Rémi Houël

Valve (United States)

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Co-Authors

D Loisance

Académie Nationale de Médecine

Matthias Kirsch

University of Lausanne

Emmanuelle Vermès

Centre Hospitalier Universitaire Amiens-Picardie

Pascal Leprince

Fondation pour l’innovation en Cadiométabolisme et Nutrition

Hervé Breton

Centre Hospitalier Universitaire de Rennes

Bernard Albat

Centre Hospitalier Universitaire de Montpellier

Hélène Eltchaninoff

Université de Rouen Normandie

Martine Gilard

Inserm

Dominique Thébert

Hôpital Privé Jacques Cartier

Jin Bo Su

Philips (India)

Cooperative Institutions

Inserm

262

Assistance Publique – Hôpitaux de Paris

161

Université Paris Cité

103

Sorbonne Université

Université Claude Bernard Lyon 1

Centre National de la Recherche Scientifique

Centre Hospitalier Universitaire Henri-Mondor

Hôpitaux Universitaires Henri-Mondor

Pitié-Salpêtrière Hospital

Lille’s Cardiology Hospital

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Aortic wall alterations after use of gelatin-resorcinol-formalin glue

The Annals of Thoracic Surgery (2002)

Matthias Kirsch Maryvonne Ginat Laure Lecerf Rémi Houël D Loisance

GLUE

Gelatin

Resorcinol

10.1016/s0003-4975(01)03008-9

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Citations (36)

[External ventricular support in primary cardiogenic shock].

PubMed (2000)

Rémi Houël Emmanuelle Vermès P. Le Besnerais M. L. Hillion B. Alimoussa

Primary cardiogenic shock is a common condition with a high mortality rate. In this indication, mechanical assist plays an important part and has improved a lot over the last decade. The authors report their experience with the same assist device in patients with primary cardiogenic shock. Nineteen patients (9 dilated cardiomyopathies, 7 myocardial infarctions, 2 myocardities, 1 undetermined) were treated with an external mechanical ventricular assist device (Thoratec, Berkeley, U.S.). Fourteen patients received a biventricular assist and 5 had a uni-left ventricular assist device. Four of the 19 patients were completely weaned off their ventricular assist after 13, 27, 36 and 94 days, respectively. Ten patients underwent transplantation after an average of 43 days (range 8-95 days). Of the 19 patients, 7 had a portable console allowing autonomous ambulation. Five patients died under mechanical assistance (26.9%) and 3 patients died after transplantation. Three patients required temporary haemodialysis; 4 suffered embolic complications; 4 had mediastinal haemorrhages; 4 had bleeding from other sites, and 6 suffered from late tamponnade. Fourteen patients had at least one infectious episode. The authors conclude that, in patients referred for severe primary cardiogenic shock, the implantation of an external biventricular assist is a reliable option, allowing sequential weaning or being a bridge to transplantation in non-dependent patients, providing they are severely selected.

Bridge to transplantation

Destination therapy

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Citations (2)

Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump

Anaesthesia Critical Care & Pain Medicine (2022)

Paul‐Michel Mertès Michel Kindo Julien Amour Christophe Baufreton Lionel Camilleri

To provide recommendations for enhanced recovery after cardiac surgery (ERACS) based on a multimodal perioperative medicine approach in adult cardiac surgery patients with the aim of improving patient satisfaction, reducing postoperative mortality and morbidity, and reducing the length of hospital stay.A consensus committee of 20 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société française d'anesthésie et de réanimation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Société française de chirurgie thoracique et cardio-vasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guideline process was conducted independently of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence.Six fields were defined: (1) selection of the patient pathway and its information; (2) preoperative management and rehabilitation; (3) anaesthesia and analgesia for cardiac surgery; (4) surgical strategy for cardiac surgery and bypass management; (5) patient blood management; and (6) postoperative enhanced recovery. For each field, the objective of the recommendations was to answer questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). Based on these questions, an extensive bibliographic search was carried out and analyses were performed using the GRADE approach. The recommendations were formulated according to the GRADE methodology and then voted on by all the experts according to the GRADE grid method.The SFAR/SFCTCV guideline panel provided 33 recommendations on the management of patients undergoing cardiac surgery under cardiopulmonary bypass or off-pump. After three rounds of voting and several amendments, a strong agreement was reached for the 33 recommendations. Of these recommendations, 10 have a high level of evidence (7 GRADE 1+ and 3 GRADE 1-); 19 have a moderate level of evidence (15 GRADE 2+ and 4 GRADE 2-); and 4 are expert opinions. Finally, no recommendations were provided for 3 questions.Strong agreement existed among the experts to provide recommendations to optimise the complete perioperative management of patients undergoing cardiac surgery.

Grading (engineering)

Guideline

Perioperative medicine

Cardiothoracic surgery

Vascular surgery

10.1016/j.accpm.2022.101059

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Citations (55)

β₂-Adrenergic Signaling in Human Heart: Shift from the Cyclic AMP to the Arachidonic Acid Pathway

Molecular Pharmacology (2003)

Catherine Pavoine Niloufar Behforouz Chantal Gauthier Sabine Le Gouvello Françoise Roudot‐Thoraval

