Publications by authors named "Dreyfus J"

Despite the challenges associated with periprocedural imaging, transcatheter tricuspid valve interventions have shown important impact on outcomes. A comprehensive understanding of the anatomy of the right heart and surrounding structures is crucial. One way to optimize these interventions is by identifying the optimal fluoroscopic viewing angles along the S-curve of the tricuspid valve.

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Importance: Correction of tricuspid regurgitation using tricuspid transcatheter edge-to-edge repair (T-TEER) in addition to guideline-directed optimized medical therapy (OMT) may improve clinical outcomes.

Objective: To evaluate the efficacy of T-TEER + OMT vs OMT alone in patients with severe, symptomatic tricuspid regurgitation.

Design, Setting, And Participants: Investigator-initiated, prospective, randomized (1:1) trial evaluating T-TEER + OMT vs OMT alone in adult patients with severe, symptomatic tricuspid regurgitation.

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Background: The rise of transcatheter tricuspid valve implantation (TTVI) therapies represents a major advancement for high-risk patients with severe tricuspid valve regurgitation, offering a safer, minimally invasive alternative to open-heart surgery. However, the low volume of procedures and training highlights an urgent need for skills development and pre-procedural preparation, which simulation can address by enhancing learning and expanding treatment availability.

Case Summary: An 87-year-old woman with permanent atrial fibrillation and symptomatic severe functional tricuspid regurgitation underwent a transcatheter tricuspid valve replacement with the LuX-Valve system.

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Article Synopsis
  • * Despite advancements in understanding and treating aortic stenosis, there are still significant gaps in knowledge about its causes, severity assessment, and treatment strategies.
  • * The review, from the Heart Valve Council of the French Society of Cardiology, highlights these gaps and suggests areas for future research to enhance patient outcomes.
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Background And Aims: Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery.

Methods: In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4-5, and high: ≥6).

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Background And Objective: Failure rates after first-line treatment of localized prostate cancer (PCa) treatment remain high; therefore, it is essential to improve the selection and identification of at-risk patients to reduce mortality. The aim of the ANDROCAN study was to evaluate the biochemical recurrence (BCR) in patients with localized PCa treated by total prostatectomy at 5 yr after surgery, according to their presurgery gonadal status.

Methods: A prospective cohort study was conducted including 1318 patients undergoing total prostatectomy for localized PCa with a 5-yr postoperative follow-up.

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Background: The best management of symptomatic patients with low-gradient (LG) severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF) has not been established. The Randomised study for the Optimal Treatment of symptomatic patients with low-gradient severe Aortic valve Stenosis (ROTAS) trial aimed to assess the superiority of aortic valve replacement (AVR) versus medical treatment (MT) in this specific group of AS patients.

Methods: Patients with symptomatic LG severe AS and preserved LVEF (>50%) underwent dobutamine stress echocardiography and/or CT-aortic calcium score to confirm AS severity and were then randomised 1:1 to AVR or MT.

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Article Synopsis
  • A study assessed the procedural and early outcomes of transjugular transcatheter tricuspid valve replacement (TTVR) for patients with symptomatic tricuspid regurgitation using the LuX-Valve Plus system across 15 centers from January 2022 to February 2024.
  • Among 76 patients with a median age of 78, the procedure significantly reduced tricuspid regurgitation, with 95% of patients showing improvement at one month.
  • While there were some adverse events including 4 in-hospital deaths and some bleeding, overall survival at one month was high at 94.4%, and patients reported better functional status.
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Tissues release microRNAs (miRNAs) in small extracellular vesicles (sEVs) including exosomes, which can regulate gene expression in distal cells, thus acting as modulators of local and systemic metabolism. Here, we show that insulin regulates miRNA secretion into sEVs from 3T3-L1 adipocytes and that this process is differentially regulated from cellular expression. Thus, of the 53 miRNAs upregulated and 66 miRNAs downregulated by insulin in 3T3-L1 sEVs, only 12 were regulated in parallel in cells.

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  • This study investigates how intraprocedural residual mitral regurgitation (rMR) and mean mitral valve gradient (MPG) affect outcomes for patients with primary mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER).
  • Researchers analyzed data from 1,509 patients in the PRIME-MR registry, focusing on differences in 2-year outcomes based on the severity of rMR and MPG levels.
  • Results indicated that higher levels of rMR (≥2+) were linked to worse clinical outcomes, while MPG did not significantly impact patient prognosis after the procedure.
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Background: Urinary tract infection (UTI) prevention benefits of cranberry intake are clinically validated, especially for women and children. To ensure the benefits of cranberry dietary supplement products, the anti-adhesion activity (AAA) against uropathogenic bacteria is routinely used in in vitro bioassays to determine the activity in whole product formulations, isolated compounds, and ex vivo bioassays to assess urinary activity following intake. D-mannose is another dietary supplement taken for UTI prevention, based on the anti-adhesion mechanism.

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Aims: As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in pre-procedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element computational simulation model to predict the results of transcatheter edge-to-edge repair (TEER) interventions.

Methods And Results: We prospectively enrolled patients with secondary mitral regurgitation (MR) referred for a clinically indicated TEER.

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Article Synopsis
  • * It found that patients with mild residual TR had an 85% survival rate, while those with moderate and severe TR had significantly lower rates of 70% and 44%, respectively.
  • * The research emphasizes the need for a more detailed classification of TR severity to better predict patient outcomes and highlights the goal of achieving at least mild to moderate residual TR for successful interventions.
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Background: Large health insurance claims databases can be used to estimate rates of rare safety outcomes. We measured incidence rates of rare outcomes that could be used to contextualize adverse events among people receiving pneumococcal vaccines in clinical trials or clinical practice. However, algorithms used to identify outcomes in administrative databases are subject to error.

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Background: Transcatheter (TAVR) has supplanted surgical (SAVR) aortic valve replacement (AVR).

Aim: To evaluate whether adoption of this technology has varied according to centre volume at the nationwide level.

Methods: From an administrative hospital-discharge database, we collected data on all AVRs performed in France between 2007 and 2019.

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  • The study examines the effectiveness of the TRI-SCORE in predicting outcomes for patients undergoing transcatheter tricuspid valve intervention (TTVI), using data from a large, international registry called TriValve.
  • Among the 634 patients analyzed, those with a TRI-SCORE of 8 or higher were found to have a significantly increased risk of all-cause mortality and complications within 30 days of the procedure, compared to those with lower TRI-SCOREs.
  • Despite indicating a higher risk for severe outcomes, the TRI-SCORE overall showed limited effectiveness in predicting clinical results following TTVI, as improvements in patient functional class were observed across all TRI-SCORE levels.
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Aims: Tricuspid regurgitation (TR) is commonly observed in patients with severe left-sided valvular heart disease (VHD). This study sought to assess TR frequency, management and outcome in this population.

Methods And Results: Among 6883 patients with severe native left-sided VHD or previous left-sided valvular intervention enrolled in the EURObservational Research Programme prospective VHD II survey, moderate or severe TR was very frequent in patients with severe mitral VHD (30% when mitral stenosis, 36% when mitral regurgitation [MR]), especially in patients with secondary MR (46%), and rare in patients with severe aortic VHD (4% when aortic stenosis, 3% when aortic regurgitation).

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Background: The coronavirus disease of 2019 (COVID-19) pandemic lockdowns limited access to medical care. The impact on surgical (SAVR) and transcatheter (TAVR) aortic valve replacement (AVR) has been poorly described.

Aim: We sought to evaluate the impact of the COVID-19 pandemic on the number and modalities of AVR, patient demographics and in-hospital outcomes at the nationwide level.

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