97782 Tome 15 – no. 4 – September 2023 ISSN 1878-6480 Supplements Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases Supplements Offi cial journal of the French Society of Cardiology Editor-in-Chief Ariel A Cohen Deputy editor Bernard Iung Editorial board Victor Aboyans Philippe Acar Laurence Amar Denis Angoulvant Franck Boccara Haran Burri Yves Cottin Shinichi Goto Roberto Lang Guillaume Lebreton Christophe Leclercq Gilles Lemesle Paul Milliez Agnès Pasquet Philippe Pibarot Etienne Puymirat Statistical consultant Julien Magne Technical editor Sophie Rushton-Smith How to contact the journal Clarisse Barillé Service de cardiologie Hôpital Saint-Antoine (pavillon Lemierre) 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12 Tel.: 33 (0)1 49282886 E-mail: clarisse.barille@aphp.fr Scientifi c committee E. Aliot (France), P. Amouyel (France), M. Böehm (Germany), P. Bonhoeffer (United Kingdom), D. Bonnet (France), E. Bruckert (France), T. Carrel (Switzerland), M. Cohen (United States), A. Cribier (France), N. Danchin (France), J.-C. Daubert (France), J. Davignon (Canada), G. Derumeaux (France), E. Eeckhout (Switzerland), F. Follath (Switzerland), B. Gerber (Belgium), P. Guéret (France), G. Habib (France), A. Hagege (France), M. Komadja (France), B. Kreitmann (France), R. Lang (United States), S. Laurent (France), H. le Marec (France), J. Lima (United States), N. Ludwig (United Kingdom), Z. Mallat (France), G. Marx (United States), J.-L. Monin (France), E. Mousseaux (France), P. Nataf (France), P. Nihoyannopoulos (United Kingdom), G. Parati (Italy), L. Perrault (Canada), L. Pierard (Belgium), B. Prendergast (United Kingdom), S. Priori (Italy), D. Revel (France), V. Roger (United States), R. Rosenhek (Austria), M. Safar (France), M. Sarano (United States), E.J. Schaefer (United States), M. Scherrer Crosbie (United States), J. Schwitter (Switzerland), P. Serruys (Netherlands), M. Simoons (Netherlands), P.G. Steg (France), G. Tomaselli (United States), P. Tornos (Spain), C. Tribouilloy (France), A. Vahanian (France) Archives of Cardiovascular Diseases Supplements (ISSN 1878-6480) 2023 (volume 15) One year, 4 issues. Address order and payment to Elsevier Masson SAS, Service Abonnements, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex: payment by check or credit card (CB, EuroCard, MasterCard or Visa: indicate no, and expiration date); « La Banque Postale », Centre de Paris, nº RIB 20041 00001 1904540H020 95. Subscriptions begin 4 weeks after receipt of payment and start with the fi rst issue of the calendar year. Back issues and volumes are available from the publisher. Claims for missing issues should be made within 6 months of publication. Includes air delivery. Journal manager – Fabienne Loÿe. Tel.: (33) 01 71 16 54 04. E-mail: f.loye@elsevier.com. Commercial manager – Advertising – Tel.: (33) 01 71 16 51 03. Fax: (33) 01 71 16 51 84. E-mail: Claire Ebersold c.ebersold@elsevier.com Subscriptions – Tel.: (33) 01 71 16 55 99. Fax: (33) 01 71 16 55 77. http://www.em-consulte.com/infos Publisher – Anne-Elisabeth Fournié. E-mail: a.fournie@elsevier.com Publishing director – Daniel Rodriguez Printed in France by Jouve, 53101 Mayenne. Dépôt légal à parution. Archives of Cardiovascular Diseases Supplements
© 2023 Elsevier Masson SAS. All rights reserved. Simplifi ed joint stock company with sole shareholder, with a capital of 47 275 384 €- Sole shareholder: Elsevier Holding France SAS, President: Daniel Rodriguez - Registered offi ce: 65, rue Camille-Desmoulins, 92130 Issy-les-Moulineaux. - RCS Nanterre 542 037 031 This journal and the individual contributions contained in it are protected under copyright, and the following terms and conditions apply to their use in addition to the terms of any Creative Commons or other user license that has been applied by the publisher to an individual article: Photocopying Single photocopies of single articles may be made for personal use as allowed by national copyright laws. Permission is not required for photocopying of articles published under the CC BY license nor for photocopying for non-commercial purposes in accordance with any other user license applied by the publisher. Permission of the publisher and payment of a fee is required for all other photocopying, including multiple or systematic copying, copying for advertising or promotional purposes, resale, and all forms of document delivery. Special rates are available for educational institutions that wish to make photocopies for non-profi t educational classroom use. Derivative Works Users may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions or companies. Other than for articles published under the CC BY license, permission of the publisher is required for resale or distribution outside the subscribing institution or company. For any subscribed articles or articles published under a CC BY-NC-ND license, permission of the publisher is required for all other derivative works, including compilations and translations. Storage or Usage Except as outlined above or as set out in the relevant user license, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission of the publisher. Permissions For information on how to seek permission visit www.elsevier.com/permissions or call: (+44) 1865 843830 (UK) / (+1) 215 239 3804 (USA). Author rights Author(s) may have additional rights in their articles as set out in their agreement with the publisher (more information at http://www.elsevier.com/authorsrights). Notice No responsibility is assumed by the publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verifi cation of diagnoses and drug dosages should be made. Although all advertising material is expected to conform to ethical (medical) standards, inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer. For a full and complete Guide for Authors, please refer to the World Wide Web: http://www.elsevier.com/locate/acvd The Multimedia Components available for your journal are identifi ed by the pictograms listed below. CrossMark logo doesn’t designate a Multimedia Component. It gives readers the information they need to verify that they are using the most recent and reliable versions of a document. Simply click on it. Image Description Image Description Podcast Clinical case Video/Animation Bilingualism Self evaluation Document status Supplementary informations (documents for patients, legal documents, images, decision tree…) Available online at www.sciencedirect.com ScienceDirect Information environmental / Environmental information Origine du papier / Paper origin Italie / Italy Pourcentage des fi bres recyclées / Percentage recycled fi bre 0% Certifi cation des fi bres / fi bre certifi cation PEFC Eutrophisation de l’eau / water eutrophication 6g P tonne-1
