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Papers by Luc Jacquet

Research paper thumbnail of Point-of-care versus diagnostic ultrasound in the intensive care unit

Poster: "ECR 2013 / A-196 / Point-of-care versus diagnostic ultrasound in the intensive care... more Poster: "ECR 2013 / A-196 / Point-of-care versus diagnostic ultrasound in the intensive care unit " by: " E. Danse 1, P.-F. Laterre1, L. Jacquet1, C. A. Dragean2, M. I. Nica1, P. Trefois3, L. Annet1; 1Brussels/BE, 2Bruxelles/BE, 3Bruxelles, Bruxelles/BE"

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Research paper thumbnail of Evolution of human cardiac myocyte dimension during prolonged mechanical support

The Journal of Thoracic and Cardiovascular Surgery, 1991

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Research paper thumbnail of Abstract 17830: Are Continuous-Flow Left Ventricular Assist Devices (CF-LVAD) Better Than the Waiting List? A Propensity-score Matched Analysis of CF-LVAD versus Waiting List for Adult Patients in United Network for Organ Sharing Status II (UNOS-II)

Circulation, Nov 25, 2014

Introduction: The improved outcomes of third-generation continuous-flow left ventricular assist d... more Introduction: The improved outcomes of third-generation continuous-flow left ventricular assist devices (CF-LVAD) in bridge-to-transplant and the high attrition rate among patients awaiting an allograft have raised the question whether CF-LVADs are better than the waiting list for transplant eligible patients. Hypothesis: we assessed the hypothesis that survival after LVAD is improved compared to waiting list in adult patients listed in UNOS status II. Methods: We identified all patients >18 years of age in the Organ Procurement and Transplantation Network (OPTN) database listed for their first heart transplant in the US in UNOS status II with no mechanical circulatory support at time of listing and not candidates to multi-organ transplant between January 2011 and March 2014. Of 2468 patients listed during the study period, 208 patients received a third-generation CF-LVAD. CF-LVAD and NO-LVAD patients were then matched 1:2 by mean of the closest-neighbor Propensity Score and survival of the matched groups was estimated with the Kaplan-Meier method. Results: One hundred and ninety CF-LVAD patients were PS-matched with 380 NO-LVAD patients. The matched groups were similar for several baseline characteristics (p=ns). In the CF-LVAD subgroup, 158 patients (83.2%) were transplanted, 21 (11.1%) were still on support and on the list, and 11 patients (5.8%) died or were delisted. In the NO-LVAD group, 314 patients (82.6%) were transplanted, 48 (12.6%) were still on the list and 18 patients (4.7%) died or were delisted. Freedom from death or delisting with CF-LVAD was 80.5% versus 85.5% of NO-LVAD patients at 18 months postoperatively (p=0.4). Cumulative survival considering also the post-transplant period was similar in the two groups at 24 months since listing (80.4% CF-LVAD versus 79.4% NO-LVAD, p=0.3). Conclusions: In conclusion, heart transplant candidates listed in status II and supported with CF-LVAD have shown a similar survival on the waiting list compared to candidates without LVAD. Overall survival of patients who received CF-LVAD was similar to survival of patients who did not receive mechanical support. Further studies are needed to clarify whether the allocation advantage given to the LVAD patients on the waiting list is still justified.

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Research paper thumbnail of Can prolonged intensive care therapy be predicted in cardiac surgical patients?

Current Opinion in Critical Care, 1999

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Research paper thumbnail of The History of Research on Ventricular Assist Devices and Total Artificial Heart

Dawn and Evolution of Cardiac Procedures, 2012

This chapter will focus on research specifically aimed at the total or partial replacement of the... more This chapter will focus on research specifically aimed at the total or partial replacement of the heart’s function or that of one of its ventricles to support a failing heart for a prolonged period of time. The first report on the use a total artificial heart (TAH) to sustain life in an animal dates back to 1958. In 1969, the first human implantation of a pneumatic TAH was reported for bridge to transplantation and, after more than 10 years of research, a TAH as definitive therapy was used for the first time in 1982 without much success. About 20 years later, a totally implantable pump was released for clinical use. The initial feasibility study demonstrated that the device still needs improvements before a more widespread application can be expected. Most of the initial ventricular assist devices (VAD) were internal or paracorporeal pneumatically activated blood pumps and were temporarily used while waiting recovery of the heart’s function or as a bridge to transplantation. For long-term support, however, an internal energy converter was necessary. An electrically activated LVAD was designed and used for the first time in 1984. In the 1990s, two implantable, electrically activated VAD were extensively used as a bridge to transplantation with excellent long-term results that opened the way to their use as destination therapy. Smaller continuous flow pumps, either centrifugal or axial, were created to overcome the problems of the pulsatile pumps. Some of these smaller pumps are nowadays used for extended duration with excellent results. Continuous flow technology is now integrated into TAH that are investigated in animals.

