Validation of I-Phy palm, an indicator of pesticide pollution risk: Method and preliminary results

Validation of I-Phy palm, an indicator of pesticide pollution risk. Method and preliminary results. 5. International Conference on Oil Palm and Environment (ICOPE

Transcatheter aortic valve implantation: technical aspects, results and indications

SummaryThe development of the percutaneous heart valve (PHV) may become a primary therapeutic modality for the high risk and inoperable patients with critical symptomatic aortic stenosis. The first human percutaneous aortic valve implant was performed by our group in April 2002. To date, more than 500 Cribier-Edwards-PHV have been implanted worldwide using arterial trans-femoral or trans-apical approach. Data on the retrograde transfemoral approach is growing with more than 270 patients implanted as of October 2007. Procedural success rate is high (86%) and the 30-day mortality is 12%. Today, 2 patients are alive at a follow-up of more than 4 years. The same Cribier-Edwards-PHV can be implanted using trans-apical approach. In this procedure, PHV is introduced under direct vision into the left ventricle via a mini-thoracotomy. This obviates the concerns regarding vascular access in the presence of small caliber vessels and/or vascular occlusive disease. More than 200 patients have been treated with this approach. In the European experience 30-day mortality is 14%.There is intense interest in PHV technology, and there are multiple devices at various stages of development in animals and humans. The most developed is the CoreValve Revalving® Technology. More than 350 patients have been treated with this technique. The immediate and mid-term results with this device are promising with a procedural success of 92% and a 30-day mortality of 15%.The future of this technology and its application is dependent on the continued collaboration between general internists, cardiologists, surgeons, engineers, and industry

080: Long-term outcomes after heart transplantation for Emery-Dreifuss muscular dystrophy

BackgroundEmery-Dreifuss muscular dystrophy (EDMD) is an hereditary syndrome related to mutations in lamin A/C gene (LMNA) and is characterised by severe dilated cardiomyopathy, mostly slight peripheral muscular dystrophy, supra-ventricular arrhythmia and atrio-ventricular (AV) block. Transplantation for EDMD is rarely reported in the ISHLT registry. We aim to study outcomes after heart transplantation (HTx) for end-stage heart failure in twelve EDMD patients.Methods12 cases of HTx performed for EDMD confirmed by genetic analysis in a single institution between 1997 and 2011 were compared to 12 patients age, sex and year of transplantation matched. Survival curves were analysed by Kaplan-Meier method.ResultsBefore transplantation, EDMD patients had similar age (56 vs 57 yo, p=0,81), sex ratio (42% male), pre-transplantation NYHA functional class III (p=0,207), left ventricular ejection fraction (LVEF=33% vs 32%, p=0,89), higher rate of supra-ventricular arrythmia (100% vs 45%, p=0,002) and AV block (58% vs 12.5%, p=0,042) compared to non-EDMD. After HTx, NYHA functional class was similar (I, p=1,00), LVEF (72+/-5,91% vs 69+/-11,3%, p=0,49), rejection rate (19+/-3,8% vs 40+/-8,2% by year, p=0,45), infection rate (14% vs 6% by year, p=0,087), renal function (eGFR=89+/-49 vs 66+/-37ml/min, p=0,22) were similar after HTx in EDMD and non-EDMD group. Survival rate at 1 year, 2 years, 5 years were not significantly different (respectively 91.6%, 90.9%, 81.5% versus 100%, 100%, 100% p=0,146). 42% EDMD patients had slight muscular dysfunction, compatible with good quality of life.ConclusionDespite reluctance for heart transplantation in end-stage HF patients with EDMD, long term outcomes are similar to non EDMD patients at 1,2 and 5-year follow-up in our institution