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28 results on '"Azmoun, Alexandre"'

2. Transcarotid Approach for Transcatheter Aortic Valve Replacement With the Sapien 3 Prosthesis: A Multicenter French Registry

Author

Overtchouk, Pavel, Folliguet, Thierry, Pinaud, Frédéric, Fouquet, Oliver, Pernot, Mathieu, Bonnet, Guillaume, Hubert, Maxime, Lapeze, Joël, Claudel, Jean Philippe, Ghostine, Said, Azmoun, Alexandre, Caussin, Christophe, Zannis, Konstantinos, Harmouche, Majid, Verhoye, Jean-Philippe, Lafont, Antoine, Chamandi, Chekrallah, Ruggieri, Vito Giovanni, Di Cesare, Alessandro, Leclercq, Florence, Gandet, Thomas, and Modine, Thomas

Published
2019
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11. Cost‐effectiveness of left ventricular assist devices for patients with end‐stage heart failure: analysis of the French hospital discharge database

Author

Tadmouri, Abir, Blomkvist, Josefin, Landais, Cécile, Seymour, Jerome, and Azmoun, Alexandre

Subjects
Adult, Heart Failure, Male, Incremental cost‐effectiveness ratio, Cost-Benefit Analysis, PMSI, Middle Aged, Markov Chains, Patient Discharge, Costs, Young Adult, Original Research Articles, Cost‐effectiveness, Left ventricular assist devices, Prevalence, Quality of Life, Humans, Female, Original Research Article, France, Heart-Assist Devices, health care economics and organizations, Aged, Follow-Up Studies, Retrospective Studies
Abstract

Aims Although left ventricular assist devices (LVADs) are currently approved for coverage and reimbursement in France, no French cost‐effectiveness (CE) data are available to support this decision. This study aimed at estimating the CE of LVAD compared with medical management in the French health system. Methods and results Individual patient data from the ‘French hospital discharge database’ (Medicalization of information systems program) were analysed using Kaplan–Meier method. Outcomes were time to death, time to heart transplantation (HTx), and time to death after HTx. A micro‐costing method was used to calculate the monthly costs extracted from the Program for the Medicalization of Information Systems. A multistate Markov monthly cycle model was developed to assess CE. The analysis over a lifetime horizon was performed from the perspective of the French healthcare payer; discount rates were 4%. Probabilistic and deterministic sensitivity analyses were performed. Outcomes were quality‐adjusted life years (QALYs) and incremental CE ratio (ICER). Mean QALY for an LVAD patient was 1.5 at a lifetime cost of €190 739, delivering a probabilistic ICER of €125 580/QALY [95% confidence interval: 105 587 to 150 314]. The sensitivity analysis showed that the ICER was mainly sensitive to two factors: (i) the high acquisition cost of the device and (ii) the device performance in terms of patient survival. Conclusions Our economic evaluation showed that the use of LVAD in patients with end‐stage heart failure yields greater benefit in terms of survival than medical management at an extra lifetime cost exceeding the €100 000/QALY. Technological advances and device costs reduction shall hence lead to an improvement in overall CE.

