Publications by authors named "Rouviere P"
Article Synopsis
- Predicting outcomes for patients receiving Left Ventricular Assist Devices (LVADs) is crucial, but current methods focusing on right ventricular function are lacking in prognostic value.
- The study utilized data from the ASSIST-ICD registry to evaluate right ventriculoarterial coupling as a potential predictor of all-cause mortality upon LVAD implantation.
- Findings showed that while some measures like TAPSE/sPAP and PAPi were not linked to long-term survival, the ratio of right atrial pressure to pulmonary capillary wedge pressure (RAP/PCWP) was significantly associated with increased mortality, maintaining its relevance even after adjusting for other risk factors.
Article Synopsis
- - 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.
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.
Background: Novel oral anticoagulants are used in atrial fibrillation. Idarucizumab has been approved for reversal of dabigatran in situations of life-threatening hemorrhage or emergency surgery.
Objectives: We report a single center experience of ten patients on dabigatran therapy who were given idarucizumab prior to heart transplantation.
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.
Rupture of Valsalva sinus remains a very rare and deadly complication of Valsalva sinus aneurysm with a high mortality rate. We report here the case of a 47-year-old man who presented to the emergency department with acute exercise-induced dyspnea, chest pain, and fever. Transthoracic (TTE) and transesophageal echocardiography (TEE) highlighted a rupture of the right Valsalva sinus in the right atrium due to infective endocarditis.
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- 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.
Article Synopsis
- 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.
Article Synopsis
- Heart failure (HF) is widespread and continues to rise globally, even with advances in treatment, especially in advanced heart failure (AdHF) where patients do not respond to standard therapies.
- There is limited research on how medical treatments specifically impact AdHF, but the review highlights the importance of addressing this gap.
- Mechanical circulatory devices (MCD) serve as a viable alternative to heart transplantation for AdHF patients, improving quality of life and reducing mortality, emphasizing the need for timely identification and treatment due to their rapid decline in health.
Article Synopsis
- * 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.
Temporary mechanical circulatory support (TCS) is recommended for patients with profound cardiogenic shock (CS). Extracorporeal membrane oxygenation (ECMO) and Impella are possible TCS devices, but the device choice and the implantation timing are not definitely established, specifically during acute myocardial infarction. We have analyzed the respective use of ECMO or Impella (2.
View Article and Find Full Text PDFPeripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) exposes the patient to a pulmonary blood flow bypass and a left ventricle afterload increase. Impella, a catheter-mounted microaxial rotary pump, has been proposed for left ventricle (LV) unloading in combination with VA ECMO. In order to assess the effect of Impella on pulmonary flow and LV preload, we checked Doppler pulmonary artery velocity-time integral (pVTI) and LV diastolic diameter (LVED) by transesophageal echocardiography and end-tidal carbon dioxide (EtCO2) during a step-by-step increase in Impella flow (Impella ramp test).
View Article and Find Full Text PDFIntroduction: Cardiogenic shock refractory to standard therapy with inotropes and/or intra-aortic balloon pump is accompanied with an unacceptable high mortality. Percutaneous left ventricular assist devices may provide a survival benefit for these very sick patients. In this study, we describe our experience with the Impella 5.
View Article and Find Full Text PDFA coronary artery bypass involves taking blood vessels from another part of the patient's body to bypass one or several major coronary stenoses. Coronary artery bypass using cardiopulmonary bypass and off-pump coronary artery bypass are the two methods used to revascularise the heart after a myocardial infarction.
View Article and Find Full Text PDFBackground: Many proteins and peptides have been used in therapeutic or industrial applications. They are often produced in microbial production hosts by fermentation. Robust protein production in the hosts and efficient downstream purification are two critical factors that could significantly reduce cost for microbial protein production by fermentation.
View Article and Find Full Text PDFBionanotechnology aims to impart new properties to materials from unique functionalities present in biomolecules. However, the promise of bionanotechnology has not materialized beyond the biomedical field due in large part to issues of scalability, purity, and cost of manufacturing. In this work we demonstrate an approach to co-engineer production and system functionality into a single polypeptide.
View Article and Find Full Text PDFVisceral artery aneurysms constitute a rare vascular disease, with a risk of rupture associated to a high mortality. Often asymptomatic, they are discovered following a routine radiological examination. We present the case of a 71-year-old patient with multiple aneurysms involving the celiac trunk, the splenic artery, and the common hepatic artery.
View Article and Find Full Text PDFThere are very few cases in English literature of recurrent postoperative aortic fistulas (RPAFs). These are neo-communications between the aortic bloodstream and the lumen of contiguous organs which occur after unpredictable periods from surgical treatment of a previous fistula. The supradiaphragmatic aorta may fistulize into the airways, pulmonary circulation, oesophagus, and cardiac chambers; the infradiaphragmatic aorta into the intestine, stomach, and vena cava.
View Article and Find Full Text PDFA Brevundimonas vesicularis strain DC263 isolated from surface soil was shown to produce hydroxylated astaxanthin. A carotenoid synthesis gene cluster containing ten genes was cloned from strain DC263, among which eight genes were involved in carotenoid synthesis. In addition to the crtW gene encoding the 4,4'-beta-ionone ring ketolase and the crtZ gene encoding the 3,3'-beta-ionone ring hydroxylase that were responsible for astaxanthin synthesis, the cluster also contained a novel gene crtG identified recently encoding the 2,2'-beta-ionone ring hydroxylase that further hydroxylate astaxanthin.
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