Bertrand LEOBON | Université Paul Sabatier de Toulouse (original) (raw)

Papers by Bertrand LEOBON

Archives of Cardiovascular Diseases, Apr 1, 2023

Background: There is a limited understanding of correlation between strain variables obtained in ... more Background: There is a limited understanding of correlation between strain variables obtained in two-dimensional strain echocardiography (2D STE) analysis and three-dimensional echocardiography, especially their role to predict three-dimensional ejection fraction (3D EF). We aimed to evaluate the technical synergy between these two independent techniques. Methods: Retrospective review of transthoracic echocardiogram with 3D and 2D STE from 2016 to 2017 at Veterans Affairs Louisville Hospital. Results: 100 patients were identified. Mean age was 60.9 + 13 with 91% males, 97% in sinus rhythm, mean body surface area 2 + 0.2 kg/ m2. There was a strong negative correlation between global longitudinal strain (GLS) and 3D EF (r=0.84, P=0.001) (figure 1). Moreover, 3D EF could be derived with a strong correlation (r=0.85, P=0.001) from 2D STE derived GLS and end-diastolic volume (EDV) using the following formula: 3D EF=21.036+(-2.128 * GLS) + (0.043 * EDV). However, 3D derived synchrony parameter-'time to minimum systolic volume form 16 segments' (TMSV 16) did not correlate with 2D STE derived synchrony data. Conclusion: GLS demonstrated a good correlation with 3D EF. GLS and EV derived by strain can accurately predict 3D EF.

CardioVascular and Interventional Radiology, Mar 26, 2011

Stent graft has resulted in major advances in the treatment of trauma patients with blunt traumat... more Stent graft has resulted in major advances in the treatment of trauma patients with blunt traumatic aortic injury (TAI) and has become the preferred method of treatment at many trauma centers. In this review, we provide an overview of the place of stent grafts for the management of this disease. As a whole, TEVAR repair of TAIs offers a survival advantage and reduction in major morbidity, including paraplegia, compared with open surgery. However, endovascular procedures in trauma require a sophisticated multidisciplinary and experienced team approach. More research and development of TAI-specific endograft devices is needed and large, multicenter studies will help to clarify the role of TEVAR compared with open repair of TAI.

Journal of Immunology, Dec 1, 2017

The genetic predisposition to multiple sclerosis (MS) is most strongly conveyed by MHC class II h... more The genetic predisposition to multiple sclerosis (MS) is most strongly conveyed by MHC class II haplotypes, possibly by shaping the autoimmune CD4 T cell repertoire. Whether Ag-processing enzymes contribute to MS susceptibility by editing the peptide repertoire presented by these MHC haplotypes is unclear. Thymus-specific serine protease (TSSP) is expressed by thymic epithelial cells and thymic dendritic cells (DCs) and, in these two stromal compartments, TSSP edits the peptide repertoire presented by class II molecules. We show in this article that TSSP increases experimental autoimmune encephalomyelitis severity by limiting central tolerance to myelin oligodendrocyte glycoprotein. The effect on experimental autoimmune encephalomyelitis severity was MHC class II allele dependent, because the lack of TSSP expression conferred protection in NOD mice but not in C57BL/6 mice. Importantly, although human thymic DCs express TSSP, individuals segregate into two groups having a high or 10-fold lower level of expression. Therefore, the level of TSSP expression by thymic DCs may modify the risk factors for MS conferred by some MHC class II haplotypes.

Journal of Interventional Cardiology, Dec 1, 2009

The present observational study compares in-hospital and 12-month clinical outcomes in elderly pa... more The present observational study compares in-hospital and 12-month clinical outcomes in elderly patients with unprotected left main coronary artery disease treated either with coronary artery bypass grafting or drugeluting stent. Methods: From January 2004 to December 2007, 211 patients (pts) with unprotected left main coronary artery (ULMCA) stenosis, aged 75 or older, underwent coronary revascularization either with coronary artery bypass graft (CABG) (106 pts) or drug-eluting stent (DES) (105 pts). The decision to treat with CABG or percutaneous coronary intervention (PCI) was dependent on the patient's and the physician's choice. The occurrence of major adverse cardiac or cerebrovascular events (MACCE: death, nonfatal myocardial infarction, or stroke) and revascularizations was recorded after 1 year of follow-up. A multivariate logistic regression analysis was performed using a propensity score method to take potential baseline differences between groups into account. Results: In-hospital MACCE rates were 5.7% and 3.8% in the CABG and PCI groups, respectively (P = 0.748). After 1 year of follow-up, these rates were, respectively, 13.9% and 14.9% (P = 0.841), and rates for target vessel revascularization at 12 months were 1.0% and 13.9% (P < 0.001). The PCI group was significantly associated with older age, dyslipidemia, history of cancer, high Euroscore, elevated creatininemia, single-vessel disease, fewer chronic occlusions of the left anterior descending artery, and more LMCA stenosis ≥70%. The multivariate logistic regression analysis was adjusted for age, diabetes, left ventricular ejection fraction, Euroscore, and plasma creatininemia and stratified on the score of propensity to be treated with PCI. In the subgroup below median propensity score, the adjusted odds ratio for 1-year MACCE was OR = 0.91 (95% confidence interval: 0.14 to 5.98; P = 0.924) whereas OR was 0.16 (0.04-0.69; P = 0.013) in the subgroup above median propensity score. Conclusions: In patients with a high probability of being treated with PCI (older age, high Euroscore, high creatininemia, single-vessel disease,. . .), the 1-year risk of MACCE was significantly lower in PCI-than in CABG-treated subjects. No significant difference was found in other cases.