Published
2017

15. Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI

Author

Auffret, Vincent, Lefevre, Thierry, Belle, Eric, Eltchaninoff, Hélène, Iung, Bernard, Koning, René, Motreff, Pascal, Leprince, Pascal, Philippe, Philippe, Manigold, Thibaut, Souteyrand, Geraud, Boulmier, Dominique, Joly, Patrick, Pinaud, Frédéric, Himbert, Dominique, Collet, Philippe, Rioufol, Gilles, Ghostine, Said, Bar, Olivier, Dibie, Alain, Champagnac, Didier, Leroux, Lionel, Collet, Frédéric, Teiger, Emmanuel, Darremont, Olivier, Folliguet, Thierry, Leclercq, Florence, Lhermusier, Thibault, Olhmann, Patrick, Huret, Bruno, Lorgis, Luc, Drogoul, Laurent, Bertrand, Bernard, Spaulding, Christian, Quilliet, Laurent, Cuisset, Thomas, Delomez, Max, Beygui, Farzin, Claudel, Philippe, Hepp, Alain, Jégou, Arnaud, Gommeaux, Antoine, Mirode, Anfani, Christiaens, Luc, Christophe, Christophe, Cassat, Claude, Metz, Damien, MANGIN, Lionel, Isaaz, Karl, Jacquemin, Laurent, Guyon, Philippe, Pouillot, Christophe, Makowski, Serge, Bataille, Vincent, Rodes-Cabau, Josep, Gilard, Martine, Laskar, Marc, Chevalier, Bernard, Hovasse, Thomas, Donzeau Gouge, Patrick, Farge, Arnaud, Romano, Mauro, Bertrand, Bertrand, Bouvier, Erik, Bauchart, Jean, Delhaye, Cédric, Houpe, David, Robert, Robert, Leroy, Fabrice, Sudre, Arnaud, Juthier, Francis, Koussa, Mohamed, Modine, Thomas, Rousse, Natacha, Auffray, Jean, Richard, Richard, Berland, Jacques, Godin, Mathieu, Bessou, Jean, Letocart, Vincent, Roussel, Jean, Combaret, Nicolas, d’Ostrevy, Nicolas, Innorta, Andrea, Clerfond, Guillaume, Vorilhon, Charles, Bedossa, Marc, Leurent, Guillaume, Anselmi, Amedeo, Harmouche, Majid, Donal, Erwan, Bille, Jacques, Houel, Rémi, Abi Khalil, Wissam, Delepine, Stéphane, Fouquet, Olivier, Roule, Frédéric, Abtan, Jérémie, Urena, Marina, Alkhoder, Soleiman, Ghodbane, Walid, Arangalage, Dimitri, Brochet, Eric, Goublaire, Coppelia, Choussat, Rémi, Lebreton, Guillaume, Mastrioanni, Chiro, Dauphin, Raphaël, Dubreuil, Olivier, Durand de Gevigney, Guy, Finet, Gérard, Harbaoui, Brahim, Ranc, Sylvain, Farhat, Fadi, Jegaden, Olivier, Obadia, Jean, Pozzi, Matteo, Ghostine, Saïd, Fradi, Sahbi, Azmoun, Alexandre, Kauffmann, Martin, Blanchard, Didier, Chassaing, Stephan, Chatel, Didier, Le Page, Olivier, Tauran, Arnaud, Bruere, Didier, Bodson, Laurent, Meurisse, Yvon, Seemann, Aurélie, AMABILE, NICOLAS, Simon, Simon, Drieu, Luc, Ohanessian, Alice, Veugeois, Aurélie, Debauchez, Matthieu, Zannis, Konstantinos, Czitrom, Daniel, Diakov, Chrystelle, Raoux, François, Lienhart, Yves, Staat, Patrick, Zouaghi, Oualid, Doisy, Vincent, Frieh, Philippe, Wautot, Fabrice, Dementhon, Julie, Garrier, Olivier, Jamal, Fadi, Leroux, Pierre, Casassus, Frédéric, Séguy, Benjamin, Barandon, Laurent, Labrousse, Louis, Peltan, Julien, Cornolle, Claire, Dijos, Marina, Lafitte, Stephane, Bayet, Gilles, Charmasson, Claude, Vaillant, Alain, Vicat, Jacques, Giacomoni, Marie Paule, Bergoend, Eric, Zerbib, Céline, Louis Leymarie, Jean, Clerc, Philippe, Choukroun, Emmanuel, Elia, Nicolas, Grimaud, Philippe, Guibaud, Philippe, Wroblewski, Stéphane, Abergel, Eric, Bogino, Emmanuel, Dehant, Patrick, Simon, Marc, Angioi, Michel, Lemoine, Julien, Lemoine, Simon, Popovic, Batric, Maureira, Pablo, Huttin, Olivier, Selton Suty, Christine, Cayla, Guillaume, Delseny, Delphine, Levy, Gilles, Maupas, Eric, Rivalland, François, Robert, Gabriel, Schmutz, Laurent, Targosz, Frédéric, Albat, Bernard, Dubar, Arnaud, Durrleman, Nicolas, Gandet, Thomas, Munos, Emmanuel, Cade, Stéphane, Cransac, Frédéric, Bouisset, Frédéric, Grunenwald, Etienne, Bertrand, Marc, Fournier, Pauline, Morel, Olivier, Ohlmann, Patrick, Kindo, Michel, Hoang, Minh Tam, Petit, Hélène, Samet, Hafida, Trinh, Anne, Lecoq, Guillaume, Morelle, Jean François, Richard, Pascal, Derieux, Thierry, Monier, Emmanuel, Joret, Cédric, Bouchot, Olivier, Meyer, Pierre, Lopez, Stéphane, Tapia, Michel, Teboul, Jacques, Elbeze, Pierre, Mihoubi, Alain, Vanzetto, Gérald, Wittenberg, Olivier, Bach, Vincent, Martin, Cécile, Sauier, Carole, Casset, Charlotte, Castellant, Philippe, Bezon, Eric, Choplain, Jean, Kallifa, Ahmed, Nasr, Bahaa, Jobic, Yannick, Lafont, Antoine, Pagny, Jean, Abi