Publications by authors named "Radu Costin"
Background And Aims: Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery.
Methods: In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4-5, and high: ≥6).
Article Synopsis
- The study investigated how patients with acute respiratory distress syndrome (ARDS) tolerate changes to the ECMO membrane during veno-venous ECMO (VV-ECMO).
- Out of 70 patients treated with VV-ECMO, 32 required 56 membrane changes due to complications, with 59% of these changes resulting in severe adverse events such as hypoxemia or cardiac issues.
- Key factors linked to poor tolerance of membrane changes were identified as low tidal volume, low respiratory compliance, low oxygen levels, and high blood flow through the ECMO system, with specific threshold values established for assessing risk.
Introduction: Pulmonary vascular dysfunction during severe acute respiratory distress syndrome (ARDS) may lead to right ventricle (RV) dysfunction and acute cor pulmonale (ACP). The occurrence/persistence of ACP despite conventional extracorporeal membrane oxygenation (ECMO) is a challenging situation. We explored the usefulness of a specific dual-lumen cannula that bypasses the RV, and on which a veno-pulmonary arterial assist (V-P ECMO) was mounted, in ARDS patients.
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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.
Objectives: The TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.
Methods: Using a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017.
Unlabelled: Heart transplantation in cardiac amyloidosis (CA) patients is possible and generally considered for transplantation if other organs are not affected. In this study, we aimed to describe and assess outcome in patients following heart transplantations at our CA referral center.
Methods: We assessed all CA patients that had heart transplantations at our center between 2005 and 2018.
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.
Background: Veno-arterial Extracorporeal Life Support (V-A ECLS) has gained increasing place into the management of patients with refractory cardiogenic shock or cardiac arrest. Both surgical and percutaneous approach can be used for cannulation, but percutaneous approach has been associated with fewer complications. Angio-guided percutaneous cannulation and decannulation may further decrease the rate of complication.
View Article and Find Full Text PDFBackground: Aging myocardium undergoes progressive cardiac hypertrophy and interstitial fibrosis with diastolic and systolic dysfunction. Recent metabolomics studies shed light on amino acids in aging. The present study aimed to dissect how aging leads to elevated plasma levels of the essential amino acid phenylalanine and how it may promote age-related cardiac dysfunction.
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- 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.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation for patients with cardiogenic shock or cardiac arrest is an attractive strategy since it provides a quick restoration of organ perfusion. One major limitation of VA-ECMO is left ventricle (LV) distension which is associated with poor prognosis. To prevent or treat LV distension, LV decompression may be required.
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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.
Late cardiovascular complication after varicose vein endovascular ablation.
Interact Cardiovasc Thorac Surg
May 2020
Venous insufficiency of the lower limbs is one of the most common vascular disorders affecting millions of people worldwide. Endovascular techniques are considered by current guidelines as simple, safe and effective. Persistence or even migration of foreign bodies after varicose vein endovascular surgery is a rare and unfeared complication.
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- The use of temporary mechanical circulatory support through venoarterial ECMO is growing for patients with severe acute circulatory failure that doesn't respond to standard treatments.
- Proper implantation and daily management of these devices require specialized expertise and resources.
- The current organization and regulation for managing these patients is unclear, prompting the suggestion for a dedicated territorial structure to enhance care.
Aims: Cardiac fibrosis is associated with left ventricular (LV) remodelling and contractile dysfunction in aortic stenosis (AS). The fibrotic process in this condition is still unclear. The aim of this study was to determine the role of both local and systemic inflammation as underlying mechanisms of LV fibrosis and contractile dysfunction.
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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.
Background: Aortic valve calcification (AVC) quantification is computed from multidetector computed tomography (MDCT). The aim of this study was to test the hypothesis that three-dimensional (3D) transthoracic echocardiography can be used to provide a bedside method to assess AVC.
Methods: The study included 94 patients (mean age, 78 ± 12 years; mean aortic valve [AV] area, 1.
Exercise Training in a Patient With a Left Ventricular Assist Device and Large Aortic Valve Thrombus.
J Cardiopulm Rehabil Prev
November 2017
Details Of The Clinical Case: An aortic valve thrombus (AVT) is a rare complication after HeartMate II implantation. In a 44-year-old man, a large AVT was discovered 6 weeks after implantation of a HeartMate II for severe dilated cardiomyopathy. The aortic valve was permanently closed.
View Article and Find Full Text PDFAims: Serial invasive endomyocardial biopsies (EMB) remain the gold standard for acute cellular rejection (ACR) diagnosis. However histological grading has several limitations. We aimed to explore the value of myocardial Gene Expression Profiling (GEP) for diagnosing and identifying predictive biomarkers of ACR.
View Article and Find Full Text PDFBackground: Right ventricular (RV) dysfunction is a strong predictor of poor outcomes in heart failure. Its prognostic meaning in cardiac amyloidosis (CA) is under-investigated.
Methods: Hundred and twenty nine patients with suspected CA and an interventricular septum thickness (IVST) ≥ 12 mm underwent echocardiography with measurement of left ventricular (LV) and RV longitudinal strain (LS), late gadolinium-enhancement (LGE) cardiac MRI, and standard evaluation.
Meckel diverticulum is the most common abnormality of the gastrointestinal tract arising from an incomplete obliteration of the vitelline duct during the intrauterine life. Although tumor development in Meckel diverticulum is not a common situation, it can occur due to the persistence of cellular islets with gastric, pancreatic or intestinal origin. The presence of a neuroendocrine tumor arising from Meckel diverticulum is even scarcer.
View Article and Find Full Text PDFObjectives: The aim of this study was to compare left ventricular longitudinal strain (LS) evaluated by 2-dimensional echocardiography with cardiac magnetic resonance (CMR) in cardiac amyloidosis (CA), establish correlations between histological and imaging findings, and assess the prognostic usefulness of LS measurement and CMR.
Background: CA is a condition with a poor prognosis due chiefly to 3 forms of amyloidosis: light-chain amyloidosis (AL), hereditary transthyretin (M-TTR), and wild-type transthyretin (WT-TTR). Two-dimensional echocardiography measurement of LS has been reported to detect early left ventricular systolic dysfunction.