Publications by authors named "Olivier Chavanon"
Acute type A aortic syndromes and ski: management in an emergency care network.
J Cardiovasc Surg (Torino)
December 2024
Background: Skiing can cause aortic syndromes. The pre-hospital management of these patients may be compromised by the mountainous terrain. A regional emergency care network helps to optimize time frames, especially in a challenging geography.
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- - The study aims to determine if the preoperative pulmonary artery pulsatility index (PAPi) can predict mortality after left ventricular assist device (LVAD) implantation, as right ventricular failure is a significant concern following the procedure.
- - An analysis of 117 patients from 2007 to 2021 revealed that those with a PAPi of 2.84 or higher had a significantly better 3-month survival rate compared to those with lower PAPi levels.
- - Other factors influencing 2-year mortality included systemic hypertension, diabetes, and whether the LVAD was used as a bridge to transplant, with notable differences in survival outcomes between these groups.
Background: High preoperative fibrinogen levels are associated with reduced bleeding rates after cardiac surgery. Fibrinogen is directly involved in inflammatory processes and is a cardiovascular risk factors. Whether high fibrinogen levels before cardiac surgery are a risk factor for mortality or morbidity remains unclear.
View Article and Find Full Text PDFHelpfulness of the liver disease scores in cardiac surgery for cirrhotic patients.
Gen Thorac Cardiovasc Surg
September 2022
Objectives: Liver cirrhosis is a well-known risk factor of mortality after cardiac surgery, but not considered in the widely used EuroSCOREII (ESII). The objective was to analyse the performance of the ESII, the Child-Pugh-Turcotte (CPT) and the Model of End-stage Liver Disease (MELD) scores to predict hospital mortality in cardiac surgery for cirrhotic patients and to analyse the survival according to the preoperative cirrhosis status.
Methods: Preoperative and cirrhosis characteristics and postoperative outcomes were compared according to hospital mortality.
Article Synopsis
- The study investigates the outcomes of cardiogenic shock patients receiving temporary circulatory support (TCS) as a bridge to left ventricular assist device (LVAD) implantation, comparing them to patients without TCS.
- Out of 329 patients analyzed, those under TCS had similar 30-day survival rates to those who had TCS removed or did not use a bridging strategy but experienced longer ICU stays and increased mechanical ventilation time.
- Key predictors of mortality in the TCS group include combined surgery with LVAD, body mass index (BMI), and duration of heart failure, while the use of TCS itself did not significantly impact survival rates.
Article Synopsis
- Advanced heart failure patients often experience delays in being referred for mechanical circulatory support, specifically left ventricular assist devices (LVAD), which raises concerns about their survival rates post-implantation.
- The study analyzed data from the ASSIST-ICD registry involving 303 non-inotrope-dependent patients, discovering that factors like older age and certain surgical procedures significantly increase mortality risk after receiving an LVAD.
- Despite LVAD support, survival rates over five years remain low, highlighting the need for improved patient selection to enhance outcomes in such high-risk individuals.
Objective: Atrioventricular valve surgery poses a risk of myocardial infarction due to the proximity of the coronary arteries. Percutaneous techniques also present a risk of coronary injury. Our objective was to identify, on the mitral and the tricuspid annuli, the zones of high risk given their proximity to the circumflex artery and the right coronary artery, respectively.
View Article and Find Full Text PDFPurpose: Prognostication of refractory out-of-hospital cardiac arrest (OHCA) is essential for selecting the population that may benefit from extracorporeal cardiopulmonary resuscitation (ECPR). We aimed to examine the prognostic value of signs of life before or throughout conventional CPR for individuals undergoing ECPR for refractory OHCA.
Methods: Pooling the original data from three cohort studies, we estimated the prevalence of signs of life, for individuals with refractory OHCA resuscitated with ECPR.
Article Synopsis
- LVAD implantation in patients with recently diagnosed cardiomyopathy is under-researched, and this study aims to explore characteristics and outcomes of such patients within 30 days of their diagnosis.
- Out of 652 patients studied, 117 had recently diagnosed cardiomyopathy and experienced LVAD implantation after an average of 15 days, showing they were generally younger and had more severe symptoms compared to those with remote diagnoses.
- Although immediate postoperative survival rates were similar between groups, patients with recently diagnosed cardiomyopathy had improved long-term survival, with certain factors like sudden cardiac arrest identified as risk indicators for higher mortality.
Article Synopsis
- LVAD implantation can be a viable treatment option for elderly patients (70+) with heart failure who aren't suitable for heart transplants.
