Budget Impact Analysis of Impella CP Utilization in the Management of Cardiogenic Shock in France: A Health Economic Analysis.

Introduction: Early detection and treatment of cardiogenic shock (CS) is crucial to avoid irreparable multiorgan damage and mortality. Impella CP is a novel temporary mechanical circulatory support (MCS) device associated with greater hemodynamic support and significantly fewer device-related complications compared with other MCS devices, e.g.

Benefits of a 14-year surgical site infections active surveillance programme in a French teaching hospital.

Background: Surgical site infections (SSIs) are the second most common healthcare-associated infection. Active SSI surveillance can help inform preventative measures and assess the impact of these measures.

Aim: We aimed to describe the evolution in trends over 14 years of prospective active SSI surveillance and implementations of SSI prevention measures in a French Teaching Hospital.

Budget Impact Associated with the Introduction of the Impella 5.0 Mechanical Circulatory Support Device for Cardiogenic Shock in France.

Aim: Cardiogenic shock (CS), if not diagnosed and treated rapidly, can lead to irreversible multiorgan damage and death. An economic analysis was conducted to determine the budget impact of the introduction of Impella 5.0, a mechanical circulatory support (MCS) device that directly unloads the left ventricle, into clinical practice in patients with left ventricular CS in France.

Adaptive multilevel splitting: Historical perspective and recent results.

This article first presents a short historical perpective of the importance splitting approach to simulate and estimate rare events, with a detailed description of several variants. We then give an account of recent theoretical results on these algorithms, including a central limit theorem for Adaptive Multilevel Splitting (AMS). Considering the asymptotic variance in the latter, the choice of the importance function, called the reaction coordinate in molecular dynamics, is also discussed.

Mid- and long-term prognosis of off- vs. on-pump coronary artery bypass graft in patients with multisite artery disease.

Background: Among patients with coronary artery disease (CAD), around 25% have multisite artery disease (MSAD). Patients with CAD and MSAD are at higher risk of peri-operative and long-term cardiovascular events. Whether off-pump coronary bypass grafting (CABG) can improve their prognosis is unknown.

Adult Bone Marrow Three-Dimensional Phenotypic Landscape of B-Cell Differentiation.

Background: The different B-cell subsets in human bone marrow result from a dynamic equilibrium between endogenous production, B-cell bone marrow reentry and terminal plasma cell differentiation. Our aim was to define and quantify the different medullary B-cell subsets.

Methods: A series of 32 normal adult bone marrows plus 15 normal adult blood samples was studied by nine color flow cytometry (CD10, CD19, CD24, CD27, CD34, CD38, CD45, IgM, and IgD).

The intrinsic prognostic value of the ankle-brachial index is independent from its mode of calculation.

The object of this study was to compare the prognostic value of different methods of ankle-brachial index (ABI) calculation. From April 1998 to September 2008, we calculated the ABI in 1223 patients before coronary artery bypass grafting. The ABI was calculated according to five different calculation modes of the numerator.

Which echocardiographic parameters improve the risk prediction for peri-operative outcomes in patients undergoing coronary bypass surgery: a prospective study.

Objective: To assess the performance of transthoracic echocardiographic parameters to predict operative mortality and morbidity in patients undergoing coronary artery bypass grafting, and to assess its incremental prognostic value as compared to the Society of Thoracic Surgeons (STS) score.

Materials And Methods: We prospectively collected the clinical and biological data required to calculate the STS score in patients hospitalised for coronary artery bypass grafting. Preoperative transthoracic echocardiography was performed for each patient.

Fulminant giant-cell myocarditis on mechanical circulatory support: Management and outcomes of a French multicentre cohort.

Aims: Giant-cell myocarditis (GCM) is a rare and often fatal form of myocarditis. Only a few reports have focused on fulminant forms. We describe the clinical characteristics, management and outcomes of GCM patients rescued by mechanical circulatory support (MCS).

Relation Between Renin-Angiotensin System Blockers and Survival Following Isolated Aortic Valve Replacement for Aortic Stenosis.

Renin-angiotensin system blockers (RASb) improve cardiac remodeling, but their clinical utility after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) is unclear. We aimed to assess the impact of RASb on short- and long-term survival following isolated SAVR for severe AS. From January 2005 to January 2014, 508 consecutive patients had isolated SAVR for severe AS.

Genome-Wide Association Mapping of Flowering and Ripening Periods in Apple.

Deciphering the genetic control of flowering and ripening periods in apple is essential for breeding cultivars adapted to their growing environments. We implemented a large Genome-Wide Association Study (GWAS) at the European level using an association panel of 1,168 different apple genotypes distributed over six locations and phenotyped for these phenological traits. The panel was genotyped at a high-density of SNPs using the Axiom®Apple 480 K SNP array.

