Publications by authors named "Frédéric Jacques"

55 Publications

Preoperative physical frailty assessment among octogenarians undergoing cardiac surgery: Upgrading the "eyeball" test.

J Thorac Cardiovasc Surg 2021 Apr 9. Epub 2021 Apr 9.

Cardiac Surgery, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address:

Objectives: There are many well-described, but as yet unproven, physical ability tools to assess frailty. The objective of this study was to evaluate the effectiveness of 4 preoperative physical tests in predicting mortality, morbidity, and functional outcomes among octogenarians undergoing cardiac surgery.

Methods: Between 2016 and 2019, 200 patients aged 80 years or more undergoing elective cardiac surgery were prospectively recruited. Four physical tests were performed preoperatively: 5-m walk time, timed up-and-go, 5 time sit-to-stand, and handgrip strength tests. The primary end point was a composite of in-hospital mortality, neurologic, and pulmonary complications. Multivariate analysis was performed.

Results: In-hospital mortality was 1.5%. Slow performance on the 5-m walk test (time ≥6.4 seconds) was the only independent predictor of the composite end point among the tests evaluated (odds ratio, 2.70; 95% confidence interval, 1.34-5.45; P = .006). At follow-up, patients with a slow 5-m walk test had a significantly lower midterm survival compared with patients with a normal test result (1-year survival 91.5% vs 98.7%, log-rank P = .03). Mean Physical and Mental Component Scores of the 12-item short form survey were 47.2 ± 8.3 and 53.6 ± 5.9, respectively, which are comparable to those of a general population aged more than 75 years.

Conclusions: The 5-m walk time test is an independent predictor of a composite of in-hospital mortality and major morbidity, as well as midterm survival. This test could be used as a simple adjunctive preoperative tool for octogenarians undergoing cardiac surgery.
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http://dx.doi.org/10.1016/j.jtcvs.2021.02.100DOI Listing
April 2021

The effect of centre volume and procedure location on major complications and mortality from transvenous lead extraction: an ESC EHRA EORP European Lead Extraction ConTRolled ELECTRa registry subanalysis.

Europace 2021 Mar 15. Epub 2021 Mar 15.

Electrophysiology Division, Lead Extraction Program, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval , 2725 Chemin Ste-Foy, Quebec G1V 4G5, Canada.

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http://dx.doi.org/10.1093/europace/euab038DOI Listing
March 2021

An autopsy view of the Hemi-commando procedure.

J Card Surg 2021 Feb 1;36(2):701-702. Epub 2020 Dec 1.

Service of Cardiac Surgery, Multidisciplinary Departement of Cardiology, Institut de cardiologie et de pneumologie, Université Laval, Qubec, Canada.

Invasive endocarditis involving the fibrous skeleton of the heart requires complex high-risk surgical management. For combined aortic and mitral infection in whom the posterior mitral leaflet and at least the free edge of anterior mitral valve could be spared, a modification of the Commando procedure was suggested: the "Hemi-commando procedure." We report the autopsy images of a Hemi-commando procedure after in unfortunate death in a 24 years old man 17 days after surgery.
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http://dx.doi.org/10.1111/jocs.15221DOI Listing
February 2021

Large Intramural Aortic Hematoma with Intimal Tear.

Aorta (Stamford) 2020 Aug 9;8(4):118-120. Epub 2020 Nov 9.

Departments of Cardiac Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec-IUCPQ, Quebec, QC, Canada.

A 72-year-old man presented with excruciating epigastric pain. A chest computed tomography angiography revealed an aortic intramural hematoma. A filling defect within the distal ascending aorta was noted. Images of an intramular hematoma and surgical details of an ascending aortic replacement under deep hypothermic circulatory arrest are provided.
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http://dx.doi.org/10.1055/s-0040-1714058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732563PMC
August 2020

Subcutaneous Implantable Defibrillators: When it Is Time to Extract.

JACC Clin Electrophysiol 2020 07;6(7):871-873

Cardiac Surgery Division, Lead Extraction Heart Team, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada.

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http://dx.doi.org/10.1016/j.jacep.2020.04.014DOI Listing
July 2020

Cardiovascular Collateral Damages at the Time of COVID-19.

Can J Cardiol 2020 08 22;36(8):1327.e7. Epub 2020 Jun 22.

Association des chirurgiens cardiovasculaires et thoraciques du Québec, Montréal, Québec, Canada.