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Research paper thumbnail of Conduite et complications de l’oxygénation extracorporelle veinoveineuse

Réanimation, 2013

RésuméCet article se propose de tracer, à la lumière de la littérature, les grandes lignes de la ... more RésuméCet article se propose de tracer, à la lumière de la littérature, les grandes lignes de la prise en charge des patients traités par oxygénation extracorporelle veinoveineuse pour une insuffisance respiratoire réfractaire aux traitements conventionnels. Nous diviserons la période d’assistance externe en trois phases successives : la phase d’initiation du traitement, une phase d’entretien et une phase de sevrage et d’arrêt de la thérapeutique. À chacune de ces périodes, nous nous attacherons à décrire les réglages et la surveillance du circuit extérieur ainsi que le traitement et la surveillance du patient lui-même. Nous nous attacherons également à décrire à chaque étape les complications le plus fréquemment rencontrées et les traitements proposés.AbstractThis article reviews the management of patients treated with venovenous extracorporeal membrane oxygenation (ECMO) for acute respiratory failure refractory to the conventional therapies. The period of extracorporeal respiratory support can be divided in three successive periods: the period of ECMO initiation, the period of treatment with ECMO, and the period of ECMO weaning. We will describe the main technical aspects of ECMO as well as the monitoring of the extracorporeal circuit and the ECMO-treated patient. The most frequent complications in each period of the management of ECMO-treated patients will be described and the possible adequate solutions will be considered.

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Research paper thumbnail of The Case ∣ Multiple-organ failure in a dialysis patient with pericarditis

Kidney International, 2011

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Research paper thumbnail of Hemodynamic effects and safety of sotalol in the prevention of supraventricular arrhythmias after coronary artery bypass surgery

Journal of Cardiothoracic and Vascular Anesthesia, 1994

Sotalol is a beta-adrenergic blocking drug with the additional property of lengthening the cardia... more Sotalol is a beta-adrenergic blocking drug with the additional property of lengthening the cardiac action potential. These electrophysiologic properties render the drug attractive for use in the prevention of postoperative supraventricular arrhythmias (SVA), and previous studies have suggested that it was indeed effective. The hemodynamic response to sotalol and its safety early after coronary artery bypass graft (CABG) surgery were therefore studied. Forty-two patients undergoing CABG were randomly assigned either to receive sotalol to prevent postoperative SVA (25 patients) or to serve as controls (17 patients). Sotalol was started 6 hours after surgery if patients had a cardiac index > 2.8 L/min/m2 with a pulmonary capillary wedge pressure < 15 mmHg, and if they had no contraindications to the use of beta-blockers. The drug was given as a loading infusion of 1 mg/kg over 2 hours, followed by a maintenance infusion of 0.15 mg/kg/h for 24 hours. Three hours later, patients received the first oral dose of 80 mg to be repeated every 8 or 12 hours. Adverse effects necessitating discontinuation of the drug (bradycardia < 50 beats/min, systolic blood pressure < 90 mmHg, or cardiac index < 2.2 L/min/m2) occurred in six patients (24%) and were mainly related to the loading infusion. The hemodynamic data for patients who completed the study were characterized by a significant fall of the cardiac index caused by a lower heart rate without significant change of the stroke volume index. The incidence of supraventricular arrhythmias was not significantly different in the two groups (3/19 in the sotalol group, 5/17 in the control group).(ABSTRACT TRUNCATED AT 250 WORDS)

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Research paper thumbnail of Vasodilatory Shock During Cardiopulmonary Bypass in Bartter Syndrome

