C.-M. Pilard , G. Cardouat , I. Gauthereau , P. Robillard , F. Sauvestre , F. Pelluard , S. Berenguer , L. Sentilhes , F. Coatleven , L. Renesme , E. Dumas-De-La-Roque , R. Marthan , P. Berger , V. Freund-Michel , C. Guibert
{"title":"Celastrol: A new potential therapeutic option in pulmonary hypertension associated with bronchopulmonary dysplasia","authors":"C.-M. Pilard , G. Cardouat , I. Gauthereau , P. Robillard , F. Sauvestre , F. Pelluard , S. Berenguer , L. Sentilhes , F. Coatleven , L. Renesme , E. Dumas-De-La-Roque , R. Marthan , P. Berger , V. Freund-Michel , C. Guibert","doi":"10.1016/j.acvdsp.2023.07.040","DOIUrl":"10.1016/j.acvdsp.2023.07.040","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Bronchopulmonary dysplasia is a common pathology of premature newborns caused by oxygen and </span>mechanical ventilation<span>, resulting in hypoalveolarization and impaired angiogenesis<span>. It can be complicated by pulmonary hypertension (PH-BPD) with excess mortality. Celastrol has anti-inflammatory and antioxidant properties.</span></span></p></div><div><h3>Objective</h3><p>We addressed potential therapeutic interest of celastrol in PH-BPD.</p></div><div><h3>Methods</h3><p>Different concentrations of celastrol (0,1–0,5–1<!--> <!-->mg/kg/d) were tested in a murine model of hyperoxic PH-BPD (14 days with 90% O<sub>2</sub><span>–Hx). We evaluated hemodynamic<span> parameters with echocardiography, lung remodeling with histological methods and pulmonary arterial (PA) reactivity with myograph. Cytoplasmic calcium (Ca</span></span><sub>2</sub><span><span>+i) response to endothelin-1 (ET-1) was evaluated in human fetal PA smooth muscle cells (fPASMC) with </span>spectrophotometry in normoxic (21% O</span><sub>2</sub>) and Hx conditions (48<!--> <!-->h with 60% O<sub>2</sub><span>). Inflammation and oxidant stress were also addressed.</span></p></div><div><h3>Results/Expected results</h3><p>Celastrol reduces mortality at doses of 1 and 0,5<!--> <!-->mg/kg/d compared to Hx control. At 1<!--> <span><span><span>mg/kg/d, it normalizes PA acceleration time and reduces vascular hyperreactivity to ET-1 inversely to phenylephrine and 5-HT, with no effect on the altered response to </span>acetylcholine induced by Hx. At all doses, it decreases right </span>heart hypertrophy<span><span> and vascular remodeling<span> but has no effect on media cells proliferation observed in Hx condition. It has also no impact on </span></span>alveolarization and vascular density. Although celastrol (0.1 and 0.3</span></span> <!-->μM) decreases the increased Ca<sub>2</sub><span>+i response to ET-1 in Hx in fPASMC, expression of ET-1 receptors was unchanged. In fPASMC, celastrol 0.3</span> <span>μM decreases the increased concentration of IL6 observed in Hx but has no effect on IL8 and MIF. In both models, Hx-induced oxidant stress remains mild with absence of protein carbonylation<span> and lipid peroxidation and celastrol at 1</span></span> <span>mg/kg/d increases heme oxygenase 1 expression.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>Celastrol has a preventive dose-dependent effect on major hallmarks of PH induced by Hx and could be considered as a new potential therapeutic option for PH-BPD.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44898428","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}
C. Vasile , X. Bouteiller , M. Avesani , C. Velly , C. Chan , J.B. Thambo , X. Iriart
{"title":"Exploring the potential of artificial intelligence in pediatric echocardiography. Preliminary results from the first pediatric study using AI software developed for adults","authors":"C. Vasile , X. Bouteiller , M. Avesani , C. Velly , C. Chan , J.B. Thambo , X. Iriart","doi":"10.1016/j.acvdsp.2023.07.038","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.07.038","url":null,"abstract":"<div><h3>Introduction</h3><p>Transthoracic echocardiography<span> is the first-line non-invasive investigation for assessing pediatric patients. Sometimes performing echocardiography in pediatric patients can be challenging for physicians and sonographers due to factors such as patient cooperation and time constraints.</span></p></div><div><h3>Objective</h3><p>Our primary purpose was to establish whether the Ligence Heart software validated for analyzing adult echocardiography could be transposed to pediatric patients.</p></div><div><h3>Methods</h3><p>The study was conducted at the University Hospital of Bordeaux between August and September 2022 and included 45 patients with normal or near-normal heart architecture who underwent a 2D TTE. The ultrasound scans were performed manually by two medical practitioners, a senior, a junior and the AI software provided by Ligence Heart Company. Twenty-three features were assessed through echocardiography for each patient. We compared the agreement between methods and observers.