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http://dx.doi.org/10.1016/j.cjca.2020.06.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308022PMC
August 2020

Transitioning to Del Nido cardioplegia for all-comers: the next switching gear?

BMC Cardiovasc Disord 2020 05 8;20(1):215. Epub 2020 May 8.

Service of Cardiac Surgery, Institut universitaire de cardiologie et de pneumologie de Québec-IUCPQ, Université Laval, Quebec City, QC, G1V 4G5, Canada.

Background: Exclusive use of Del Nido cardioplegia administration in all adult patients undergoing cardiac surgery has been studied for operative, postoperative and myocardial protection outcomes.

Methods: From November 2016 to October 2017, Del Nido cardioplegia was used in 131 consecutive patients (DN group). Using a propensity score, DN group was compared to 251 patients having received intermittent cold blood cardioplegia (CB group).

Results: Preoperative characteristics were similar in DN and CB groups. Operative outcomes were statistically different (p < 0.0001): cardiopulmonary bypass (CPB) time (DN 105.9 ± 46.5, CB 131.2 ± 38.8); aortic cross-clamp time (DN 80.8 ± 35.5, CB 102.2 ± 31.3); operative time (DN 203.1 ± 65.0, CB 241.5 ± 54.7); total cardioplegia volume (DN 1328 ± 879, CB 3773 ± 1226); and peak glycemia on CPB (DN 8.2 ± 2.3, CB 9.0 ± 1.8). No statistical differences were noted in intensive care unit stay, hospital stay and hospital death. Myocardial protection outcomes were similar: discharge left ventricular ejection fraction (DN 52 ± 11, CB 51 ± 10); Troponin levels at the end of the surgery (DN 871 ± 1623, CB 1958 ± 854), day 1 (DN 853 ± 1139, CB 993 ± 8234) and day 4 (DN 442 ± 540, CB 463 ± 317).

Conclusion: Del Nido cardioplegia use in all adult cardiac surgeries is associated with improved surgical efficiency. The design of larger trials including adults combined cardiac procedures and emergencies is needed.
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http://dx.doi.org/10.1186/s12872-020-01506-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206735PMC
May 2020

Right atrial catheter "ghost" removal by cardiac surgery: A pediatric case series report.

Pediatr Blood Cancer 2020 06 24;67(6):e28197. Epub 2020 Mar 24.

Cardiovascular Surgery, CHU de Québec-Laval, Quebec, Canada.

Fibrin sheath formation around long-term indwelling central venous catheters is common and usually benign. Fibrin sheath can persist after catheter removal and rarely leads to complications. This is a report of three pediatric oncology patients that required cardiac surgery for cardiac embolization of a "ghost" catheter several years after catheter removal. One case required tricuspid valve replacement for complete tricuspid valve destruction and two had erosion through the atrial wall. The severity of these rare complications mandates follow-up of "ghost" catheters in pediatric oncology patients.
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http://dx.doi.org/10.1002/pbc.28197DOI Listing
June 2020

Tricuspid Intervention Following Pulmonary Valve Replacement in Adults With Congenital Heart Disease.

J Am Coll Cardiol 2020 03;75(9):1033-1043

Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada; Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.

Background: Tricuspid regurgitation (TR) is common among adults with corrected tetralogy of Fallot (TOF) or pulmonary stenosis (PS) referred for pulmonary valve replacement (PVR). Yet, combined valve surgery remains controversial.

Objectives: This study sought to evaluate the impact of concomitant tricuspid valve intervention (TVI) on post-operative TR, length of hospital stay, and on a composite endpoint consisting of 7 early adverse events (death, reintervention, cardiac electronic device implantation, infection, thromboembolic event, hemodialysis, and readmission).

Methods: The national Canadian cohort enrolled 542 patients with TOF or PS and mild to severe TR who underwent isolated PVR (66.8%) or PVR+TVI (33.2%). Outcomes were abstracted from charts and compared between groups using multivariable logistic and negative binomial regression.

Results: Median age at reintervention was 35.3 years. Regardless of surgery type, TR decreased by at least 1 echocardiographic grade in 35.4%, 66.9%, and 92.8% of patients with pre-operative mild, moderate, and severe insufficiency. In multivariable analyses, PVR+TVI was associated with an additional 2.3-fold reduction in TR grade (odds ratio [OR]: 0.44; 95% confidence interval [CI]: 0.25 to 0.77) without an increase in early adverse events (OR: 0.85; 95% CI: 0.46 to 1.57) or hospitalization time (incidence rate ratio: 1.17; 95% CI: 0.93 to 1.46). Pre-operative TR severity and presence of transvalvular leads independently predicted post-operative TR. In contrast, early adverse events were strongly associated with atrial tachyarrhythmia, extracardiac arteriopathy, and a high body mass index.

Conclusions: In patients with TOF or PS and significant TR, concomitant TVI is safe and results in better early tricuspid valve competence than isolated PVR.
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http://dx.doi.org/10.1016/j.jacc.2019.12.053DOI Listing
March 2020

Pacing therapy in children with isolated complete atrioventricular block: a retrospective study of pacing system survival and pacing-related complications in a national cohort.

Europace 2020 02;22(2):330-332

Services of Pediatric Cardiac Surgery, Department of Surgery, Centre mère-enfant Soleil, CHU de Québec-Université Laval, Quebec City, Canada.

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http://dx.doi.org/10.1093/europace/euz334DOI Listing
February 2020

More Than 25 Years of Experience With the Ross Procedure in Children: A Single-Center Experience.

Ann Thorac Surg 2020 08 24;110(2):638-644. Epub 2019 Dec 24.

Division of Pediatric Cardiac Surgery, Centre Mère-Enfant Soleil, CHU de Quebec, Université Laval, Quebec City, Quebec, Canada. Electronic address:

Background: Aortic valve replacement in children represents an important challenge. Concerns regarding pulmonary autograft and homograft longevity requiring reoperations are well recognized. Very long-term outcomes after the Ross procedure are still unknown. We reviewed our experience with the Ross procedure, aiming to define very long-term survival rate and freedom from reintervention.

Methods: This was a single-center retrospective cohort including 63 consecutive children who underwent the Ross procedure. Median follow-up duration was 20.5 years. Time-related events were assessed using Kaplan-Meier estimator.

Results: There were 51 (81%) boys, mean age 10.1 ± 5.8 years. Isolated aortic stenosis was the most common diagnosis (n = 29, 46%) and 34 (54%) patients previously underwent cardiac surgery. There was 1 (1.6%) in-hospital death. Overall survival at 5, 15, and 25 years was 96.7%, 94.4%, and 94.4%, respectively. Freedom from any autograft-related reintervention was 98.1%, 86.4%, and 61.2% at 5, 15, and 25 years, respectively. Fifteen (24%) patients underwent autograft reoperations. Among them, 10 (67%) patients underwent valve-sparing autograft reoperation. Freedom from any pulmonary conduit reintervention was 93.2%, 58.2%, and 28.3% at 5, 15, and 25 years, respectively. Thirty (46.6%) patients underwent conduit reintervention (8 percutaneous, 22 surgical replacements).

Conclusions: The pediatric Ross procedure is associated with excellent long-term survival. Ross-related reinterventions are more than twice as common on the pulmonary homograft than on the autograft.
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http://dx.doi.org/10.1016/j.athoracsur.2019.10.093DOI Listing
August 2020

Caseous Calcification of the Mitral Annulus: A Role for Surgery.

Ann Thorac Surg 2020 06 10;109(6):e441-e444. Epub 2019 Oct 10.

Service of Cardiac Surgery, Institut de cardiologie et de pneumologie de Québec (IUCPQ)-Université Laval, Quebec City, Quebec, Canada. Electronic address:

An 80-year-old man followed for aortic stenosis was found to have an intracardiac mass. Multiple imaging modalities were inconclusive in characterizing the mass but raised concerns about the potential malignancy of the mass. Fear of operating on an elderly patient with a potential for cardiac neoplasia led to a percutaneous transseptal biopsy that failed to provide a clear diagnosis. Cardiac valvular surgery was performed in addition to excisional biopsy of the mass that turned out to be caseous necrosis of mitral annular calcifications.
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http://dx.doi.org/10.1016/j.athoracsur.2019.08.110DOI Listing
June 2020

Concurrent Epicardial Cardiac Resynchronization at Time of Complicated Biventricular Device Extraction: A Potentially Life-Saving Option.

Can J Cardiol 2019 06 19;35(6):796.e13-796.e16. Epub 2019 Mar 19.

