Archives of Cardiovascular Diseases Supplements最新文献

{"title":"Evaluation of cancer screening coverage in adults with congenital heart disease","authors":"M. Albertini ,&nbsp;P. David ,&nbsp;S. Hascoet ,&nbsp;M. Ladouceur ,&nbsp;L. Guirgis ,&nbsp;E. Fournier ,&nbsp;I. Van Aerschot ,&nbsp;J. Radojevic ,&nbsp;V. Waldmann ,&nbsp;L. Iserin ,&nbsp;S. Cohen","doi":"10.1016/j.acvdsp.2023.07.030","DOIUrl":"10.1016/j.acvdsp.2023.07.030","url":null,"abstract":"<div><h3>Introduction</h3><p>The risk of cancer in adults with congenital heart disease (ACHD) is 23% higher than in the general population.</p></div><div><h3>Objective</h3><p>The objective of our study was to assess cancer screening coverage in ACHD.</p></div><div><h3>Methods</h3><p>This was a prospective, observational, bicentric study of ACHD patients. Data were collected through a self-questionnaire proposed to all consecutive patients over 25 years from September 2022 to March 2023. Information on cervical, breast and colorectal cancer screening was collected and compared with screening data provided by Santé Publique France.</p></div><div><h3>Results/Expected results</h3><p>A total of 263 patients were included. The mean age was 44 years (range, 25–78), 122 (46%) patients were male, and 99 (38%) patients had a complex CHD. Eleven (4%) patients had a history of cancer. The screening participation rate for breast cancer was higher in ACHD patients (72%) compared to the general population from Ile de France region (39%, <em>P</em> <!-->&lt;<!--> <!-->0.001) and from the whole French population (51%, <em>P</em> <!-->=<!--> <!-->0.002). For colorectal and cervical cancers, the screening participation rate were 36% and 65%, compared to 31% and 51% in Île de France region and 34% and 59% in the whole French population, respectively with no statistically significant difference (<span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>Cancer screening coverage in ACHD patients was greater than non-congenital patients for breast cancer, but comparable for colorectal and cervical cancers. The screening participation rate remained however lower than European objectives for all cancers. Our data call for specific actions to better screen this aging population at high risk for cancer.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 287"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43432610","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":"Sinus venosus atrial septal defect in adults: Surgical repair using partial thoracoscopic approach","authors":"L. Le Gloan ,&nbsp;A. Mugniot ,&nbsp;F. Wautot ,&nbsp;P. Guérin","doi":"10.1016/j.acvdsp.2023.07.019","DOIUrl":"10.1016/j.acvdsp.2023.07.019","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>The decision regarding optimal treatment for </span>atrial septal defect<span> (ASD) in adults should be given by a multidisciplinary ACHD team; the best treatment in the presence of right ventricular overload is timely closure, irrespective of age. So far, despite new percutaneous approach for </span></span>sinus venosus<span> ASD closure, surgery remains gold standard, performed via a median sternotomy<span> on cardiopulmonary bypass.</span></span></p></div><div><h3>Methods</h3><p><span><span>Minimally invasive cardiac surgery offers the possibility to repair ASD with a video-assisted approach through a right mini </span>thoracotomy. We report the use of a partial thoracoscopic, combining a small anterior thoracotomy to </span>thoracoscopy in 3 adults of 20, 42 and 46 years old, 1 woman and 2 men.</p></div><div><h3>Results/Expected results</h3><p><span><span>Our female patient was offered a periaareolar incision<span><span>. All 3 patients had a sinus venosus ASD with right ventricular enlargement. They had no pulmonary hypertension and all had one isolated right superior pulmonary vein<span> connected to the superior vena cava. None had a </span></span>persistent left superior vena cava draining to the </span></span>coronary sinus<span> and none had significant tricuspid regurgitation. All ASD were successfully repaired with a two-patch technique, by means of 2 ports positioned on the right chest wall to allow the insertion of surgical instruments and a small thoracotomy. Mean time of cardiopulmonary bypass was 188</span></span> <!-->minutes, mean time of aortic cross-clamp was 122<!--> <!-->minutes and mean time of operation was 242<!--> <span>minutes. Post-operative mechanical ventilation duration averaged 309</span> <!