Publications by authors named "Pierre Corbi"

74 Publications

Predictors of Early Stroke or Death in Patients Undergoing Transcatheter Aortic Valve Implantation.

J Stroke Cerebrovasc Dis 2021 Aug 12;30(8):105912. Epub 2021 Jun 12.

Department of Neurology, CHU La Milétrie, Poitiers, France and University of Poitiers, France.

Background/objective: While postoperative stroke is a known complication of Transcatheter Aortic Valve Implantation (TAVI), predictors of early stroke occurrence have not been specifically reviewed. The objective of this study was to estimate the predictors and incidence of stroke during the first 30 days post-TAVI.

Methods: A cohort of 506 consecutive patients having undergone TAVI between January 2017 and June 2019 was extracted from a prospective database. Preoperative, intraoperative and postoperative characteristics were analyzed by univariate analysis followed by logistic regression to find predictors of the occurrence of stroke or death within the first 30 days after the procedure.

Results: Incidence of stroke within 30 days post-TAVI was 4.9%, [CI 95% 3.3-7.2], i.e., 25 strokes. Four out of the 25 patients (16%) with a stroke died within 30 days post-TAVI. After logistic regression analysis, the predictors of early stroke related to TAVI were: CHA2Ds2VASc score ≥ 5 (odds ratio [OR] 2.62; 95% CI: 1.06-6.49; p = .037), supra-aortic access vs. femoral access (OR: 9.00, 95%CI: 2.95-27.44; p = .001) and introduction post-TAVI of a single vs. two or three antithrombotic agents (OR: 5.13; CI 95%: 1.99 to 13.19; p = .001). Over the 30-day period, bleeding occurred in 28 patients (5.5%), in 25 of whom, it was associated with femoral or iliac artery access injury. Anti-thrombotic regimen was not associated with bleeding; two patients out of 48 (4.1%) bled with a single anti-thrombotic regimen vs. 26 patients out of 458 (5.6%) with a dual or triple anti-thrombotic regimen (p = 0.94). The overall 30-day mortality rate was 3.9%, [95% CI 2.5-6.0]. Patients with a single post-TAVI antithrombotic agent (OR: 44.07 [CI 95% 13.45-144.39]; p < .0001) and patients with previous coronary artery bypass surgery or coronary artery stenting (OR: 6.16, [CI 95% 1.99-21.29]; p = .002) were at significantly higher risk of death within the 30-day period.

Conclusion: In this large-scale single-center retrospective study, a single post-TAVI antithrombotic regimen independently predicted occurrence of early stroke or death. Dual or triple antithrombotic regimen was not associated with a higher risk of bleeding and should be considered as an option in patients undergoing TAVI.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105912DOI Listing
August 2021

Sutureless versus conventional bioprostheses for aortic valve replacement in severe symptomatic aortic valve stenosis.

J Thorac Cardiovasc Surg 2021 03 14;161(3):920-932. Epub 2020 Dec 14.

Cardio-Thoracic Surgery Department, Heart and Vascular Center, Maastricht University Medical Center (MUMC+), Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.

Objective: Sutureless aortic valves are a novel option for aortic valve replacement. We sought to demonstrate noninferiority of sutureless versus standard bioprostheses in severe symptomatic aortic stenosis.

Methods: The Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement is a prospective, randomized, adaptive, open-label trial. Patients were randomized (March 2016 to September 2018) to aortic valve replacement with a sutureless or stented valve using conventional or minimally invasive approach. Primary outcome was freedom from major adverse cerebral and cardiovascular events (composite of all-cause death, myocardial infarction, stroke, or valve reintervention) at 1 year.

Results: At 47 centers (12 countries), 910 patients were randomized to sutureless (n = 453) or conventional stented (n = 457) valves; mean ages were 75.4 ± 5.6 and 75.0 ± 6.1 years, and 50.1% and 44.9% were female, respectively. Mean ± standard deviation Society of Thoracic Surgeons scores were 2.4 ± 1.7 and 2.1 ± 1.3, and a ministernotomy approach was used in 50.4% and 47.3%, respectively. Concomitant procedures were performed with similar rates in both groups. Noninferiority was demonstrated for major adverse cerebral and cardiovascular events at 1 year, whereas aortic valve hemodynamics improved equally in both groups. Use of sutureless valves significantly reduced surgical times (mean extracorporeal circulation times: 71.0 ± 34.1 minutes vs 87.8 ± 33.9 minutes; mean crossclamp times: 48.5 ± 24.7 vs 65.2 ± 23.6; both P < .0001), but resulted in a higher rate of pacemaker implantation (11.1% vs 3.6% at 1 year). Incidences of perivalvular and central leak were similar.

Conclusions: Sutureless valves were noninferior to stented valves with respect to major adverse cerebral and cardiovascular events at 1 year in patients undergoing aortic valve replacement (alone or with coronary artery bypass grafting). This suggests that sutureless valves should be considered as part of a comprehensive valve program.
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http://dx.doi.org/10.1016/j.jtcvs.2020.11.162DOI Listing
March 2021

Hypnosis Versus Placebo During Atrial Flutter Ablation: The PAINLESS Study: A Randomized Controlled Trial.

JACC Clin Electrophysiol 2020 11 12;6(12):1551-1560. Epub 2020 Aug 12.

Centre Hospitalier Universitaire (CHU) Poitiers, Cardiology Department, Poitiers, France.

Objectives: The aim of this study was to assess the superiority of hypnosis versus placebo on pain perception and morphine consumption during typical atrial flutter (AFL) ablation.

Background: AFL ablation commonly requires intravenous opioid for analgesia, which can be associated with adverse outcomes. Hypnosis is an alternative technique with rising interest, but robust data in electrophysiological procedures are lacking.

Methods: This single center, randomized controlled trial compared hypnosis and placebo during AFl ablation. In addition to the randomized intervention, all patients were treated according to the institution's standard of care analgesia protocol (administration of 1 mg of intravenous morphine in case of self-reported pain ≥5 on an 11-point numeric rating scale or on demand). The primary endpoint was perceived pain quantified by patients using a visual analog scale.

Results: Between October 2017 and September 2019, 113 patients (mean age 70 ± 12 years, 21% women) were randomized to hypnosis (n = 56) or placebo (n = 57). Mean pain score was 4.0 ± 2.2 in the hypnosis group versus 5.5 ± 1.8 in the placebo group (p < 0.001). Pain perception, assessed every 5 min during the whole procedure, was consistently lower in the hypnosis group. Patients' sedation scores were also better in the hypnosis group than in the placebo group (8.3 ± 2.2 vs. 5.4 ± 2.5; p < 0.001). Finally, morphine requirements were significantly lower in the hypnosis group (1.3 ± 1.3 mg) compared with the placebo group (3.6 ± 1.8 mg; p < 0.001).

Conclusions: In this first randomized trial, hypnosis during AFL ablation was superior to placebo for alleviating pain and reducing morphine consumption.
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http://dx.doi.org/10.1016/j.jacep.2020.05.028DOI Listing
November 2020

Myocardial infarction revealed a giant right coronary artery aneurysm.

J Card Surg 2019 Dec 15;34(12):1651-1652. Epub 2019 Nov 15.

Department of Thoracic and Cardiovascular Surgery, Cardio-Vascular Center, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1111/jocs.14357DOI Listing
December 2019

Thoracic Endometriosis and Hepatothorax.

Ann Thorac Surg 2019 12 23;108(6):e415. Epub 2019 Jul 23.

Department of Thoracic and Cardiovascular Surgery, Cardio-vascular Center, Poitiers University Hospital, Poitiers, France.

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http://dx.doi.org/10.1016/j.athoracsur.2019.05.082DOI Listing
December 2019

Dissecting Thoracic Aneurysm in Takayasu Arteritis With Concomitant Tuberculosis.

Ann Thorac Surg 2020 02 27;109(2):e119-e121. Epub 2019 Jun 27.

Department of Thoracic and Cardiovascular Surgery, Cardio-vascular Center, University Hospital of Poitiers, Poitiers, France.

We present a case of dissecting aneurysm of ascending aorta in a 15-year-old patient secondary to Takayasu arteritis with concomitant tuberculosis, with an emphasis on multimodality imaging findings and to illustrate preoperative and postoperative medical management. Antituberculosis therapy, high-dose corticosteroids, antiplatelet therapy, and β-blockers were administrated during the initial active phase. The patient presented with acute chest pain 3 months after medical therapy initiation. We performed an ascending aorta and aortic arch replacement with branched Dacron grafts. Only a handful of similar, but not identical, cases of Takayasu arteritis with concomitant tuberculosis leading to aortic dissection have been described previously.
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http://dx.doi.org/10.1016/j.athoracsur.2019.05.014DOI Listing
February 2020

Multicentre, open-label, randomised, controlled clinical trial comparing 2% chlorhexidine-70% isopropanol and 5% povidone iodine-69% ethanol for skin antisepsis in reducing surgical-site infection after cardiac surgery: the CLEAN 2 study protocol.

BMJ Open 2019 06 17;9(6):e026929. Epub 2019 Jun 17.

INSERM U1070, Universite de Poitiers UFR Medecine et Pharmacie, Poitiers, France.

Introduction: Surgical-site infection (SSI) is the second most frequent cause of healthcare-associated infection worldwide and is associated with increased morbidity, mortality and healthcare costs. Cardiac surgery is clean surgery with low incidence of SSI, ranging from 2% to 5%, but with potentially severe consequences.Perioperative skin antisepsis with an alcohol-based antiseptic solution is recommended to prevent SSI, but the superiority of chlorhexidine (CHG)-alcohol over povidone iodine (PVI)-alcohol, the two most common alcohol-based antiseptic solutions used worldwide, is controversial. We aim to evaluate whether 2% CHG-70% isopropanol is more effective than 5% PVI-69% ethanol in reducing the incidence of reoperation after cardiac surgery.

Methods And Analysis: The CLEAN 2 study is a multicentre, open-label, randomised, controlled clinical trial of 4100 patients undergoing cardiac surgery. Patients will be randomised in 1:1 ratio to receive either 2% CHG-70% isopropanol or 5% PVI-69% ethanol for perioperative skin preparation. The primary endpoint is the proportion of patients undergoing any re-sternotomy between day 0 and day 90 after initial surgery and/or any reoperation on saphenous vein/radial artery surgical site between day 0 and day 30 after initial surgery. Data will be analysed on the intention-to-treat principle.

Ethics And Dissemination: This protocol has been approved by an independent ethics committee and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.

Trial Registration Number: EudraCT 2017-005169-33 and NCT03560193.
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http://dx.doi.org/10.1136/bmjopen-2018-026929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596966PMC
June 2019

Flail chest in polytraumatized patients: surgical fixation using Stracos reduces ventilator time and hospital stay.

Biomed Res Int 2015 1;2015:624723. Epub 2015 Feb 1.

Thoracic and Cardiac Surgery Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.

Objectives: Conservative management of patients with flail chest is the treatment of choice. Rib fracture repair is technically challenging; however, with the advent of specially designed molding titanium clips, surgical management has been simplified. Surgical stabilization has been used with good outcomes. We are reporting on our institutional matched-case-control study.

Methods: Between April 2010 and April 2011, ten polytraumatized patients undergoing rib stabilization for flail chest were matched 1 : 1 to 10 control patients by age ±10 years, sex, neurological or vertebral trauma, abdominal injury, and arm and leg fractures. Surgery was realized in the first 48 hours.

Results: There were no significant differences between groups for matched data and prognostic scores: injury severity score, revised trauma score, and trauma injury severity score. Ventilator time (142 ± 224 versus 74 ± 125 hours, P = 0.026) and overall hospital stay (142 ± 224 versus 74 ± 125 hours, P = 0.026) were significantly lower for the surgical group after adjustment on prognostic scores. There was a trend towards shorter ICU stay for operative patients (12.3 ± 8.5 versus 9.0 ± 4.3 days, P = 0.076).

Conclusions: Rib fixation with Stracos is feasible and decreases the length of ventilation and hospital stay. A multicenter randomized study is warranted so as to confirm these results and to evaluate impact on pulmonary function status, pain, and quality of life.
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http://dx.doi.org/10.1155/2015/624723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331314PMC
December 2015

Percutaneous coronary intervention versus coronary artery bypass grafting in severe left ventricle dysfunction.

Ann Thorac Surg 2014 Nov 30;98(5):1888-9. Epub 2014 Oct 30.

Department of Cardio-thoracic Surgery, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021Poitiers Cedex, France.

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http://dx.doi.org/10.1016/j.athoracsur.2014.04.013DOI Listing
November 2014

Partial aortic valve replacement: a new and simple approach for endocarditis.

Ann Thorac Surg 2014 Oct;98(4):e101-2

Department of Cardiothoracic Surgery, University Hospital of Poitiers, Poitiers, France.

We describe the replacement of a single cusp in two patients with severe aortic regurgitation due to endocarditis with a one third stentless bioprosthesis, with excellent results in both.
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http://dx.doi.org/10.1016/j.athoracsur.2014.07.041DOI Listing
October 2014

Primary B-cell cardiac lymphoma presenting as a biatrial mass.

Asian Cardiovasc Thorac Ann 2016 Feb 15;24(2):221. Epub 2014 Jul 15.

Department of Cardiothoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1177/0218492314544160DOI Listing
February 2016

Multilevel obstruction of left ventricular outflow tract in Shone complex adult.

Asian Cardiovasc Thorac Ann 2015 Feb 2;23(2):231. Epub 2013 Dec 2.