Cardiac Surgery Division, Multidisciplinary Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Laval, Québec, Canada. Electronic address:

A 60-year-old man with cardiac resynchronization therapy defibrillator (CRT-D) lead endocarditis underwent transvenous lead extraction that was complicated by coronary sinus laceration and tamponade. Severe left ventricular dysfunction and unstable hemodynamic parameters persisted after emergent sternotomy, drainage, and repair. Reinstitution of cardiac resynchronization therapy with an epicardial device resulted in immediate hemodynamic improvement. Our case illustrates the potentially life-saving nature of single-stage extraction and reimplantation in resynchronization responders.
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http://dx.doi.org/10.1016/j.cjca.2019.03.011DOI Listing
June 2019

Neonatal Cardiac Arrest From Left Ventricular Cardiac Hemangioma: A Surprising Presentation.

Can J Cardiol 2019 04 13;35(4):544.e3-544.e5. Epub 2019 Feb 13.

Services de Chirurgie Cardiovasculaire Pédiatrique, Québec-Université Laval, Quebec City, Quebec, Canada.

Cardiac hemangioma is rare, even more when leading to a cardiovascular collapse in a seemingly healthy newborn. A 6-day-old neonate had a tamponade caused by a basolateral hemangioma of the left ventricle. Partial surgical resection was performed. A congenital lobular capillary hemangioma was diagnosed upon histologic examination. The patient recovered completely and shows normal development at the 12-month follow-up.
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http://dx.doi.org/10.1016/j.cjca.2019.01.023DOI Listing
April 2019

Surgical Atrioventricular Valve Replacement With Melody Valve in Infants and Children.

Circ Cardiovasc Interv 2018 11;11(11):e007145

Department of Cardiology and Cardiac Surgery, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, Milan, Italy (V.M., S.M.E.).

Background Pediatric patients with atrioventricular valve disease have limited options for prosthetic valve replacement in sizes <15 mm. Based on successful experience with the stented bovine jugular vein graft (Melody valve) in the right ventricular outflow tract, the prosthesis has been modified for surgical valve replacement in pediatric patients with atrioventricular dysfunction with the intention of subsequent valve expansion in the catheterization laboratory as the child grows. Methods and Results A multicenter, retrospective cohort study was performed among patients who underwent atrioventricular valve replacement with Melody valve at 17 participating sites from North America and Europe, including 68 patients with either mitral (n=59) or tricuspid (n=9) replacement at a median age of 8 months (range, 3 days to 13 years). The median size at implantation was 14 mm (range, 9-24 mm). Immediately postoperatively, the valve was competent with low gradients in all patients. Fifteen patients died; 3 patients underwent transplantation. Nineteen patients required reoperation for adverse outcomes, including valve explantation (n=16), left ventricular outflow tract obstruction (n=1), permanent pacemaker implantation (n=1), and paravalvular leak repair (n=1). Twenty-five patients underwent 41 episodes of catheter-based balloon expansion, exhibiting a significant decrease in median gradient ( P<0.001) with no significant increase in grade of regurgitation. Twelve months after implantation, cumulative incidence analysis indicated that 55% of the patients would be expected to be free from death, heart transplantation, structural valve deterioration, or valve replacement. Conclusions The Melody valve is a feasible option for surgical atrioventricular valve replacement in patients with hypoplastic annuli. The prosthesis shows acceptable short-term function and is amenable to catheter-based enlargement as the child grows. However, patients remain at risk for mortality and structural valve deterioration, despite adequate early valvular function. Device design and implantation techniques must be refined to reduce complications and extend durability. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02505074.
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http://dx.doi.org/10.1161/CIRCINTERVENTIONS.118.007145DOI Listing
November 2018

Post esophagectomy diaphragmatic hernia: a case report of a rare cause of acute respiratory distress.

J Cardiothorac Surg 2018 Nov 15;13(1):114. Epub 2018 Nov 15.

Service of Cardiac Surgery, Multidisciplinary Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, QC, Canada.

Background: Diaphragmatic hernia is frequent among the elderly and is usually associated with mild chronic digestive and respiratory symptoms.

Case Presentation: An elderly post-esophagectomy male patient, in the early postoperative period of cardiac surgery, presented with acute respiratory distress. An emergent surgery was performed to reduce a giant diaphragmatic herniation.