-->minutes and the mean duration of ICU stay was less than 24<!--> <span>hours for all. No death, residual shunt, moderate tricuspid regurgitation or lung atelectasis was found at 2 months.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>This partial thoracoscopic approach appears as a feasible and safe approach for surgical closure of sinus venosus ASD in adults. Furthermore, it seems to allow less pain and better cosmetic outcome, particularly in women, using a periareolar incision.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 282"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46437762","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":"Surgical or transcatheter pulmonary valve replacement, how to choose ?","authors":"P. Normandin ,&nbsp;A. Houeijeh ,&nbsp;J.B. Baudelet ,&nbsp;O. Domanskii ,&nbsp;A. Delarue ,&nbsp;S. Bichali ,&nbsp;F. Juthier ,&nbsp;F. Godart","doi":"10.1016/j.acvdsp.2023.07.018","DOIUrl":"10.1016/j.acvdsp.2023.07.018","url":null,"abstract":"<div><h3>Introduction</h3><p>Pulmonary valve replacement<span> (PVR) is indicated for right ventricle outflow tract (RVOT) dysfunction. The choice between the transcatheter PVR (TPVR) and the surgical PVR (SPVR) is debated.</span></p></div><div><h3>Objective</h3><p>We aimed to compare the TPVR to the SPVR, considered previously as the gold standard, to determine the best choice for each patient.</p></div><div><h3>Methods</h3><p>A retrospective observational study was conducted in Lille University hospital. All patients who had PVR between January 2012 and May 2021 were included. The primary outcome was the incidence of valve failure defined as the occurrence of death, endocarditis or the need for secondary intervention.</p></div><div><h3>Results</h3><p>In total, 273 patients were included (100 patients with TPVR (36.6%) and 173 with SPVR (63.4%)). Age at the intervention was 25.1<!--> <!-->±<!--> <!-->14.8 years for TPVR and 34.9<!--> <!-->±<!--> <span>15.7 years for SPVR. The outlet malformation was the main pathology (65% of TPVR and 61.3% of SPVR) followed by the Ross intervention (18% of TPVR and 11.6% of SPVR). The mean duration of the follow-up was 3.6</span> <!-->±<!--> <!-->2,8 years for TPVR and 3.9<!--> <!-->±<!--> <!-->0,9 years for SPVR. Valve diameters were higher in the SPVR group (9%<!--> <!-->&lt;<!--> <!-->20<!--> <!-->mm – 44% 20–22<!--> <!-->mm and 47%<!--> <!-->&gt;<!--> <!-->22<!--> <!-->mm for TPVR; and 3.6%<!--> <!-->&lt;<!--> <!-->22<!--> <!-->mm and 96,4%<!--> <!-->&gt;<!--> <!-->22<!--> <!-->mm for SPVR) and post-intervention transvalvular gradient was higher in the TPVR group.</p><p>The primary outcome was not significantly different in TPVR than in SPVR (16.33% vs. 8.7% respectively, <em>P</em> <!-->=<!--> <!-->0.846), and the freedom from primary outcome at 9 years of follow up was 57% in TPVR and 84% in SPVR (<span>Figure 1</span>), after adjusting for predefined confounders (age at the intervention, size of the valve, and disease).</p><p>The risks factors for primary outcome were number of previous surgeries (<em>P</em> <!-->=<!--> <!-->0.0190) and small size of the valve (threshold<!--> <!-->&lt;<!--> <!-->22<!--> <!-->mm, hazard ratio 0.27, <em>P</em> <!-->=<!--> <!-->0.0363).</p></div><div><h3>Conclusion/Perspectives</h3><p>The choice between TPVR and SPVR should be individualized based on each patient, their risk factors and the size of their right ventricle outflow tract. A larger size of the valve (&gt;<!--> <!-->22<!--> <span>mm if possible) may be preferable mainly in patients with several previous surgeries.</span></p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Pages 281-282"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41430005","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":"Heart failure with preserved ejection fraction (HFpEF) in children","authors":"S. Quennelle ,&nbsp;L. Houyel ,&nbsp;D. Khraiche ,&nbsp;Z. Belhadjer ,&nbsp;J. Grynblat ,&nbsp;A. Neuraz ,&nbsp;N. Garcelon ,&nbsp;D. Bonnet","doi":"10.1016/j.acvdsp.2023.07.003","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Heart failure (HF) with preserved ejection fraction (HFpEF) is a complex cardiac condition that results from a structural or functional impairment of filling of the heart. It has a high prevalence in elderly but has rarely been analyzed in children.</p></div><div><h3>Objective</h3><p>To identify HFpEF in children with biventricular physiology without shunt or outflow tract obstruction, through a dedicated algorithm applied to a large tertiary hospital database, and to describe the causes, hemodynamic<span> profiles, treatment, and hard outcomes of this population.