Department of Cardiothoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1177/0218492313515499DOI Listing
February 2015

Acute aortic dissection in an adult patient with retro-oesophageal aortic arch.

Eur J Cardiothorac Surg 2014 Nov 26;46(5):924. Epub 2014 Feb 26.

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/ejcts/ezu042DOI Listing
November 2014

Abnormal origin of the right coronary artery in a patient with left ventricular non-compaction.

Eur J Cardiothorac Surg 2014 Sep 8;46(3):506. Epub 2014 Jan 8.

Department of Cardio-thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/ejcts/ezt591DOI Listing
September 2014

Aortic root replacement in a patient with left ventricular noncompaction.

Ann Thorac Surg 2014 Jan;97(1):e1-3

Department of Cardiothoracic Surgery, University Hospital of Poitiers, Poitiers, France.

We describe the case of a 57-year-old woman with noncompaction of the left ventricle and regurgitant bicuspid aortic valve who presented with progressive congestive heart failure and was successfully treated with aortic root replacement. The long-term outcome for these patients is poor because of progressive left ventricular impairment, increased rates of life-threatening arrhythmias, and intraventricular thrombi. To our knowledge, only 3 patient with noncompaction of the left ventricle has been reported to have undergone aortic valve replacement for severely regurgitant bicuspid aortic valve. Herein, we describe a patient with noncompaction of the left ventricle who underwent successful mechanical aortic root replacement.
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http://dx.doi.org/10.1016/j.athoracsur.2013.08.017DOI Listing
January 2014

TachoSil to prevent postoperative pericardial adhesions.

Ann Thorac Surg 2014 Jan;97(1):378-9

Department of Cardiothoracic Surgery, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers cedex, France.

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http://dx.doi.org/10.1016/j.athoracsur.2013.06.075DOI Listing
January 2014

Post-myocardial infarction ventricular septal defect.

J Card Surg 2013 Nov 17;28(6):721-2. Epub 2013 Oct 17.

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1111/jocs.12228DOI Listing
November 2013

eComment. Prevention of sternal wound infection.

Interact Cardiovasc Thorac Surg 2013 Aug;17(2):382-3

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715213PMC
August 2013

eComment. Pleiotropic effects of statins after cardiac surgery.

Interact Cardiovasc Thorac Surg 2013 Aug;17(2):352

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715205PMC
August 2013

eComment. Multiple approaches for sternal dehiscence.

Interact Cardiovasc Thorac Surg 2013 Jun;16(6):723-4

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653497PMC
June 2013

Late postcardiotomy sternal dehiscence: a simple approach using Stratos® system.

J Card Surg 2013 Nov 9;28(6):632-4. Epub 2013 May 9.

Department of Cardio-thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

Management of late sternal dehiscence is challenging and time consuming. Although numerous techniques exist including rewiring and titanium plates screwing to stabilize the sternum, we describe an alternative technique by using four titanium clips and one connecting bar.
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http://dx.doi.org/10.1111/jocs.12123DOI Listing
November 2013

Foreign bodies in the heart.

Interact Cardiovasc Thorac Surg 2013 May;16(5):711-2

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630439PMC
May 2013

Cardiac tamponade as a manifestation of acute mediastinitis.

Interact Cardiovasc Thorac Surg 2013 May;16(5):704

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630442PMC
May 2013

eComment. Pseudoaneurysm secondary to native valve endocarditis.

Interact Cardiovasc Thorac Surg 2013 Apr;16(4):548-9

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598060PMC
April 2013

eComment. A novel lower age threshold for use of biological valves.

Interact Cardiovasc Thorac Surg 2013 Apr;16(4):507-8

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivt054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598064PMC
April 2013

eComment. Coronary endarterectomy with or without inflow conduit?

Interact Cardiovasc Thorac Surg 2013 Mar;16(3):305

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivs557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3568828PMC
March 2013

eComment. Antimicrobial vascular grafts in cardiac surgery.

Interact Cardiovasc Thorac Surg 2013 Jan;16(1):83

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivs474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523636PMC
January 2013

eComment. Ambulatory veno-venous extracorporeal membrane oxygenation.

Interact Cardiovasc Thorac Surg 2013 Jan;16(1):59

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1093/icvts/ivs487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523638PMC
January 2013

Left thoracotomy for coronary artery bypass grafting in a patient with an ileo-coloplasty.

Heart Lung Circ 2013 May 16;22(5):392-3. Epub 2012 Nov 16.

Department of Cardio-Thoracic Surgery, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1016/j.hlc.2012.10.003DOI Listing
May 2013
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