Akar, Ramzi, Fabiani, Jean, Zegdi, Rachid, Berrebi, Alain, Puscas, Tania, Desveaux, Bernard, Ivanes, Fabrice, Bourguignon, Thierry, Aupy, Blandine, Perault, Romain, Bonnet, Jean, Lambert, Marc, Grisoli, Dominique, Jaussaud, Nicolas, Salaün, Erwan, Laghzaoui, Amine, Savoye, Christine, Bignon, Mathieu, Roule, Vincent, Sabatier, Rémy, Ivascau, Calin, Saplacan, Vladimir, Saloux, Eric, Bouchayer, Damien, Tremeau, Guillaume, Diab, Camille, Lapeze, Joel, Pelissier, Franck, Sassard, Thomas, Matz, Catherine, Monsarrat, Nicolas, Carel, Ivan, Sibellas, Franck, Curtil, Alain, Dambrin, Grégoire, Favereau, Xavier, Ghorayeb, Gabriel, Guesnier, Laurent, Khoury, Wassim, Pouzet, Bruno, Vaislic, Claude, Cheikh-Khelifa, Riadh, Hilpert, Loïc, Maribas, Philippe, Hannebicque, Gery, Hochart, Philippe, Paris, Marc, Pecheux, Max, Fabre, Olivier, Leborgne, Laurent, Peltier, Marcel, Le Breton, Hervé, Laboratoire Traitement du Signal et de l'Image (LTSI), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Privé Jacques Cartier [Massy], Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires (RNMCD - U1011), 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), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), 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, Clinique St Hilaire ( Service de Cardiologie, Rouen), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie cardiaque et thoracique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Saint-Joseph [Marseille], Service de chirurgie cardio-vasculaire et thoracique, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Institut de cardiologie [CHU Pitié-Salpêtrière], Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon (HCL), Centre Chirurgical Marie Lannelongue (CCML), Clinique St Gatien et Groupe Athérome Cardiologie Interventionnelle/SF, Clinique St Gatien, Institut Mutualiste de Montsouris (IMM), Clinique du Tonkin, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Hôpital Privé Clairval [Marseille], Centre d'Investigation Clinique Henri Mondor (CIC Henri Mondor), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Clinique Saint Augustin, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de cardiologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de cardiologie [Toulouse], CHU Strasbourg, Hôpital Privé Saint Martin Caen, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut Arnaud Tzanck, Centre Hospitalier Universitaire [Grenoble] (CHU), 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), Service de Cardiologie (CHU Trousseau, Tours), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre de Biologie pour la Gestion des Populations (UMR CBGP), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Université de Montpellier (UM)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Polyclinic du Bois, Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Infirmerie Protestante Lyon Caluire, parent, Clinique de la Sauvegarde [Lyon], Parly II Private Hospital, Le Chesnay, Hôpital privé Bois-Bernard, Service de Cardiologie [Amiens], CHU Amiens-Picardie, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Hôpital Dupuytren [CHU Limoges], Hôpital universitaire Robert Debré [Reims], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Hôpital Nord (Saint Etienne), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre cardiologique du Nord (CCN), Clinique Sainte Clotilde, Hôpital Ambroise Paré [AP-HP], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), 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), Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval [Québec] (ULaval), 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 Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Unité de Taphonomie médico-légale et Anatomie - ULR 7367 (UTML&A), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hémostase et pathologie cardiovasculaire, EA2693-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, chirurgie thoracique et cardio-vasculaire, Service de chirurgie cardiaque, Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Microbiology Institute of CHUV, Service de Cardiologie de l'hopital de la Croix Rousse, Department of Hemodynamics and Interventional Cardiology, Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de chirurgie cardiaque et transplantation, Hôpital Louis Pradel [CHU - HCL], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-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)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Cardiologie Interventionnelle / Coro-scanner / IRM Cardiaque, Clinique Saint Gatien, Hôpital nord, St Etienne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie cardio-vasculaire, Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], École de chirurgie, faculté de médecine de