Journal of Cardiothoracic and Vascular Anesthesia, 2008

ABSTRACT BARTTER SYNDROME IS A hereditary disorder caused by genetic mutations of the kidney tran... more ABSTRACT BARTTER SYNDROME IS A hereditary disorder caused by genetic mutations of the kidney transporters and ion channels. It is characterized by chronic sodium depletion, reduced intravascular volume. and hyporesponsiveness to aquiotensin II and pressor agents. This results in an increased activation of the renin-angiotensin-aldosterone system and increased production of prostaglandins. Systemic vascular resistance often decreases with the onset of cardiopulmonary bypass (CPB). In some patients, a vasodilatory shock can occur with a severe and sustained drop of blood pressure. The case of a patient with known Bartter syndrome who presented with severe vasodilatory shock during CPB resistant to alpha-agonists and vasopressin but was treated successfully with nonsteroidal anti-inflammatory drugs is presented. This case emphasizes the fact that prostaglandin synthase inhibitors may play a substantial role in treating hypotension during CPB in specific patients.

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Research paper thumbnail of Allosensitization in bridge to transplant Novacor left ventricular assist device patients: analysis of long-term outcomes with regard to acute rejection and chronic allograft vasculopathy☆

European Journal of Cardio-Thoracic Surgery, 2008

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Research paper thumbnail of Randomized trial of intermittent antegrade warm blood versus cold crystalloid cardioplegia

The Annals of Thoracic Surgery, 1999

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Research paper thumbnail of Cardiac rhythm disturbances early after orthotopic heart transplantation: Prevalence and clinical importance of the observed abnormalities

Journal of the American College of Cardiology, 1990

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Research paper thumbnail of Case report Resection of the ascending aorta and aortic valve patch closure for type A aortic dissection after Novacor w LVAD insertion

A 60-year-old patient developed an acute type A aortic dissection in the postoperative course of ... more A 60-year-old patient developed an acute type A aortic dissection in the postoperative course of a Novacorw left ventricular assist device. We performed a resection of the ascending aorta with an aortic valve patch closure, end-to-end anastomosis of the outflow graft to the distal ascending aorta and two venous grafts to the coronary arteries, in order to avoid residual aortic

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Research paper thumbnail of Hypothermic continuous machine perfusion enables preservation of energy charge and functional recovery of heart grafts in an ex vivo model of donation following circulatory death

European Journal of Cardio-Thoracic Surgery, 2015

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Research paper thumbnail of Hypothermic continuous machine perfusion improves metabolic preservation and functional recovery in heart grafts

Transplant International, 2014

The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be ... more The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be enlarged by improving graft preservation. Hypothermic machine perfusion (MP) has been shown to improve kidney, liver, or lung graft preservation. Sixteen pig hearts were recovered following cardioplegia and randomized to two different groups of 4-hour preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems, Itasca, Il). The grafts then underwent reperfusion on a Langendorff for 60 min. Energetic metabolism was quantified at baseline, postpreservation, and postreperfusion by measuring lactate and high-energy phosphates. The contractility index (CI) was assessed both in vivo prior to cardioplegia and during reperfusion. Following reperfusion, the hearts preserved using CS exhibited higher lactate levels (56.63 ± 23.57 vs. 11.25 ± 3.92 μmol/g; P < 0.001), increased adenosine monophosphate/adenosine triphosphate (AMP/ATP) ratio (0.4 ± 0.23 vs. 0.04 ± 0.04; P < 0.001), and lower phosphocreatine/creatine (PCr/Cr) ratio (33.5 ± 12.6 vs. 55.3 ± 5.8; P <0.001). Coronary flow was similar in both groups during reperfusion (107 ± 9 vs. 125 + /-9 ml/100 g/min heart; P = ns). CI decreased in the CS group, yet being well-preserved in the MP group. Compared with CS, MP resulted in improved preservation of the energy state and more successful functional recovery of heart graft.