Usefulness of Electrocardiographic Strain to Predict Survival After Surgical Aortic Valve Replacement for Aortic Stenosis.

Electrocardiographic (ECG) strain has been reported as a specific marker of midwall left ventricular (LV) myocardial fibrosis, predictive of adverse clinical outcomes in aortic stenosis (AS), but its prognostic impact after aortic valve replacement (AVR) is unknown. We aimed to assess the impact of ECG strain on long-term mortality after surgical AVR for AS. From January 2005 to January 2014, patients with interpretable preoperative ECG who underwent isolated AVR for AS were included.

Echocardiography is useful to predict postoperative atrial fibrillation in patients undergoing isolated coronary bypass surgery: A prospective study.

Objective:: Postoperative atrial fibrillation is a major complication following coronary artery bypass graft. We hypothesized that, beyond clinical and electrocardiogram (ECG) data, transthoracic echocardiography could improve the prediction of postoperative atrial fibrillation.

Methods:: We prospectively studied 169 patients in sinus rhythm who underwent isolated coronary artery bypass graft in our institution.

Outcomes after surgery for acute type A aortic dissection in "non-Marfan syndrome" patients with long life expectancy: A 24-year follow-up.

Background: Long-term survival and risk of reoperation in "non-Marfan syndrome" patients with a long life expectancy who undergo emergency surgery for acute type A aortic dissection (aTAAD) are not well known.

Aim: To analyse survival, risk of reoperation and quality of life in this population.

Methods: From 1990 to 2010, all patients aged≤50 years and not affected by Marfan syndrome, who underwent emergency surgery for aTAAD at two institutions, were included in this analysis.

Fate of aortic bioprostheses: An 18-year experience.

Objective: To report our experience in aortic valve replacement with the Mitroflow (Sorin, Vancouver, Canada) aortic bioprosthesis.

Methods: We retrospectively reviewed all patients who underwent aortic valve replacement with a Mitroflow bioprosthesis at our institution from January 1994 to December 2011. No exclusion criteria were retained.

Is surgical site scrubbing before painting of value? Review and meta-analysis of clinical studies.

Background: Surgical site infections are major surgical complications. Surgical site scrubbing before painting is controversial.

Aim: To conduct a meta-analysis of clinical trials that compared pre-operative scrubbing before painting with painting alone for the prevention of surgical site infections.

[Update of the 2013 consensus conference "Management of the preoperative risk of infection"].

Unlabelled: The surgical site infections (SSI) are rare adverse events that may have severe consequences in terms of morbidity, mortality and costs. Guidelines on the preparation of the patient can reduce the risk of SSI. Previous guidelines were published in 2004.

Octogenarians with uncomplicated acute type a aortic dissection benefit from emergency operation.

Background: The management of acute type A aortic dissection (aTAAD) in octogenarian patients is controversial. This study analyzed the surgical outcomes to identify patients who should undergo operations.

Methods: Beginning in January 2000, we established a registry including all octogenarian patients operated on for type A acute aortic dissection.

Results of mechanical circulatory support in France.

Objective: To present the analyzed results on mechanical circulatory support (MCS) collected over a 7-year period, from 2000 to 2006, in France.

Methods: A cohort of 520 patients was analyzed. Mean age was 43.

A multiple replica approach to simulate reactive trajectories.

A method to generate reactive trajectories, namely equilibrium trajectories leaving a metastable state and ending in another one is proposed. The algorithm is based on simulating in parallel many copies of the system, and selecting the replicas which have reached the highest values along a chosen one-dimensional reaction coordinate. This reaction coordinate does not need to precisely describe all the metastabilities of the system for the method to give reliable results.

Usefulness of postoperative heart rate as an independent predictor of mortality after coronary bypass grafting.

Heart rate (HR) predicts mortality and cardiovascular events in the general population and in patients with coronary artery disease. However, little evidence is available for patients after coronary revascularization. The aim of this study was to assess the prognostic value of ambulatory postoperative HR after coronary artery bypass grafting.

[Postoperative period in cardiac surgery: don't forget heparin induced thrombocytopenia!].

Type II heparin-induced thrombocytopenia (HIT) has a low incidence in cardiac surgery, but its mortality once declared is high. Its clinical recognition can be difficult with these patients who usually have thrombocytopenia in postoperative period and who are predisposed to develop HIT prematurely. Thromboses in this context must be specific, and treatment, which is nowadays well codified, must be begun without waiting for biologic results.