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Bergeron, Sébastien

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Bergeron

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Sébastien

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Université Laval. Département de médecine

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Voici les éléments 1 - 10 sur 18
  • PublicationAccès libre
    Bioprosthetic mitral valve thrombosis : a multifaceted and challenging clinical and imaging spectrum
    (Elsevier Inc., 2021-11-17) Châteauneuf, Gabriel; De Larochellière, Hugo; Clavel, Marie-Annick; Kalavrouziotis, Dimitri; Charbonneau, Éric; Dagenais, François; Morin, Francis; Silva, Iria; Turgeon, Pierre-Yves; Paradis, Jean-Michel; Bernier, Mathieu; Beaudoin, Jonathan; Bergeron, Sébastien; Rodés-Cabau, Josep; Mohammadi, Siamak; Pibarot, Philippe; O'Connor, Kim; Salaun, Erwan
    Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter aortic valve replacement has been emphasized in recent published data, but few reports have focused on bioprosthetic mitral valve thrombosis. Bioprosthetic mitral valve thrombosis is a complex and multifaceted process that is associated with a wide spectrum of clinical and imaging features. The clinical presentation ranges from incidental discovery to systemic embolic events and acute heart failure. Comprehensive transthoracic echocardiographic assessment is key for early detection of subtle changes in bioprosthetic valve morphology and / or function, and indirect signs of reduced leaflet motion such as color paucity. Transesophageal echocardiography is essential to confirm the presence of valve thrombosis. Multimodality imaging is gaining increased acceptance for the evaluation of systemic embolism and for ruling out infective endocarditis using cardiac and extracardiac anatomical and metabolic imaging. This report illustrates both : 1) the spectrum of clinical and imaging characteristics associated with mitral bioprosthetic valve thrombosis ; and 2) the case-by-case management of this challenging condition by the heart team.
  • PublicationRestreint
    Feasibility and initial results of percutaneous aortic valve implantation including selection of the transfemoral or transapical approach in patients with severe aortic stenosis
    (Elsevier, 2008-11-01) Bertrand, Olivier; Dumont, Éric; Villeneuve, Jacques; De Larochellière, Robert; Rodés-Cabau, Josep; Doyle, Daniel; Bergeron, Sébastien; Lemieux, Jerome; Pibarot, Philippe; Clavel, Marie-Annick; Raby, Kathlee
  • PublicationRestreint
    Severe valvular regurgitation and late prosthesis embolization after percutaneous aortic valve implantation
    (Elsevier Science, 2009-01-19) Villeneuve, Jacques; Dumont, Éric; Rodés-Cabau, Josep; Couture, Christian; Doyle, Daniel; Bergeron, Sébastien; De Larochellière, Robert; Pibarot, Philippe; Clavel, Marie-Annick
    We report the case of a 79-year-old man with low-flow, low-gradient aortic stenosis who underwent transapical aortic valve implantation. The deployment of a 26-mm Edwards SAPIEN valve (Edwards Lifesciences Inc, Irvine, CA) was complicated with the occurrence of severe central aortic regurgitation that was successfully treated with the implantation of a second valve (“valve-in-valve”). Postoperative progress was satisfactory but 2 days after the procedure he suddenly developed cardiogenic shock secondary to the migration of the aortic bioprothesis into the left ventricular outflow tract. Open-heart surgery was undertaken to remove the valves and perform standard aortic valve replacement, but the patient died perioperatively.
  • PublicationRestreint
    Validation and characterization of transcatheter aortic valve effective orifice area measured by Doppler echocardiography
    (American College of Cardiology, 2011-10-04) Larose, Éric; Rodés-Cabau, Josep; Dumont, Éric; Bergeron, Sébastien; Bagur, Rodrigo Hernan; Pibarot, Philippe; De Larochellière, Robert; Dumesnil, Jean G.; Doyle, Daniel; Clavel, Marie-Annick
    Objectives : The objectives were to compare different Doppler echocardiographic methods for the measurement of prosthetic valve effective orifice area (EOA) following transcatheter aortic valve implantation (TAVI) and to determine the factors influencing the EOA of transcatheter balloon expandable valves.