Comité local d’organisaƟ on Virginie Fouilloux, Marseille Caroline Ovaert, Marseille OrganisaƟ on logisƟ que OVERCOME 13-15 rue des Sablons 75116 Paris France Tél. : +33 (0)1 40 88 97 97 Fax : +33 (0)1 43 59 76 07 fcpc@overcome.fr Comité scienƟ fi que Sylvie Di Filippo, Lyon (Présidente de la FCPC) SébasƟ en Hascoët, Paris (Secrétaire de la FCPC) Pascal Amedro, Bordeaux Alban-Elouen Baruteau, Nantes Claire Bertail, Lyon Nicolas Combes, Toulouse Olivia Domanski, Lille Clément Karsenty, Toulouse Daniela Laux, Paris Bruno Lefort, Tours Pamela Moceri, Nice Caroline Ovaert, Marseille Jean-Benoît Thambo, Bordeaux Olivier Raisky, Paris
Archives of Cardiovascular Disease Supplements (2023) 15 , iv CONTENTS Available online at www.sciencedirect.com ScienceDirect Éditoriaux Éditorial Le Comité d’Organisation local, C. Ovaert et V. Fouilloux, au nom de toute l’équipe médico-chirurgicale marseillaise ............................................................................................................ 271 Editorial The Local Organising Committee, C. Ovaert and V. Fouilloux, on behalf of the entire Marseille medical and surgical team ......................................................................................... 272 Résumés Communications Orales — Jeudi 14 septembre 2023 de 10h à 11h .............................................. 273 Communications Orales — Vendredi 15 septembre 2023 de 9h30 à 10h30...................................... 277 Présentations fl ash — Jeudi 14 septembre 2023 de 10h00 à 11h00 .............................................. 280 Présentations fl ash — Vendredi 15 septembre 2023 de 9h30 à 10h30 ........................................... 285 Session jeunes chercheurs — Vendredi 15 septembre 2023 de 12h à 13h ....................................... 290 E-posters ................................................................................................................... 293 Index ....................................................................................................................... I11
Archives of Cardiovascular Disease Supplements 15 (2023) 271 Available online at ScienceDirect www.sciencedirect.com Éditorial « Marseille. C’est la ville de tous mes rêves, de toutes mes passions. Marseille la magnifique, la tchatcheuse, la passionnée, la charnelle, Marseille la trop belle, Marseille couleur, Marseille soleil, Marseille porte ouverte, Marseille qui ne donne son cœur qu’à ceux qui l’aiment. » Bernard Tapie Cher(e)s ami(e)s, cher(e)s collègues, C’est avec une grande joie que nous vous invitons à Marseille pour le 19e Congrès de la Filiale de Cardiologie Pédiatrique et Congénitale de la Société fran¸caise de cardiologie, qui se tiendra du mercredi 13 au vendredi 15 septembre 2023 au City Center Vieux Port. Pour cette première édition marseillaise, nous vous proposerons un programme scientifique et social à l’image de notre ville. Le congrès débutera le mercredi 13 septembre par une journée de DPC (médical) consacrée au sujet passionnant de l’insuffisance cardiaque, du fœtus à l’adulte avec cardiopathie congénitale. Suivront ensuite deux jours de sessions scientifiques magnifiques où comme de coutume dans notre société savante, les travaux de nos équipes francophones, et en particulier nos jeunes collaborateurs au sein de ces équipes, seront mis à l’honneur et valorisés. Les sessions à thèmes seront tout aussi riches que palpitantes, incluant entre autres l’hypertension pulmonaire et divers sujets de chirurgie et réanimation. Oui, nous tchatcherons, nous discuterons, nous échangerons, car à Marseille nous aimons garder la porte ouverte aux idées des autres. Marseille la trop Belle veut également accueillir les paramédicaux avec un programme riche en sujets remarquables, incluant la prise en charge anténatale jusqu’à celle des adultes avec cardiopathie congénitale, en passant par le bloc opératoire et la réanimation. Marseille vous donnera son cœur si vous l’aimez, et le programme social, résolument tourné vers la mer et le soleil, vous convaincra de tous ses charmes. Au plaisir de se retrouver tous ensemble ! Le Comité d'Organisation local, Caroline Ovaert∗,Virginie Fouilloux, Au nom de toute l’équipe médico-chirurgicale marseillaise, Service Médico-chirurgical de cardiologie pédiatrique et congénitale, Hôpital de la Timone, Marseille, France ∗Correspondance. E-mail address: caroline.ovaert@ap-hm.fr (C. Ovaert) https://doi.org/10.1016/j.acvdsp.2023.08.001 1878-6480/© 2023 Published by Elsevier Masson SAS.
Archives of Cardiovascular Disease Supplements 15 (2023) 272 Available online at ScienceDirect www.sciencedirect.com Editorial ‘‘Marseille. The city of dreams, the city of passion. Marseille the magnificent, the chatterbox, the passionate, the sensual one, Marseille all too beautiful, Marseille full of colours, Marseille bathed in sunlight, Marseille so welcoming. Marseille, that only gives her heart to those who love her’’. Bernard Tapie Dear friends and colleagues, It is our great pleasure to invite you to Marseille for the 19th Congress of the Paediatric and Congenital Cardiology Branch of the French Society of Cardiology, to be held from Wednesday 13 to Friday 15 September 2023 at the City Center Vieux Port. For this first Marseillaise edition, we will offer you a scientific and social programme that reflects the beauty and charm of our city. The congress will begin on Wednesday 13 September with a (medical) CPD day dedicated to the fascinating subject of heart failure, from foetal to adult congenital heart disease. This will be followed by two days of magnificent scientific sessions which will enlighten the work of our French-speaking teams, and in particular, our young collaborators within these teams, as is the custom in our scientific society. Themed sessions will include exciting topics such as pulmonary hypertension and various aspects of surgery and intensive care. Yes, we’ll certainly be chatting, discussing and exchanging ideas. In Marseille, we like to remain widely open to other people’s ideas. Marseille all too beautiful wants to welcome paramedics with a programme full of remarkable topics, including patient care from foetuses to adults with congenital heart disease, live in the operating room and in intensive care. Marseille will give you her heart if you love her, and the social programme — resolutely turned towards the sea and the sun, will convince you of all its charms. We look forward to seeing you all. The Local Organising Committee, Caroline Ovaert∗, Virginie Fouilloux, On behalf of the entire Marseille medical and surgical team, Department of Congenital and Pediatric Cardiac, Children’s Hospital La Timone, Marseille, France ∗Correspondence. E-mail address: caroline.ovaert@ap-hm.fr (C. Ovaert) https://doi.org/10.1016/j.acvdsp.2023.08.002 1878-6480/© 2023 Published by Elsevier Masson SAS.
Archives of Cardiovascular Disease Supplements 15 (2023) 273—276 Available online at ScienceDirect www.sciencedirect.com Communications orales — Jeudi 14 septembre 2023 de 10h à 11h 00015 Neonatal coarctation of the aorta: A 10 years observational study to identify influencing factor of the technique of surgery O.Werner1, M. Pouzenc2,∗, S. Guillaumont3, M. Vincenti2, G. De La Villeon2 1 Florence University Hospital, Florence, Italy 2 Montpellier University Hospital, Montpellier, France 3 Institut Saint Pierre, Palavas Les Flots, France ∗ Corresponding author. Introduction Coarctation of the aorta is one of the most common congenital heart diseases (5—8%) with various clinical presentations (neonatal vs. pediatric, with or without cardiac insufficiency). On a surgical point of view, there are many different techniques that will take into account the anatomy of the aortic arch and whether or not it is hypoplastic, the associated heart defect and the patient’s characteristics. The choice of this surgical technique is one of the predominant elements of the future prognosis (recoarctation, arterial hypertension). However, the choice of the surgeon whether to treat or not the aortic arch with an extended plasty is not very codified as the definition of hypoplasia itself can be discussed. Moreover there is a need to evaluate the contribution of different imaging techniques into the decision making process. This retrospective multicentric study intends to assess the potential influencing factors of the type of surgery and to make an epidemiological description of neonatal coarctation. Methods Retrospective multicentric observational study including patients of less than 1 years-old operated of coarctation of the aorta between 2011 and 2021 in four surgical centers in south France. Results/Expected results In total, 686 patients included. 43% of antenatal diagnosis; Sex ratio M/F: 68/32%; 6% of genetic test positive; the global mortality rate was 3%. 23% of patients presented cardiac insufficiency at diagnosis. Prostaglandin perfusion was necessary in 58% of cases. In echocardiography, an aortic arch hypoplasia was described between 53—57% of cases, depending of analysis method. A CT angiography was performed in 19% of patients with 58% of hypoplasia described. Concerning surgery, an aortic arch plasty was performed in only 18% of patients. The main predictors of surgical technique was antenatal screening, cardiac malformations associated, use of prostin, the horizontal aortic size, mitral hypoplasia. Standard deviation was not significant. Conclusion/Perspectives These preliminary results give an interesting view of the epidemiology of coarctation in France. Further extended data will be presented. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.002 00026 Heart failure with preserved ejection fraction (HFpEF) in children S. Quennelle1,∗, L. Houyel2, D. Khraiche2, Z. Belhadjer2, J. Grynblat3, A. Neuraz1, N. Garcelon4, D. Bonnet1 1 Hôpital Necker — Enfants Malades, AP—HP, université Paris Cité, Paris, France 2 Hôpital Necker — Enfants Malades, AP—HP, Paris, France 3 Hôpital Necker — Enfants Malades, AP—HP, France 4 Hôpital Necker — Enfants Malades, AP—HP, Science Platform, Imagine Institute, Université de Paris Cité, Paris, France ∗ Corresponding author. Introduction Heart failure (HF) with preserved ejection fraction (HFpEF) is a complex cardiac condition that results from a structural or functional impairment of filling of the heart. It has a high prevalence in elderly but has rarely been analyzed in children. Objective To identify HFpEF in children with biventricular physiology without shunt or outflow tract obstruction, through a dedicated algorithm applied to a large tertiary hospital database, and to describe the causes, hemodynamic profiles, treatment, and hard outcomes of this population. Methods We applied a combination of clinical, echocardiographic, and hemodynamic measurements to confirm the diagnosis of HFpEF to identify children with a confirmed HFpEF phenotype extracted from a pediatric hospital data warehouse. Results/Expected results In total, 137 HFpEF cases were included. Mean age was 7±5.7 years. The cardiovascular causes of HFpEF were hypertrophic cardiomyopathy (44%), restrictive cardiomyopathy (RCM) (32%), cardiomyopathy due to repeated cardiac surgeries (10%), dilated cardiomyopathy (7%), and constrictive pericarditis (7%) (Figure 1). Children with RCM had the worst prognosis (27% ten years transplant-free survival, P< 0.005). Mean patient follow-up was 5.3 years. 43% of the patients were hospitalized for 1878-6480/
Communications orales — Jeudi 14 septembre 2023 de 10h à 11h acute HF, 12% were transplanted and 31% died. NT-proBNP increase was found in all groups and was associated with mortality and transplantation, HR 1.91 (95% CI 1.31, 2.76, p-value < 0.001). Based on echocardiographic evaluation, 56% of the patients were diagnosed with pulmonary hypertension (PH), associated with mortality and transplantation, HR 2.84 (95% CI 1.58, 5.10, P< 0.001). In the 48 patients who underwent right heart catheterization, post-capillary or combined PH were the most frequent but the 15% with isolated pre-capillary PH had poorer outcomes, HR 4.60 (95% CI, 1.46, 14.5, P=0.009). Conclusion/Perspectives HFpEF is a rare and concerning condition in children. Younger age, RCM, acute HF episodes, increased NT-proBNP are associated with hard outcomes. A precapillary component in patients with PH is associated with poorer outcomes. Fig. 1 Causes of HFpEF in children. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.003 00028 Fetal aortic valvuloplasty: A single center retrospective review of the last 10 years S. Malekzadeh-Milani , R. Corroenne , M. Meot∗, H. Bagdadi , B. Stos , Y. Ville , I. Szezepanski , M. Levy , D. Laux , D. Bonnet , J. Stirnemann M3c-Necker, Hôpital Necker Enfants Malades, Paris, France ∗ Corresponding author. Introduction Fetal aortic stenosis (FAS) has a poor prognosis. Fetal aortic valvuloplasty (FAV) has been proposed to improve postnatal outcome by promoting left ventricular (LV) growth. Data on long-term evolution of patients who received FAV are scarce. Objective Report our retrospective single center experience on FAV focusing on post-natal evolution of the patients. Methods All fetuses with FAV were retrospectively included. Fetal, FAV and neonatal data were recorded. Univentricular or biventricular strategies (UniV or BiV) at birth were collected as well as type of intervention. Causes of death and follow-up (FU) were reviewed. Results/Expected results Fifty-eight fetuses with critical AS received 63 FAV at a mean gestational age of 24.6 weeks between 2011 and 2022. At the time of FAV, LV end diastole Z-score varied from —3 to +3. Technical procedural success was reported in 50/58 fetuses. There were 9 in utero demises and 9 terminations of pregnancy (TOP). Thirty eight newborns were delivered at a mean gestational age of 38.1 weeks (8/38 preterms) and a mean weight of 2925 grams (1270—3220 grams). In total, 21 patients required prostaglandin. 9 patients had UniV at birth and 3 patients are still alive. The remaining 29 patients had BiV at birth with 3 univentricular conversion. In the 26 patients with BIV, 23 patients are alive at last FU. Three patients have never been operated on. Thirteen needed one intervention on the aortic valve: 10 had a surgical commissurotomy and 3 had a balloon valvuloplasty. Eleven had 2 interventions and 2 had 3 interventions. Mean age at last FU was 26 [8—112] months. Conclusion/Perspectives Severity of FAS is confirmed with 50% of the fetuses alive at last FU. A low incidence of UniV is reported because of high rate of TOP or palliative care at birth. Among patients with BiV, rate of reintervention is high but long-term survival is satisfactory. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.004 00040 Pregrancy in Fontan patients: Should we refine the current recommendations? M. Ladouceur1,∗, G. Gennesseaux1, V. Gruschen2, Pregnancy Outcomes In Fontans With Anticoagulation Therapy (profit) Inverstigator2 1 Hopital Européen Georges Pompidou, Paris, France 2 Nhs Golden Jubilee, Glasgow, United Kingdom ∗ Corresponding author. Introduction Pregnancies in patients with a Fontan circulation are high-to very high-risk pregnancies. European and American recommendations consider patients with any Fontan complications should be counseled against becoming pregnant. Objective This study sought to evaluate maternal complications in patients with Fontan circulation according to the modified WHO (mWHO) classification. Methods We performed a retrospective observational cohort study across 13 international centers. Maternal and fetal outcomes were reviewed according to baseline risk assessed as per the mWHO classification. Women with oxygen saturations < 85%, NYHA functional class IV, depressed ventricular function, moderate to severe atrioventricular valve regurgitation, refractory arrhythmia, plastic bronchitis, or protein-losing enteropathy (PLE) were considered at very high risk of complications (mWHO IV), those without any Fontan complication were classified at high risk (mWHO III). The risk of remaining patients who experienced other types of Fontan complications was classified as mWHO III—IV. Results/Expected results We analyzed 84 women (median age 27 years, interquartile range 23-30) with Fontan physiology undergoing 108 complete pregnancies, average gestation of 33±5 weeks. Fiftytwo (48%) pregnancies were classified as mWHO III, 45 (42%) mWHO III—IV, and 11 (10%) mWHO IV (Table 1). None patients had a previous history of PLE or plastic bronchitis. There was no maternal death. Cardiovascular complications occurred in 13 (25%), 16 (35%) and 4 (36%) pregnancies classified mWHO III, III—IV, and IV respectively (P= 0.74). Cardiovascular complication rates remained not significantly different when patients with any Fontan complications were compared to patients without (36% vs. 25%, P= 0.23; Table 1). There were high rates of fetal (n= 73, 68%) and obstetrical (n=75, 69% including 38 bleeding events) complications without significant difference between the 3 risk groups. Conclusion/Perspectives Maternal cardiovascular complications occurred in one-third of pregnancies whatever the mWHO classification. Even if there is no reported maternal death, women with Fontan circulation should be carefully counseled on pregnancy risks. 274
Archives of Cardiovascular Disease Supplements 15 (2023) 273—276 Table 1 Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.005 00047 Cardiac magnetic resonance parameters to predict ventricular arrhythmias inducibility before pulmonary valve replacement in patient with tetralogy of Fallot MD Grégoire Albenque1,∗, PhD, MD Francis Bessière2, PhD, MD Gilles Soulat3,4, MD Arshid Azarine5, MD Mohamed Bakloul6, MD Emre Belli1, PhD, MD Damien Bonnet3,7, PhD, MD Loic Boussel2, MD Eric Bruguière8, PhD, MD Sarah Cohen1,9, MD Hubert Delasnerie8, MD Sylvie Di Filippo2, MD Arnaud Dulac2, MD Kevin Gardey2, MD Roland Henaine2, MD Laurence Iserin6, PhD, MD Clément Karsenty8, PhD, MD Magalie Ladouceur3,6, MD Antoine Legendre6,7, MD Sophie Malekzadeh-Milani8, MD Alice Maltret1, PhD, MD Eloi Marijon3,10, PhD, MD Elie Mousseaux3, MD Jelena Radojevic1, MD Miarisoa Ratsimandresy8, PhD, MD Sébastien Hascoët1,9, MD Nicolas Combes1,8, PhD, MD Victor Waldmann3,4,7,10 1 Department of Congenital Heart Diseases, Centre de référence malformations cardiaques congénitales complexes M3C, hôpital Marie-Lannelongue, groupe hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France 2 Louis Pradel Hospital, hospices civils de Lyon, université Lyon 1 Claude-Bernard, Lyon, France 3 Université Paris Cité, Inserm, PARCC, 75015 Paris, France 4 Department of Radiology, Georges-Pompidou European Hospital, AP—HP, 75015 Paris, France 5 Radiology Department, groupe hospitalier Paris Saint-Joseph, Paris, France 6 Adult Congenital Heart Disease Medico-Surgical Unit, European Georges-Pompidou Hospital, Paris, France 7 M3C-Necker, hôpital universitaire Necker-Enfants-malades, AP—HP, Paris, France 8 Pasteur Clinic, Toulouse, France 9 Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France 10 Cardiac Electrophysiology Unit, European Georges-Pompidou Hospital, Paris, France ∗ Corresponding author. Introduction Ventricular arrhythmias and sudden death are recognized complications of tetralogy of Fallot (TOF). Electrophysiological study (EPS) is increasingly performed prior to pulmonary valve replacement (PVR) in these patients to evaluate and treat the arrhythmic substrate. Objective We aimed to assess the value of cardiac magnetic resonance (CMR) to refine pre-operative risk stratification in this population. Methods A prospective multicenter study was conducted to systematically assess EPS in patients with TOF referred for PVR from January 2020 to December 2021. Multiple CMR parameters were analyzed and correlated with EPS results. Results/Expected results Among a total of 120 patients enrolled, 108 (90.0%) patients who had a CMR prior to EPS were analyzed. A VA was inducible in 24 (22.2%) patients. Clinical characteristics of patients associated with EPS results are presented in Table 1. Concerning CMR variables, mean