Conclusions: An acute transhiatal herniation can cause serious respiratory impairment; surgical repair should be considered in select patients of cardiac surgery.
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http://dx.doi.org/10.1186/s13019-018-0802-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238405PMC
November 2018

Early diaphragmatic plication after cardiac surgery: a case report in an obese patient.

J Cardiothorac Surg 2018 Sep 26;13(1):98. Epub 2018 Sep 26.

Institut universitaire de cardiologie et de pneumologie de Québec, Department of Specialized Medecine, Service of Intensive Care Medicine, Université Laval, Québec, Canada.

Background: Diaphragmatic plication to help ventilation weaning of an adult obese patient after cardiac surgery is very uncommon. Diaphragm paralysis is usually treated with conservative measures and ventilator support, after which surgical management is considered after months of medical monitoring.

Case Presentation: We report the case of a morbidly obese patient to whom ventilation weaning was unsuccessful following coronary artery bypass graft operation with mitral valve replacement. A de novo right hemidiaphragm elevation was seen on the chest X-ray. Diaphragmatic plication was performed promptly to treat severe respiratory insufficiency and generated favorable outcomes.

Conclusions: Early diaphragmatic plication could be considered in the postoperative period of cardiothoracic surgery to facilitate management and ventilation weaning in the context of de novo diaphragm paralysis.
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http://dx.doi.org/10.1186/s13019-018-0780-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158825PMC
September 2018

Buttocks Hard as Rocks: Not Wanted after Aortic Dissection Repair.

Aorta (Stamford) 2018 Feb 27;6(1):37-40. Epub 2018 Jul 27.

Service of Cardiac Surgery, Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City, Quebec, Canada.

The authors report the case of a patient developing a gluteal compartment syndrome after DeBakey type I dissection repair. Prompt recognition and treatment led to successful results. The surgical approach to the gluteal compartment is described.
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http://dx.doi.org/10.1055/s-0038-1639379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136677PMC
February 2018

Cardiac Implantable Electronic Device Infection: Detailed Analysis of Cost Implications.

Can J Cardiol 2018 08 7;34(8):1026-1032. Epub 2018 May 7.

Electrophysiology Division, Institut Universitaire de cardiologie et de pneumologie de Québec, Québec, Canada. Electronic address:

Background: Infections of cardiac implantable electronic devices (CIED) are associated with significant morbidity and mortality. Despite many preventive measures, this condition is associated with significant costs for the health care system.

Methods: We retrospectively analyzed all infection cases referred for lead extraction at a single university hospital over 1 year (2015-2016). We then calculated all costs related to the infection episode per patient using hospital databases and charts review.

Results: Thirty-eight patients with CIED infections (29% women-mean age 71 ± 14 years) were referred for lead extraction (27 pocket infections, 11 endocarditis). Devices were mainly pacemakers (60%). When the pathogen was identified, Staphylococcus aureus methicillin sensitive was the main cause. Extraction was performed in all but 3 cases (92%). One death occurred in the nonextracted group. Respective durations of hospitalization and intravenous and antibiotic administration for patients undergoing extraction were 21 and 36 days. The calculated mean total cost for CIED infection management was CAD$29,907 (median: 26,879; range: CAD$4,827-$62,585). Mean hospital charges were CAD$12,291, accounting for 41% of the total costs.

Conclusions: This study represents the first analysis of the direct costs associated with lead extraction in Canada. Device infections are associated with significant costs and increased morbidity. Any preventive measure will have a significant impact on the economic burden of the health care system and patient outcome after lead extraction.
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http://dx.doi.org/10.1016/j.cjca.2018.05.001DOI Listing
August 2018

Anomalous Left Coronary Artery From the Pulmonary Artery: Masquerading as Peripartum Cardiomyopathy.

Ann Thorac Surg 2018 07 9;106(1):e33-e35. Epub 2018 Mar 9.

Service of Cardiac Surgery, Service of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval, Quebec City, Quebec, Canada; Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada. Electronic address:

Diagnosed with peripartum cardiomyopathy 8 years earlier, a 45-year-old woman had sudden cardiac death. After resuscitation, the patient was diagnosed with an anomalous origin of the left coronary artery from the pulmonary artery and underwent a successful coronary repair. The management of a patient with clinical features of cardiomyopathy is reviewed.
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http://dx.doi.org/10.1016/j.athoracsur.2018.02.013DOI Listing
July 2018

Sutureless Versus Conventional Pulmonary Vein Repair: A Magnetic Resonance Pilot Study.