- An observational study analyzed 652 patients from 2006 to 2016, with 74 (11.3%) being elderly, showing similar hospitalization patterns and complication rates between elderly and younger patients.
- The findings indicate that elderly patients receiving LVADs have comparable mid-term survival rates to younger patients, supporting the use of LVADs in this age group.
Article Synopsis
- The study examined how low and high body mass index (BMI) affect survival outcomes in patients who underwent left-ventricular assist device (LVAD) surgery across 19 medical centers from 2006 to 2016.
- Out of 652 patients studied, those with high BMI typically had more co-existing health issues and were mostly male, while underweight patients had the lowest survival rates overall.
- Four key predictors of mortality were identified for patients with abnormal BMI: high total bilirubin levels, hypertension, whether they were receiving LVAD as destination therapy, and previous cardiac surgeries, categorizing patients into low, intermediate, and high risk for 1-year mortality.
Cardiac pseudoaneurysm is a contained rupture of the cardiac wall. Rarely symptomatic, the risk of death by stroke or rupture is high and suggests surgical treatment. Surgical strategy depends on its anatomical considerations.
View Article and Find Full Text PDFBackground: The aim of this study was to compare the new EuroSCORE (ES) 2 prediction model in high-risk patients with the 2 other oldest additive ES (aES) and logistic ES (lES).
Methods: Consecutive adult patients undergoing all cardiac surgery except heart transplantation and left ventricular assist device were included. The 3 risk scores were collected before surgery.
A 60-year-old woman with a family history of aortic dissection in her mother was investigated for dysphagia. Her scan showed a right aortic arch with a large Kommerell's diverticulum causing esophageal compression. Her left vertebral artery, which originated abnormally low in the thorax, was embolized preoperatively to limit operative difficulties.
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- The study aimed to assess the usage and outcomes of left ventricular assist devices (LVADs) in France from 2007 to 2016 using data from the ASSIST-ICD registry, involving 671 patients across 20 hospitals.
- The overall survival rates for LVAD support or transplantation were 65.2% at 1 year, steadily decreasing to 47.7% by 5 years, with significant complications such as infections and strokes noted.
- The findings highlight improved survival outcomes compared to earlier registries, despite patients being older and having more severe conditions, indicating differences in national treatment approaches and patient profiles.
Article Synopsis
- The study aimed to assess how uncommon etiologies of cardiomyopathy affect patient outcomes in those receiving Left-ventricular assist devices (LVADs) compared to more common ischemic or idiopathic dilated cardiomyopathies.
- Conducted over 19 centers from 2006 to 2016, the research found that out of 652 LVAD recipients, 90.5% had ischemic/idiopathic causes, while 9.5% had uncommon causes like hypertrophic cardiomyopathy, cancer-related cardiac dysfunction, and myocarditis.
- Although both groups had similar survival rates during a 9.1-month follow-up, those with hypertrophic cardiomyopathy,
Article Synopsis
- The study investigates the occurrence and impact of early ventricular arrhythmias (VAs) in patients who received left ventricular assist devices (LVAD) post-surgery, focusing on the first 30 days after implantation.
- Significant predictors of early VAs include a prior history of VAs and undergoing additional surgeries alongside the LVAD procedure, with early VAs notably increasing the risk of death within the first month.
- Despite early VAs raising the risk of 30-day mortality, they do not affect long-term survival rates in patients who are discharged alive from the hospital.*
Background: Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes.
Objective: We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients.
Methods: Patients analyzed were those included in the multicenter ASSIST-ICD observational study.
Background: Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections.
Methods: Patients included in the ASSIST-ICD study (19 centers) were enrolled.
Background: Diaphragm paresis is common after cardiac surgery and may delay the weaning from the ventilator. Our objective was to evaluate diaphragm thickening during weaning and secondly the muscle thickness as a marker of myotrauma.
Methods: Patients undergoing elective cardiac surgery were prospectively included.
Introduction: Previous studies have shown that statin use before coronary surgery decreases the mortality and morbidity. This benefit was not clearly detected in isolated valve surgery. The aim of this study was to assess the effect of preoperative statin therapy on postoperative complications and mortality in a large group of patients undergoing valve surgery.
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- * Conducted at 19 centers over a decade, the study tracked 659 LVAD recipients, finding that 26.9% experienced late VAs, defined as sustained arrhythmias requiring treatment more than 30 days post-implant.
- * Researchers identified six key risk factors for late VAs, leading to the development of a "VT-LVAD score" that categorizes patients into risk groups, potentially aiding in decision-making for ICD implantation.
Objectives: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients.
Methods: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus.