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Papers by Jean-benoît Thambo

Research paper thumbnail of Reliability of echocardiographic parameters of the systemic right ventricle systolic function: A prospective multicentre study

Archives of Cardiovascular Diseases Supplements, 2021

Research paper thumbnail of Left atrial appendage patency and device-related thrombus after percutaneous left atrial appendage occlusion: a computed tomography study

European heart journal cardiovascular Imaging, Jan 2, 2018

Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-rel... more Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion. Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter. Follow-up CT was performed after >3 months to assess device implantation criteria, device leaks and DRT. CT findings were related to patient and device characteristics, as well as to outcome during follow-up. One-hundred and seventeen patients (age 74 ± 9, 37% women, CHA2DS2VASc 4.4 ± 1.3, and HASBLED 3.5 ± 1.0) were implanted with Amplatzer cardiac plug (ACP)/Amulet (71%) or Watchman (29%). LAA patency was detected in 44% on arterial phase CT images and 69% on venous phase images. The most common leak location was postero-inferior. LAA patency ...

Research paper thumbnail of Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke

New England Journal of Medicine, 2017

Research paper thumbnail of Percutaneous balloon atrial septostomy on top of venoarterial extracorporeal membrane oxygenation results in safe and effective left heart decompression

European heart journal. Acute cardiovascular care, Jan 14, 2016

Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extra... more Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aimed to assess whether balloon atrioseptostomy (BAS) is a safe and efficient strategy. All patients who underwent percutaneous static BAS under VA-ECMO at four tertiary institutions were retrospectively reviewed. From 2000 to 2014, BAS was performed in 64 patients (32 adults and 32 children). Indications for ECMO support included acute myocarditis (31.3%) and non-myocarditis cardiac disease, mostly end-stage dilated cardiomyopathy (32.8%). BAS was required because of pulmonary oedema/haemorrhage and left ventricular (LV) distension. The mean balloon diameter was 21.8 ± 8.4mm. Adequate LA decompression was achieved in all patients. Mean LA pressure fell from 24.2 ± 6.9 mmHg to 7.8 ± 2.6 mmHg (p < 0.001). The left-to-right atrial pressure gradient fell from 17.2 ± 7.1 mmHg to 0.09 ± 0.5 mmHg (p < 0.001). Echocardiography showed an unrestr...

Research paper thumbnail of Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

European journal of pediatrics, Jan 28, 2016

Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the... more Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe permanent cardiac pacing in almost all patients, including those with structural heart abnormalities. Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current understanding of the pathogenetic mechanisms, clinical course, and optimal management of congenital and...

Research paper thumbnail of 0094: Left atrial appendage sizing for percutaneous occlusion with Amplatzer cardiac plug: a multimodality imaging approach

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of 0095: Evaluation of peri device leaks after percutaneous left atrial appendage closure using cardiac computed tomography

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of The future of left atrial appendage occlusions: When extraordinary claims require evidence…

Archives of Cardiovascular Diseases, 2015

Research paper thumbnail of Characteristics and long-term outcome of non-immune isolated atrioventricular block diagnosed in utero or early childhood: a multicentre study

European Heart Journal, 2011

Research paper thumbnail of 341 Parental electrocardiographic screening identifies a high degree of inheritance for congenital and childhood non-immune isolated atrioventricular block

Archives of Cardiovascular Diseases Supplements, 2012

Research paper thumbnail of 325 Clinical presentation and long-term clinical outcomes of non immune, isolated atrioventricular block diagnosed in utero or early childhood

Archives of Cardiovascular Diseases Supplements, 2012

Research paper thumbnail of 294 Clinical presentation and long-term outcome of non immune and isolated atrioventricular block when congenital or diagnosed during childhood: a French multicentric study on 141 patients

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 242 Clinical presentation and long-term outcome of non immune and isolated atrioventricular block when congenital or diagnosed during childhood: a French multicentric study on 141 patients

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 313 Levosimendan in dilated cardiomyopathy and refractory cardiogenic shock in children

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 0290: Left atrial remodeling after percutaneous left atrial appendage closure

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of Clinical and mutational spectrum in a cohort of 105 unrelated patients with dilated cardiomyopathy

European Journal of Medical Genetics, 2011

Research paper thumbnail of Single-centred experience with levosimendan in paediatric decompensated dilated cardiomyopathy

Archives of cardiovascular diseases, Jan 8, 2015

Children with dilated cardiomyopathy in advanced heart failure may spend a long time awaiting hea... more Children with dilated cardiomyopathy in advanced heart failure may spend a long time awaiting heart transplantation. Consequently, mechanical circulatory support is sometimes required as a bridge to transplantation. Levosimendan, a positive inotropic agent, has been reported to be safe and efficient for the treatment of paediatric heart failure. To report our experience with levosimendan in children with decompensated dilated cardiomyopathy. Paediatric patients with dilated cardiomyopathy on the transplant waiting list and with criteria for mechanical support were included in this single-centred retrospective study. Each patient received at least one 24-hour infusion of levosimendan before mechanical circulatory support was considered. Biological and echocardiographic data were analysed. Six patients were included over a 24-month period. The median age was 25.5months (7.7-34.2months); 82 infusions were performed. Median B-type natriuretic peptide concentration decreased significantl...

Research paper thumbnail of Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients With Atrial Fibrillation

Circulation, 2013

Background— The multicenter PROTECT AF study (Watchman Left Atrial Appendage System for Embolic P... more Background— The multicenter PROTECT AF study (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) was conducted to determine whether percutaneous left atrial appendage closure with a filter device (Watchman) was noninferior to warfarin for stroke prevention in atrial fibrillation. Methods and Results— Patients (n=707) with nonvalvular atrial fibrillation and at least 1 risk factor (age >75 years, hypertension, heart failure, diabetes, or prior stroke/transient ischemic attack) were randomized to either the Watchman device (n=463) or continued warfarin (n=244) in a 2:1 ratio. After device implantation, warfarin was continued for ≈45 days, followed by clopidogrel for 4.5 months and lifelong aspirin. Study discontinuation rates were 15.3% (71/463) and 22.5% (55/244) for the Watchman and warfarin groups, respectively. The time in therapeutic range for the warfarin group was 66%. The composite primary efficacy end point included stroke, s...

Research paper thumbnail of 267: Multiparametric assessment of the Right Ventricle by echography in patients with repaired Tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with MRI

Archives of Cardiovascular Diseases Supplements, 2013

ABSTRACT Evaluation of the right ventricle (RV) using transthoracic echocardiography is challengi... more ABSTRACT Evaluation of the right ventricle (RV) using transthoracic echocardiography is challenging in patients with repaired tetralogy of Fallot (rTOF). To evaluate the accuracy of conventional echocardiographic variables and real-time three-dimensional echocardiography (RT3DE) in assessing right ventricular (RV) volumes and function compared with magnetic resonance imaging (MRI), in adult patients with rTOF and referred for pulmonary valve replacement (PVR). Complete echocardiography was performed on 26 consecutive patients referred for PVR, before and 1 year after surgery. All variables were compared with MRI. Correlations between conventional variables and MRI were absent or poor when assessing RV ejection fraction (RVEF), except for fractional area of change (FAC; r=0.70, P&lt;0.01 before PVR; r=0.68, P&lt;0.01 after PVR) and RT3DE (r=0.96, P&lt;0.01 before PVR; r=0.98, P&lt;0.01 after PVR). The RV volume correlation between RT3DE and MRI was excellent before and after surgery for RV end-diastolic volume (r=0.88, P&lt;0.01 and r=0.91, P&lt;0.01, respectively) and RV end-systolic volume (r=0.92, P&lt;0.01 and r=0.95, P&lt;0.01, respectively). The accuracy of these indices, as a diagnostic test for impaired RV (&lt;45%), was good: Youden&#39;s indexes varied from 0.47 to 0.89; areas under the receiver operating characteristic curve before and after PVR were 0.86 and 0.81 for FAC and 0.98 and 0.97 for RT3DE, respectively. Commonly used echocardiography variables, such as tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity, did not sensitively evaluate global RVEF. A global approach, that includes the whole RV and integration of its different components, was more reliable in patients with rTOF. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Research paper thumbnail of Intra-diaphragmatic pacemaker implantation in very low weight premature neonate

Interactive CardioVascular and Thoracic Surgery, 2009

Implantation of a pacemaker (PM) in very low weight premature neonates can be a challenging proce... more Implantation of a pacemaker (PM) in very low weight premature neonates can be a challenging procedure because of the actual dimension of generators. Ideal placement of the PM is still controversial. We describe a technique of intra-diaphragmatic PM implantation in a 1.3 kg neonate.

Research paper thumbnail of Reliability of echocardiographic parameters of the systemic right ventricle systolic function: A prospective multicentre study

Archives of Cardiovascular Diseases Supplements, 2021

Research paper thumbnail of Left atrial appendage patency and device-related thrombus after percutaneous left atrial appendage occlusion: a computed tomography study

European heart journal cardiovascular Imaging, Jan 2, 2018

Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-rel... more Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion. Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter. Follow-up CT was performed after >3 months to assess device implantation criteria, device leaks and DRT. CT findings were related to patient and device characteristics, as well as to outcome during follow-up. One-hundred and seventeen patients (age 74 ± 9, 37% women, CHA2DS2VASc 4.4 ± 1.3, and HASBLED 3.5 ± 1.0) were implanted with Amplatzer cardiac plug (ACP)/Amulet (71%) or Watchman (29%). LAA patency was detected in 44% on arterial phase CT images and 69% on venous phase images. The most common leak location was postero-inferior. LAA patency ...

Research paper thumbnail of Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke

New England Journal of Medicine, 2017

Research paper thumbnail of Percutaneous balloon atrial septostomy on top of venoarterial extracorporeal membrane oxygenation results in safe and effective left heart decompression

European heart journal. Acute cardiovascular care, Jan 14, 2016

Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extra... more Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aimed to assess whether balloon atrioseptostomy (BAS) is a safe and efficient strategy. All patients who underwent percutaneous static BAS under VA-ECMO at four tertiary institutions were retrospectively reviewed. From 2000 to 2014, BAS was performed in 64 patients (32 adults and 32 children). Indications for ECMO support included acute myocarditis (31.3%) and non-myocarditis cardiac disease, mostly end-stage dilated cardiomyopathy (32.8%). BAS was required because of pulmonary oedema/haemorrhage and left ventricular (LV) distension. The mean balloon diameter was 21.8 ± 8.4mm. Adequate LA decompression was achieved in all patients. Mean LA pressure fell from 24.2 ± 6.9 mmHg to 7.8 ± 2.6 mmHg (p < 0.001). The left-to-right atrial pressure gradient fell from 17.2 ± 7.1 mmHg to 0.09 ± 0.5 mmHg (p < 0.001). Echocardiography showed an unrestr...

Research paper thumbnail of Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

European journal of pediatrics, Jan 28, 2016

Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the... more Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe permanent cardiac pacing in almost all patients, including those with structural heart abnormalities. Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current understanding of the pathogenetic mechanisms, clinical course, and optimal management of congenital and...

Research paper thumbnail of 0094: Left atrial appendage sizing for percutaneous occlusion with Amplatzer cardiac plug: a multimodality imaging approach

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of 0095: Evaluation of peri device leaks after percutaneous left atrial appendage closure using cardiac computed tomography

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of The future of left atrial appendage occlusions: When extraordinary claims require evidence…

Archives of Cardiovascular Diseases, 2015

Research paper thumbnail of Characteristics and long-term outcome of non-immune isolated atrioventricular block diagnosed in utero or early childhood: a multicentre study

European Heart Journal, 2011

Research paper thumbnail of 341 Parental electrocardiographic screening identifies a high degree of inheritance for congenital and childhood non-immune isolated atrioventricular block

Archives of Cardiovascular Diseases Supplements, 2012

Research paper thumbnail of 325 Clinical presentation and long-term clinical outcomes of non immune, isolated atrioventricular block diagnosed in utero or early childhood

Archives of Cardiovascular Diseases Supplements, 2012

Research paper thumbnail of 294 Clinical presentation and long-term outcome of non immune and isolated atrioventricular block when congenital or diagnosed during childhood: a French multicentric study on 141 patients

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 242 Clinical presentation and long-term outcome of non immune and isolated atrioventricular block when congenital or diagnosed during childhood: a French multicentric study on 141 patients

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 313 Levosimendan in dilated cardiomyopathy and refractory cardiogenic shock in children

Archives of Cardiovascular Diseases Supplements, 2011

Research paper thumbnail of 0290: Left atrial remodeling after percutaneous left atrial appendage closure

Archives of Cardiovascular Diseases Supplements, 2016

Research paper thumbnail of Clinical and mutational spectrum in a cohort of 105 unrelated patients with dilated cardiomyopathy

European Journal of Medical Genetics, 2011

Research paper thumbnail of Single-centred experience with levosimendan in paediatric decompensated dilated cardiomyopathy