Ann Thorac Surg 2018 04 23;105(4):1248-1254. Epub 2018 Feb 23.

Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: Two different surgical techniques are used to repair anomalous pulmonary venous connection or pulmonary vein (PV) stenosis: the classic repair (CR) and the sutureless repair (SR). The purpose of this study was to compare the prevalence of PV stenosis between the two surgical approaches.

Methods: Patients were prospectively recruited irrespective of symptoms or previous imaging findings. Cardiac magnetic resonance imaging and echocardiography were performed in a blinded fashion on the same day.

Results: Twenty-five patients (13 male) after PV repair completed the study. Twelve patients had undergone CR and 13 SR (in 1 patient as a reoperation after CR). The median age at operation was 2 months (range: 1 day to 5 years) and was similar for both groups; the median age at the time of cardiac magnetic resonance was 9 years (range: 6 to 17 years) and 9 years (range: 6 to 14 years) for the CR and SR, respectively. Four patients had PV stenosis. All 4 patients had had total anomalous pulmonary venous connection, 1 patient had undergone repair with the CR and 2 with a primary SR; 1 patient had first undergone a CR, followed by a SR for stenosis. Echocardiography provided complete visualization of all PVs in only 11 patients (44%). Notable stenosis of at least one PV was missed by echocardiography in 2 patients.

Conclusions: This pilot study indicates that not only CR but also SR may be burdened by a risk of postoperative PV stenosis. Magnetic resonance imaging should be used routinely for the postoperative monitoring for the development of PV obstruction.
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http://dx.doi.org/10.1016/j.athoracsur.2017.11.015DOI Listing
April 2018

Mitral Annular Calcification and Mitral Valve Replacement: A New Approach.

Ann Thorac Surg 2018 Feb;105(2):e55-e57

Service of Cardiac Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada. Electronic address:

Mitral valve replacement is technically challenging in the context of mitral annular calcification. A new surgical strategy is described that was used in a 71-year-old obese patient, where intraatrial prosthesis insertion and valve fixation into native uncalcified structures were performed without calcium debridement.
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http://dx.doi.org/10.1016/j.athoracsur.2017.09.028DOI Listing
February 2018

Long-term outcome of transvenous pacemaker implantation in infants: a retrospective cohort study.

Europace 2018 07;20(7):1227

Service of Electrophysiology, Multidisciplinary Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, 2725 Ch Ste-Foy, Ville de Québec, QC, Canada.

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http://dx.doi.org/10.1093/europace/eux210DOI Listing
July 2018

Clinical Outcomes Following the Ross Procedure in Adults: A 25-Year Longitudinal Study.

J Am Coll Cardiol 2017 Oct;70(15):1890-1899

Division of Cardiac Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Université Laval, Quebec City, Quebec, Canada. Electronic address:

Background: Very few reports of long-term outcomes of patients who underwent the Ross procedure have been published.

Objectives: The authors reviewed their 25-year experience with the Ross procedure with the aim of defining very-long-term survival and factors associated with Ross-related failure.

Methods: Between January 1990 and December 2014, the Ross procedure was performed in 310 adults (mean age 40.8 years) at a single institution. All patients were prospectively added to a dedicated cardiac surgery registry. Complete post-operative clinical examination and history were obtained, and transthoracic echocardiography was performed according to a standardized protocol. There was no loss to follow-up. Median follow-up was 15.1 years and up to 25 years.

Results: Bicuspid aortic valve was diagnosed in 227 patients (73.2%), and the most common indication for surgery was aortic stenosis (n = 225 [72.6%]). Freedom from any Ross-related reintervention was 92.9% and 70.1% at 10 and 20 years, respectively. Independent risk factors for pulmonary autograft degeneration were pre-operative large aortic annulus (hazard ratio: 1.1; p = 0.01), pre-operative aortic insufficiency (hazard ratio: 2.7; p = 0.002), and concomitant replacement of the ascending aorta (hazard ratio: 7.7; p = 0.0003). There were 4 hospital deaths (1.3%), and overall survival at 10 and 20 years was 94.1% and 83.6%, respectively. Long-term survival was not significantly different in patients who required Ross-related reintervention (log-rank p = 0.70). However, compared with the general population, survival was significantly lower in patients following the Ross procedure when matched on age and sex (p < 0.0001).