RV end-diastolic volume index was 157±39 ml and was not statistically different in patients with positive vs. negative EPS (164±49 vs. 155±35, P= 0.395). However, a RV/LV end-diastolic volume index ratio > 2.4 was significantly associated with a higher likelihood of inducibility (OR 3.10, 95%CI 1.14—8.74, P= 0.040). Mean RV end-systolic volume index tended to be upper in patient with positive EPS (101±35 vs. 86±26, P= 0.072). The RV ejection fraction measured on CMR also tended to be slightly lower in patients with positive EPS (40±7 vs. 43±9, P= 0.069) unlike the LV ejection fraction (P= 0.600). Mean pulmonary annulus diameter were also significantly associated with positive EPS (31±8 vs. 26±7 mm, OR 1.10 [1.02—1.18] per 1 mm increment, P= 0.012). A pulmonary annulus diameter > 28 mm was associated with an OR of 2.9 [1.10—8.11] (P= 0.047). In multivariable analysis, RV/LV end-diastolic volume index ratio > 2.4 (OR 4.6 [1.2—22.5], P= 0.036) and history of atrial arrhythmia (OR 10.9 [2.6—60.8], P= 0.002) remained independent predictors of VA inducibility (Figure 1). Conclusion/Perspectives In patients with TOF prior to PVR, RV/LV end-diastolic volume index ratio and pulmonary annulus diameter are associated with ventricular arrhythmia inducibility during EPS. CMR parameters, in combination with other clinical factors, may be useful to improve pre-operative risk stratification. Fig. 1 Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.006 00048 Trends in hospitalizations in congenital heart disease patients in France: A national PMSI database analysis S. Hascoet∗, S. Cohen , C. Karanfilovic , A. Buronfosse Hopital Marie Lannelongue, Le Plessis-Robinson, France ∗ Corresponding author. Introduction Thanks to the progresses made in the management of congenital heart diseases (CHD), life expectancy of these patients has greatly improved, including those of patients with complex CHD. Epidemiology of this growing population is rapidly evolving. French data are needed to prepare each regional healthcare plan. Objective We aim to analyse national PMSI database to assess trends and projections. 275
Communications orales — Jeudi 14 septembre 2023 de 10h à 11h Methods We investigated the number of hospitalizations stay of children and adults with CHD over 10 years from 2013 to 2022 in France. Complexity of CHD was defined according to M3C classification. Results/Expected results Number of hospital stays of patients with CHD varied from 37,339 to 45,310 in total and from 9,320 to 11,006 for patients with complex CHD. Over 10 years, the latter represent 26.2% of all hospitalizations. In children, it varied from 19,787 to 23,023 in total and from 5,714 to 6,987 for children with complex CHD. Over 10 years, the latter represent 30.6% of all hospitalizations. The number of neonates with CHD hospitalized is very stable over time ranging from 1380 to 1596. A similar trend is observed for children. In adults with CHD, it increased continuously by 55.9% from 15,056 to 23,475 and from 3,564 to 4,294 for adults with complex CHD. Over 10 years, the latter represent 21.0% of all hospitalizations. There is an increase in hospitalizations in adults with CHD with a 5-year projection suggesting an increase up to 35%. In particular number of ACHD hospitalized for management of arrhythmia or for catheterization has almost doubled over 10 years (Figure 1). Conclusion/Perspectives Number of children with complex CHD seems to be very stable over time. On the other hand, there is a growing number of hospitalizations in adults with CHD. Next healthcare plan should contribute to develop facilities for the specific management of adults with CHD in these centres. Fig. 1 Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.007 276
Archives of Cardiovascular Disease Supplements 15 (2023) 277—279 Available online at ScienceDirect www.sciencedirect.com Communications orales — Vendredi 15 septembre 2023 de 9h30 à 10h30 00003 Prevalence and consequences of mitral annular disjunction and Pickelhaude sign in children with mitral valve prolapse G. Vaksmann∗, I. Bouzguenda , M.P. Guillaume , P. Gras , A. Richard Hôpital privé de la Louvière, Lille, France ∗ Corresponding author. Introduction Mitral annulus disjunction (MAD) and Pickelhaube sign are increasingly identified as risk factors for malignant ventricular arrhythmias (VAs) and sudden cardiac death in adults with mitral valve prolapse (MVP). Their prevalence and consequences in children have never been studied. Objective To determine MAD prevalence in children with MVP and its potential link with Vas. Methods A cohort of 49 consecutive children from a single institution (age 12.8±3.0, 33 females) with MVP and comprehensive clinical, arrhythmia (24-h Holter monitoring and exercise test) and doppler echocardiographic characterization including pulsed wave tissue doppler (PWTD) of the lateral mitral annulus was identified. The relationship between clinical and echocardiographic data and the presence of VAs was studied. Results/Expected results The presence of MAD was common (n= 25, 51%). Only 5 patients had significant VAs (lown > 2) characterized by polymorphic premature ventricular contractions or couplets. The presence of MAD was not associated with significant VAs on 24h-Holter monitoring but an association was found between significant VAs and spiked high velocity midsystolic signal > 16 cm/s on PWTD of the lateral mitral annulus (Pickelhaube sign, Figure 1) (P= 0.004), myxomatous mitral valve (P= 0.004) and left ventricular dilatation (P= 0.01). No patient had severe VAs characterized by ventricular tachycardia nor symptoms of dysrhythmia. Four out of 7 patients (57%) with coexisting Pickelhaube sign and myxomatous mitral valve had significant VAs. No difference was found between patients with or without MAD for gender, history of palpitation, severity of mitral regurgitation, incidence of connective tissue disorders and medications with beta-blockers or ACE inhibitors. Conclusion/Perspectives MAD is a common finding in children with MVP. Its presence was not associated with significant VAs on 24hour Holter monitoring, but the Pickelhaube sign and the presence of myxomatous mitral valve may help to detect patients prone to significant VAs. Fig. 1 MAD (left) and Pickelhaube sign (right). Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.009 00013 Percutaneous edge-to-edge repair of systemic tricuspid regurgitation in adults with congenital heart disease L. LeGloan1,∗, X. Iriart2, H. Bouvaist3, Y. Lavie-Badie4, E. Hereau5, P. Guérin5 1 CHU de Nantes, l’institut Du Thorax, Nantes, France 2 CHU de Bordeaux, Bordeaux, France 3 CHU de Grenoble, Grenoble, France 4 CHU de Toulouse, Toulouse, France 5 CHU de Nantes, Nantes, France ∗ Corresponding author. Introduction Systemic tricuspid valve regurgitation (TR) is often encountered in patients with atrial correction of transposition of the great arteries (acTGA) or congenitally corrected transposition of the great arteries (ccTGA). When at least moderate, it is related to impaired functional capacity, heart failure and mortality. Management is a matter of debate as medical management is limited and valvular surgery at risk. Among adults with severe and symptomatic systemic mitral regurgitation at high risk for surgery, percutaneous edge-to-edge repair is now proposed as a reasonable alternative. Methods We hypothetised that percutaneous management of systemic TR may be feasible and safe. A monthly national dedicated multidisciplinary meeting was therefore organized, including cardiologists and surgeons dedicated to adults with CHD. All concerned 1878-6480/
Communications orales — Vendredi 15 septembre 2023 de 9h30 à 10h30 patients were evaluated and a decision was taken and thereafter offered to each patients. Results/Expected results So far, 9 patients, of whom 1 female, with a median age of 41±14 years, were included, 4 with acTGA and 5 with ccTGA. The procedures were performed in 4 French tertiary CHD centers between May 2019 and June 2022, following institutional review board approval. The XTR MitraClip device (Abbott, Santa Clara, CA) was used, 1 MitraClip was used in 5 patients, 2 in 2 and 3 in 1. The procedure was not possible in 1 patient, because of impossibility to achieve appropriate orientation of the clip on the tricuspid valve. No complication was reported. At 6 months of follow-up, we noticed a decrease in the TR of at least 1 grade in 8 patients. NYHA functional class improved in 5 patients and diuretics doses decreased in 4. Conclusion/Perspectives Transcatheter edge-to-edge repair appears as a feasible and safe procedure in patients with significant systemic TR. Further studies need to be performed to precise the optimal position of percutaneous reduction of systemic TR in the management of these patients. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.010 00025 Congenital disconnection of the pulmonary arteries J. Karila Cohen∗, D. Bonnet Nekcer, Paris, France ∗ Corresponding author. Introduction Disconnected pulmonary artery is a rare anomaly that can be isolated or associated with complex intracardiac malformations. Early re-implantation of the disconnected pulmonary artery is recommended to allow growth and satisfactory pulmonary perfusion while preventing collateral arteries development. Objective To describe the characteristics of patients with disconnected pulmonary artery and, for those who had surgical re-implantation, to determine the incidence, delay and predictive factors of re-intervention for reconnected pulmonary artery stenosis. Methods We include patient with diagnosis of congenitally disconnected PA and surgical repair at our institution. Results/Expected results Retrospective observational study of 55 patients with a disconnected pulmonary artery. Fifty-one underwent surgical correction and were followed up at our institution between 2000 and 2022. Disconnected pulmonary arteries were observed in isolation in 31% of the cases. The most frequent form was left pulmonary artery originating from the arterial duct (58%). The re-implantation was Fig. 1 done at median age of 12 days. Anastomotic stenosis was observed during follow-up in 71% of the patients with 75% of them requiring re-intervention (55% of the population). The median delay to reintervention was 3.2 years after re-implantation, and more than 25% of re-interventions on the re-implanted pulmonary artery occurred within the first postoperative year. We found more re-intervention if associated cardiac defect, without significant statistic difference. Weight at re-confluence, presence of ductal tissue at the origin of the pulmonary artery, and prior shunt placement on the disconnected pulmonary artery were not found to be risk factors for re-intervention (Figure 1). Conclusion/Perspectives After surgical re-implantation of pulmonary artery, more than 50% of patients required re-intervention for pulmonary artery stenosis. Technical improvements should be sought to reduce incidence of this complication. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.011 00027 Characteristics and outcomes of neonatal balloon atrial septostomy for transposition of the great vessels: ORA — TGV study H. Lucron1,∗, S.G. Malekzadeh-Milani2, T. Perouse De Montclos3, A.E. Baruteau4, C. Ovaert5, Z. Jalal6, L. Bonnemains7, C. Karsenty8, O. Domanski9, H. Bouvaist10, P. Maragnes11, A. Charbonneau12, J.M. Jellimann13, S. Hascoët1, D. Bonnet2 1 Hopital Marie Lannelongue, Le Plessis-Robinson, France 2 AP—HP, hôpital Necker-Enfants-Malades, Paris, France 3 CHU de Lyon, Lyon, France 4 CHU de Nantes, Nantes, France 5 AP—HM, hôpitaux de Marseille, Marseille, France 6 CHU de Bordeaux, Bordeaux, France 7 CHRU de Strasbourg, Strasbourg, France 8 CHU de Toulouse, Toulouse, France 9 CHRU de Lille, Lille, France 10 CHU de Grenoble, Grenoble, France 11 CHU de Caen, Caen, France 12 CHU de Reims, Reims, France 13 CHRU de Nancy, Nancy, France ∗ Corresponding author. Introduction Balloon atrial septostomy (BAS) improves oxygenation in neonates with Transposition of the Great Vessels (TGV). New non-EC marked BAS catheters have obtained temporary approval in France. Objective We aim to investigate outcomes of neonatal BAS in the current area. Methods An on-going multi-center French prospective observational registry was set up in September 2022 including all neonates undergoing BAS for TGV. Results/Expected results To date, 60 neonates (93.5% of termbabies, weight: 3.1 [2.8—3.4] Kg, prenatal diagnosis: 88.5%, isolated form of TGV: 68.9%) underwent 62 BAS (50% on general anaesthesia) in 14 participating centres. The procedure was performed over night or during weekend in 39.3% of cases. BAS was performed most often the day of birth (65.6%), in the catheter lab (59%) using an umbilical venous route (67.2%). The latter required conversion to a femoral route in 22.0% of patients. BAS was guided by ultrasounds and fluoroscopy in 90.2% and 55.7% of cases, respectively. Two to 4 BAS manoeuvre were required in 82.0% of cases. In 14.8% of patients, the use of a second type of BAS catheter was required. Z5 and Z6 catheters were used in 45.6% and 54.4% of cases, respectively. Overall, BAS was successfully achieved in 93.5% of cases. BAS failures included 3 crossing failures (n = 3) and a failure of enlargement of the atrial septum with a low-volume Z5 catheter (n = 1). One transient complete atrio-ventricular block was also reported. 278