  • PublicationRestreint
    Comparison of the hemodynamic performance of percutaneous and surgical bioprostheses for the treatment of severe aortic stenosis
    (Elsevier Biomedical, 2009-05-19) Bertrand, Olivier; Webb, John G. (John Graydon); Rodés-Cabau, Josep; Bergeron, Sébastien; Altwegg, Lukas; Pibarot, Philippe; Dumont, Éric; Clavel, Marie-Annick; Thompson, Chris; De Larochellière, Robert; Doyle, Daniel; Masson, Jean-Bernard
    Objectives : This study was undertaken to compare the hemodynamic performance of a percutaneous bioprosthesis to that of surgically implanted (stented and stentless) bioprostheses for the treatment of severe aortic stenosis. Methods : Fifty patients who underwent percutaneous aortic valve implantation (PAVI) with the Cribier-Edwards or Edwards SAPIEN bioprosthetic valve (Edwards Lifesciences, Inc., Irvine, California) were matched 1:1 for sex, aortic annulus diameter, left ventricular ejection fraction, body surface area, and body mass index, with 2 groups of 50 patients who underwent surgical aortic valve replacement (SAVR) with a stented valve (Edwards Perimount Magna [SAVR-ST group]), or a stentless valve (Medtronic Freestyle, Medtronic, Minneapolis, Minnesota [SAVR-SL group]). Doppler echocardiographic data were prospectively obtained before the intervention, at discharge, and at 6- to 12-month follow-up. Results : Mean transprosthetic gradient at discharge was lower (p < 0.001) in the PAVI group (10 ± 4 mm Hg) compared with the SAVR-ST (13 ± 5 mm Hg) and SAVR-SL (14 ± 6 mm Hg) groups. Aortic regurgitation (AR) occurred more frequently in the PAVI group (mild: 42%, moderate: 8%) compared with the SAVR-ST (mild: 10%, moderate: 0%) and SAVR-SL (mild: 12%, moderate: 0%) groups (p < 0.0001). At follow-up, the mean gradient in the PAVI group remained lower (p < 0.001) than that of the SAVR-ST group, but was similar to that of the SAVR-SL group. The incidence of severe prosthesis-patient mismatch was significantly lower (p = 0.007) in the PAVI group (6%) compared with the SAVR-ST (28%) and SAVR-SL (20%) groups. However, the incidence of AR remained higher (p < 0.0001) in the PAVI group compared with the 2 other groups. Conclusions : PAVI provided superior hemodynamic performance compared with the surgical bioprostheses in terms of transprosthetic gradient and prevention of severe prosthesis-patient mismatch, but was associated with a higher incidence of AR.
  • PublicationRestreint
    Left atrial decompression using unidirectional left-to-right interatrial shunt : initial experience in treating symptomatic heart failure with preserved ejection fraction with the W-Wave device
    (American College of Cardiology, 2015-05-01) Campelo-Parada, Francisco; Abdul-Jawad Altisent, Omar; Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Del Trigo, Maria; Bernier, Mathieu; Verheye, Stefan; Pibarot, Philippe; Keren, Gad; Puri, Rishi; Katzenellenbogen, Rotem; Rozenfeld, Erez; Abraham, William T.
  • PublicationRestreint
    Unidirectional left-to-right interatrial shunting for treatment of patients with heart failure with reduced ejection fraction : a safety and proof-of-principle cohort study
    (Elsevier, 2016-03-26) Campelo-Parada, Francisco; Abdul-Jawad Altisent, Omar; Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Del Trigo, Maria; Bernier, Mathieu; Pibarot, Philippe; Eigler, Neal; Puri, Rishi; Rozenfeld, Erez; Regueiro, Ander; Abraham, William T.
    Background: In patients with heart failure, interventions to reduce elevated left atrial pressure improve symptoms and reduce the risk of hospital admission. We aimed to assess the safety and potential efficacy of therapeutic left-to-right interatrial shunting in patients with heart failure with reduced ejection fraction. Methods: We did this proof-of-principle cohort study at one centre in Canada. Patients (aged =18 years) with New York Heart Association (NYHA) class III chronic heart failure with reduced ejection fraction were enrolled under the Canadian special access programme. Shunt implants were done after transseptal catheterisation with transoesophageal echocardiographic guidance under general anaesthesia. Patients had clinical and echocardiography evaluations at baseline and months 1 and 3 after shunt implantation. Findings: Between Oct 10, 2013, and March 27, 2015, we enrolled ten patients. The device was successfully implanted in all patients; no device-related or procedural adverse events occurred during follow-up. Transoesophageal echocardiography at 1 month showed that all shunts were patent, with no thrombosis or migration. From baseline to 3 month follow-up, we recorded improvements in NYHA classification (from class III to class II in seven [78%] of nine patients, from class III to class I in one [11%] patient, and no change in one [11%] patient; p=0·0004); quality of life, as assessed by the Duke Activity Status Index (from a mean score of 13 [SD 6·2] to 24·8 [12·9]; p=0·016) and the Kansas City Cardiomyopathy Questionnaire (from a mean score of 44·3 [SD 9·8] to 79·1 [13·0]; p=0·0001); and 6 min walk test distance (from a mean of 244 m [SD 112] to 318 m [134]; p=0·016). Pulmonary capillary wedge pressure was reduced from a mean of 23 mm Hg (SD 5) at baseline to 17 mm Hg (8) at 3 months (p=0·035), with no changes in right atrial pressure, pulmonary arterial pressure, or pulmonary resistance. No patient was admitted to hospital for worsening heart failure. One (10%) patient was admitted to hospital with gastrointestinal bleeding at month 1; one (10%) patient died after incessant ventricular tachycardia storm, which led to terminal heart failure 2 months post-procedure. Interpretation: This first-in-man experience with an implanted left-to-right interatrial shunt demonstrates initial safety and early beneficial clinical and haemodynamic outcomes in patients with heart failure with reduced ejection fraction. Further large-scale randomised studies are warranted.
  • PublicationRestreint
    Comparison of hemodynamic performance of the balloon-expandable SAPIEN 3 Versus SAPIEN XT transcatheter valve
    (American College of Cardiology, 2014-07-17) Dahou, Abdellaziz; Dumont, Éric; Webb, John G. (John Graydon); Larose, Éric; Dvir, Danny; Rodés-Cabau, Josep; Bergeron, Sébastien; Paradis, Jean-Michel; Amat Santos, Ignacio J.; Pasian, Sergio; Bilodeau, Sylvie; Urena Alcazar, Marina; Pibarot, Philippe; Thompson, Christopher R.; Dumesnil, Jean G.; Allende, Ricardo; Ribeiro, Henrique B.; Leipsic, Jonathon; De Larochellière, Robert
    The SAPIEN 3 valve (S3V) is a new-generation transcatheter valve with enhanced anti-paravalvular leak properties, but no data comparing with earlier transcatheter valve systems are available. We aimed to compare the hemodynamic performance of the S3V and the SAPIEN XT valve (SXTV) in a case-matched study with echo core laboratory analysis. A total of 27 patients who underwent transcatheter aortic valve replacement (TAVR) with the S3V were matched for prosthesis size (26 mm), aortic annulus area, and mean diameter measured by computed tomography, left ventricular ejection fraction, body surface area, and body mass index with 50 patients treated with the SXTV. The prosthesis size was determined by oversizing of 1% to 15% of annulus area. Doppler echocardiographic images collected at baseline and 1-month follow-up were analyzed in a central echocardiography core laboratory. The need for postdilation was higher in the SXTV group (20% vs 4%, p=0.047), and mean residual gradient and effective orifice area were similar in both groups (p>0.05). The incidence of paravalvular aortic regurgitation was greater with the SXTV (≥mild: 42%, moderate: 8%) than with the S3V (≥mild: 7%, moderate: 0%; p=0.002 for ≥mild vs SXTV). The implantation of an S3V was the only factor associated with trace or no paravalvular leak after TAVR (p=0.007). In conclusion, TAVR with the S3V was associated with a very low rate of paravalvular leaks and need for balloon postdilation, much lower than that observed with the earlier generation of balloon-expandable valve (SXTV). The confirmation of these results in a larger cohort of patients will represent a major step forward in using transcatheter valves for the treatment of aortic stenosis.