</p></div><div><h3>Results/Expected results</h3><p>The mean age of our patients at the time of evaluation was 8.2 years<!--> <!-->±<!--> <span>5.7, and the main reason for referral to our service was the presence of a heart murmur. Bland-Altman analysis showed good agreement between AI and the senior physician for two parameters (aortic annulus and E wave) regardless of the age of the children included in the study. A good agreement between AI and physicians was also achieved for two other features (STJ and EF) but only for patients older than 9 years. For other features, a good agreement was found between physicians but not with the AI, or a poor agreement was established. In the first case, maybe proper training of the AI could improve the measurement, but in the latter case, for now, it seems unrealistic to expect to reach a satisfactory accuracy.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>Based on this preliminary study on a small cohort group of pediatric patients, the AI soft originally developed for the adult population had provided promising results in evaluating aortic annulus, STJ, and E wave.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49737579","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}
Le Comité d’Organisation local, Caroline Ovaert, Virginie Fouilloux, Au nom de toute l’équipe médico-chirurgicale marseillaise
{"title":"Éditorial","authors":"Le Comité d’Organisation local, Caroline Ovaert, Virginie Fouilloux, Au nom de toute l’équipe médico-chirurgicale marseillaise","doi":"10.1016/j.acvdsp.2023.08.001","DOIUrl":"10.1016/j.acvdsp.2023.08.001","url":null,"abstract":"","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45778000","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":"Congenital disconnection of the pulmonary arteries","authors":"J. Karila Cohen, D. Bonnet","doi":"10.1016/j.acvdsp.2023.07.011","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.07.011","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Disconnected pulmonary artery is a rare anomaly that can be isolated or associated with complex intracardiac malformations. Early re-implantation of the disconnected pulmonary artery is recommended to allow growth and satisfactory pulmonary perfusion while preventing </span>collateral arteries development.</p></div><div><h3>Objective</h3><p>To describe the characteristics of patients with disconnected pulmonary artery and, for those who had surgical re-implantation, to determine the incidence, delay and predictive factors<span> of re-intervention for reconnected pulmonary artery stenosis.</span></p></div><div><h3>Methods</h3><p>We include patient with diagnosis of congenitally disconnected PA and surgical repair at our institution.</p></div><div><h3>Results/Expected results</h3><p>Retrospective observational study of 55 patients with a disconnected pulmonary artery. Fifty-one underwent surgical correction and were followed up at our institution between 2000 and 2022.</p><p><span>Disconnected pulmonary arteries were observed in isolation in 31% of the cases. The most frequent form was left pulmonary artery originating from the arterial duct (58%). The re-implantation was done at median age of 12 days. Anastomotic stenosis was observed during follow-up in 71% of the patients with 75% of them requiring re-intervention (55% of the population). The median delay to re-intervention was 3.2 years after re-implantation, and more than 25% of re-interventions on the re-implanted pulmonary artery occurred within the first postoperative year. We found more re-intervention if associated cardiac defect, without significant statistic difference. Weight at re-confluence, presence of ductal tissue at the origin of the pulmonary artery, and prior shunt placement on the disconnected pulmonary artery were not found to be risk factors for re-intervention (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>After surgical re-implantation of pulmonary artery, more than 50% of patients required re-intervention for pulmonary artery stenosis. Technical improvements should be sought to reduce incidence of this complication.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49737666","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":"Surfao-cardio study: Trans-abdominal fetal ECG analysis in the second trimester of pregnancy in a cohort of healthy fetuses","authors":"M. Lachaud , R. Souriau , B. Rivet , J. Fontecave","doi":"10.1016/j.acvdsp.2023.07.017","DOIUrl":"10.1016/j.acvdsp.2023.07.017","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Although feasible with ultrasound, analysis of the fetal heart rhythm sometimes remains a challenge in the absence of access to the </span>fetal electrocardiogram. In particular in case of suspected long QT, ultrasound does not allow the measurement of the ST segment.