</span></p></div><div><h3>Methods</h3><p>We applied a combination of clinical, echocardiographic, and hemodynamic measurements to confirm the diagnosis of HFpEF to identify children with a confirmed HFpEF phenotype extracted from a pediatric hospital data warehouse.</p></div><div><h3>Results/Expected results</h3><p>In total, 137 HFpEF cases were included. Mean age was 7<!--> <!-->±<!--> <span><span>5.7 years. The cardiovascular causes of HFpEF were hypertrophic cardiomyopathy (44%), </span>restrictive cardiomyopathy<span> (RCM) (32%), cardiomyopathy due to repeated cardiac surgeries (10%), dilated cardiomyopathy (7%), and constrictive pericarditis (7%) (</span></span><span>Figure 1</span>). Children with RCM had the worst prognosis (27% ten years transplant-free survival, <em>P</em> <!-->&lt;<!--> <span>0.005). Mean patient follow-up was 5.3 years. 43% of the patients were hospitalized for acute HF, 12% were transplanted and 31% died. NT-proBNP increase was found in all groups and was associated with mortality and transplantation, HR 1.91 (95% CI 1.31, 2.76, p-value</span> <!-->&lt;<!--> <!-->0.001). Based on echocardiographic evaluation, 56% of the patients were diagnosed with pulmonary hypertension (PH), associated with mortality and transplantation, HR 2.84 (95% CI 1.58, 5.10, <em>P</em> <!-->&lt;<!--> <span>0.001). In the 48 patients who underwent right heart catheterization, post-capillary or combined PH were the most frequent but the 15% with isolated pre-capillary PH had poorer outcomes, HR 4.60 (95% CI, 1.46, 14.5, </span><em>P</em> <!-->=<!--> <!-->0.009).</p></div><div><h3>Conclusion/Perspectives</h3><p>HFpEF is a rare and concerning condition in children. Younger age, RCM, acute HF episodes, increased NT-proBNP are associated with hard outcomes. A precapillary component in patients with PH is associated with poorer outcomes.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Pages 273-274"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725605","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":"Use of T1 mapping in cardiovascular MRI in follow up of a pediatric fabry cohort","authors":"O. Werner,&nbsp;M. Fila,&nbsp;L. Ichay,&nbsp;M. Vincenti","doi":"10.1016/j.acvdsp.2023.07.034","DOIUrl":"10.1016/j.acvdsp.2023.07.034","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Fabry disease<span> (FD) is a rare X-linked lysosomal storage disorder caused by a mutation on the </span></span><em>alpha-galactosidase-A</em><span><span> gene. The prognosis lies in the severity of the cardiac involvement which is the leading cause of mortality. Usually, it presents with hypertrophic cardiomyopathy, valvular disease, or conduction abnormalities. This process of storage is also present in every other organ and begins before </span>birth<span>. Enzyme replacement therapy<span><span> (ERT) has shown a spectacular effect on extra-cardiac symptoms especially if started early in life. The effect of ERT on cardiac lesions is still a research question. Cardiac magnetic resonance (CMR) is a key exam in FD with its capacity of tissular characterization. But to date, there is a lack of data in the </span>pediatric population to understand how to integrate CMR in early therapeutic decisions.</span></span></span></p></div><div><h3>Methods</h3><p>Monocentric cross-sectional study carried out in Montpellier University hospital from 2016 to 2022. All pediatric patients with FD were evaluated over time with clinical, biological and cardiac imaging (CMR, TEE). The objective was to determine the place of CMR in the therapeutic decisions.</p></div><div><h3>Results/Expected results</h3><p>In total, 6 patients were included, 3 boys/3 girls. Five patients were treated with ERT during the study. Low T1 values were observed in 4 patients. The normalization of T1 values was observed in the 4 years after ERT introduction for 3 patients (<span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>CMR has to take an important role in the evaluation of FD. In the pediatric population, a recurrent assessment can be useful to detect the pejorative evolution of T1, especially in partial forms of Fabry disease. Obvious need of strong data is required to help the clinician in his daily practice.