Conclusions: The Ross procedure was associated with excellent long-term valvular outcomes and survival, regardless of the need for reintervention. Adults presenting with aortic insufficiency or a dilated aortic annulus or ascending aorta were at greater risk for reintervention. Unlike previous reports, long-term survival was lower in Ross patients compared with matched subjects.
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http://dx.doi.org/10.1016/j.jacc.2017.08.030DOI Listing
October 2017

Ligand recognition and helical stacking formation are intimately linked in the SAM-I riboswitch regulatory mechanism.

RNA 2017 10 12;23(10):1539-1551. Epub 2017 Jul 12.

Department of Biology, Faculty of Sciences, RNA Group, Université de Sherbrooke, Sherbrooke, Quebec J1K 2R1, Canada.

Riboswitches are noncoding mRNA elements that control gene expression by altering their structure upon metabolite binding. Although riboswitch crystal structures provide detailed information about RNA-ligand interactions, little knowledge has been gathered to understand how riboswitches modulate gene expression. Here, we study the molecular recognition mechanism of the -adenosylmethionine SAM-I riboswitch by characterizing the formation of a helical stacking interaction involving the ligand-binding process. We show that ligand binding is intimately linked to the formation of the helical stacking, which is dependent on the presence of three conserved purine residues that are flanked by stacked helices. We also find that these residues are important for the formation of a crucial long-range base pair formed upon SAM binding. Together, our results lend strong support to a critical role for helical stacking in the folding pathway and suggest a particularly important function in the formation of the long-range base pair.
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http://dx.doi.org/10.1261/rna.061796.117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602112PMC
October 2017

Thrombolysis of prosthetic mitral valve thrombosis in an infant.

J Card Surg 2017 May;32(5):310-312

Service of Pediatric Cardiology, Centre Mère-Enfant Soleil, CHU de Québec-Université Laval, Quebec, Canada.

A 7-week-old female developed thrombosis of a mechanical mitral valve and was successfully treated with recombinant tissue plasminogen activator (rt-PA). The management of infants with thrombosed mechanical prosthesis is reviewed.
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http://dx.doi.org/10.1111/jocs.13135DOI Listing
May 2017

Surgical ablation in patients undergoing mitral valve surgery: impact of lesion set and surgical techniques on long-term success.

Europace 2017 02;19(2):332

Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada.

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http://dx.doi.org/10.1093/europace/euw028DOI Listing
February 2017

New insights into the phylogeny of Burasaieae (Menispermaceae) with the recognition of a new genus and emphasis on the southern Taiwanese and mainland Chinese disjunction.

Mol Phylogenet Evol 2017 04 31;109:11-20. Epub 2016 Dec 31.

State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China.

Taiwan is a continental island lying at the boundary between the Eurasian and the Philippine tectonic plates and possesses high biodiversity. Southern Taiwan, viz. Hengchun Peninsula, is notably floristically different from northern Taiwan. The floristic origin and relationships of the Hengchun Peninsula have been rarely investigated in a phylogenetic context. In this study, data from six plastid and nuclear sequences were used to reconstruct phylogenetic relationships within Burasaieae (Menispermaceae), which mainly inhabits tropical rainforests. The tree-based comparisons indicate that the position of Tinospora sensu stricto conflicts significantly between the cpDNA and ITS trees. However, alternative hypothesis tests from the ITS data did not reject the result of the cpDNA data, which suggests that tree-based comparisons might sometimes generate an artificial incongruence, especially when markers with high homoplasy are used. Based on the combined cpDNA and ITS data, we present an inter-generic phylogenetic framework for Burasaieae. Sampled species of Tinospora are placed in three different clades, including Tinospora dentata from southern Taiwan and T. sagittata from mainland China in an unresolved position alongside six lineages of Burasaieae. By integrating lines of evidence from molecular phylogeny, divergence times, and morphology, we recognize the three Tinospora clades as three different genera, including Tinospora sensu stricto, a new genus (Paratinospora) for T. dentata and T. sagittata, and Hyalosepalum resurrected. Tinospora dentata, now endemic to the Hengchun Peninsula, originated from the Late Eocene (ca. 39Ma), greatly predating the formation of Taiwan. Our study suggests that the flora of the Hengchun Peninsula contains some ancient components that might have migrated from mainland China.
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http://dx.doi.org/10.1016/j.ympev.2016.12.038DOI Listing
April 2017