</p></div><div><h3>Objective</h3><p>Within the framework of the ANR SurFAO project, the Surfao-Cardio clinical study consisted in including 20 patients whose fetus did not present any cardiac morphological abnormality, between 22SA and 29SA. A trans-abdominal electrical recording was performed. The abdominal signals were formatted and processed to extract a fetal ECG. From the latter, measurements were made, automatically for RR intervals and manually for PR intervals.</p><p>These data were compared for each patient with ultrasound measurements in different modalities (M mode, Mitral-Aorta Profile, VCS-Aorta Doppler, Pulmonary Vein-Pulmonary Artery Doppler).</p></div><div><h3>Results/Expected results</h3><p>The fetal heart rate was analyzable in 12 of the 20 patients with a possible analysis of the QRS morphology for 12/12 patients and of the PR for 8/12 patients.</p><p>The correlations between the ultrasound data and the fetal ECG were respectively R<!--> <!-->=<!--> <!-->0.79 (<em>n</em> <!-->=<!--> <!-->12, <em>P</em> <!--><<!--> <!-->0.05) for heart rate and R<!--> <!-->=<!--> <!-->0.81 (<em>n</em> <!-->=<!--> <!-->8, <em>P</em> <!--><<!--> <!-->0.05) for PR intervals (<span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>This preliminary study showed the feasibility of trans abdominal fetal ECG with good reliability of PR measurement. Some material limitations related to the recording of the trans-abdominal ECG were identified, giving hope for an improvement in the percentage of possible measurements and access to ST-segment measurement.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45931529","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}
MD Grégoire Albenque , PhD, MD Francis Bessière , PhD, MD Gilles Soulat , MD Arshid Azarine , MD Mohamed Bakloul , MD Emre Belli , PhD, MD Damien Bonnet , PhD, MD Loic Boussel , MD Eric Bruguière , PhD, MD Sarah Cohen , MD Hubert Delasnerie , MD Sylvie Di Filippo , MD Arnaud Dulac , MD Kevin Gardey , MD Roland Henaine , MD Laurence Iserin , PhD, MD Clément Karsenty , PhD, MD Magalie Ladouceur , MD Antoine Legendre , MD Sophie Malekzadeh-Milani , PhD, MD Victor Waldmann
{"title":"Cardiac magnetic resonance parameters to predict ventricular arrhythmias inducibility before pulmonary valve replacement in patient with tetralogy of Fallot","authors":"MD Grégoire Albenque , PhD, MD Francis Bessière , PhD, MD Gilles Soulat , MD Arshid Azarine , MD Mohamed Bakloul , MD Emre Belli , PhD, MD Damien Bonnet , PhD, MD Loic Boussel , MD Eric Bruguière , PhD, MD Sarah Cohen , MD Hubert Delasnerie , MD Sylvie Di Filippo , MD Arnaud Dulac , MD Kevin Gardey , MD Roland Henaine , MD Laurence Iserin , PhD, MD Clément Karsenty , PhD, MD Magalie Ladouceur , MD Antoine Legendre , MD Sophie Malekzadeh-Milani , PhD, MD Victor Waldmann","doi":"10.1016/j.acvdsp.2023.07.006","DOIUrl":"10.1016/j.acvdsp.2023.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Ventricular arrhythmias and sudden death are recognized complications of </span>tetralogy of Fallot (TOF). Electrophysiological study (EPS) is increasingly performed prior to </span>pulmonary valve replacement (PVR) in these patients to evaluate and treat the arrhythmic substrate.</p></div><div><h3>Objective</h3><p><span>We aimed to assess the value of cardiac magnetic resonance (CMR) to refine pre-operative </span>risk stratification in this population.</p></div><div><h3>Methods</h3><p>A prospective multicenter study was conducted to systematically assess EPS in patients with TOF referred for PVR from January 2020 to December 2021. Multiple CMR parameters were analyzed and correlated with EPS results.</p></div><div><h3>Results/Expected results</h3><p>Among a total of 120 patients enrolled, 108 (90.0%) patients who had a CMR prior to EPS were analyzed. A VA was inducible in 24 (22.2%) patients. Clinical characteristics of patients associated with EPS results are presented in Table 1. Concerning CMR variables, mean RV end-diastolic volume index was 157<!--> <!-->±<!--> <!-->39<!--> <!-->ml and was not statistically different in patients with positive vs. negative EPS (164<!--> <!-->±<!--> <!-->49 vs. 155<!--> <!-->±<!--> <!-->35, <em>P</em> <!-->=<!--> <!-->0.395). However, a RV/LV end-diastolic volume index ratio<!--> <!-->><!--> <!-->2.4 was significantly associated with a higher likelihood of inducibility (OR 3.10, 95%CI 1.14–8.74, <em>P</em> <!-->=<!--> <!