Nancy, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), European Synchrotron Radiation Facility (ESRF), Service de Cardiologie (BREST - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'urologie, Clinique Cardiologie et Hypertension Artérielle, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Clinique de chirurgie cardiaque, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Cardiologie, Brest, Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Développement artériel, Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie‑Obstétrique, Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique (SEILIRM), Normandie Université (NU)-Normandie Université (NU), Service de cardiologie et maladies vasculaires [CHU de Rennes], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Gabriel Montpied (CHU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pathologie cardiaque, Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Dijon, Rayonnement Synchrotron et Recherche Medicale (RSRM), Université Joseph Fourier - Grenoble 1 (UJF)-European Synchrotron Radiation Facility (ESRF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5)-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), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Epidémiologie et Biostatistique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Centre Hospitalier Universitaire de Clermont-Ferrand, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de Chirurgie Thoracique et Cardiovasculaire [CHU Pitié-Salpêtrière], Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Hôpital Arnaud de Villeneuve-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hôpital Paule de Viguier, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre chirurgical Marie Lannelongue, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université de Montpellier (UM)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Traitement du Signal et de l'Image ( LTSI ), 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 ), Service de cardiologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Clinique St Hilaire ( Service de Cardiologie, Rouen ), CHU Gabriel Montpied ( CHU ), Assistance publique - Hôpitaux de Paris - AP-HP (FRANCE), CHU Angers, Hospices Civils de Lyon ( HCL ), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique Henri Mondor ( CIC Henri Mondor ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Institut Mutualiste de Montsouris ( IMM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Rayonnement Synchrotron et Recherche Medicale ( RSRM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -ESRF-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Nutrition, obésité et risque thrombotique ( NORT ), Aix Marseille Université ( AMU ) -Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Universitaire de Cardiologie et de Pneumologie de Québec ( IUCPQ ), Université Laval, 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 ), Unité de Taphonomie médico-légale ( UTML ), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), EA2693-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Hôpital Louis Pradel [CHU - HCL], Cardiovasculaire, métabolisme, diabétologie et nutrition ( CarMeN ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hospices Civils de Lyon ( HCL ) -Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National de la Recherche Agronomique ( INRA ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Imagerie Adaptative Diagnostique et Interventionnelle ( IADI ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), European Synchrotron Radiation Facility ( ESRF ), Service de Cardiologie ( BREST - Cardio ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Michallon, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Université Grenoble Alpes - UFR Médecine ( UGA UFRM ), Université Grenoble Alpes ( UGA ), Hôpital de la Cavale Blanche - CHRU Brest ( CHU - BREST ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique ( SEILIRM ), Université de Caen Normandie ( UNICAEN ), Départment de cardiologie [Caen], Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Caen, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Gynécologie [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), 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) (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 de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Unité de Taphonomie médico-légale (UTML), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, and Université Grenoble Alpes (UGA)

