peri-operative myocardial injury/infarction, Peri-operative treatment of arrhythmias, Post-operative cardiac surveillance, Pre-operative cardiac risk assessment, Pre-operative cardiac testing, Pre-operative coronary artery revascularization, Pre-operative treatment of valvular disease, Humans, Risk Assessment, Intraoperative Complications, Postoperative Complications, Cardiology and Cardiovascular Medicine
Abstract

Sí

Published
2022
Full Text
View/download PDF

29. Vasoplegic Syndrome after Cardiac Surgery for Infective Endocarditis

Author

Pascal Lim, Margaux Le Maistre, Lucas Benoudiba Campanini, Quentin De Roux, Nicolas Mongardon, Valentin Landon, Hassina Bouguerra, David Aouate, Paul-Louis Woerther, Fihman Vincent, Adrien Galy, Vania Tacher, Sébastien Galien, Pierre-Vladimir Ennezat, Antonio Fiore, Thierry Folliguet, Raphaelle Huguet, Armand Mekontso-Dessap, Bernard Iung, and Raphael Lepeule

Subjects
endocarditis, vasoplegic syndrome, shock, outcome, General Medicine
Abstract

Purpose: Post-operative vasoplegic syndrome is a dreaded complication in infective endocarditis (IE). Methods and Results: This retrospective study included 166 consecutive patients referred to cardiac surgery for non-shocked IE. Post-operative vasoplegic syndrome was defined as a persistent hypotension (mean blood pressure < 65 mmHg) refractory to fluid loading and cardiac output restoration. Cardiac surgery was performed 7 (5–12) days after the beginning of antibiotic treatment, 4 (1–9) days after negative blood culture and in 72.3% patients with adapted anti-biotherapy. Timing of cardiac surgery was based on ESC guidelines and operating room availability. Most patients required valve replacement (80%) and cardiopulmonary bypass (CPB) duration was 106 (95–184) min. Multivalvular surgery was performed in 43 patients, 32 had tricuspid valve surgery. Post-operative vasoplegic syndrome was reported in 53/166 patients (31.9%, 95% confidence interval of 24.8–39.0%) of the whole population; only 15.1% (n = 8) of vasoplegic patients had a post-operative documented infection (6 positive blood cultures) and no difference was reported between vasoplegic and non-vasoplegic patients for valve culture and the timing of cardiac surgery. Of the 23 (13.8%) in hospital-deaths, 87.0% (n = 20) occurred in the vasoplegic group and the main causes of death were multiorgan failure (n = 17) and neurological complications (n = 3). Variables independently associated with vasoplegic syndrome were CPB duration (1.82 (1.16–2.88) per tertile) and NTproBNP level (2.11 (1.35–3.30) per tertile). Conclusions: Post-operative vasoplegic syndrome is frequent and is the main cause of death after IE cardiac surgery. Our data suggested that the mechanism of vasoplegic syndrome was more related to inflammatory cardiovascular injury rather than the consequence of ongoing bacteremia.

Published
2022

30. Delayed hospitalisation for heart failure after transcatheter repair or medical treatment for secondary mitral regurgitation: a landmark analysis of the MITRA-FR trial

Author

Guillaume Leurent, Vincent Auffret, Erwan Donal, Hervé Corbineau, Daniel Grinberg, Guillaume Bonnet, Pierre-Yves Leroux, Patrice Guérin, Fabrice Wautot, Thierry Lefèvre, David Messika-Zeitoun, Bernard Iung, Xavier Armoiry, Jean-Noël Trochu, Florent Boutitie, Jean-François Obadia, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hospices Civils de Lyon (HCL), Hôpital Louis Pradel [CHU - HCL], CHU Marseille, Médipôle Lyon-Villeurbanne, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Cardio-Thoracique de Monaco (CCTM), Hôpital Privé Jacques Cartier [Massy], University of Ottawa [Ottawa], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Matériaux, ingénierie et science [Villeurbanne] (MATEIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), The MITRA-FR trial was financed by an academic grant from the French Ministry of Health., Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Université Sorbonne Paris Nord