-->0.040). Mean RV end-systolic volume index tended to be upper in patient with positive EPS (101<!--> <!-->±<!--> <!-->35 vs. 86<!--> <!-->±<!--> <!-->26, <em>P</em> <!-->=<!--> <span>0.072). The RV ejection fraction measured on CMR also tended to be slightly lower in patients with positive EPS (40</span> <!-->±<!--> <!-->7 vs. 43<!--> <!-->±<!--> <!-->9, <em>P</em> <!-->=<!--> <!-->0.069) unlike the LV ejection fraction (<em>P</em> <!-->=<!--> <!-->0.600). Mean pulmonary annulus diameter were also significantly associated with positive EPS (31<!--> <!-->±<!--> <!-->8 vs. 26<!--> <!-->±<!--> <!-->7<!--> <!-->mm, OR 1.10 [1.02–1.18] per 1<!--> <!-->mm increment, <em>P</em> <!-->=<!--> <!-->0.012). A pulmonary annulus diameter<!--> <!-->><!--> <!-->28<!--> <!-->mm was associated with an OR of 2.9 [1.10–8.11] (<em>P</em> <!-->=<!--> <!-->0.047). In multivariable analysis, RV/LV end-diastolic volume index ratio<!--> <!-->><!--> <!-->2.4 (OR 4.6 [1.2–22.5], <em>P</em> <!-->=<!--> <span>0.036) and history of atrial arrhythmia (OR 10.9 [2.6–60.8], </span><em>P</em> <!-->=<!--> <!-->0.002) remained independent predictors of VA inducibility (<span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>In patients with TOF prior to PVR, RV/LV end-diastolic volume index ratio and pulmonary annulus diameter are associated with ventricular arrhythmia inducibility during EPS. CMR parameters, in combination with other clinical factors, may be us","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48976913","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}
A. Boutaled , M. Tabat , Y. Mekouar , G. Bennani , A. Drighil , G. Lembarki
{"title":"Adult interrupted aortic arch revealed by resistant arterial hypertension","authors":"A. Boutaled , M. Tabat , Y. Mekouar , G. Bennani , A. Drighil , G. Lembarki","doi":"10.1016/j.acvdsp.2023.07.048","DOIUrl":"10.1016/j.acvdsp.2023.07.048","url":null,"abstract":"<div><h3>Introduction</h3><p>Interrupted aortic arch<span><span> (IAA) is a rare congenital heart condition where there is a complete discontinuation between the ascending and descending aorta. The association with a patent ductus arteriosus<span> or developed arterial collateral allows survival until adulthood in extremely rare cases. Transthoracic echocardiography is helpful for the diagnosis, but the exact interruption site and collateral vessels are more accurately highlighted by computed tomography </span></span>angiography (CTA) and magnetic resonance imaging (MRI).</span></p></div><div><h3>Results/Expected results</h3><p><span>A 50 year-old-patient with a history of hypertension was admitted for severe high blood pressure. The main functional symptom that prompted his consultation was a grade II NYHA dyspnea evolving for few weeks. Physical examination found a blood pressure of 190/110</span> <!-->mmHg at the right arm, 120/70<!--> <!-->mmHg at the left arm, and 110/70<!--> <span>mmHg at lower limbs. Cardiac and pulmonary auscultation were normal. The electrocardiogram showed left ventricular hypertrophy<span><span>. Transthoracic echocardiography<span> revealed severe left ventricular hypertrophy with good left ventricular function and dilatation of the </span></span>ascending aorta measured at 47</span></span> <span><span>mm. The suprasternal notch view suggested a type B IAA. CTA confirmed the diagnosis, exhibiting an IAA located between the left carotid and left subclavian artery with an arterial collateral network emerging from descending branch of the </span>transverse cervical artery (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>Adult forms of IAA are a rare and complex manifestation of a congenital heart condition. They present significant challenges due to the severity of symptoms and high operative risk involved in treatment<span>. An accurate and timely diagnosis is essential and can be achieved through a combination of echocardiography and advanced imaging techniques such as CTA or MRI angiography. A multidisciplinary approach involving a team of specialists is crucial for optimizing the management of these patients.</span></p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47715164","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}
P. Padovani , V. Fouilloux , J.B. Thambo , M. Ly , P. Aldebert , O. Baron , F. Roubertie , N. Benbrik , C. Ovaert , Z. Jalal , A.E. Baruteau
