Publications by authors named "Herve Breton"
Background: Large datasets of transcatheter aortic valve implantation (TAVI) for pure aortic valve regurgitation (PAVR) are scarce.
Aims: We aimed to report procedural safety and long-term clinical events (CE) in a contemporary cohort of PAVR patients treated with new-generation devices (NGD).
Methods: Patients with grade III/IV PAVR enrolled in the FRANCE-TAVI Registry were selected.
Background: The influence of permanent pacemaker implantation upon outcomes after transcatheter aortic valve implantation (TAVI) remains controversial.
Aims: To evaluate the impact of permanent pacemaker implantation after TAVI on short- and long-term mortality, and on the risk of hospitalization for heart failure.
Methods: Data from the large FRANCE-TAVI registry, linked to the French national health single-payer claims database, were analysed to compare 30-day and long-term mortality rates and hospitalization for heart failure rates among patients with versus without permanent pacemaker implantation after TAVI.
Aims: Aortic stenosis (AS) is causing myocardial damage and replacement is mainly indicated based on symptoms. Non-invasive estimation of myocardial work (MW) provides a less afterload-dependent too for assessing myocardial function. We sought to look at the impact of transcatheter aortic valve implantation (TAVI) on the myocardium at long-term follow-up and according to current indications.
View Article and Find Full Text PDFObjectives: The estimation of systolic pulmonary artery pressure (sPAP) by transthoracic echocardiography (TTE) is challenging in patients with severe tricuspid regurgitation (TR). The study aimed to determine the reliability of the assessment of sPAP by TTE in this population.
Methods: This study was a single-centre analysis of consecutive patients at the University Hospital of Rennes with right heart catheterisation and TTE, performed with a maximum delay of 48 hours.
New-onset conduction disturbances, including left bundle branch block and permanent pacemaker implantation, remain a major issue after transcatheter aortic valve implantation. Preprocedural risk assessment in current practice is most often limited to evaluation of the baseline electrocardiogram, whereas it may benefit from a multimodal approach, including ambulatory electrocardiogram monitoring and multidetector computed tomography. Physicians may encounter equivocal situations during the hospital phase, and the management of follow-up is not fully defined, despite the publication of several expert consensuses and the inclusion of recommendations regarding the role of electrophysiology studies and postprocedural monitoring in recent guidelines.
View Article and Find Full Text PDFArticle Synopsis
- Guidelines suggest aortic valve replacement for severe aortic stenosis when patients exhibit symptoms or reduced left ventricular ejection fraction, which indicates advanced disease severity.
- This study aimed to analyze changes in myocardial work for patients undergoing transcatheter aortic valve implantation (TAVI) by evaluating echocardiographic data before and after the procedure.
- The results showed a significant decrease in mean transaortic pressure gradient and improvements in myocardial work indices post-TAVI, indicating that these measures could help better understand the left ventricular effects of aortic stenosis and treatment outcomes.
Background: Promptly identifying individuals with addictive disorders reduces mortality and morbidity and improves quality of life. Although screening in primary care with the Screening, Brief Intervention and Referral Treatment strategy has been recommended since 2008, it remains underutilized. This may be due to barriers including lack of time, patient reluctance or perhaps the timing and approach for discussing addiction with their patients.
View Article and Find Full Text PDFAims: Unprotected left main coronary artery (ULMCA) occlusion is a rare and disastrous condition with scarce data on presentation and outcomes. Herein, we report data on patients presenting with acute coronary syndrome due to ULMCA occlusion at four different institutions.
Methods: This is an international multicentre observational study.
Article Synopsis
- The study examined patients with prosthetic valve endocarditis (PVE) after transcatheter aortic valve implantation (TAVI), focusing on those with absent vs. evident echocardiographic signs of infective endocarditis (IE).
- Among 578 patients, 15.1% had no echocardiographic signs, mostly treated via transfemoral access and showing more complications compared to those with evident signs.
- Patients with absent imaging had higher rates of infections from Staphylococcus aureus and enterococci but similar in-hospital and one-year mortality risks, indicating they still represent a high-risk group for IE despite negative imaging.