Subjects
Heart Failure, Heart Valve Prosthesis Implantation, Hospitalization, Cardiac Catheterization, Treatment Outcome, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, Mitral Valve Insufficiency, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine
Abstract

International audience; BACKGROUND: In the MITRA-FR trial, transcatheter mitral valve repair (TMVR) was not associated with a 2-year clinical benefit in patients with secondary mitral regurgitation (SMR). AIMS: This landmark analysis aimed at investigating a potential reduction of the hospitalisation rate for heart failure (HF) between 12 and 24 months after inclusion in the MITRA-FR trial in patients randomised to the intervention group (TMVR with the MitraClip device), as compared with patients randomised to the control group (guideline-directed medical therapy [GDMT]). METHODS: The MITRA-FR trial randomised 307 patients with SMR for TMVR on top of GDMT (TMVR group; n=152) or for GDMT alone (control group; n=155). We conducted a 12-month landmark analysis in surviving patients who were not hospitalised for HF within the first 12 months of follow-up. The primary endpoint was the 1-year cumulative number of HF hospitalisations. RESULTS: A total of 140 patients (TMVR group: 67; GDMT group: 73) were selected for this landmark analysis with similar characteristics at inclusion in the trial. The primary endpoint was 28 events per 100 patient-years in the TMVR group, as compared with 60 events per 100 patient-years in the GDMT group (hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.20-1.02; p=0.057). CONCLUSIONS: In this landmark analysis of the MITRA-FR trial, the cumulative rate of HF hospitalisation between 12 and 24 months among patients treated with TMVR on top of GDMT was approximately half as many as those of patients treated with GDMT alone, a difference which did not reach statistical significance in the setting of a low number of events.

Published
2022
Full Text
View/download PDF

31. Towards a new journal

Author

Ariel Cohen, Yves Cottin, and Bernard Iung

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Published
2022

32. Poor oral health and hygiene habits in patients with infective endocarditis and previously identified predisposing cardiac condition: A prospective cohort study

Author

Vanessa Moby, Sarah Millot, Marie-Line Erpelding, Edouard Euvrard, Geoffrey Bourgeois, Hélène Martin-Thomé, Catherine Chirouze, Pierre Tattevin, Christophe Strady, Nelly Agrinier, Francois Alla, Bernard Iung, Christine Selton-Suty, Bruno Hoen, Xavier Duval, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Nanomédecine, imagerie, thérapeutique - UFC (UR 4662) (NIT / NANOMEDECINE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Polyclinique Courlancy (PC), Polyclinique de Courlancy, Hopital Privé Sévigné [Cesson-Sévigné, France], Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Polyclinique Saint André, Laboratoire de Biotechnologie et Microbiologie Appliquée (LBMA), Université Bordeaux Segalen - Bordeaux 2-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [CHRU Nancy], Centre de Recherche Translationnelle - Center for Translational Science (CRT), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was supported by the French Ministry of Health, Société Française de Cardiologie, and Fédération Française de Cardiologie (grant 2009), Inserm XM/GB/2009–051., EI-dents Association pour lȉEtude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group, and Jonchère, Laurent

Subjects
Microbiology (medical), Habits, Infectious Diseases, Endocarditis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Hygiene, Oral Health, Endocarditis, Bacterial, Prospective Studies, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2022
Full Text
View/download PDF

33. Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial

Author

Marko Banovic, Svetozar Putnik, Martin Penicka, Gheorghe Doros, Marek A. Deja, Radka Kockova, Martin Kotrc, Sigita Glaveckaite, Hrvoje Gasparovic, Nikola Pavlovic, Lazar Velicki, Stefano Salizzoni, Wojtek Wojakowski, Guy Van Camp, Serge D. Nikolic, Bernard Iung, Jozef Bartunek, Emanuele Barbato, Bernard De Bruyne, Filip Casselman, Ivan De Grieck, Alex Heyse, Bernard Stockman, Marc Vanderheyden, Frederik Van Durme, Frank Van Praet, Eric Wyffels, Bojan Biocina, Sime Manola, Jan Pirk, Erik Cura-Stura, Mauro Rinaldi, Gaetano Maria De Ferrari, Antonella Fava, Elena Maria Richiardi, Jelena Celutkiene, Marta Filipova, Joanna Ciosek, Michal Guzy, Radoslaw Kurzelowski, Marija Bjelobrk, Aleksandra Ilic, Mila Kovacevic, Tatjana Miljkovic, Andrej Preveden, Ilija Srdanovic, Srdjan Aleksandric, Milika Asanin, Branko Beleslin, Milica Bojanic, Nikola Boskovic, Sladjana Bosic, Natasa Cvetinovic, Vladimir Dedovic, Vojislav Giga, Predrag Jandric, Milena Jaukovic, Miodrag Jovanovic, Ana Kovacevic-Kuzmanovic, Goran Loncar, Andrea Manojlovic, Milos Matkovic, Predrag Mitrovic, Ivana Nedeljkovic, Milan Nedeljkovic, Olgica Petrovic, Arsen Ristic, Mirjana Seper, Dragan Simic, Sanja Stankovic, Sinisa Stojkovic, Vladan Vukcevic, and Katarina Zivic

Subjects
Adult, Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Physiology (medical), 80 and over, Medicine, Humans, asymptomatic, 030212 general & internal medicine, Prospective Studies, 10. No inequality, intervention, Aged, Aged, 80 and over, Heart Valve Prosthesis Implantation, business.industry, aortic stenosis, Aortic Valve Stenosis, Middle Aged, medicine.disease, 3. Good health, Surgery, Conservative treatment, Stenosis, Heart Valve Prosthesis, randomized controlled trial, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background: Surgical aortic valve replacement (SAVR) represents a class I indication in symptomatic patients with severe aortic stenosis (AS). However, indications for early SAVR in asymptomatic patients with severe AS and normal left ventricular function remain debated. Methods: The AVATAR trial (Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis) is an investigator-initiated international prospective randomized controlled trial that evaluated the safety and efficacy of early SAVR in the treatment of asymptomatic patients with severe AS, according to common criteria (valve area ≤1 cm 2 with aortic jet velocity >4 m/s or a mean transaortic gradient ≥40 mm Hg), and with normal left ventricular function. Negative exercise testing was mandatory for inclusion. The primary hypothesis was that early SAVR would reduce the primary composite end point of all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure compared with a conservative strategy according to guidelines. The trial was designed as event-driven to reach a minimum of 35 prespecified events. The study was performed in 9 centers in 7 European countries. Results: Between June 2015 and September 2020, 157 patients (mean age, 67 years; 57% men) were randomly allocated to early surgery (n=78) or conservative treatment (n=79). Follow-up was completed in May 2021. Overall median follow-up was 32 months: 28 months in the early surgery group and 35 months in the conservative treatment group. There was a total of 39 events, 13 in early surgery and 26 in the conservative treatment group. In the early surgery group, 72 patients (92.3%) underwent SAVR with operative mortality of 1.4%. In an intention-to-treat analysis, patients randomized to early surgery had a significantly lower incidence of primary composite end point than those in the conservative arm (hazard ratio, 0.46 [95% CI, 0.23–0.90]; P =0.02). There was no statistical difference in secondary end points, including all-cause mortality, first heart failure hospitalizations, major bleeding, or thromboembolic complications, but trends were consistent with the primary outcome. Conclusions: In asymptomatic patients with severe AS, early surgery reduced a primary composite of all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure compared with conservative treatment. This randomized trial provides preliminary support for early SAVR once AS becomes severe, regardless of symptoms. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02436655.