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 289"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47427961","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":"Prenatal screening for congenital heart disease: Status report in a level 3 maternity hospital","authors":"F. Mraihi,&nbsp;J. Basli,&nbsp;A. Mezni,&nbsp;O. Mchirgui,&nbsp;M.M. Gharbi,&nbsp;D. Chelli","doi":"10.1016/j.acvdsp.2023.07.046","DOIUrl":"10.1016/j.acvdsp.2023.07.046","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Congenital heart disease is a condition in which the heart and blood vessels are affected at the time of </span>birth<span> antenatal diagnosis<span> of these malformations<span> allows the organization of neonatal care.</span></span></span></p></div><div><h3>Objective</h3><p>The objective of our study is to evaluate the value of ultrasound in the diagnosis of congenital heart disease and the contribution of ultrasound in the management of this disease.</p></div><div><h3>Methods</h3><p><span>We conducted a retrospective, descriptive study carried out at the department of gynecology-obstetrics D. We included in this study pregnant women aged 18 years and older and whose gestational age (GA) was ≥ 14 weeks of amenorrhea. Clear and </span>informed consent was sought from the patients to participate in the study.</p></div><div><h3>Results/Expected results</h3><p>During our study, 96 observations were included. The average age of the patients was 32.4 years, ranging from 20 to 45 years. The most represented age group (36%) was between 30 and 35 years old. The majority of marriages were non-consanguineous at 70%. 7% of the heart diseases were detected before 18 weeks of amenorrhea and 49% between 18 and 24 weeks of amenorrhea. The majority of the heart diseases were detected after 24 weeks (43%). In total, 62% of the cardiopathies corresponds to abnormalities of the 4 chambers. 35% of the malformations are conotronic disorders. 4% of the congenital heart diseases are abnormalities of the heart rhythm. 15% of the 4 cavities anomalies are related to chromosomal aberrations. 38% of CAV are related to T21. 18% of patients had a medical termination of pregnancy (MTP), against 81% who continued their pregnancies.</p></div><div><h3>Conclusion/Perspectives</h3><p>In spite of the progress made in the prenatal diagnosis of Congenital Heart Disease and the increasing competence of referral ultrasound physicians in the detection of these anomalies, the rate of detection in the general population is still low as well as the term of detection.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 294"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47359514","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":"Brain encoding of speech sounds in newborns with complex congenital heart disease: Towards the identification of early biomarkers of language delay","authors":"W. Rozalen,&nbsp;B. Desnous,&nbsp;C. Ovaert,&nbsp;T. Beretti,&nbsp;C. François","doi":"10.1016/j.acvdsp.2023.07.042","DOIUrl":"10.1016/j.acvdsp.2023.07.042","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Newborns with </span>complex congenital heart disease (CCCHD) are at high risk of neurodevelopmental disorders of multifactorial aetiology, including brain immaturity comparable to moderately pre-term infants. Nearly one third of children with CCCHD have a language delay, which negatively impacts their academic performance, communication, and social interactions.</p></div><div><h3>Objective</h3><p>Our team has shown that moderate preterm newborns have impaired cortical encoding of vowels compared to term newborns. Newborns with CCCHD may have a similar early encoding profile to preterm infants, which might serve as an early functional biomarker of language delay in this population.</p></div><div><h3>Methods</h3><p>We recruited 15 newborns with CCHD, between March and December 2022 within the department of Paediatric Cardiology in La Timone Children's Hospital. These neonates were passively exposed to a sequence of syllables using an earpiece, while cortical and subcortical event-related potentials were simultaneously recorded.</p></div><div><h3>Results/Expected results</h3><p>CCCHD newborns had a significantly longer neural conduction<span> time between the cochlea and the first brainstem relay (inferior colliculus), compared with term newborns. We hypothesize that the amplitude of cortical event-related potentials will be lower in newborns with CCCHD compared to term newborns.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>This altered encoding pattern is likely to be caused by immature auditory pathways. Thus, the detection of early alteration of perception could help to identify newborns at risk of language delay, allowing the implementation of targeted rehabilitation before the onset of speech disorder.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 292"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44183047","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":"Trends in hospitalizations in congenital heart disease patients in France: A national PMSI database analysis","authors":"S. Hascoet,&nbsp;S. Cohen,&nbsp;C. Karanfilovic,&nbsp;A. Buronfosse","doi":"10.1016/j.acvdsp.2023.07.007","DOIUrl":"10.1016/j.acvdsp.2023.07.007","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Thanks to the progresses made in the management of congenital heart diseases (CHD), life expectancy of these patients has greatly improved, including those of patients with </span>complex CHD<span>. Epidemiology of this growing population is rapidly evolving. French data are needed to prepare each regional healthcare plan.</span></p></div><div><h3>Objective</h3><p>We aim to analyse national PMSI database to assess trends and projections.</p></div><div><h3>Methods</h3><p>We investigated the number of hospitalizations stay of children and adults with CHD over 10 years from 2013 to 2022 in France. Complexity of CHD was defined according to M3C classification.</p></div><div><h3>Results/Expected results</h3><p>Number of hospital stays of patients with CHD varied from 37,339 to 45,310 in total and from 9,320 to 11,006 for patients with complex CHD. Over 10 years, the latter represent 26.2% of all hospitalizations.</p><p>In children, it varied from 19,787 to 23,023 in total and from 5,714 to 6,987 for children with complex CHD. Over 10 years, the latter represent 30.6% of all hospitalizations. The number of neonates with CHD hospitalized is very stable over time ranging from 1380 to 1596. A similar trend is observed for children.</p><p><span>In adults with CHD, it increased continuously by 55.9% from 15,056 to 23,475 and from 3,564 to 4,294 for adults with complex CHD. Over 10 years, the latter represent 21.0% of all hospitalizations. There is an increase in hospitalizations in adults with CHD with a 5-year projection suggesting an increase up to 35%. In particular number of ACHD hospitalized for management of arrhythmia or for catheterization has almost doubled over 10 years (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>Number of children with complex CHD seems to be very stable over time. On the other hand, there is a growing number of hospitalizations in adults with CHD. Next healthcare plan should contribute to develop facilities for the specific management of adults with CHD in these centres.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Pages 275-276"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45928021","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":"What about congenital heart diseases operated in adults? A case series of 130 patients","authors":"T. Sendi,&nbsp;F. Ben Saida,&nbsp;S. Mleyhi,&nbsp;J. Ziadi,&nbsp;F. Ghedira,&nbsp;R. Denguir","doi":"10.1016/j.acvdsp.2023.07.044","DOIUrl":"10.1016/j.acvdsp.2023.07.044","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span><span>Congenital heart disease is the most common </span>congenital malformation and affects nearly 1% of </span>births. Surgery for congenital heart disease in adults has special characteristics that differentiate it from congenital heart surgery in children and heart surgery for acquired </span>diseases<span> in adults: the diversity of the anatomoclinical situations and the difficulty of the specific surgical techniques are the most important. The presence of multiorgan involvement is common in these patients, which complicates anesthesia and the postoperative period.</span></p></div><div><h3>Objective</h3><p>The main objective of our work was to evaluate the immediate and 6-month results of congenital heart diseases surgery in adulthood in terms of feasibility, morbidity and mortality.</p></div><div><h3>Methods</h3><p>It was a retrospective descriptive study conducted in the Cardiovascular Surgery<span> Department of La Rabta Hospital over a 10 year period. We included patients who underwent surgical correction in adulthood (≥ 18 years). We excluded patients who files were not usable or who were lost to follow-up. We recruited 130 patients with congenital heart disease diagnoses on echocardiography and operated on in adulthood. According to the type of the congenital disease, these patients were subdivided into 2 groups according to cyanogenic or not heart disease.