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks.
Patients And Methods: Paravalvular leak (PVL) and patient-prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality.
Background: Randomized trials comparing the first-generation absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, CA, USA) with a drug-eluting stent showed a moderate but significant increase in the rate of 3-year major adverse cardiac events and scaffold thrombosis, followed by a decrease in adverse events after 3 years.
Aim: The objective of this study was to assess the 5-year outcomes of patients treated with at least one absorb BVS and included in the FRANCE ABSORB registry.
Methods: All patients treated in France with an absorb BVS were prospectively included in a large nationwide multicentre registry.
Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex.
Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.
Introduction: This research examines the dialectical relationships between the precautionary principle, the logic of prevention and prudential dynamics, based on accounts of the experiences of academics in nearly fifteen countries around the world.
Aim Of The Study: The study examines the contradictory relationships generated by the perceptions of risk and urgency between the injunctions to act in accordance with the rules prescribed by the health authorities and the dynamics of self-training allowing the singular and prudent integration of rules for the maintenance of individual and collective life in a pandemic situation.
Results: Two levels of results are characterized: concerning the method, the survey system potentially constitutes a monitoring system enabling the production of "flash surveys" giving access to the state of the epidemic situation from local relays in different countries around the world.
Article Synopsis
- The French TAVI registries analyzed patient data from TAVI procedures from 2010 to 2021 to identify trends in patient characteristics and outcomes.
- Over the decade, while the age of patients remained stable around 83 years, the surgical risk score improved, indicating better overall health among patients undergoing the procedure.
- Key findings included a significant increase in TAVI procedures, a shift toward iliofemoral access, and a decrease in mortality rates and hospital stay lengths, showcasing improvements in the procedure's safety and efficiency.
Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.
View Article and Find Full Text PDFBackground: Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR).
Objective: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR.
Methods: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR.
Background: Conduction disturbances requiring permanent pacemaker implantation (PPI) remain a common complication of transcatheter aortic valve replacement (TAVR).
Objective: The purpose of this study was to determine the prognostic impact of PPI after TAVR according to the timing of implantation relative to TAVR.
Methods: A total of 1199 patients (median age 83 years; interquartile range 78-86 years; 549 [45.
Background: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.
Objectives: The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB).
Methods: Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE.
Objective: Our project aims to provide: an overview of the impact of the COVID-19 pandemic on the field of mental health professionals in 23 countries;a model of recommendations for good practice and proposals for methods and digital tools to improve the well-being at work of mental health professionals and the quality of services offered during crisis and post-crisis periods;an in-depth ethics review of the assessment of the use of numerical tools for psychiatry professionals and patient support, including teleconsulting.
Methods: This is a large international survey conducted among 2,000 mental health professionals in 23 countries over a 12-month period. This survey will be based on 30 individual interviews and 20 focus group sessions, and a digital questionnaire will be sent online to 2,000 professionals based on the criteria of gender, age, professional experience, psychiatric specialty, context of work in psychiatry, and geographical location.
Background: Ventricular arrhythmias can be life-threatening complications of ST-segment elevation myocardial infarction (STEMI).
Aims: To describe the incidence, predictors and in-hospital impact of early ventricular arrhythmia (EVA, occurring
Methods: Data from 13,523 patients enrolled in a prospective registry were analysed.
Background: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients.
Methods: This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR.
Background: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR).
Methods: Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries.
Article Synopsis
- Surgical aortic valve replacement (SAVR) is recommended for low-risk patients, while the Heart Team should decide between transcatheter aortic valve implantation (TAVI) and surgery for others, with a preference for TAVI in older patients.
- A multicenter study surveyed 1,049 patients aged 75 and older to understand the role of age and surgical risk in treatment decisions for severe aortic stenosis, finding that TAVI was preferred in 71% of cases.
- The study revealed that as age increases, particularly after 80, the influence of surgical risk scores on treatment decisions decreases significantly, leading most patients to be referred for TAVI even if they have low surgical risk; however, 10%
Objectives: This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm).
Background: PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice.
Methods: Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR.