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Le but de cette étude est d'analyser le pronostic vital à court et à long terme des patients ayant bénéficié d'une chirurgie de remplacement de la valve aortique (RVAo) par une prothèse mécanique. Dans un but de contrôle de qualité, nous souhaitons comparer les événements observés à ceux prédits par des scores validés pour la mortalité et les autres complications à court et à long terme. Une évaluation du pouvoir de prédiction des différents scores pour la prédiction de la mortalité à 1 an est réalisée.Matériel et méthodes : Une série consécutive de 690 patients (63 ans d'âge moyen) ayant bénéficié d'un RVAo par une prothèse mécanique de janvier 1998 à décembre 2012. L'implantation a été associée à un pontage coronarien chez 214 patients (31,0 %), à un BENTALL chez 80 patients (11,6 %), à une buse/plastie chez 14 patients (2,0 %), à une myomectomie septale chez 23 patients (3,3 %), à une endartériectomie carotidienne chez 15 patients (2,2 %), à un MAZE chez 9 patients (1,3 %) et à une fermeture d'un foramen ovale perméable chez 10 patients (1,4 %). Le devenir à court et à long terme fut analysé rétrospectivement et comparé à des scores prédictifs (l'EuroSCORE I, l'EuroSCORE II et le STS).Résultats: La mortalité opératoire est de 4,3%. Les complications post-opératoires sont : un infarctus du myocarde chez 17 patients (2,5%), un AVC chez 12 patients (1,7%), une dialyse chez 25 patients (3,6%), une implantation d'un pacemaker chez 37 patients (5,4%) et de la FA chez 279 patients (40,4%). Les complications à long terme sur une durée de 3,4 années de suivi moyen, sont : 39 événements hémorragiques (5,7%), 24 AVC (3,5%), 8 reprise de plaie sternale (1 ,2%), 6 redo (0,9%), 4 dysfonctions valvulaires (0,6%), 2 endocardites (0,3%) et 2 embolies périphérique s (0,3%). Le taux de survie global, estimé par la méthode de KAPLAN-MEIER, à 5 et 10 ans étaient respectivement de 84% et 60%. Pour la prédiction de la mortalité à 1 an, l'EuroSCORE 1 a la meilleure courbe ROC avec une AUC à 0,77.Conclusion : Le taux de mortalité observé est similaire aux valeurs prédites par l'EuroSCORE I et l'EuroSCORE Il. Les taux de complications procédurales correspondent aux valeurs prédites par le STS, sauf pour la ventilation prolongée et la réopération où nous avons obtenu un résultat inférieur, c'est-à-dire meilleur dans ce cas-ci. The purpose of this study is to analyze the short and long-term prognosis of patients who underwent aortic valve replacement surgery by a mechanical prosthesis. For quality control purposes, we wanted to compare the events observed against predicted scores validated for mortality and other short and long-term complications. An evaluation of the predictive power of the different scores for the prediction of 1-year mortality is carried out.Material and methods: A consecutive series of 690 patients (average age 63 years) having benefited an aortic valve replacement by a mechanical prosthesis from January 1998 to December 2012. The implantation was associated with coronary artery bypass grafting for 214 patients (31,0%), with a BENTALL for 80 patients (11,6%), with a Buse / plasty for 14 patients (2,0%), with a septal myomectomy for 23 patients (3,3%), with a carotid endarterectomy for 15 patients (2,2%), with a MAZE in 9 patients (1,3%) and with a closure of a patent foramen ovale for 10 patients (1,4%). The short and long term future was retrospectively analyzed and compared with predictive scores (the EuroSCORE I, II and STS).Results: Operative mortality was 4,3%. Postoperative complications were: a myocardial infarction for 17 patients (2,5%), a stroke for 12 patients (1,7%), a dialysis for 25 patients (3,6%), the implantation of a pacemaker for 37 patients (5,4%) and FA for 279 patients (40,4%). Long­ term complications over an average follow-up period of 3.4 years are: 39 bleeding events (5,7%), 24 strokes (3,5%), 8 resumption of sternal wound (1,2%), redo 6 (0,9%), 4 valvular dysfunction (0,6%), 2 endocarditis (0,3%) and 2 peripheral embolism (0,3%). The overall survival rate, estimated by the Kaplan-Meier method, to 5 and 10 years were 84% and 60% respectively. For the prediction of 1-year mortality, the EuroSCORE I has the best curve with a ROC AUC 0,77. Conclusions: The observed mo1tality rate is similar to the values predicted by the EuroSCORE 1 and II. The rates of procedural complications correspond to the values assessed by the STS, except for prolonged ventilation and reoperation where we obtained a lower (better) result.