Cardiologie du Foetus et de L'enfant, 2021

La dissection aortique aigue est une fracture longitudinale de la paroi de l’aorte. Le traitement... more La dissection aortique aigue est une fracture longitudinale de la paroi de l’aorte. Le traitement vise a reduire et a fixer la lesion, cette «aorto-synthese» va permettre une restauration ad integrum de l’anatomie de l’aorte indispensable pour eviter les complications et conduire a la guerison par cicatrisation.

The Annals of Thoracic Surgery, Sep 1, 2012

A wrapping procedure for acute type A aortic dissection was performed on six elderly patients at ... more A wrapping procedure for acute type A aortic dissection was performed on six elderly patients at high risk for conventional surgery. Aortic valve insufficiency was mild, with no malperfusion syndrome. A Teflon plaque or Dacron vascular prosthesis was passed around the aorta and tightened from the coronary ostia to the innominate artery. No severe neurologic complications or deaths occurred in the postoperative period. Computed tomography and magnetic resonance imaging imaging during follow-up showed aortic diameters had stabilized in all patients.

Springer eBooks, Sep 18, 2013

Annals of Pediatric Cardiology, 2018

We report a rare and serious complication of cardiac strangulation arising from the implantation ... more We report a rare and serious complication of cardiac strangulation arising from the implantation of epicardial pacing leads in a newborn. Patient's follow-up 9-month postsurgery revealed compression under the pulmonary valve annulus by a pacemaker lead, causing progressive stenosis of the right ventricular outflow tract. The epicardial leads were replaced to relieve compression, and stenosis of the right ventricular outflow tract was rectified. Pacemaker implantation in newborns is not without challenges; epicardial leads should be carefully positioned to avoid any compression of cardiac structures.

Archives of Cardiovascular Diseases Supplements, Apr 1, 2015

Introduction: The left diastolic ventricular dysfunction was frequently found in patients with ch... more Introduction: The left diastolic ventricular dysfunction was frequently found in patients with chronic renal fealure. Abnormalities of diastolic function were detected in 50% to 60% of hemodialysis patients.

Journal of Endovascular Therapy, Jun 1, 2011

In their article, Iannelli et al. report a new strategy to treat residual aortic dissection after... more In their article, Iannelli et al. report a new strategy to treat residual aortic dissection after surgical replacement of the ascending aorta. They use a new endovascular version of the Djumbodis Dissection System to join the dissected layers in the aortic arch without occlusion of the supra-aortic vessels. The results in these first 3 cases are promising, since the false lumens in the aortic arches have disappeared on computed tomography (CT) controls at 1 year without complication. The indications for the treatment of residual dissection in the arch are based on symptoms, aortic diameters, or on the growth rate. In these 3 cases, the indication was based on the growth rate. It is important to respect these classical surgical indications because this new strategy is preventive of potential but not ineluctable complications. However, it is impossible to evaluate the intraoperative rupture risk or long-term patency of the supra-aortic vessels based on these first 3 patients. After more patients, good results, and a low rate of complications in controlled trials vs. medical therapy alone, surgeons may be able to extend this procedure to most residual dissections. The different mechanisms of action and the complementary use of stent-grafts and bare stents in the treatment of aortic dissection should also be considered. Stent-grafts are used to cover the main entry of an aortic dissection, decreasing pressure and perfusion of the false lumen in favor of the true lumen. This mechanism is useful in the descending thoracic aorta, where aortic diameter is often important and where most collateral branches are occluded by the dissection. In the aortic arch or in the celiac segment, a bare graft may be efficient if the aorta is not too dilated and if the patency of

The Annals of Thoracic Surgery, Feb 1, 2004

cin serum levels during and after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Ane... more cin serum levels during and after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Anesth 1990;4:204-9. 4. Haessler D, Reverdy ME, Neidecker J, et al. Antibiotic prophylaxis with cefazolin and gentamicin in cardiac surgery for children less than ten kilograms.

Archives of Cardiovascular Diseases, Aug 1, 2014

Conclusions The TCPC postoperative year is marked by a significant increase in the levels of NTpr... more Conclusions The TCPC postoperative year is marked by a significant increase in the levels of NTproBNP. The observation does not seem to vary between left and right dominant ventricular anatomy, neither did it correlate with various parameters. NTproBNP improved in the mid-term follow-up. Disclosure of interest The authors have not supplied their declaration of conflict of interest.

Springer eBooks, Oct 4, 2006

European Journal of Cardio-Thoracic Surgery, Feb 20, 2013

The Journal of Thoracic and Cardiovascular Surgery, 2012

Interactive Cardiovascular and Thoracic Surgery, Mar 5, 2012

We reviewed our institutional experience with congenital mediastinal masses and compared the post... more We reviewed our institutional experience with congenital mediastinal masses and compared the postnatal management and outcome of patients with or without prenatal diagnosis. Between January 1997 and August 2011, 24 patients underwent surgical procedures for congenital mediastinal mass. For eight patients, the mass was detected by prenatal ultrasonography at 27 weeks of gestation (range 22-35). Postnatal management consisted in open surgery for seven patients at a mean age of 9 months (range 1 day-20 months) and sclerotherapy for one lymphangioma at 5 months of life. Sixteen patients had postnatal diagnosis at 137 months (±194) of median age. Eight bronchogenic cysts, seven bronchopulmonary foregut malformations, five teratomas, three lymphangiomas and one haemangioma were operated on. The median age at resection was 28 months (1 day-15 years). There were four emergency procedures and no surgical mortality. The median follow-up was 45 months (3-144). The duration of mechanical ventilation and hospital stay was, respectively, 4.6 h and 7.5 days for antenatal patients and 24.3 h and 14.3 days for postnatal diagnosed patients. Prenatal diagnosis allows early management of congenital mediastinal malformations. Early resection can be performed prior to the occurrence of symptoms 1 year of life and is associated with an excellent outcome and less morbidity.