Development of an in vitro model of calcified cerebral emboli in acute ischemic stroke for mechanical thrombectomy evaluation.

: BACKGROUND: Calcified cerebral emboli (CCEs) are a rare cause of acute ischemic stroke (AIS) and are frequently associated with poor outcomes. The presence of dense calcified material enables reliable identification of CCEs using non-contrast CT. However, recanalization rates with the available mechanical thrombectomy (MT) devices remain low.

Drug-induced aortic valve stenosis: An under recognized entity.

Background: We have been intrigued by the observation that aortic stenosis (AS) may be associated with characteristic features of mitral drug-induced valvular heart disease (DI-VHD) in patients exposed to valvulopathic drugs, thus suggesting that beyond restrictive heart valve regurgitation, valvulopathic drugs may be involved in the pathogenesis of AS.

Methods: Herein are reported echocardiographic features, and pathological findings encountered in a series of patients suffering from both AS (mean gradient >15mmHg) and mitral DI-VHD after valvulopathic drugs exposure. History of rheumatic fever, chest radiation therapy, systemic disease or bicuspid aortic valve disease were exclusion criteria.

Comparison of prognoses of Staphylococcus aureus left-sided prosthetic endocarditis and prosthetic endocarditis caused by other pathogens.

Background: Staphylococcus aureus prosthetic valve endocarditis (SAPIE) is a serious disease.

Aims: Our objective was to study the clinical, echocardiographic and prognostic characteristics of left-sided SAPIE, and to compare these characteristics with those of left-sided non-S. aureus prosthetic infective endocarditis (NSAPIE) (i.

Haemodynamic performance of the small supra-annular Trifecta bioprosthesis: results from a French multicentre study.

Objectives: The St Jude Medical Trifecta bioprosthesis incorporates a single pericardial sheet externally mounted on a titanium stent that provides excellent haemodynamic results. The purpose of this multicentre study was to report on the haemodynamic performance and the expected lower risk of prosthesis-patient mismatch in patient with small aortic annulus diameters.

Methods: The 19- and 21-mm Trifecta valves were implanted in 88 and 266 eligible patients, respectively between 2011 and 2013 at three centres in France (Angers, Rennes and Amiens).

Long-term prognosis of left-sided native-valve Staphylococcus aureus endocarditis.

Background: Staphylococcus aureus infective endocarditis (SAIE) is a serious and common disease.

Aims: To assess the clinical and echocardiographic characteristics and prognostic factors of left-sided native-valve SAIE, and to compare these characteristics between two periods (1990-2000 vs. 2001-2010).

Valvular heart disease associated with long-term treatment by methysergide: a case report.

This case report concerns a woman treated continuously since at least 10 years by methysergide for cluster headache. The echocardiographic and histological features of the severe valve fibrosis presented by this patient are very similar to those described with 5 HT(2B) receptors agonistic drugs.

Hemodynamic performance during exercise of the new St. Jude Trifecta aortic bioprosthesis: results from a French multicenter study.

Background: Initial experience with the new St. Jude Trifecta pericardial aortic stented bioprosthesis shows an excellent resting hemodynamic profile. Little is known about changes in the hemodynamic profile of the Trifecta valve during exercise.

Prediction of symptomatic embolism in infective endocarditis: construction and validation of a risk calculator in a multicenter cohort.

Objectives: The aim of this study was to develop and validate a simple calculator to quantify the embolic risk (ER) at admission of patients with infective endocarditis.

Background: Early valve surgery reduces the incidence of embolism in high-risk patients with endocarditis, but the quantification of ER remains challenging.

Methods: From 1,022 consecutive patients presenting with definite diagnoses of infective endocarditis in a multicenter observational cohort study, 847 were randomized into derivation (n = 565) and validation (n = 282) samples.

Predicting left ventricular dysfunction after valve repair for mitral regurgitation due to leaflet prolapse: additive value of left ventricular end-systolic dimension to ejection fraction.

Aims: Left ventricular (LV) dysfunction is the first cause of late mortality after mitral valve surgery. In this retrospective analysis, we studied the association between preoperative echocardiographic LV measures and occurrence of LV dysfunction after mitral valve repair (MVR).

Methods And Results: Between 1991 and 2009, 335 consecutive patients underwent MVR for severe mitral regurgitation due to leaflet prolapse in our institution.

Septic coronary embolism in aortic valvular endocarditis.

Acute myocardial infarction due to septic coronary emboli in active infective endocarditis is rare, but may be fatal. The case is reported of a 58-year-old man who presented with wrist arthritis, which resulted in acute aortic valvular endocarditis. Echocardiography revealed 3 mm vegetations on the posterior and anterior valve cusps, and aortic regurgitation (grade 3-4).

Heart failure in left-sided native valve infective endocarditis: characteristics, prognosis, and results of surgical treatment.

Aims: Although congestive heart failure (CHF) represents the most common cause of death in native valve infective endocarditis (IE), recent data on the outcome of IE complicated by CHF are lacking. We aimed to analyse the characteristics and prognosis of patients with left-sided native valve IE complicated by CHF and to evaluate the impact of early surgery on 1 year outcome.

Methods And Results: Two hundred and fifty-nine consecutive patients with definite left-sided native valve IE according to the Duke criteria were included in this analysis.

Infective endocarditis in elderly patients: clinical characteristics and outcome.

Background: The aim of this study was to describe a single unit experience for the treatment of acute infective endocarditis, for patients older than 75 years and to analyse the results of early surgery.

Patients And Methods: From January 1991 to June 2006 348 consecutive patients with definite acute infective endocarditis, according to Duke criteria, were prospectively enrolled in our database. Among these, 75 patients older than 75 years (mean age 79.

Predictors of death and impact of surgery in Staphylococcus aureus infective endocarditis.

Background: We studied a large cohort of adults with Staphylococcus aureus infective endocarditis to evaluate the predictors of outcome and to establish whether early surgery is associated with reduced mortality.

Methods: The study prospectively enrolled 116 consecutive patients with definite S. aureus infective endocarditis, according to Duke criteria and examined by transthoracic and transesophageal echocardiography.

Prospective randomized study comparing coronary artery bypass grafting with the new mini-extracorporeal circulation Jostra System or with a standard cardiopulmonary bypass.

Background: To assess the potential benefits of a new concept of cardiopulmonary bypass (CPB), the mini-extracorporeal circulation (MECC) Jostra System, we conducted a prospective randomized study among patients who underwent coronary artery bypass grafting (CABG) with a MECC Jostra System or with a standard CPB.

Methods: In a prospective randomized study, 400 patients underwent elective CABG using a standard CPB (200 patients) or a Jostra MECC System (200 patients). The patients were randomly assigned to have preoperative data similar for both groups.

Impact of echocardiography on indications for surgery in chronic mitral and aortic regurgitation.

Echocardiography is the key examination in the assessment of mitral and aortic regurgitation, as it is able to describe the etiology and mechanism of the disease and assess its severity and its repercussions on cardiac cavities and pulmonary pressures. Surgery now tends to be indicated at earlier stages, largely based on criteria drawn from echocardiography. In severe mitral regurgitation, surgery is not disputed in presence of left ventricular ejection fraction < 60% and/or end-systolic diameter > 45 mm.

Clinical experience with the mini-extracorporeal circulation system: an evolution or a revolution?

Purpose: We studied a cohort of 150 patients operated on with a new cardiopulmonary bypass (CPB) system. This is the mini-extracorporeal circulation (MECC) system.

Description: The MECC is a fully heparin coated closed-loop CPB system that includes a centrifugal pump and has a priming volume of 450 mL.

Bivalvular mechanical mitral-aortic valve replacement in 254 patients: long-term results--a 22-year follow-up.

Background: We have retrospectively studied 254 patients who underwent a bivalvular mechanical mitral-aortic replacement in the cardiovascular and thoracic surgery unit of Nantes from 1979 to 1989. The follow-up was 22 years (1979 to 2001). The last patient was operated on 12 years before the end of the follow-up.