Subjects
[ SDV ] Life Sciences [q-bio], [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV]Life Sciences [q-bio], transfemoral, national registry, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, outcomes, pacemaker
Abstract

International audience; Background - Transcatheter aortic valve replacement (TAVR) is standard therapy for patients with severe aortic stenosis who are at high surgical risk. However, national data regarding procedural characteristics and clinical outcomes over time are limited. Objectives - The aim of this study was to assess nationwide performance trends and clinical outcomes of TAVR during a 6-year period. Methods - TAVRs performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) registry. Findings were further compared with those reported from the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry, which captured all TAVRs performed from January 2010 to January 2012 across 34 centers. Results - A total of 12,804 patients from FRANCE TAVI and 4,165 patients from FRANCE 2 were included in this analysis. The median age of patients was 84.6 years, and 49.7% were men. FRANCE TAVI participants were older but at lower surgical risk (median logistic European System for Cardiac Operative Risk Evaluation [EuroSCORE]: 15.0% vs. 18.4%; p < 0.001). More than 80% of patients in FRANCE TAVI underwent transfemoral TAVR. Transesophageal echocardiography guidance decreased from 60.7% to 32.3% of cases, whereas more recent procedures were increasingly performed in hybrid operating rooms (15.8% vs. 35.7%). Rates of Valve Academic Research Consortium-defined device success increased from 95.3% in FRANCE 2 to 96.8% in FRANCE TAVI (p < 0.001). In-hospital and 30-day mortality rates were 4.4% and 5.4%, respectively, in FRANCE TAVI compared with 8.2% and 10.1%, respectively, in FRANCE 2 (p

Published
2017
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17. Late Outcomes of Transcatheter Aortic Valve Replacement in High-Risk Patients: The FRANCE-2 Registry

Author

Gilard, Martine, Eltchaninoff, Hélène, Donzeau Gouge, Patrick, Chevreul, Karine, Fajadet, Jean, Leprince, Pascal, Leguerrier, Alain, Lievre, Michel, Prat, Alain, Teiger, Emmanuel, Lefevre, Thierry, Tchetche, Didier, Didier, Didier, Himbert, Dominique, Albat, Bernard, Cribier, Alain, Sudre, Arnaud, Blanchard, Didier, Rioufol, Gilles, Collet, Frederic, Houel, Remi, Dos Santos, Pierre, Meneveau, Nicolas, Ghostine, Said, Manigold, Thibaut, Guyon, Philippe, Grisoli, Dominique, Le Breton, Herve, Delpine, Stephane, Favereau, Xavier, Souteyrand, Geraud, Ohlmann, Patrick, Doisy, Vincent, Grollier, Gilles, Gommeaux, Antoine, Claudel, Claude, Bourlon, Francois, Bertrand, Bernard, Laskar, Marc, Iung, Bernard, Bertrand, Michel, Cassagne, Jean, Boschat, Jacques, Lusson, Jean, Mathieu, Pierre, Logeais, Yves, Bessou, Jean-Paul, Chevalier, Bernard, Farge, Arnaud, Garot, Philippe, Hovasse, Thomas, Morice, Claude, Romano, Mauro, Vahdat, Olivier, Farah, Bruno, Carrie, Didier, Dumonteil, Nicolas, Fournial, Gérard, Bertrand, Marc, Nataf, Patrick, Vahanian, Alec, Leclercq, Florence, Piot, Christophe, Schmutz, Laurent, Aubas, Pierre, du Cailar, A., Dubar, A., Durrleman, N., Fargosz, F., Levy, Gilles, Maupas, Eric, Rivalland, François, Robert, G., Tron, Christophe, Juthier, Francis, Modine, Thomas, Van Belle, Eric, Banfi, Carlo, Sallerin, Thierry, Bar, Olivier, Barbey, Christophe, Chassaing, Stephan, Chatel, Didier, Le Page, Olivier, Tauran, Arnaud, Cao, Daniele, Dauphin, Raphael, Durand de Gevigney, Guy, Finet, Gérard, Jegaden, Olivier, Obadia, François, Beygui, Farzin, Collet, Jean-Philippe, Pavie, Alain, Vaillant, Alain, Vicat, Jacques, Wittenberg, Olivier, Joly, Patrick, Rosario, Roger, Bergeron, Patrice, Bille, Jacques, Gelisse, Richard, Couetil, Jean-Paul, Dubois Rande, Jean-Luc, Hayat, Delphine, Fougeres, Emilie, Monin, Jean-Luc, Mouillet, Gauthier, Arsac, Florence, Choukroun, Emmanuel, Dijos, Marina, Guibaud, Jean-Philippe, Leroux, Lionel, Elia, Nicolas, Chocron, Sidney, Schiele, François, Caussin, Christophe, Azmoun, Alexandre, Nottin, Rémi, Tirouvanziam, Ashok, Crochet, Dominique, Gaudin, Régis, Roussel, Jean-Christian, Bonnet, Nicolas, Digne, Franck, Mesnidrey, Patrick, Royer, Thierry, Stratiev, Victor, Bonnet, Jean-Louis, Cuisset, Thomas, Abouliatim, Issal, Bedossa, Marc, Boulmier, Dominique, Verhoye, Philippe, Delepine, Stéphane, Debrux, Jean-Louis, Furber, Alain, Pinaud, Frédéric, Bezon, Eric, Choplain, Jean-Noel, Bical, Oliver, Dambrin, Grégoire, Deleuze, Philippe, Jegou, Arnaud, Lusson, Jean-René, Azarnouch, Kasra, Durel, Nicolas, Innorta, Andrea, Lienhart, Yves, Roriz, Ricardo, Staat, Patrick, Fabiani, Jean-Noël, Lafont, Antoine, Zegdi, Rachid, Heudes, Didier, Kindo, Michel, Mazzucotelli, Jean-Philippe, Zupan, Michel, Ivascau, Calin, Lognone, Thérèse, Massetti, Massimo, Sabatier, Rémy, Huret, Bruno, Hochart, Philippe, Bouchayer, Damien, Gabrielle, François, Pelissier, Franck, Tremeau, Guillaume, Dreyfus, Gilles, Eker, Armand, Habib, Yakoub, Hugues, Nicolas, Mialhe, Claude, Chavanon, Olivier, Porcu, Paolo, Vanzetto, Gérald, Donzeau-Gouge, Patrick, Didier, Romain, Gommeaux, Bernard, Claudel, Jean-Philippe, Nutrition, obésité et risque thrombotique ( NORT ), Institut National de la Recherche Agronomique ( INRA ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Nutrition, obésité et risque thrombotique (NORT), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, predictive analysis, aortic stenosis, risk score, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract

International audience; Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up.; This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry.; The FRANCE-2 registry prospectively included all TAVRs performed in France. Follow-up was scheduled at 30 days, at 6 months, and annually from 1 to 5 years. Standardized VARC (Valve Academic Research Consortium) outcome definitions were used.; A total of 4,201 patients were enrolled between January 2010 and January 2012 in 34 centers. Approaches were transarterial (transfemoral 73%, transapical 18%, subclavian 6%, and transaortic or transcarotid 3%) or, in 18% of patients, transapical. Median follow-up was 3.8 years. Vital status was available for 97.2% of patients at 3 years. The 3-year all-cause mortality was 42.0% and cardiovascular mortality was 17.5%. In a multivariate model, predictors of 3-year all-cause mortality were male sex (p < 0.001), low body mass index, (p < 0.001), atrial fibrillation (p < 0.001), dialysis (p < 0.001), New York Heart Association functional class III or IV (p < 0.001), higher logistic EuroSCORE (p

Published
2016

20. Exclusive percutaneous peripheral veno-arterial ECMO with distal reperfusion of homolateral limb

Author

Brenot Philippe, Kloeckner Martin, Fradi Mohamed, Deleuze Philippe, Ghostine Saïd, Azmoun Alexandre, Mazzoni Lucia, Ramadan Ramzi, and Nottin Rémi

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Percutaneous, Surgical approach, Superficial femoral artery, business.industry, General Medicine, Surgery, Peripheral, Cardiac surgery, surgical procedures, operative, Acute myocarditis, Cardiothoracic surgery, Meeting Abstract, medicine, business, Cardiology and Cardiovascular Medicine
Abstract

ECMO is widely used through the world, but is still surrounded by important complications, most of them at the site of the surgical approach.

Published
2015

23. 146 Adverse impact of pre-therapeutic gradient on outcome in patients with trans-aortic valve implantation: a monocentric experience

Author

Amabile, Nicolas, primary, Ramadan, Ramzi, additional, Ghostine, Said, additional, Azmoun, Alexandre, additional, Raoux, François, additional, To, Ngoc-Tram, additional, Haddouche, Yacine, additional, Cassat, Claude, additional, Dupouy, Patrick, additional, Elhadad, Simon, additional, Nottin, Remi, additional, and Caussin, Christophe, additional

Published
2011
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24. Reply

Author

Azmoun, Alexandre, primary, Ramadan, Ramzi, additional, Al-Attar, Nawwar, additional, and Nottin, Remi, additional

Published
2009
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26. Transcatheter aortic valve implantation through carotid artery access under local anaesthesia†.

Author

Azmoun, Alexandre, Amabile, Nicolas, Ramadan, Ramzi, Ghostine, Saïd, Caussin, Christophe, Fradi, Sahbi, Raoux, François, Brenot, Philippe, Nottin, Remi, and Deleuze, Philippe

Subjects
*CAROTID artery, *LOCAL anesthesia, *COMPUTED tomography, *THORACIC surgeons, *SURGICAL arteriovenous shunts, AORTIC valve surgery
Abstract

OBJECTIVES Trans-femoral and transapical are the most commonly used accesses for transcatheter aortic valve implantation (TAVI). However, when these approaches are unsuitable, alternative accesses are needed. We report a series of 19 patients undergoing TAVI through common carotid artery (CCA) access under local anaesthesia in order to assess its feasibility and safety. METHODS From November 2008 to September 2013, 361 patients underwent TAVI at our institution. Nineteen of them (14 men) with mean age 82.2 ± 6.2 years, EuroSCORE 25.2 ± 15.7, Society of Thoracic Surgeons score 11.9 ± 5.1 and with severe peripheral arteriopathy were unsuitable for usual approaches and underwent TAVI through CCA access under local anaesthesia. Preoperative computed tomography assessed suitable carotid artery anatomy. Common carotid cross-clamping test allowed verifying patient's neurological status stability. An 18-Fr or 20-Fr sheath inserted into the CCA down into the ascending aorta was used for the delivery catheter. Valve implantation procedures were as usual. After sheath removal, the CCA was surgically purged and repaired. Feasibility and safety end points (VARC-2) were collected up to 30 days. RESULTS Transcarotid insertion of the delivery sheath was successful in all cases (8 right, 11 left) and accurate deployment of the device was achieved in 18 patients (4 Edwards SAPIEN XT® and 14 Medtronic CoreValve®). There was 1 intraoperative death by annulus rupture during preimplant balloon valvuloplasty, and 1 in-hospital death due to multisystem organ failure. There was no myocardial infarction, stroke or major bleeding. Third-degree atrioventricular block requiring pacemaker implantation occurred in 3 patients. No vascular access-site, access-related or other TAVI-related complication occurred. Echocardiography revealed good prosthesis functioning with none, mild and moderate paravalvular leak in, respectively, 8, 9 and 1 patients. Patient ambulation was immediate after TAVI and hospital stay was 4.6 ± 2.3 days. CONCLUSIONS TAVI through the CCA approach under local anaesthesia is feasible and safe. It allows continuous clinical neurological status monitoring with low risk of stroke, bleeding events, vascular access-site and access-related complications and immediate patient ambulation. It appears to be a valuable alternative access for patients who cannot undergo trans-femoral TAVI. [ABSTRACT FROM AUTHOR]

Published
2014
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27. Cost-effectiveness of left ventricular assist devices for patients with end-stage heart failure: analysis of the French hospital discharge database.