{"title":"Risk of infective endocarditis after hybrid Melody mitral valve replacement in infants: The French experience","authors":"P. Padovani , V. Fouilloux , J.B. Thambo , M. Ly , P. Aldebert , O. Baron , F. Roubertie , N. Benbrik , C. Ovaert , Z. Jalal , A.E. Baruteau","doi":"10.1016/j.acvdsp.2023.07.021","DOIUrl":"10.1016/j.acvdsp.2023.07.021","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical management of mitral valve (MV) disease is challenging in infants. We aimed at reporting the French experience with Melody mitral valve replacement (MVR).</p></div><div><h3>Methods</h3><p><span>A retrospective cohort study reporting the French experience with Melody </span>MV replacement (MVR).</p></div><div><h3>Results</h3><p><span>Seven symptomatic infants (complete atrioventricular septal defect [</span><em>n</em> <!-->=<!--> <!-->4, down syndrome: <em>n</em> <!-->=<!--> <!-->3], hammock MV [<em>n</em> <!-->=<!--> <!-->3]) underwent Melody MVR (age: 3 months [28 days–8 months], weight: 4.3<!--> <!-->kg [3.2–6.4<!--> <span>kg]) because of severe MV regurgitation (6) or mixed MV disease (1) and 14</span> <!-->mm (11–16<!--> <span>mm) MV annulus. In 2 patients whose MV was felt irreparable, Melody MVR was performed straightaway. The others underwent 2 (1–3) previous attempts of MV repair; 3 were on ECMO. Melody MVR led to competent valve and low gradient (3</span> <!-->mmHg, [1–4<!--> <!-->mmHg]). One patient died 3 days post-implant from ECMO-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, one underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical MVR at 2 years; another is currently planned for transcatheter Melody valve dilation.</p></div><div><h3>Conclusion</h3><p>Melody MVR may be considered in selected infants with small MV annulus as an alternative to mechanical MVR. Our experience highlights a high-risk of late IE that deserves further consideration.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46441178","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}
G. Butera , M. Remonato , M. Pilati , M. Jones , M. Carminati , S. Hascoet , L. Giugno , P. Betrian , A.E. Baruteau , E. Pascall , H. Lucron , G. Milani
{"title":"BeGraft aortic stents: A European multi-centre experience reporting acute safety and efficacy outcomes for the treatment of vessel stenosis in congenital heart diseases","authors":"G. Butera , M. Remonato , M. Pilati , M. Jones , M. Carminati , S. Hascoet , L. Giugno , P. Betrian , A.E. Baruteau , E. Pascall , H. Lucron , G. Milani","doi":"10.1016/j.acvdsp.2023.07.024","DOIUrl":"10.1016/j.acvdsp.2023.07.024","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Stent implantation for the treatment of vessel stenosis in </span>congenital heart diseases has become the preferred method of treatment. Availability of new covered stents may decrease complications and may have an important role in the management of patients with complex </span>anatomy.</p></div><div><h3>Objective</h3><p>The aim of this study was to evaluate the feasibility and safety of the pre-mounted cobalt-chromium stent-graft covered ePTFE Aortic BeGraft in a broad spectrum of congenital vascular lesions.</p></div><div><h3>Methods</h3><p>A retrospective study of 112 implanted Be Graft Aortic stents between 2016 and 2022 in six different European centers was performed.</p></div><div><h3>Results/Expected results</h3><p><span><span><span>One hundred four patients with mean age 13 years (range 1–70 years; 56.5 kg, range 11–115 kg) underwent BeGraft stent implantation. Seventy three patients had aortic coarctation, seven BeGraft stents were implanted </span>in patients<span><span> with Fontan circulation for either restoration of Fontan conduit<span> patency in three patients and fenestration closure in four). Fourteen BeGraft aortic stents were implanted in 12 patients with dysfunctional RVOT. Eleven patients with complex CHD had miscellaneous indications for stent implantation: </span></span>superior vena cava stenosis in 3 patients, rehabilitation of percutaneous </span></span>Potts shunt<span> in two patients, exclusion of a porto-caval fistula<span> in one patient, relief of pulmonary arteries stenosis in 3 patients and percutaneous PA debanding in two patients with ccTGA. All the stents were implanted successfully. Median stent diameter was 16</span></span></span> <!-->mm (range 7–24<!--> <span>mm). Major complications were the following: one aortic dissection<span><span>, 2 stent balloon rupture, 1 patient experienced a cerebral embolization<span> without neurological consequences and 1 patient had a femoral artery occlusion requiring </span></span>vascular surgery.</span></span></p></div><div><h3>Conclusion/Perspectives</h3><p>BeGraft stent can be used safely and effectively in a wide spectrum of congenital heart diseases. Whether these good results will be stable in the long term follow up still needs to be investigated given its recent introduction into clinical practice.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46698719","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}