Annales de cardiologie et d'angeiologie最新文献

{"title":"Réducteur de sinus coronaire : aspects techniques, prévention et gestion des complications","authors":"Matthieu Périer ,&nbsp;Hachem-Ali Haidar ,&nbsp;David Sulman ,&nbsp;Florent Huang ,&nbsp;Hakim Benamer","doi":"10.1016/j.ancard.2024.101785","DOIUrl":"10.1016/j.ancard.2024.101785","url":null,"abstract":"<div><p>Coronary sinus reducer implantation is a percutaneous technique creating a narrowing in the coronary sinus through the implantation of an hourglass-shaped endoprosthesis. It is proposed to reduce symptoms in patients suffering from refractory angina pectoris. This innovative treatment is experiencing a major craze among interventional cardiologists. It is associated with very high procedural success rates. Complications are rare and include coronary sinus dissection or perforation and migration of the device.</p><p>This review exposes the device implantation technique, the potential anatomical difficulties, the tips and tricks to overcome challenging situations. It also focuses on the prevention and management of potential complications.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101785"},"PeriodicalIF":0.3,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fermeture percutanée d'une fistule coronaro-pulmonaire : à propos d'un cas","authors":"Zakariae Laraichi ,&nbsp;Amani Farah ,&nbsp;Armand Aymard ,&nbsp;Hakim Benamer","doi":"10.1016/j.ancard.2024.101788","DOIUrl":"10.1016/j.ancard.2024.101788","url":null,"abstract":"<div><h3>Background</h3><p>A coronary artery fistula is an abnormal connection between one or more coronary arteries and a cardiac chamber or great vessel, often discovered incidentally through cardiac imaging. Although coronary artery fistulas are typically asymptomatic during the first two decades of life, particularly when small, they can become clinically significant over time.</p></div><div><h3>Case presentation</h3><p>We present the case of a 71-year-old female patient with a history of exertional dyspnea. Diagnostic coronary angiography revealed a significant coronary artery fistula originating from the proximal right coronary artery and draining into the pulmonary artery trunk. Given the patient's symptoms and the anatomical features of the fistula, she was successfully treated with transcutaneous closure using a liquid embolic agent (Onyx).</p></div><div><h3>Conclusion</h3><p>Although surgical intervention has historically been the primary treatment for CAF, minimally invasive techniques such as transcutaneous closure are proving to be effective alternatives.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101788"},"PeriodicalIF":0.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La fibrillation atriale à l'Hôpital Principal de Dakar au Sénégal : résultats et limites de la prise en charge","authors":"Mboup Waly Niang,&nbsp;Dia Khadidiatou,&nbsp;Ka Mame Madjiguène,&nbsp;Ndao Serigne Cheikh Tidiane,&nbsp;Yassine Rabab,&nbsp;Diop Marième,&nbsp;Mboup Mouhamed Cherif","doi":"10.1016/j.ancard.2024.101758","DOIUrl":"10.1016/j.ancard.2024.101758","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of the study was to determine the prevalence of AF in the cardiology department of the Hospital Principal of Dakar, then to evaluate the clinical, paraclinical, etiological and evolutionary profiles of AF and finally to identify the limits of its management in our context.</p></div><div><h3>Patients and methods</h3><p>This was a retrospective, descriptive, analytical, mono-centric study carried out at Hospital Principal of Dakar from January 2019 to August 2021. Were included, all patients admitted for atrial fibrillation, or patients who presented an atrial fibrillation during hospitalization, confirmed by electrocardiogram or long-term electrocardiographic recording during the study period.</p></div><div><h3>Results</h3><p>The prevalence of atrial fibrillation during the period of our study compared to the hospital population was 7.71%, with a sex ratio of 1.03. The mean age was 67.88 ± 14.09 years. We noted that 83.64% of patients had at least one cardiovascular risk factor, with 56.36% suffering from hypertension, 50.91% of sedentary person and 23.64% of diabetics. Clinically, 92.72% of the patients were symptomatic, with dyspnea predominating (70.91%). Cardiac arrhythmia was present in 85.45% of patients, and congestive heart failure in 47.27%. Long-term electrocardiographic recording was performed in 10 patients, showing 50% of paroxysmal atrial fibrillation. Sixty-three patients (57.27%) had permanent AF, twenty-three patients (20.91%) had persistent AF, fourteen patients (12.73%) had long-term persistent AF and ten patients (9.09%) had paroxysmal AF. Transthoracic echocardiography showed 57.27% of left atrial dilatation and 72.3% of reduced left ventricular ejection fraction. Etiologies for cardiac causes were dominated by dilated cardiomyopathy (21.82%), followed by ischemic heart disease (17.27%). In terms of treatment, the most commonly used molecule was bisoprolol (38.18%), followed by digoxin (21.81%). Anticoagulants were used in 85.46% of cases. Acenocoumarol alone was used in 69.09% of patients. Drug-induced cardioversion was attempted in 2 patients without success, and 4 patients benefited from external electric shock with 3 successes. Most patients had a favorable outcome, but 34.54% suffered hemodynamic complications (18.18%) and thromboembolic ones as well (16.36%). In-hospital mortality in our series was 20%. It was significantly related to heart failure, with a left ventricular ejection fraction &lt; 35% (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Atrial fibrillation is serious because of its hemodynamic, thromboembolic and rhythmic complications. The high mortality is explained by the underlying condition, but also by the delay in management with late diagnosis and, above all, the unavailability of ablation procedures in our context.