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Research paper thumbnail of Detection by NeuroSENSE® Cerebral Monitor of Two Major Neurologic Events During Cardiac Surgery

Journal of Cardiothoracic and Vascular Anesthesia, 2013

From the Departments of *Anesthesiology, †Cardiac Intensive Care Unit, ‡Neurology; and §Cardiac S... more From the Departments of *Anesthesiology, †Cardiac Intensive Care Unit, ‡Neurology; and §Cardiac Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium. Address reprint requests to Mona Momeni, MD, PhD, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Anesthesiology, Avenue Hippocrate 10/1821 1200, Brussels, Belgium. E-mail: mona.momeni@uclouvain.be © 2013 Elsevier Inc. All rights reserved. 1053-0770/2602-0033$36.00/0 http://dx.doi.org/10.1053/j.jvca.2013.08.012

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Research paper thumbnail of Smart Bag vs. Standard bag in the temporary substitution of the mechanical ventilation

Intensive Care Medicine, 2008

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Research paper thumbnail of Resection of the ascending aorta and aortic valve patch closure for type A aortic dissection after Novacor® LVAD insertion

European Journal of Cardio-Thoracic Surgery, 2003

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Research paper thumbnail of The effect of chronic mechanical circulatory support on neuroendocrine activation in patients with end-stage heart failure

European Journal of Cardio-Thoracic Surgery, 1999

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Research paper thumbnail of Intensive care outcome of adult patients operated on for congenital heart disease

Intensive care …, 2007

To describe the ICU outcome and the most frequent complications observed in adult patients operat... more To describe the ICU outcome and the most frequent complications observed in adult patients operated on for a congenital heart disease. Retrospective analysis of prospectively collected data and chart review in an adult cardiovascular ICU of a university hospital. 156 patients older than 15 years with congenital heart disease undergoing cardiac surgery between June 2001 and June 2005. According to the initial cardiac malformation, patients were divided in four groups with different operative risk based on the Euroscore: those diagnosed bicuspid aortic valve (n = 73) had a score of 5, those with tetralogy of Fallot (n = 33) 5.5, those with simple cardiac defect (n = 26) 3, and those with complex malformations (n = 24) 6. Only two patients (one with tetralogy of Fallot and one with complex malformations) died during the hospitalization (1.2%). Euroscore clearly overestimates the risk of surgery in this population of adults with congenital heart disease. Mortality and morbidity were low in those diagnosed bicuspid aortic valve, tetralogy of Fallot, or simple cardiac defect, justifying early surgery for incipient complications. Patients with complex congenital defect require prolonged ICU stay, sometimes with mechanical cardiac support, but their overall good outcome justifies these efforts.

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Research paper thumbnail of Point-of-care versus diagnostic ultrasound in the intensive care unit

Poster: "ECR 2013 / A-196 / Point-of-care versus diagnostic ultrasound in the intensive care... more Poster: "ECR 2013 / A-196 / Point-of-care versus diagnostic ultrasound in the intensive care unit " by: " E. Danse 1, P.-F. Laterre1, L. Jacquet1, C. A. Dragean2, M. I. Nica1, P. Trefois3, L. Annet1; 1Brussels/BE, 2Bruxelles/BE, 3Bruxelles, Bruxelles/BE"

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Research paper thumbnail of Evolution of human cardiac myocyte dimension during prolonged mechanical support

The Journal of Thoracic and Cardiovascular Surgery, 1991

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Research paper thumbnail of Abstract 17830: Are Continuous-Flow Left Ventricular Assist Devices (CF-LVAD) Better Than the Waiting List? A Propensity-score Matched Analysis of CF-LVAD versus Waiting List for Adult Patients in United Network for Organ Sharing Status II (UNOS-II)

Circulation, Nov 25, 2014

Introduction: The improved outcomes of third-generation continuous-flow left ventricular assist d... more Introduction: The improved outcomes of third-generation continuous-flow left ventricular assist devices (CF-LVAD) in bridge-to-transplant and the high attrition rate among patients awaiting an allograft have raised the question whether CF-LVADs are better than the waiting list for transplant eligible patients. Hypothesis: we assessed the hypothesis that survival after LVAD is improved compared to waiting list in adult patients listed in UNOS status II. Methods: We identified all patients >18 years of age in the Organ Procurement and Transplantation Network (OPTN) database listed for their first heart transplant in the US in UNOS status II with no mechanical circulatory support at time of listing and not candidates to multi-organ transplant between January 2011 and March 2014. Of 2468 patients listed during the study period, 208 patients received a third-generation CF-LVAD. CF-LVAD and NO-LVAD patients were then matched 1:2 by mean of the closest-neighbor Propensity Score and survival of the matched groups was estimated with the Kaplan-Meier method. Results: One hundred and ninety CF-LVAD patients were PS-matched with 380 NO-LVAD patients. The matched groups were similar for several baseline characteristics (p=ns). In the CF-LVAD subgroup, 158 patients (83.2%) were transplanted, 21 (11.1%) were still on support and on the list, and 11 patients (5.8%) died or were delisted. In the NO-LVAD group, 314 patients (82.6%) were transplanted, 48 (12.6%) were still on the list and 18 patients (4.7%) died or were delisted. Freedom from death or delisting with CF-LVAD was 80.5% versus 85.5% of NO-LVAD patients at 18 months postoperatively (p=0.4). Cumulative survival considering also the post-transplant period was similar in the two groups at 24 months since listing (80.4% CF-LVAD versus 79.4% NO-LVAD, p=0.3). Conclusions: In conclusion, heart transplant candidates listed in status II and supported with CF-LVAD have shown a similar survival on the waiting list compared to candidates without LVAD. Overall survival of patients who received CF-LVAD was similar to survival of patients who did not receive mechanical support. Further studies are needed to clarify whether the allocation advantage given to the LVAD patients on the waiting list is still justified.

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Research paper thumbnail of Can prolonged intensive care therapy be predicted in cardiac surgical patients?

Current Opinion in Critical Care, 1999

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The History of Research on Ventricular Assist Devices and Total Artificial Heart

Dawn and Evolution of Cardiac Procedures, 2012

This chapter will focus on research specifically aimed at the total or partial replacement of the... more This chapter will focus on research specifically aimed at the total or partial replacement of the heart’s function or that of one of its ventricles to support a failing heart for a prolonged period of time. The first report on the use a total artificial heart (TAH) to sustain life in an animal dates back to 1958. In 1969, the first human implantation of a pneumatic TAH was reported for bridge to transplantation and, after more than 10 years of research, a TAH as definitive therapy was used for the first time in 1982 without much success. About 20 years later, a totally implantable pump was released for clinical use. The initial feasibility study demonstrated that the device still needs improvements before a more widespread application can be expected. Most of the initial ventricular assist devices (VAD) were internal or paracorporeal pneumatically activated blood pumps and were temporarily used while waiting recovery of the heart’s function or as a bridge to transplantation. For long-term support, however, an internal energy converter was necessary. An electrically activated LVAD was designed and used for the first time in 1984. In the 1990s, two implantable, electrically activated VAD were extensively used as a bridge to transplantation with excellent long-term results that opened the way to their use as destination therapy. Smaller continuous flow pumps, either centrifugal or axial, were created to overcome the problems of the pulsatile pumps. Some of these smaller pumps are nowadays used for extended duration with excellent results. Continuous flow technology is now integrated into TAH that are investigated in animals.

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Research paper thumbnail of Conduite et complications de l’oxygénation extracorporelle veinoveineuse

Réanimation, 2013

RésuméCet article se propose de tracer, à la lumière de la littérature, les grandes lignes de la ... more RésuméCet article se propose de tracer, à la lumière de la littérature, les grandes lignes de la prise en charge des patients traités par oxygénation extracorporelle veinoveineuse pour une insuffisance respiratoire réfractaire aux traitements conventionnels. Nous diviserons la période d’assistance externe en trois phases successives : la phase d’initiation du traitement, une phase d’entretien et une phase de sevrage et d’arrêt de la thérapeutique. À chacune de ces périodes, nous nous attacherons à décrire les réglages et la surveillance du circuit extérieur ainsi que le traitement et la surveillance du patient lui-même. Nous nous attacherons également à décrire à chaque étape les complications le plus fréquemment rencontrées et les traitements proposés.AbstractThis article reviews the management of patients treated with venovenous extracorporeal membrane oxygenation (ECMO) for acute respiratory failure refractory to the conventional therapies. The period of extracorporeal respiratory support can be divided in three successive periods: the period of ECMO initiation, the period of treatment with ECMO, and the period of ECMO weaning. We will describe the main technical aspects of ECMO as well as the monitoring of the extracorporeal circuit and the ECMO-treated patient. The most frequent complications in each period of the management of ECMO-treated patients will be described and the possible adequate solutions will be considered.

