Publications by authors named "Joseph Philippe Etievent"
Background: The efficacy of antidepressant therapy in patients undergoing coronary artery bypass grafting (CABG) is not clearly established.
Methods: This double-blind trial was conducted at University Hospital, Besançon, France. Adult CABG patients were randomized (1:1) to receive escitalopram (10 mg daily) or placebo from 2 to 3 weeks before to 6 months after surgery, including 12 months post-surgery follow-up.
Cryopreserved monobloc aorto-mitral homograft implantation to treat complex recurrent endocarditis involving the intervalvular fibrous body and both aortic and mitral orifices, as previously described, remains a technically demanding procedure. We report two cases of recurrent destructive aorto-mitral endocarditis treated by a monobloc aorto-mitral homograft implantation with encouraging results.
View Article and Find Full Text PDF3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used to decrease cholesterol synthesis and are well established to reduce vascular diseases. Recently, it has been proposed that statins mobilize endothelial progenitor cells from bone marrow during the first four weeks, which could help to prevent vascular diseases. However, in humans there are few data concerning the long term effects of statin treatment on these endothelial progenitor cells.
View Article and Find Full Text PDFObjective: This study was undertaken to determine factors associated with in-hospital mortality among patients after general thoracic surgery and to construct a risk model.
Methods: Data from a nationally representative thoracic surgery database were collected prospectively between June 2002 and July 2005. Logistic regression analysis was used to predict the risk of in-hospital death.
Background: The aim of this prospective study, based on the iterative completion of the 36-item short form health survey questionnaire (SF36) after open heart surgery, was twofold: to evaluate the changes in quality of life (QOL) scores (over time and by gender, and also in comparison with scores from a normal population) and to identify possible gender differences in two-year cardiac functional status.
Methods: From July 2000 to July 2002, 590 elective patients were included in this study. Baseline and follow-up QOL surveys were obtained for 439 patients (307 males and 132 females).
Objective: The twofold aim of this prospective clinical study was to assess the accuracy of procalcitonin as a marker of postoperative infection after thoracic surgery and to compare it with C-reactive protein.
Methods: Procalcitonin and C-reactive protein concentrations, clinical symptoms of infection and systemic inflammation were recorded preoperatively and 5 days postoperatively in 157 patients undergoing the following procedures: 52 wedge resections, 28 pneumonectomies and 77 lobectomies (or bilobectomies). Patients were classified as non-infected or infected according to predefined criteria.
Background: The choice of myocardial revascularization strategy for the right coronary artery (RCA) in patients with multivessel disease and chronic stable angina remains controversial. Our aim was to determine the better strategy-hybrid, combining bypass of the left coronary network and percutaneous coronary intervention of the RCA, or exclusively surgical-and if the latter, the best conduit.
Methods: We used decision analysis, a modeling technique, to compare two RCA revascularization strategies: surgical grafting and percutaneous coronary intervention.
Article Synopsis
- A new surgical technique is introduced for creating a "pi" graft using the mammary loop method, which improves on existing methods.
- The approach involves careful preparation of the internal thoracic mammary arteries, where the right artery is connected to the left in a "Y" shape.
- This method optimizes the use of the mammary arteries' length and allows for precise measurements to be taken for the coronary anastomosis during surgery.
We present a technique that permits the grafting of two vessels with the left internal thoracic artery when a sequential graft cannot be performed. The left internal mammary artery is anastomosed to itself resulting in a loop that will be cut open at the time of the coronary anastomosis.
View Article and Find Full Text PDFBackground: This prospective randomized study aimed to compare beating and arrested heart revascularization in patients undergoing first elective coronary artery bypass graft, with cardiac troponin I release used to evaluate myocardial injury.
Methods: Seventy patients were randomly assigned to a beating or arrested heart revascularization group. Cardiac troponin I concentrations were measured in serial venous blood samples drawn preoperatively in both groups: after aortic unclamping at 6, 9, 12, and 24 hours in the arrested heart group and after the last anastomosis at 6, 9, 12, and 24 hours in the beating heart group.
Objective: Medication administration errors (MAEs) are the second most frequent type of medication errors, as has been shown in different studies in the literature. The aims of this observational study were to assess the rate and the potential clinical significance of MAEs and to determine the associated risk factors.
Design: In two departments, Geriatric Unit (GU) and Cardiovascular-Thoracic Surgery Unit (CTSU) of Besançon University Hospital (France), MAEs were identified using the undisguised observation technique and classified according to the definitions of the American Society of Health-System Pharmacists.
Background: Optimal management for patients presenting a second episode of spontaneous pneumothorax remains controversial. The aim of this study was to compare two possible treatment strategies, video-assisted thoracic surgery (VATS) and conservative management, in order to assess which of the two was better adapted for the treatment of the second episode of spontaneous pneumothorax.
Methods: The authors propose a decision analytic model including a cost-effectiveness study to compare two clinical strategies: VATS (reference strategy) and conservative management (alternative strategy).
Background: The aim of this prospective study, based on the completion of the short form health survey questionnaire (SF36) before and 1-year after open heart surgery, was threefold: to evaluate the changes in quality of life (QOL) after open heart surgery, to determine the factors influencing QOL, and to assess the relation between preoperative QOL and 1-year cardiac functional status.
Methods: Logistic regression was used to determine factors that influence patients' QOL scores and their 1-year cardiac functional status. Different groups were constituted in terms of 1-year cardiac functional status by means of an arborescent classification.
Background: Cellular cardiomyoplasty is a promising approach to improve postinfarcted cardiac function. The differentiation pathways of engrafted mesenchymal progenitor cells (MPCs) and their effects on the left ventricular function in a rat myocardial infarct heart model were analyzed.
Methods And Results: A ligation model of left coronary artery of Lewis rats was used.
We report three cases of contained rupture of the descending thoracic aorta managed by endovascular stent grafting and discuss the possibility of managing this life-threatening complication in emergency, by endoluminal devices. Further experience is needed to specify the indications for aortic stenting in descendant thoracic aortic ruptures.
View Article and Find Full Text PDFBackground: Cardiac troponin I (CTnI) has been shown to be a marker of myocardial injury. The aim of this prospective, randomized study was to compare intermittent antegrade warm cardioplegia with tepid blood cardioplegia in patients undergoing first elective coronary artery bypass graft, using CTnI release as the criterion for evaluating the adequacy of myocardial protection.
Methods: Seventy patients were randomly assigned to one of two cardioplegia groups.
Background: Quality of life (QOL) instruments help to integrate the patient's view into clinical practice and into the evaluation of new therapeutic strategies. The aim of the present study was to determine which of two generic QOL instruments, the Nottingham Health Profile (NHP) or the Short Form Health Survey (SF36), was the more suitable for use in cardiac surgery.
Methods: The NHP and the SF36 were compared before and 5 weeks after surgery.