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2. Management of the False Lumen in Post Type A Aortic Dissection Arch Aneurysms Treated With Branched Endografts.

Author

Mougin, J., Schwein, A., Postiglione, T. J., Guihaire, J., Fabre, D., and Haulon, S.

Abstract

Introduction: The treatment of chronic postdissection aneurysms of the aortic arch is a challenge. This study aims to describe false lumen management after aortic arch endovascular repair of post-type A dissection aneurysms treated with a branched endograft. Methods: In this single-center retrospective observational study, all consecutive patients undergoing endovascular treatment of aneurysmal degeneration of chronic type A aortic dissections following open repair were enrolled. The primary endpoint was maximal aortic diameter evolution measured on computed tomography angiography (CTA) performed during follow-up. Secondary endpoints included procedural success, aortic re intervention, and remodeling during follow-up. Results: Between January 2017 and June 2020, 22 patients underwent endovascular branched arch repair for post type A dissection aneurysms. Technical success was 100%. Thirteen patients (59%) had dissection involvement of at least 1 supra-aortic vessel. Midterm follow-up CTA was performed for 20 patients, 23.1 (±13.3) months after the procedure. Maximal aortic diameter at the level of the repair was decreasing in 13 (65%) patients, increasing in 2 (10%) patients, and no change was observed in 5 (25%) patients. During follow-up, 7 patients (35%) required aortic reintervention. Thoracic candy plugs were implanted for distal false lumen occlusion in 15 patients and associated with a high rate of complete remodeling (6/15 patients, 40%). Conclusion: Arch branch endografting of aneurysmal evolution of a post type A dissection aortic arch is a safe and feasible option in experienced hands. Candy plug use in favorable anatomies seems to be associated with accelerated remodeling of the aorta. Clinical Impact: There are currently no recommendations on dissected supra- aortic vessels management and the use of thoracic aorta false lumen occlusion devices during endovascular repair of chronic post dissection aneurysm of the aortic arch with branched endografts. Based on our clinical experience reported in the current manuscript, we propose a treatment algorithm for the management of the false lumen in this setting. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Sex Differences in Immunology: More Severe Development of Experimental Pulmonary Hypertension in Male Rats Exposed to Vascular Endothelial Growth Factor Receptor Blockade

Author

Deuse, Tobias, Schrepfer, Sonja, Guihaire, J, Wang, D, Fadel, E, and Reichenspurner, H

Abstract

© 2015 Julien Guihaire et al.Background. The epidemiology of pulmonary hypertension (PH) is characterized by a female preponderance, whereas males share higher severity of the disease. Objective. To compare the severity of experimental PH between male and

Published
2015

18. Anévrismes de la crosse aortique

Author

Haulon, S., primary, Fabre, D., additional, Raux, M., additional, Gouëffic, Y., additional, Mougin, J., additional, Girault, A., additional, Boulate, D., additional, Mitilian, D., additional, and Guihaire, J., additional

Published
2021
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20. Analysis of microRNA expression in the thymus of Myasthenia Gravis patients opens new research avenues

Author

Cron, M, Maillard, S, Delisle, F, Samson, N, Truffault, F, Foti, M, Fadel, E, Guihaire, J, Berrih-Aknin, S, Le Panse, R, Cron MA, Maillard S, Delisle F, Samson N, Truffault F, Foti M, Fadel E, Guihaire J, Berrih-Aknin S, Le Panse R., Cron, M, Maillard, S, Delisle, F, Samson, N, Truffault, F, Foti, M, Fadel, E, Guihaire, J, Berrih-Aknin, S, Le Panse, R, Cron MA, Maillard S, Delisle F, Samson N, Truffault F, Foti M, Fadel E, Guihaire J, Berrih-Aknin S, and Le Panse R.

Abstract

In early-onset Myasthenia Gravis (MG) with anti-acetylcholine receptor antibodies, thymic abnormalities associated with ectopic germinal centers are frequent. miRNAs by acting as post-transcriptional regulators are involved in autoimmunity. To investigate the implication of miRNAs in thymic changes associated with early-onset MG, we performed a miRnome study and data were analyzed with different approaches. miRNAs of interest were further investigated by RT-PCR and transfection experiments for functional tests. First, analyzing specific dysregulated miRNAs, we focused our attention on miR-7-5p and miR-125a-5p, and confirmed by RT-PCR their respective down- and up-regulation in MG thymuses. miR-7 was the most down-regulated thymic miRNA in MG and we observed an inverse correlation between its expression and CCL21 mRNA expression. We next showed that miR-7 down-regulation was due to thymic epithelial cells and by transfecting these cells with miR-7, we demonstrated that it controlled CCL21 release. As CCL21 is essential for germinal center development, we suggested that miR-7 could be involved in thymic changes associated with MG. miR-125a was up-regulated in MG thymuses and is of great interest as it is known to regulate FoxP3 expression, and to modulate the different inflammatory signaling pathways. Thanks to this thymic miRnome study, we also showed the specific dysregulation of miRNA clusters. In particular, we observed that miRNAs localized at the extremity of the X chromosome were down-regulated. This effect seemed linked to their close localization to the fragile X mental retardation 1 gene (FMR1) and the DNA methylation status. Altogether, this miRnome analysis demonstrated that specific thymic miRNAs can be associated with MG and provides novel insights into the pathogenesis of MG.

Published
2018

28. Anévrismes de la crosse aortique

Author

Haulon, S., primary, Fabre, D., additional, Raux, M., additional, Goueffic, Y., additional, Mougin, J., additional, Girault, A., additional, Boulate, D., additional, Mitilian, D., additional, and Guihaire, J., additional

Published
2020
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35. Preoperative C-Reactive Protein Predicts Early Postoperative Outcomes after Pulmonary Endarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension

Author

Arthur, J., primary, Amsallem, M., additional, Guihaire, J., additional, Haddad, F., additional, Lamrani, L., additional, Feuillet, S., additional, Stephan, F., additional, Jais, X., additional, Humbert, M., additional, Simonneau, G., additional, Mercier, O., additional, and Fadel, E., additional

Published
2019
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43. Right Ventricular Remodeling in Chronic Thrombo-Embolic Pulmonary Hypertension

Author

Guimaron, S., primary, Guihaire, J., additional, Amsallem, M., additional, Athur-Ataam, J., additional, Amato-Gauberville, A., additional, Isorni, M., additional, Mabille, L., additional, Potier, A., additional, Arthur-Ataam, S., additional, Dorfmüller, P., additional, Lamrani, L., additional, Deleuze, P., additional, Mussot, S., additional, Fadel, E., additional, and Mercier, O., additional

Published
2018
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44. Impact of Donor Age on Outcomes After Heart Transplantation in the Modern Era

Author

Guihaire, J., Martin, A., Noly, P. E., Rojo, Mathias, Chabanne, C., Lelong, B., Rosier, S., Roisne, A., Verhoye, J. P., Flecher, E, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], 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], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio]
Abstract

WOS:000369753800008; International audience; Meeting Abstract

Published
2016

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