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Research paper thumbnail of The Case ∣ Multiple-organ failure in a dialysis patient with pericarditis

Kidney International, 2011

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Research paper thumbnail of Hemodynamic effects and safety of sotalol in the prevention of supraventricular arrhythmias after coronary artery bypass surgery

Journal of Cardiothoracic and Vascular Anesthesia, 1994

Sotalol is a beta-adrenergic blocking drug with the additional property of lengthening the cardia... more Sotalol is a beta-adrenergic blocking drug with the additional property of lengthening the cardiac action potential. These electrophysiologic properties render the drug attractive for use in the prevention of postoperative supraventricular arrhythmias (SVA), and previous studies have suggested that it was indeed effective. The hemodynamic response to sotalol and its safety early after coronary artery bypass graft (CABG) surgery were therefore studied. Forty-two patients undergoing CABG were randomly assigned either to receive sotalol to prevent postoperative SVA (25 patients) or to serve as controls (17 patients). Sotalol was started 6 hours after surgery if patients had a cardiac index > 2.8 L/min/m2 with a pulmonary capillary wedge pressure < 15 mmHg, and if they had no contraindications to the use of beta-blockers. The drug was given as a loading infusion of 1 mg/kg over 2 hours, followed by a maintenance infusion of 0.15 mg/kg/h for 24 hours. Three hours later, patients received the first oral dose of 80 mg to be repeated every 8 or 12 hours. Adverse effects necessitating discontinuation of the drug (bradycardia < 50 beats/min, systolic blood pressure < 90 mmHg, or cardiac index < 2.2 L/min/m2) occurred in six patients (24%) and were mainly related to the loading infusion. The hemodynamic data for patients who completed the study were characterized by a significant fall of the cardiac index caused by a lower heart rate without significant change of the stroke volume index. The incidence of supraventricular arrhythmias was not significantly different in the two groups (3/19 in the sotalol group, 5/17 in the control group).(ABSTRACT TRUNCATED AT 250 WORDS)

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Research paper thumbnail of Vasodilatory Shock During Cardiopulmonary Bypass in Bartter Syndrome

Journal of Cardiothoracic and Vascular Anesthesia, 2008

ABSTRACT BARTTER SYNDROME IS A hereditary disorder caused by genetic mutations of the kidney tran... more ABSTRACT BARTTER SYNDROME IS A hereditary disorder caused by genetic mutations of the kidney transporters and ion channels. It is characterized by chronic sodium depletion, reduced intravascular volume. and hyporesponsiveness to aquiotensin II and pressor agents. This results in an increased activation of the renin-angiotensin-aldosterone system and increased production of prostaglandins. Systemic vascular resistance often decreases with the onset of cardiopulmonary bypass (CPB). In some patients, a vasodilatory shock can occur with a severe and sustained drop of blood pressure. The case of a patient with known Bartter syndrome who presented with severe vasodilatory shock during CPB resistant to alpha-agonists and vasopressin but was treated successfully with nonsteroidal anti-inflammatory drugs is presented. This case emphasizes the fact that prostaglandin synthase inhibitors may play a substantial role in treating hypotension during CPB in specific patients.

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Research paper thumbnail of Allosensitization in bridge to transplant Novacor left ventricular assist device patients: analysis of long-term outcomes with regard to acute rejection and chronic allograft vasculopathy☆

European Journal of Cardio-Thoracic Surgery, 2008

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Research paper thumbnail of Randomized trial of intermittent antegrade warm blood versus cold crystalloid cardioplegia

The Annals of Thoracic Surgery, 1999

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Research paper thumbnail of Cardiac rhythm disturbances early after orthotopic heart transplantation: Prevalence and clinical importance of the observed abnormalities

Journal of the American College of Cardiology, 1990

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Research paper thumbnail of Case report Resection of the ascending aorta and aortic valve patch closure for type A aortic dissection after Novacor w LVAD insertion

A 60-year-old patient developed an acute type A aortic dissection in the postoperative course of ... more A 60-year-old patient developed an acute type A aortic dissection in the postoperative course of a Novacorw left ventricular assist device. We performed a resection of the ascending aorta with an aortic valve patch closure, end-to-end anastomosis of the outflow graft to the distal ascending aorta and two venous grafts to the coronary arteries, in order to avoid residual aortic

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Hypothermic continuous machine perfusion enables preservation of energy charge and functional recovery of heart grafts in an ex vivo model of donation following circulatory death