Author

Tadmouri A, Blomkvist J, Landais C, Seymour J, and Azmoun A

Subjects
Adult, Aged, Cost-Benefit Analysis, Female, Follow-Up Studies, France epidemiology, Heart Failure economics, Heart Failure epidemiology, Humans, Male, Markov Chains, Middle Aged, Prevalence, Quality of Life, Retrospective Studies, Young Adult, Heart Failure surgery, Heart-Assist Devices economics, Patient Discharge statistics & numerical data
Abstract

Aims: Although left ventricular assist devices (LVADs) are currently approved for coverage and reimbursement in France, no French cost-effectiveness (CE) data are available to support this decision. This study aimed at estimating the CE of LVAD compared with medical management in the French health system., Methods and Results: Individual patient data from the 'French hospital discharge database' (Medicalization of information systems program) were analysed using Kaplan-Meier method. Outcomes were time to death, time to heart transplantation (HTx), and time to death after HTx. A micro-costing method was used to calculate the monthly costs extracted from the Program for the Medicalization of Information Systems. A multistate Markov monthly cycle model was developed to assess CE. The analysis over a lifetime horizon was performed from the perspective of the French healthcare payer; discount rates were 4%. Probabilistic and deterministic sensitivity analyses were performed. Outcomes were quality-adjusted life years (QALYs) and incremental CE ratio (ICER). Mean QALY for an LVAD patient was 1.5 at a lifetime cost of €190 739, delivering a probabilistic ICER of €125 580/QALY [95% confidence interval: 105 587 to 150 314]. The sensitivity analysis showed that the ICER was mainly sensitive to two factors: (i) the high acquisition cost of the device and (ii) the device performance in terms of patient survival., Conclusions: Our economic evaluation showed that the use of LVAD in patients with end-stage heart failure yields greater benefit in terms of survival than medical management at an extra lifetime cost exceeding the €100 000/QALY. Technological advances and device costs reduction shall hence lead to an improvement in overall CE., (© 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Published
2018
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28. Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations.

Author

Magkoutis NA, Fradi S, Azmoun A, Ramadan R, Ben Ouanes S, Vavuranakis M, Vrachatis DA, Papaioannou TG, Tousoulis D, and Ghostine S

Subjects
Administration, Oral, Anticoagulants administration & dosage, Anticoagulants therapeutic use, Aspirin therapeutic use, Clopidogrel, Drug Therapy, Combination, Humans, Ticlopidine analogs & derivatives, Ticlopidine therapeutic use, Aortic Valve Stenosis surgery, Platelet Aggregation Inhibitors therapeutic use, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement methods
Abstract

Transcatheter aortic valve implantation (TAVI) is all the more used therapeutic option for patients suffering from symptomatic severe aortic valvular stenosis declined by surgeons because of high surgical risk. Given the high bleeding and ischemic risk of this vulnerable population, their antithrombotic treatment becomes a crucial issue. There is no consensus on antithrombotic treatment after TAVI and dual antiplatelet therapy (DAPT) with aspirin (indefinitely) and clopidogrel (1-6 months) is, in general, recommended. With regards to patients with an indication for oral anticoagulation (OAC), a combination of OAC plus aspirin or clopidogrel is commonly suggested. This review underscores that it is extremely difficult to compare different antithrombotic regimens in patients undergoing TAVI because of their variable demographic characteristics. Nevertheless, available data suggest that DAPT results to more bleeding events. Still, whether it positively affects ischemic episodes is doubtful. Ongoing trials are expected to draw a clearer picture on the field.

Published
2016
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