Transcatheter Aortic Valve Replacement --- Heart Valve Prosthesis Implantation

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"Advances in structural heart disease (SHD) is occurring at a rapid rate, and the Mayo Clinic is at the forefront of developing procedural techniques in this fast-changing field. Handbook of Structural Heart Interventions provides practical, focused coverage of SHD, bringing you up to date with today's evidence-based techniques and approaches for common and uncommon SHD procedures. Ideal for both SHD trainees and established practitioners, attendings, and fellows in interventional cardiology, this easy-to-use handbook is a unique educational and clinical resource in a quickly expanding field"--Publisher's description.

Heart --- Cardiac Catheterization --- Cardiac Surgical Procedures --- Transcatheter Aortic Valve Replacement --- Heart Diseases --- Heart Defects, Congenital --- Abnormalities. --- Diseases --- Treatment. --- methods. --- surgery. --- Heart defects --- Abnormities and deformities

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Structural heart disease encompasses a wide range of abnormalities involving noncoronary structures like the heart's valves, walls, and chambers. The last decade emphasized the burden of the disease and revolutionized the treatment strategies. The number of percutaneous structural heart interventions constantly increases worldwide. While some parts of the world acquire experience with various intervention treatments, techniques, and devices, others are paving their first steps. Complex Cases in Structural Heart Interventions provide a descriptive and highly illustrative insight into unique clinical situations managed by one of the world's most experienced and innovative teams. Each case study contains a clinical presentation, imaging analysis, procedural dilemmas, and resulting outcome. A detailed explanation of the technique used, key points and tips were highlighted, and a literature review covered broad knowledge on each topic. The authors shared their knowledge and distinctive solutions from over a decade of experience to ensure an educational adventure for the medical community and a roadmap for interventional heart teams.

Heart --- Diseases --- Treatment. --- Transcatheter Aortic Valve Replacement --- Heart Valve Diseases --- Balloon Valvuloplasty --- surgery --- Balloon Valvotomy --- Balloon Valvotomies --- Balloon Valvuloplasties --- Valvotomies, Balloon --- Valvotomy, Balloon --- Valvuloplasties, Balloon --- Valvuloplasty, Balloon --- Transcatheter Aortic Valve Implantation

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There has been significant progress in the field of interventional cardiology, from the development of newer devices to newer applications of technology, resulting in improved cardiovascular outcomes. The goal of this Special Issue is to update practicing clinicians and provide a comprehensive collection of original articles, reviews, and editorials. To this end, we invited state-of-the-art reviews, including reviews of new technology and therapeutics, as well as original research in this area to be considered for inclusion in this issue. Examples include the history and evolution of interventional techniques, reviews of specific devices and technologies for coronary artery disease (i.e., stent technology, atherectomy devices, coronary physiology, intracoronary imaging, and robotics), structural heart diseases (i.e., ASD: atrial septal defect; LAAC: left atrial appendage closure; MC: MitraClip; PFO: patent foramen ovale; TAVI: transcatheter aortic valve implantation), advances in the management of challenging coronary anatomy, new biomarkers of cardiovascular disease (noncoding RNAs, etc.), and interventional techniques in the management of heart failure, peripheral arterial diseases, and pulmonary embolism. This Special Issue presents the most recent advances in the field of coronary and structural heart diseases as well as their implications for future patient care.