Archives of cardiovascular diseases, Jan 8, 2015

Children with dilated cardiomyopathy in advanced heart failure may spend a long time awaiting hea... more Children with dilated cardiomyopathy in advanced heart failure may spend a long time awaiting heart transplantation. Consequently, mechanical circulatory support is sometimes required as a bridge to transplantation. Levosimendan, a positive inotropic agent, has been reported to be safe and efficient for the treatment of paediatric heart failure. To report our experience with levosimendan in children with decompensated dilated cardiomyopathy. Paediatric patients with dilated cardiomyopathy on the transplant waiting list and with criteria for mechanical support were included in this single-centred retrospective study. Each patient received at least one 24-hour infusion of levosimendan before mechanical circulatory support was considered. Biological and echocardiographic data were analysed. Six patients were included over a 24-month period. The median age was 25.5months (7.7-34.2months); 82 infusions were performed. Median B-type natriuretic peptide concentration decreased significantl...

Research paper thumbnail of Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients With Atrial Fibrillation

Circulation, 2013

Background— The multicenter PROTECT AF study (Watchman Left Atrial Appendage System for Embolic P... more Background— The multicenter PROTECT AF study (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) was conducted to determine whether percutaneous left atrial appendage closure with a filter device (Watchman) was noninferior to warfarin for stroke prevention in atrial fibrillation. Methods and Results— Patients (n=707) with nonvalvular atrial fibrillation and at least 1 risk factor (age >75 years, hypertension, heart failure, diabetes, or prior stroke/transient ischemic attack) were randomized to either the Watchman device (n=463) or continued warfarin (n=244) in a 2:1 ratio. After device implantation, warfarin was continued for ≈45 days, followed by clopidogrel for 4.5 months and lifelong aspirin. Study discontinuation rates were 15.3% (71/463) and 22.5% (55/244) for the Watchman and warfarin groups, respectively. The time in therapeutic range for the warfarin group was 66%. The composite primary efficacy end point included stroke, s...

Research paper thumbnail of 267: Multiparametric assessment of the Right Ventricle by echography in patients with repaired Tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with MRI

Archives of Cardiovascular Diseases Supplements, 2013

ABSTRACT Evaluation of the right ventricle (RV) using transthoracic echocardiography is challengi... more ABSTRACT Evaluation of the right ventricle (RV) using transthoracic echocardiography is challenging in patients with repaired tetralogy of Fallot (rTOF). To evaluate the accuracy of conventional echocardiographic variables and real-time three-dimensional echocardiography (RT3DE) in assessing right ventricular (RV) volumes and function compared with magnetic resonance imaging (MRI), in adult patients with rTOF and referred for pulmonary valve replacement (PVR). Complete echocardiography was performed on 26 consecutive patients referred for PVR, before and 1 year after surgery. All variables were compared with MRI. Correlations between conventional variables and MRI were absent or poor when assessing RV ejection fraction (RVEF), except for fractional area of change (FAC; r=0.70, P&lt;0.01 before PVR; r=0.68, P&lt;0.01 after PVR) and RT3DE (r=0.96, P&lt;0.01 before PVR; r=0.98, P&lt;0.01 after PVR). The RV volume correlation between RT3DE and MRI was excellent before and after surgery for RV end-diastolic volume (r=0.88, P&lt;0.01 and r=0.91, P&lt;0.01, respectively) and RV end-systolic volume (r=0.92, P&lt;0.01 and r=0.95, P&lt;0.01, respectively). The accuracy of these indices, as a diagnostic test for impaired RV (&lt;45%), was good: Youden&#39;s indexes varied from 0.47 to 0.89; areas under the receiver operating characteristic curve before and after PVR were 0.86 and 0.81 for FAC and 0.98 and 0.97 for RT3DE, respectively. Commonly used echocardiography variables, such as tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity, did not sensitively evaluate global RVEF. A global approach, that includes the whole RV and integration of its different components, was more reliable in patients with rTOF. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Research paper thumbnail of Intra-diaphragmatic pacemaker implantation in very low weight premature neonate

Interactive CardioVascular and Thoracic Surgery, 2009

Implantation of a pacemaker (PM) in very low weight premature neonates can be a challenging proce... more Implantation of a pacemaker (PM) in very low weight premature neonates can be a challenging procedure because of the actual dimension of generators. Ideal placement of the PM is still controversial. We describe a technique of intra-diaphragmatic PM implantation in a 1.3 kg neonate.