We have recently established that enhancement of intracellular calcium cycling and contraction in response to β₂-adrenergic receptor (β₂-AR) stimulation exclusively relies on the activation of the cytosolic phospholipase A₂ (cPLA₂) and arachidonic acid production, via a pertussis toxin-sensitive G protein (possibly Gi), in embryonic chick cardiomyocytes. We aimed to investigate the relevance of the β₂-AR/Gi/cPLA₂ pathway in the human myocardium. In left ventricular biopsies obtained from explanted hearts, β₂-AR stimulation exerted either an inhibition of cPLA₂ that was insensitive to pertussis toxin (PTX) treatment, or an activation of cPLA₂, sensitive to PTX treatment. In right atrial appendages from patients who were undergoing open heart surgery, we demonstrated that β₂-AR-induced activation of cPLA₂ was favored in situations of altered β₁-AR and/or β₂-AR/adenylyl cyclase (AC) stimulations. Alterations were characterized by an increase in EC₅₀value of norepinephrine and a decrease in the maximal AC activation in response to zinterol, respectively. Quantitative reverse transcription-polymerase chain reaction analyses highlighted a positive correlation between the expression of AC5 and AC6 mRNAs in human cardiac atria, which suggested that functional alterations in AC responses were unlikely to be related to changes in the AC5/AC6 mRNA ratio. In addition, the shift from the cyclic AMP to the arachidonic acid pathway was not supported at the transcriptional level by opposite regulation of AC and cPLA₂mRNAs expression. This study gives the first evidence of the recruitment of cPLA₂by β₂-ARs in the human heart and suggests that the Gi/cPLA₂pathway could substitute for a deficient Gs/AC pathway in mediating β₂-AR responses.

10.1124/mol.64.5.1117

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Citations (30)

Long-term results of the bentall operation versus separate replacement of the ascending aorta and aortic valve.

PubMed (2002)

Rémi Houël Céline Soustelle Matthias Kirsch Marie Line Hillion Carlos Renaut

Aortic valve disease associated with ascending aorta dilatation can be treated either by separate replacement of the aortic valve and ascending aorta, or by a composite valved graft.Between 1974 and 1999, 117 patients underwent a Bentall operation (BP), and 63 a separate replacement procedure (SP) of the ascending aorta and aortic valve. Anatomic lesions were dystrophic aneurysm in 79 patients, annuloectasia in 65, chronic dissection in 14, acute dissection in 18, and other etiology in four. Mean follow up was 3.45+/-3.47 and 8.75+/-6.8 years in the BP and SP groups, respectively.Early mortality was 7.7% in the BP group versus 11% in the SP group (p = NS). Actuarial survival at 10 years postoperatively in these groups was respectively 77.7+/-5.6% versus 75.8+/-6.9% (p = NS). However, freedom from late complication of the ascending aorta was significantly different (97.3+/-1.9% versus 68.3+/-9.0% at 10 years postoperatively). SP was identified as a risk factor for late complication of the ascending aorta by multivariate analysis (p = 0.01; odds ratio = 9). No statistical difference was observed on late reoperation rates.Separate replacement of the ascending aorta and aortic valve carries a higher complication rate for the remaining ascending aorta on long-term follow up when compared with the Bentall procedure. However, there were no differences in terms of late mortality.

Bentall procedure

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Citations (19)

[Computer-assisted coronary surgery].

PubMed (2001)

D Loisance Rémi Houël Matthias Kirsch O Rosanval Dominique Thébert

Mammary artery

Surgical anastomosis

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Citations (1)

Computational simulation model of transcatheter edge-to-edge mitral valve repair: a proof-of-concept study

European Heart Journal - Cardiovascular Imaging (2024)

David Messika‐Zeitoun Jamal Mousavi Mohammad Pourmoazen Florian Cotte Julien Dreyfus

As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in pre-procedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element computational simulation model to predict the results of transcatheter edge-to-edge repair (TEER) interventions.

Proof of concept

10.1093/ehjci/jeae137

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Citations (1)

Pseudointima in Inflow and Outflow Conduits of a Left Ventricular Assist System: Possible Role in Clinical Outcome

ASAIO Journal (2001)

Rémi Houël M Moczar Maryvonne Ginat D Loisance

Activation of blood coagulation and thromboemboli have been shown to present significant clinical risks in patients supported with an left ventricular assist system (LVAS). The interaction of pseudointima (PI) with blood in the conduits of the device could be involved in these clinical complications. Our aim was to study the morphology of the PI versus duration of circulatory support. Novacor N 100 PC LVASs were explanted from 10 men and 2 women after a mean of 209 days (range 23–560 days) of circulatory assistance. PI in the inflow and outflow conduits were investigated with immunohistochemical assays. In the inflow conduits, a loosely adherent PI had built up from collagen type I and III fibers growing into and between fibrin deposits. Disorganized collagenous matrix and longitudinally oriented collagen fibers included α-smooth muscle actin positive cells with random orientation. Macrophages were concentrated in the fibrin and were dispersed throughout the extracellular matrix. In the outflow conduits, a thin, adherent PI was composed of regular collagen type I and III layers. Collagen type I fibers had grown into the woven Dacron and α-smooth muscle actin positive cells were oriented in the axis of the blood flow. Macrophages were concentrated in the Dacron and reached the inner collagen layers. Venous blood flow in the inflow conduits allows the development of a non endothelialized irregular collagenous matrix intermingled with fibrin and invaded by macrophages. These persistent structural features progress with duration of circulatory assistance and reflect matrix degradation and remodeling. The potential to release thromboembolic fragments from the non stable, thrombogenic PI may be involved in the thromboembolic or neurologic complications sustained by 5 of 12 patients who were on circulatory support for as long as 200 days.

Outflow

Inflow

Electrical conduit

Ventricular Function

10.1097/00002480-200105000-00024

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Citations (7)

Doppler tissue imaging to predict myocardial recovery during mechanical circulatory support

The Annals of Thoracic Surgery (2000)

Emmanuelle Vermès Rémi Houël Marc A. Simon P. Le Besnerais D Loisance

Doppler imaging

10.1016/s0003-4975(00)02159-7