Medicine --- left atrial appendage --- WATCHMAN occlusive device --- 2D transesophageal echocardiography --- 3D transesophageal echocardiography --- computerized tomography --- atherosclerosis --- cholesterol --- FDG --- inflammation --- PET --- statins --- coronary artery bypass --- on-pump coronary artery bypass --- off-pump coronary artery bypass --- young patients --- severe aortic stenosis --- longitudinal axis strain --- late gadolinium enhancement --- cardiac magnetic resonance imaging --- optical coherence tomography --- percutaneous coronary interventions --- borderline lesions --- nonsignificant lesions --- left main --- bifurcations --- bilateral internal mammary artery --- coronary artery disease --- coronary artery bypass grafting --- da Vinci --- sternotomy --- outcome --- stent thrombosis --- bioresorbable scaffold --- drug eluting stents --- stent bioresorbable --- congenital heart disease --- cardiac surgery --- open heart --- progenitor cells --- regeneration --- stem cells --- subclinical coronary artery disease --- accelerated atherosclerosis --- HIV infection --- carotid intima-media thickness --- coronary calcium scoring --- coronary CT angiography --- magnetic resonance angiography --- fluorodeoxyglucose positron emission tomography --- mechanical circulatory support --- percutaneous coronary intervention --- cardiogenic shock --- acute myocardial infarction --- patient selection --- right heart catheterization --- pulmonary hypertension --- heart failure --- diagnosis --- prognostic evaluation --- clinical implications --- systemic disease --- cardiac computed tomography --- cardiac magnetic resonance --- feature tracking --- tagging --- myocardial deformation --- strain --- radial --- ulnar --- distal radial --- snuffbox --- aortic valvuloplasty --- dual antiplatelet therapy --- antiplatelet --- structural heart disease --- bioresorbable vascular scaffold --- drug-eluting stent --- angioplasty --- acute coronary syndrome --- chronic total occlusion --- target vessel failure --- re-occlusion --- surveillance coronary angiography --- meta-analysis --- ACURATE neo --- SAPIEN 3 --- transcatheter aortic valve replacement --- TAVR --- TAVI --- low risk --- STS --- aortic stenosis --- SAVR --- left atrial appendage --- WATCHMAN occlusive device --- 2D transesophageal echocardiography --- 3D transesophageal echocardiography --- computerized tomography --- atherosclerosis --- cholesterol --- FDG --- inflammation --- PET --- statins --- coronary artery bypass --- on-pump coronary artery bypass --- off-pump coronary artery bypass --- young patients --- severe aortic stenosis --- longitudinal axis strain --- late gadolinium enhancement --- cardiac magnetic resonance imaging --- optical coherence tomography --- percutaneous coronary interventions --- borderline lesions --- nonsignificant lesions --- left main --- bifurcations --- bilateral internal mammary artery --- coronary artery disease --- coronary artery bypass grafting --- da Vinci --- sternotomy --- outcome --- stent thrombosis --- bioresorbable scaffold --- drug eluting stents --- stent bioresorbable --- congenital heart disease --- cardiac surgery --- open heart --- progenitor cells --- regeneration --- stem cells --- subclinical coronary artery disease --- accelerated atherosclerosis --- HIV infection --- carotid intima-media thickness --- coronary calcium scoring --- coronary CT angiography --- magnetic resonance angiography --- fluorodeoxyglucose positron emission tomography --- mechanical circulatory support --- percutaneous coronary intervention --- cardiogenic shock --- acute myocardial infarction --- patient selection --- right heart catheterization --- pulmonary hypertension --- heart failure --- diagnosis --- prognostic evaluation --- clinical implications --- systemic disease --- cardiac computed tomography --- cardiac magnetic resonance --- feature tracking --- tagging --- myocardial deformation --- strain --- radial --- ulnar --- distal radial --- snuffbox --- aortic valvuloplasty --- dual antiplatelet therapy --- antiplatelet --- structural heart disease --- bioresorbable vascular scaffold --- drug-eluting stent --- angioplasty --- acute coronary syndrome --- chronic total occlusion --- target vessel failure --- re-occlusion --- surveillance coronary angiography --- meta-analysis --- ACURATE neo --- SAPIEN 3 --- transcatheter aortic valve replacement --- TAVR --- TAVI --- low risk --- STS --- aortic stenosis --- SAVR