Published
2022

35. Correction to: Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry

Author

Marta Hernández-Meneses, Lilia Zakhama, Antoni Bayes-Genis, Eduard Quintana, Aldo Pietro Maggioni, Eustachio Agricola, Abdallah Almaghraby, Bernard Iung, Mouaz Al-Mallah, Lucia Soriente, Carmen Olmos, Daniel Lovric, Elena Raevschi, Kevin Bouiller, Patrick Assayag, and Ugur Canpolat

Subjects
Microbiology (medical), Infectious Diseases, General Medicine
Published
2022
Full Text
View/download PDF

36. Erratum to 'Evolution of TAVI patients and techniques over the past decade: The French TAVI registries' [Arch. Cardiovasc. Dis. 115 (4) (2022) 206–13]

Author

Romain Didier, Herve Le Breton, Hélène Eltchaninoff, Guillaume Cayla, Philippe Commeau, Jean-Philippe Collet, Thomas Cuisset, Nicolas Dumonteil, Jean-Philippe Verhoye, Sylvain Beurtheret, Thierry Lefèvre, Bernard Iung, and Martine Gilard

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Published
2022
Full Text
View/download PDF

38. Collaborateurs

Author

Alpert Joseph, S., Francesca, Baratto, Barrabés José, A., Bax Jeroen, J., Ruxandra, Beyer, Jasper, Boeddinghaus, Eric, Bonnefoy-Cudraz, Borger Michael, A., Jens, Bremerich, Héctor, Bueno, Haran, Burri, John, Camm A., Rajiv, Choudhary, Claeys Marc, J., Jacques, Creteur, Dalzell Jonathan, R., Jeroen, Dauw, Davierwala Piroze, M., De Carlini Caterina, C., De Graaf Michiel, A., Suzanne, De Waha-Thiele, Paolo, Della Bella, Dagmara, Dilling, Docherty Kieran, F., Gregory, Ducrocq, Mohammed, El Mahdiui, Volkmar, Falk, Dimitrios, Farmakis, Gerasimos, Filippatos, Flachskampf Frank, A., Giuseppe, Gargiulo, Gayat, Etienne, Bulent, Gorenek, Eric, Graulus, Sigrun, Halvorsen, Christian, Hassager, Stephane, Heymans, Kurt, Huber, Borja, Ibanez, Massimo, Imazio, Bernard, Iung, Jaffe Allan, S., Stefan, James, Mark, Johnson, Katritsis Demosthenes, G., Jan, Klages, Stavros, Konstantinides, Nikola, Kozhuharov, Lucia, Kroft, Marcin, Kurzyna, Sergio, Leonardi, Stefano, Maggiolini, Alan, Maisel, Jasmin, Martin, Arantxa, Mas, Josep, Masip, Giulio, Maurizi, McMurray John, J.V., Alexandre, Mebazaa, Eleni, Michou, Andreas, Mitsis, Thomas, Modine, Morley-Smith Andrew, C., Christian, Mueller, Wilfried, Mullens, Pavlos, Myrianthefs, Thomas, Nestelberger, Nolan, Jerry P., Matthew, Parkin, Richard, Paul, John, Pepper, Petrie, Mark C., Kenneth, Planas, Susanna, Price, Elena, Puerto, Tom, Quinn, Angelo, Rendina Erino, Jolien, Roos-Hesselink, Marc, Schepens, Felix, Schoenrath, Scholte Arthur, J.H.A., Juerg, Schwitter, Kevin, Shah, Simon, André R., Alessandro, Sionis, Smit, Jeff M., Janina, Stepinska, Neasa, Starr, Holger, Thiele, Franck, Thuny, Kristian, Thygesen, Adam, Torbicki, Marco, Tubaro, Raphael, Twerenbold, Alec, Vahanian, Marco, Valgimigli, Camilla, Vanni, Johan, Vijgen, Jean-Louis, Vincent, Pascal, Vranckx, Christiaan, Vrints, Nicholas, Wettersten, White, Harvey D., Stephan, Windecker, and Jayne, Wood

Published
2023
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results