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 6","pages":"Article 101758"},"PeriodicalIF":0.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un infarctus, mais pas du myocarde!","authors":"Pierre Robert,&nbsp;Benoit Lattuca","doi":"10.1016/j.ancard.2024.101795","DOIUrl":"10.1016/j.ancard.2024.101795","url":null,"abstract":"<div><p>Pulmonary embolism (PE) is a common and serious cardiovascular disease. The management of PE patients with myocardial damage but without hemodynamic instability (intermediate/high risk) has long remained limited to anticoagulant therapy with no demonstrated positive effect of thrombolysis. In this specific population, percutaneous techniques have been developed and appear as interesting alternative in patients with clinical, biological and morphological severity criteria to reduce the evolutive risk to a more severe form and improve patients’ prognosis. We report here the case of a 49-year-old patient treated for a massive bilateral and proximal PE revealed by syncope with right ventricular impact in whom percutaneous pulmonary thrombectomy was proposed in the absence of clinical improvement after the initiation of anticoagulant therapy. The precise indications for percutaneous techniques need to be clarified in patients with intermediate/high risk PE and ongoing randomized studies should provide additional results to better identify their place in the therapeutic arsenal.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101795"},"PeriodicalIF":0.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le gradient reste élevé après mon TAVI, que faire?","authors":"Emmanuel Gall ,&nbsp;Hakim Benamer ,&nbsp;Dominique Fourchy ,&nbsp;Mauro Romano ,&nbsp;Philippe Garot ,&nbsp;Mariama Akodad","doi":"10.1016/j.ancard.2024.101789","DOIUrl":"10.1016/j.ancard.2024.101789","url":null,"abstract":"<div><p>Over the past two decades, transcatheter aortic valve implantation (TAVI) has become a safe and effective therapeutic option for symptomatic and severe aortic stenosis, regardless of the surgical risk spectrum. With the expansion of TAVI indications to low-risk and younger patients, it is crucial to ensure satisfactory and durable hemodynamic outcomes to guarantee transcatheter heart valve (THV) longevity. However, secondary THV dysfunction may occur, often manifested by an increased transvalvular gradient. According to VARC-3 criteria, these dysfunctions can be attributed to four main mechanisms: 1) structural valve deterioration; 2) non-structural valve dysfunction; 3) thrombosis; 4) and endocarditis. Each mechanism leads to specific abnormalities, requiring a systematic diagnostic approach and appropriate treatment. This article illustrates, through two clinical cases, the diagnosis and management of secondary transvalvular gradient elevation after TAVI.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101789"},"PeriodicalIF":0.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthésie locale comparée à l'anesthésie locorégionale dans les procédures TAVI par voie transfémorale","authors":"Clément Jehl ,&nbsp;Stéphane Sanchez ,&nbsp;Laurent Chapoutot ,&nbsp;Sophie Tassan Mangina ,&nbsp;Virginie Heroguelle ,&nbsp;Aurelien Villecourt ,&nbsp;Damien Metz ,&nbsp;Laurent Faroux","doi":"10.1016/j.ancard.2024.101786","DOIUrl":"10.1016/j.ancard.2024.101786","url":null,"abstract":"<div><h3>Introduction</h3><p>Transcatheter aortic valve implantation (TAVI) has become the treatment of choice for the most fragile patients with severe aortic stenosis. The transfemoral route is preferred as the simplest and safest. The aim of our study was to compare the efficacy, tolerance and safety of local vs. locoregional anesthesia in trans-femoral TAVI procedures.</p></div><div><h3>Material and method</h3><p>This was a single-center retrospective study. Patients treated with femoral TAVI between February 25 and November 15, 2022 at the University Hospital of Reims were included, and two groups (local and locoregional anesthesia) were compared.</p></div><div><h3>Results</h3><p>TAVI success rate (92.9%), death rate (3.0%) and procedure duration (90.5 ± 13.5 minutes) did not differ between groups (<em>p</em> = 0.18, 0.15 and 0.55 respectively). For intra- and post-procedural treatments, the use of sedation, analgesics and benzodiazepines did not differ between groups. The cumulative dose of Remifentanil used per-procedure was lower in the local anesthesia group than in the locoregional anesthesia group (148.6 ± 71.9 mcg vs. 208.9 ± 110.0 mcg; <em>p</em> = 0.025).