</span></p></div><div><h3>Results/Expected results</h3><p>The average age was 32 years old. A female predominance was objectified (72%). At diagnosis, 46% of our patients were symptomatic with dyspnea. At pre-surgical echocardiographic evaluation, LVEF was preserved in 125 patients (96%) with an average of 65.7<!--> <!-->±<!--> <span>10.4%. 85% of operations were under CPB. 46% of patients used vasoactive drugs upon discharge from CPB. Intra-hospital mortality was 5% and intra-hospital morbidity was 31%. The complications had a favorable evolution. This postoperative morbidity was the cause of a longer hospital stay.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>Nowadays, some other techniques seek to register as less invasive alternatives to conventional surgery such as closure of septal defects percutaneously and totally computer-assisted endoscopic occlusion which offers an excellent aesthetic result.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 293"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49115628","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":"Failure to post-dilate BeSmooth peripheral stents to adult vessel size diameters during bench-side tests","authors":"R. Haddad,&nbsp;D. Bonnet,&nbsp;S. Malekzadeh-Milani","doi":"10.1016/j.acvdsp.2023.07.015","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.07.015","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Low-profile stent implantation remains a rescue treatment<span> for aortic coarctation and branch </span></span>pulmonary arteries stenosis in small children. Stent re-expansion to cope with vascular growth remains problematic.</p></div><div><h3>Objective</h3><p>To evaluate ex-vivo feasibility and mechanical behavior of over-dilating BeSmooth peripheral stents (Bentley InnoMed, Germany).</p></div><div><h3>Methods</h3><p>Three BeSmooth stents in diameters of 7, 8, and 10<!--> <!-->mm were dilated to nominal pressure and then 13atm. Test-1 (sequential up-sizing post-dilation without re-stenting): BeSmooth Ø7<!--> <!-->×<!--> <!-->23<!--> <!-->mm was post-dilated using 12, 14, and 16<!--> <!-->mm high-pressure balloons. Test-2 (post-dilation until plateau/breakpoint then re-stenting): BeSmooth Ø10<!--> <!-->×<!--> <!-->57<!--> <!-->mm was post-dilated with 14<!--> <!-->mm balloon until plateau/breakpoint and then with 48<!--> <!-->mm bare-metal Optimus-XXL stent hand-mounted on 14<!--> <!-->mm balloon. Test-3 (straightforward re-stenting): BeSmooth Ø8<!--> <!-->×<!--> <!-->57<!--> <!-->mm was directly post-dilated with 48<!--> <!-->mm bare-metal Optimus-XXL stent hand-mounted on 16<!--> <span>mm balloon. The stents’ diameter and length were measured. Balloon rupture and stent fracture patterns were closely evaluated.</span></p></div><div><h3>Results/Expected results</h3><p>Test-1: BeSmooth Ø7<!--> <!-->×<!--> <!-->23<!--> <!-->mm was post-dilated to 10<!--> <!-->mm diameter with a little shortening. Up-sizing the stent to 11<!--> <!-->mm with the Ø14<!--> <!-->mm balloon led to the stent shrinking to 3.2<!--> <!-->mm. At 20atm pressure, BeSmooth Ø7<!--> <!-->×<!--> <!-->23<!--> <!-->mm shortened to 2<!--> <!-->mm forming a 12<!--> <!-->mm diameter solid ring circle, and the 16<!--> <!-->mm woven balloon ruptured radially. Test-2: The BeSmooth Ø10<!--> <!-->×<!--> <!-->23<!--> <!-->mm reached a plateau diameter of 13<!--> <!-->mm without shortening and the balloon did not rupture. Stent-in-stent re-expansion showed that at 10atm pressure, BeSmooth Ø10<!--> <!-->×<!--> <!-->57<!--> <!-->mm fractured longitudinally in various dispatched breaking points at a diameter of 13<!--> <!-->mm without shortening and ruptured the balloon with multiple pinholes. Test-3: At 10atm pressure, BeSmooth Ø8<!--> <!-->×<!--> <!-->57<!--> <!-->mm fractured centrally at three different points at a diameter of 11.5<!--> <!-->mm without shortening and the balloon broke radially in half.</p></div><div><h3>Conclusion/Perspectives</h3><p>In our benchmark tests, extreme shortening, severe balloon rupture, or unpredictable stent fracture patterns at small balloon diameters limits the safe post-dilation of BeSmooth stents beyond 13<!--> <!-->mm. BeSmooth stents are not ideal candidates for off-label stent interventions in smaller patients.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 280"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725478","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}