  • PublicationRestreint
    Significant mitral regurgitation left untreated at the time of aortic valve replacement : a comprehensive review of a frequent entity in the transcatheter aortic valve replacement era.
    (Elsevier Biomedical, 2014-06-24) DeLarochellière, Hugo; Laflamme, Louis; Dumont, Éric; Côté, Mélanie; Nombela-Franco, Luis; Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Beaudoin, Jonathan; Laflamme, Jérôme; García, Eulogio; Doyle, Daniel; Macaya, Carlos; Urena Alcazar, Marina; Jiménez-Quevedo, Pilar; Pibarot, Philippe; Allende, Ricardo; Ribeiro, Henrique B.; De Larochellière, Robert
    Significant mitral regurgitation (MR) is frequent in patients with severe aortic stenosis (AS). In these cases, concomitant mitral valve repair or replacement is usually performed at the time of surgical aortic valve replacement (SAVR). Transcatheter aortic valve replacement (TAVR) has recently been considered as an alternative for patients at high or prohibitive surgical risk. However, concomitant significant MR in this setting is typically left untreated. Moderate to severe MR after aortic valve replacement is therefore a relevant entity in the TAVR era. The purpose of this review is to present the current knowledge on the clinical impact and post-procedural evolution of concomitant significant MR in patients with severe AS who have undergone aortic valve replacement (SAVR and TAVR). This information could contribute to improving both the clinical decision-making process in and management of this challenging group of patients.
  • PublicationAccès libre
    Left atrial decompression through unidirectional left-to-right interatrial shunt for the treatment of left heart failure : first-inman experience with the V-Wave device
    (Europa Ed., 2015-01-01) Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Bernier, Mathieu; Urena Alcazar, Marina; Pibarot, Philippe; Allende, Ricardo; Verheye, Stefan; Ribeiro, Henrique B.; Keren, Gad; Yaacoby, Menashe; Nitzan, Yaacov; Abraham, William T.
    Aims: Elevated filling pressures of the left atrium (LA) are associated with poorer outcomes in patients with chronic heart failure. The V-Wave is a new percutaneously implanted device intended to decrease the LA pressure by the shunting of blood from the LA to the right atrium. This report describes the first-in-man experience with the V-Wave device. Methods and results: A 70-year-old man with a history of heart failure of ischaemic origin, left ventricular dysfunction (LVEF: 35%, pulmonary wedge: 19 mmHg), no right heart dysfunction, NYHA Class III and orthopnoea despite optimal treatment, was accepted for V-Wave device implantation. The device consists of an ePTFE encapsulated nitinol frame that is implanted at the level of the interatrial septum and contains a trileaflet pericardium tissue valve sutured inside which allows a unidirectional LA to right atrium shunt. The procedure was performed through a transfemoral venous approach under fluoroscopic and TEE guidance. The device was successfully implanted and the patient was discharged 24 hours after the procedure with no complications. At three-month follow-up a left-to-right shunt through the device was confirmed by TEE. The patient was in NYHA Class II, without orthopnoea, the Kansas City Cardiomyopathy index was 77.6 (from 39.1 at baseline) and NT-proBNP was 322 ng/mL (from 502 ng/mL at baseline). The QP/QS was 1.17 and the pulmonary wedge was 8 mmHg, with no changes in pulmonary pressure or right ventricular function. Conclusions: Left atrial decompression through a unidirectional left-to-right interatrial shunt represents a new concept for the treatment of patients with left ventricular failure. The present report shows the feasibility of applying this new therapy with the successful and uneventful implantation of the V-Wave device, which was associated with significant improvement in functional, quality of life and haemodynamic parameters at 90 days.