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The arterial pole is one of the most complex parts of the heart both in development and disease. It involves the collaboration and orchestration of contributions from the first and second heart fields as well as the neural crest. The precursor cells differentiate into endocardial cushions and putative cardiac valves, the myocardium, and epicardium of the heart, but also into the different layers of the main arterial vessels. These include not only the aorta and the pulmonary trunk but also the pulmonary and coronary arteries, and during development, the arterial duct. Many transcriptional and signaling networks act in timely concert to acquire the proper asymmetric development and function and pressure and flow dynamics. This is not only a human or even mammalian ‘enterprise,’ but is also taking place in so-called ancestral forms from fish to reptiles, including birds. In humans, it is small wonder that many clinical syndromes may arise when something in this complexity is amiss. This Special Issue of JCDD contains contributions focussed on the heart fields, congenital cardiac malformations and associated syndromes, with special emphasis on the cardiac outflow tract. The Issue is devoted to Prof. Dr. Adriana Gittenberger-de Groot, who dedicated her extensive career to research on cardiovascular development.

transforming growth factor beta-3 --- cardiac development --- loeys dietz syndrome-5 --- arrhythmogenic right ventricular dysplasia --- rienhoff syndrome --- cleft palate --- congenital heart disease --- outflow tract septation --- signaling networks --- transcription factor AP-2α --- cardiovascular development --- outflow tract --- pharyngeal arch artery --- neural crest cell --- pharyngeal ectoderm --- Tetralogy of Fallot --- monozygotic twins --- discordant phenotype --- genetics --- variations --- epigenetics --- DNA methylation --- candidate genes --- acute aortic syndrome --- cardiovascular disease --- aorta --- aortic valve replacement --- surgical --- aortic surgery --- bicuspid aortic valve --- Bentall --- Kommerell’s diverticulum --- right sided aortic arch --- anomalous left subclavian artery --- arteria lusoria --- tracheal compression --- esophageal compression --- transposition great arteries coronary anatomy --- Rac1 --- proliferation --- cell polarity --- congenital heart defects --- compact myocardium --- trabeculation --- aortic stenosis --- asymptomatic --- early surgery --- watchful waiting --- cardiac progenitor cells --- second heart field --- neural crest --- endocardium --- cushion --- valve --- ductus arteriosus --- neointima --- tunica media --- transcriptome --- lineage tracing --- developmental biology --- cell identity --- atrioventricular valve --- epicardium --- lateral cushion --- major cushion --- myxomatous degeneration --- homograft --- semilunar valves --- aortic regurgitation --- superimposed tissue --- original leaflet --- myofibroblasts --- free edge folding --- remodeling --- dissection of ductus arteriosus --- sudden unexpected intrauterine death --- single coronary artery --- Leiden Convention coronary coding system --- Lipton classification --- coronary artery anatomy --- transposition of the great arteries --- arterial switch operation --- coronary artery --- coronary complications --- imaging --- fetal aortic stenosis --- prenatal ultrasound --- postmortem histology --- speckle tracking analysis --- endocardial fibro-elastosis --- endocardial cushions --- cartilage --- foramen of Panizza --- left aorta --- right aorta --- pulmonary trunk --- pharyngeal arch arteries --- coronary arteries --- cardiac fields --- cardiomyocyte --- progenitor specification --- heart tube --- aortic wall --- cardiovascular pathogenesis --- arterial duct