</p></div><div><h3>Conclusions</h3><p>In this non-randomized retrospective study, local and locoregional anesthesia had comparable safety and efficacy in transfemoral TAVI procedures. In a constrained context and with a view to simplification, these results encourage transfemoral TAVIs to be performed under local anaesthesia, and to consider a “PCI-like” approach, without the presence of an anaesthetist, for selected patients without respiratory, musculoskeletal or agitation disorders, or vascular approach difficulties.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101786"},"PeriodicalIF":0.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apport de l'imagerie endocoronaire dans la prise en charge d'une dissection iatrogène","authors":"Pascal Motreff ,&nbsp;Nicolas Combaret ,&nbsp;Thomas Mouyen ,&nbsp;Géraud Souteyrand","doi":"10.1016/j.ancard.2024.101794","DOIUrl":"10.1016/j.ancard.2024.101794","url":null,"abstract":"<div><p>Iatrogenic coronary dissections are rare but potentially serious. Their management is complex, particularly if the dissection occurs without an angioplasty guide in the arterial lumen. In this context, angiography alone is insufficient, and endocoronary imaging is essential (using optical coherence or IVUS) to guide angioplasty when necessary (guide in the true lumen, coverage of the tear). We report here the case of an iatrogenic dissection of the right coronary artery treated with OFDI guiding.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101794"},"PeriodicalIF":0.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment je gère cette fuite paravalvulaire inhabituelle","authors":"B. Gérardin,&nbsp;S. Hascoët,&nbsp;JN. Andarelli,&nbsp;C. Batteux,&nbsp;G. Albenque,&nbsp;M. Kloeckner,&nbsp;D. Blanchard,&nbsp;P. Brenot","doi":"10.1016/j.ancard.2024.101790","DOIUrl":"10.1016/j.ancard.2024.101790","url":null,"abstract":"<div><p>Percutaneous treatment of para-prosthetic valve leaks (PVL) is an alternative to redo surgery. Based on the clinical case of an unusual aortic para-prosthetic leak closure (PVLc), are presented successively the diagnostic difficulties of PVL, the modalities of therapeutic choice, the main technical steps of PVLc followed by a review of results and complications.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101790"},"PeriodicalIF":0.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évolution fatale d'une résection complète d'un sarcome cardiaque pléomorphe indifférencié : à propos d'un cas","authors":"Yassin El Mourabit ,&nbsp;Youssef Saadouni ,&nbsp;Mohammed Tribak ,&nbsp;Rhissassi Mohamed Jaafar ,&nbsp;Rochdi Sayah ,&nbsp;Mohamed Laaroussi","doi":"10.1016/j.ancard.2024.101769","DOIUrl":"10.1016/j.ancard.2024.101769","url":null,"abstract":"<div><h3>Introduction</h3><p>Undifferentiated pleomorphic sarcoma (UPS) is a very rare malignant primary cardiac tumor with a poor prognosis.</p></div><div><h3>Observation</h3><p>A 34-year-old woman complained of dyspnea evolving in a febrile context with altered general condition: Transthoracic echocardiography (TTE) revealed a left intra-atrial mass measuring 51/26 mm in diameter. A thoracic computed tomography (CT) revealed a mass occupying the left atrium measuring 42/28/34 mm, associated with two pulmonary metastases. The cardiac mass was resected and the postoperative suites were fatal. Histological diagnosis was UPS.</p></div><div><h3>Conclusion</h3><p>We present an atypical case of invasive UPS, which was surgically resected and scheduled for radio-chemotherapy with a fatal outcome.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 6","pages":"Article 101769"},"PeriodicalIF":0.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Je n'arrive pas à passer mon guide dans la branche fille ; cas clinique et revue de la littérature","authors":"Sara Jourani,&nbsp;Matthieu Perier,&nbsp;Hakim Benamer","doi":"10.1016/j.ancard.2024.101792","DOIUrl":"10.1016/j.ancard.2024.101792","url":null,"abstract":"<div><p>We present the case of a 53-year-old patient with history of hypertension and dyslipidemia, admitted for effort-induced angina. Coronary angiography revealed two-vessel disease with severe stenosis of the LAD- Diagonal bifurcation (MEDINA 1-1-1). This lesion was considered complex regarding the severe stenosis of the bifurcation core, the angulation &lt;45°, and the severity and length of the diagonal lesion. The procedure was planned according to a TAP technique. The flow in the diagonal was however lost after stenting the main vessel causing an ST elevation with chest pain. It was subsequently recovered using the rescue jailed balloon technique before re-crossing the stent struts of the LAD using a Gaia First® (Asahi) guidewire. The aim of this case report is to illustrate some pitfalls that can be encountered in bifurcation percutaneous interventions and to present technical solutions to solve difficult side branch access issues through a literature review.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 4","pages":"Article 101792"},"PeriodicalIF":0.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}