Archives of Cardiovascular Disease Supplements 15 (2023) 277—279 Conclusion/Perspectives To date, BAS success rate seems lower than expected. The continuation of this study and its expected European extension will likely contribute to clarify these points in a context of world shortage in dedicated low profile/high volume catheters. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.012 00044 Transcatheter PDA closure in preterm: Where do we stand? A prospective multicenter French survey S. Malekzadeh-Milani1,∗, B. Lefort2, M. Bakloul3, S. Douchin4, C. Dauphin5, A. Akhavi6, N. Benbrik7, M. Meot8, D. Bonnet7, A. Baruteau7 1 M3c Necker-Enfants-Malades, Paris, France 2 CHU de Tours, Tours, France 3 CHU de Lyon, Lyon, France 4 CHU de Grenoble, Grenoble, France 5 CHU de Clermont-Ferrand, Clermont Ferrand, France 6 CHU de Reims, Reims, France 7 CHU de Nantes, Nantes, France 8 M3c-Necker-Enfants Malades, Paris, France ∗ Corresponding author. Introduction Transcatheter persistent ductus arteriosus (PDA) in extremely-low-birth-weight infants has proved to be feasible and safe but midterm outcomes data are scarce. We report herein results from the French nationwide Premiclose registry. Objective We report herein results from the French nationwide Premiclose registry. Methods All infants who attempted device PDA closure at a procedural weight < 2 kg were prospectively included from 7 tertiary institutions between October 2017 and June 2022. Demographic and procedural data were reviewed as well as respiratory and cardiac follow-up. Results/Expected results In total, 274 patients (mean birth weight: 812±213 grams, mean gestational age: 25.8±1.9 weeks) were included. Mean procedural age and weight were 31±12 days and 1250±330 grams respectively. Patients were all symptomatic with a hemodynamically significant PDA. Procedure was performed under both fluoroscopy (fluoro time: 4.5±4min) and transthoracic echocardiography guidance in all patients; 240 (87.6%) procedures were contrast free. Successful PDA closure was achieved in 97%. Complications occurred in 10 patients, with major adverse events in 3 (1.1%) consisting in device embolization in 2 and tamponnade in 1. There was no procedural death. Post ligation cardiac syndrome was noted in 4% and escalation of respiratory support in 20% of the cases. During follow-up, 8 late complications were reported with 3 patients requiring aortic coarctation treatment and one patient awaiting LPA stenosis treatment. Over time, significantly smaller patients were treated with significantly lower complications. Neurologic assessment is ongoing and will be presented. Conclusion/Perspectives Our large series confirms favorable results of transcatheter PDA closure in extremely-low-birth-weight infants, along with demonstrating learning curve, high procedural success, low procedural complications and low rate of post ligation cardiac syndrome but escalation in respiratory support. Late cardiac complications were few but long-term follow-up remains mandatory. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.013 279
Archives of Cardiovascular Disease Supplements 15 (2023) 280—284 Available online at ScienceDirect www.sciencedirect.com Présentations flash — Jeudi 14 septembre 2023 de 10h00 à 11h00 00004 Failure to post-dilate BeSmooth peripheral stents to adult vessel size diameters during bench-side tests R. Haddad∗, D. Bonnet , S. Malekzadeh-Milani M3c-Necker, Paris, France ∗ Corresponding author. Introduction Low-profile stent implantation remains a rescue treatment for aortic coarctation and branch pulmonary arteries stenosis in small children. Stent re-expansion to cope with vascular growth remains problematic. Objective To evaluate ex-vivo feasibility and mechanical behavior of over-dilating BeSmooth peripheral stents (Bentley InnoMed, Germany). Methods Three BeSmooth stents in diameters of 7, 8, and 10 mm were dilated to nominal pressure and then 13atm. Test-1 (sequential up-sizing post-dilation without re-stenting): BeSmooth Ø7×23mm was post-dilated using 12, 14, and 16 mm high-pressure balloons. Test-2 (post-dilation until plateau/breakpoint then re-stenting): BeSmooth Ø10×57 mm was post-dilated with 14 mm balloon until plateau/breakpoint and then with 48 mm bare-metal Optimus-XXL stent hand-mounted on 14 mm balloon. Test-3 (straightforward restenting): BeSmooth Ø8×57 mm was directly post-dilated with 48 mm bare-metal Optimus-XXL stent hand-mounted on 16 mm balloon. The stents’ diameter and length were measured. Balloon rupture and stent fracture patterns were closely evaluated. Results/Expected results Test-1: BeSmooth Ø7×23 mm was postdilated to 10 mm diameter with a little shortening. Up-sizing the stent to 11 mm with the Ø14 mm balloon led to the stent shrinking to 3.2 mm. At 20atm pressure, BeSmooth Ø7×23 mm shortened to 2 mm forming a 12 mm diameter solid ring circle, and the 16 mm woven balloon ruptured radially. Test-2: The BeSmooth Ø10×23mm reached a plateau diameter of 13 mm without shortening and the balloon did not rupture. Stent-in-stent re-expansion showed that at 10atm pressure, BeSmooth Ø10×57 mm fractured longitudinally in various dispatched breaking points at a diameter of 13 mm without shortening and ruptured the balloon with multiple pinholes. Test3: At 10atm pressure, BeSmooth Ø8×57 mm fractured centrally at three different points at a diameter of 11.5 mm without shortening and the balloon broke radially in half. Conclusion/Perspectives In our benchmark tests, extreme shortening, severe balloon rupture, or unpredictable stent fracture patterns at small balloon diameters limits the safe post-dilation of BeSmooth stents beyond 13 mm. BeSmooth stents are not ideal candidates for off-label stent interventions in smaller patients. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.015 00008 The French Coccinelle study: Risk of lympho-hematopoietic malignancies after medical ionizing radiation exposure from cardiac catheterization during childhood E. Rage1,∗, S. Hascoët2, C. Dauphin3, S. Di Filippo4, S. Douchin5, F. Godart6, P. Guérin7, P. Helms8, C. Karsenty9, B. Lefort10, P. Mauran11, C. Ovaert12, J.F. Piéchaud13, J.B. Thambo14, D. Bonnet15 1 Institut de radioprotection et de sûreté nucléaire (irsn), Fontenay-Aux-Roses, France 2 Cardiology Department, hôpital Marie Lannelongue, Le Plessis-Robinson, France 3 Cardiology Department, CHU of Clermont-Ferrand, Clermont-Ferrand, France 4 Paediatric and Congential Cardiology Department, hôpital Femme-Mère-Enfant, hospices civils De Lyon, université Claude-Bernard Lyon 1, Lyon, France 5 Cardiopédiatrie, hôpital Couple-Enfant, CHU of Grenoble Alpes, Grenoble, France 6 Service de cardiologie infantile et congénitale, Institut cœur poumon, Lille, France 7 CHU of Nantes, Inserm, Nantes université, clinique cardiologique et des maladies vasculaires, Cic 1413, Institut du thorax, Nantes, France 8 Unit of Cardiopediatrics, University Hospital Of Strasbourg, Strasbourg, France 9 Pediatric and Congenital Cardiology, Children’s Hospital and Inserm U1048, I2mc, Institut des maladies métaboliques et cardiovasculaires, université de Toulouse, Toulouse, France 10 Institut des cardiopathies congénitales, CHRU de Tours, Tours, France 1878-6480/