European Journal of Cardio-Thoracic Surgery, 2015

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Research paper thumbnail of Hypothermic continuous machine perfusion improves metabolic preservation and functional recovery in heart grafts

Transplant International, 2014

The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be ... more The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be enlarged by improving graft preservation. Hypothermic machine perfusion (MP) has been shown to improve kidney, liver, or lung graft preservation. Sixteen pig hearts were recovered following cardioplegia and randomized to two different groups of 4-hour preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems, Itasca, Il). The grafts then underwent reperfusion on a Langendorff for 60 min. Energetic metabolism was quantified at baseline, postpreservation, and postreperfusion by measuring lactate and high-energy phosphates. The contractility index (CI) was assessed both in vivo prior to cardioplegia and during reperfusion. Following reperfusion, the hearts preserved using CS exhibited higher lactate levels (56.63 ± 23.57 vs. 11.25 ± 3.92 μmol/g; P < 0.001), increased adenosine monophosphate/adenosine triphosphate (AMP/ATP) ratio (0.4 ± 0.23 vs. 0.04 ± 0.04; P < 0.001), and lower phosphocreatine/creatine (PCr/Cr) ratio (33.5 ± 12.6 vs. 55.3 ± 5.8; P <0.001). Coronary flow was similar in both groups during reperfusion (107 ± 9 vs. 125 + /-9 ml/100 g/min heart; P = ns). CI decreased in the CS group, yet being well-preserved in the MP group. Compared with CS, MP resulted in improved preservation of the energy state and more successful functional recovery of heart graft.

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Research paper thumbnail of Detection by NeuroSENSE® Cerebral Monitor of Two Major Neurologic Events During Cardiac Surgery

Journal of Cardiothoracic and Vascular Anesthesia, 2013

From the Departments of *Anesthesiology, †Cardiac Intensive Care Unit, ‡Neurology; and §Cardiac S... more From the Departments of *Anesthesiology, †Cardiac Intensive Care Unit, ‡Neurology; and §Cardiac Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium. Address reprint requests to Mona Momeni, MD, PhD, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Anesthesiology, Avenue Hippocrate 10/1821 1200, Brussels, Belgium. E-mail: mona.momeni@uclouvain.be © 2013 Elsevier Inc. All rights reserved. 1053-0770/2602-0033$36.00/0 http://dx.doi.org/10.1053/j.jvca.2013.08.012

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Research paper thumbnail of Smart Bag vs. Standard bag in the temporary substitution of the mechanical ventilation

Intensive Care Medicine, 2008

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Research paper thumbnail of Resection of the ascending aorta and aortic valve patch closure for type A aortic dissection after Novacor® LVAD insertion

European Journal of Cardio-Thoracic Surgery, 2003

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Research paper thumbnail of The effect of chronic mechanical circulatory support on neuroendocrine activation in patients with end-stage heart failure

European Journal of Cardio-Thoracic Surgery, 1999

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Research paper thumbnail of Intensive care outcome of adult patients operated on for congenital heart disease

Intensive care …, 2007

To describe the ICU outcome and the most frequent complications observed in adult patients operat... more To describe the ICU outcome and the most frequent complications observed in adult patients operated on for a congenital heart disease. Retrospective analysis of prospectively collected data and chart review in an adult cardiovascular ICU of a university hospital. 156 patients older than 15 years with congenital heart disease undergoing cardiac surgery between June 2001 and June 2005. According to the initial cardiac malformation, patients were divided in four groups with different operative risk based on the Euroscore: those diagnosed bicuspid aortic valve (n = 73) had a score of 5, those with tetralogy of Fallot (n = 33) 5.5, those with simple cardiac defect (n = 26) 3, and those with complex malformations (n = 24) 6. Only two patients (one with tetralogy of Fallot and one with complex malformations) died during the hospitalization (1.2%). Euroscore clearly overestimates the risk of surgery in this population of adults with congenital heart disease. Mortality and morbidity were low in those diagnosed bicuspid aortic valve, tetralogy of Fallot, or simple cardiac defect, justifying early surgery for incipient complications. Patients with complex congenital defect require prolonged ICU stay, sometimes with mechanical cardiac support, but their overall good outcome justifies these efforts.

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