Archives of Cardiovascular Disease Supplements 15 (2023) 280—284 11 Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU of Reims, Reims, France 12 Cardiologie pédiatrique et congénitale, Timone Enfants, AP—HM et Inserm 1251, Aix-Marseille université, Marseille, France 13 Institut hospitalier Jacques-Cartier, Massy, France 14 Department of Pediatric And Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, France 15 M3c-Necker, hôpital universitaire Necker-Enfants Malades, université de Paris Cité, Paris, France ∗ Corresponding author. Introduction Cardiac catheterization (CC) has largely improved the diagnosis and treatment of congenital heart disease in children over the last decades, but it leads to exposure to low doses of Xrays. Children have a greater radiation sensitivity, however, little is known about the long-term radiation associated cancer risks. Objective This study aims to assess the risk of lymphohematopoietic malignancies among children diagnosed and/or treated with CC. Methods The COCCINELLE cohort includes children from 15 French paediatric cardiology departments who underwent a first CC between 2000—2013, before 16 years old. The cohort was linked with national registries to identify cancer cases and collect information on predisposing factors to cancer (PF). Individual cumulative doses to active bone marrow (ABM) were calculated with the PCXMC software, based on detailed dosimetric information retrieved from reports of 1,139 CC procedures. Standardised incidence ratios (SIRs) and relative risks (RR) of haematological malignancies associated with the 2-year lagged ABM dose were calculated. Results/Expected results The cohort included 17,104 children, followed 6.5 years on average. 22,227 CC procedures were collected, with a mean individual ABM cumulative dose of 3.0 mGy. 38 lympho-hematopoietic malignancies were counted (23 lymphoma and 15 leukemia). A significant excess of cancer incidence was observed (SIR = 3.8 [95% confidence interval 2.9; 4.9]), which wasn’t anymore observed after excluding patients with PF (SIR = 1.3 [0.6; 2.7]). The ABM dose wasn’t significantly associated with the risk of lympho-hematopoietic malignancies (RR/mGy = 1.00 [0.88; 1.10]) or lymphoma (RR/mGy = 1.03 [0.90; 1.14]) after adjustment for attained age, gender and PF. Conclusion/Perspectives No significant increase of cancer incidence was observed after excluding patients with PF and no dose-response relationship was observed between the risk of lympho-hematopoietic malignancies or lymphoma and cumulative ABM dose arising from CC procedure. The extension of the COCCINELLE study and the European Harmonic project will help to better assess health effects of CC exposure during childhood. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.016 00009 Surfao-cardio study: Trans-abdominal fetal ECG analysis in the second trimester of pregnancy in a cohort of healthy fetuses M. Lachaud1,∗, R. Souriau2, B. Rivet3, J. Fontecave2 1 Service de cardiologie pédiatrique et congénitale, CHU of Grenoble Alpes, University of Grenoble Alpes, Grenoble, France 2 University of Grenoble Alpes, Cnrs, Umr 5525, Vetagro Sup, Grenoble Inp, Timc, 38000 Grenoble, France 3 University of Grenoble Alpes, Cnrs, Grenoble-Inp, Gipsa-Lab, 38000 Grenoble, France ∗ Corresponding author. Introduction Although feasible with ultrasound, analysis of the fetal heart rhythm sometimes remains a challenge in the absence of access to the fetal electrocardiogram. In particular in case of suspected long QT, ultrasound does not allow the measurement of the ST segment. Objective Within the framework of the ANR SurFAO project, the Surfao-Cardio clinical study consisted in including 20 patients whose fetus did not present any cardiac morphological abnormality, between 22SA and 29SA. A trans-abdominal electrical recording was performed. The abdominal signals were formatted and processed to extract a fetal ECG. From the latter, measurements were made, automatically for RR intervals and manually for PR intervals. These data were compared for each patient with ultrasound measurements in different modalities (M mode, Mitral-Aorta Profile, VCS-Aorta Doppler, Pulmonary Vein-Pulmonary Artery Doppler). Results/Expected results The fetal heart rate was analyzable in 12 of the 20 patients with a possible analysis of the QRS morphology for 12/12 patients and of the PR for 8/12 patients. The correlations between the ultrasound data and the fetal ECG were respectively R = 0.79 (n=12, P< 0.05) for heart rate and R=0.81 (n=8, P< 0.05) for PR intervals (Figure 1). Conclusion/Perspectives This preliminary study showed the feasibility of trans abdominal fetal ECG with good reliability of PR measurement. Some material limitations related to the recording of the trans-abdominal ECG were identified, giving hope for an improvement in the percentage of possible measurements and access to ST-segment measurement. Fig. 1 Fetal ECG. Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.acvdsp.2023.07.017 00010 Surgical or transcatheter pulmonary valve replacement, how to choose ? P. Normandin1,∗, A. Houeijeh1, J.B. Baudelet1, O. Domanskii1, A. Delarue1, S. Bichali1, F. Juthier2, F. Godart1 1 CHU de Lille, service de cardiologie pédiatrique, 59000 Lille, France 2 CHU de Lille, service de chirurgie cardiaque, 59000 Lille, France ∗ Corresponding author. Introduction Pulmonary valve replacement (PVR) is indicated for right ventricle outflow tract (RVOT) dysfunction. The choice between the transcatheter PVR (TPVR) and the surgical PVR (SPVR) is debated. Objective We aimed to compare the TPVR to the SPVR, considered previously as the gold standard, to determine the best choice for each patient. Methods A retrospective observational study was conducted in Lille University hospital. All patients who had PVR between January 281
RkJQdWJsaXNoZXIy MTk3NTQxMg==