Recent publications : Previews

Performance of highly sensitive cardiac troponin T assay to detect ischaemia at PET-CT in low-risk patients with acute coronary syndrome: a prospective observational study


Beata Morawiec, Stephane Fournier, Maxime Tapponnier, John O Prior, Pierre Monney, Vincent Dunet, Nathalie Lauriers, Frederique Recordon, Catalina Trana, Juan-Fernando Iglesias, Damian Kawecki, Olivier Boulat, Daniel Bardy, Sabine Lamsidri, Eric Eeckhout, Olivier Hugli, Olivier Muller. BMJ Open 2017;7:e014655.Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay’s performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented.

Letter by Fournier et al Regarding Article, “Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation: Influence of Pressure Overload on the Evaluation of Lesions Severity”


Fournier S, Harbaoui B, Muller O.Circ Cardiovasc Interv. 2017 Apr;10(4). We read with great interest the recent publication by Pesarini et al regarding the functional assessment of coronary artery disease in patients undergoing transcatheter aortic valve implantation (TAVI). The authors report that angiographically intermediate lesions may become functionally significant after TAVI, whereas variation in the fractional flow reserve (FFR) would not affect the diagnostic decision based on the 0.8 cutoff in patients at the extremes of the quantitative coronary angiography spectrum (unobstructed arteries or severe lesions). The authors should be commended for their work in a field where data are sparse; however, we think that a few significant points must be highlighted.

Entrapment of Rotational Atherectomy Burrs in Freshly Implanted Stents: First Illustration of the Rolled-Up Phenomenon


J Invasive Cardiol. 2016 Nov;28(11):E132-E133Fournier S, Iglesias JF, Zuffi A, Eeckhout E, Tozzi P, Muller O. OBJECTIVES:We aimed to illustrate one of the mechanisms of rotational atherectomy burr entrapment in a coronary stent where the burr was rolled up in the stent’s struts.METHODS:We report a case where the treatment of a mid right coronary artery (RCA) lesion using a rotational atherectomy device was attempted. During the procedure, the burr suddenly got stuck in a freshly implanted stent in the distal RCA. Despite several attempts and maneuvers, we were unable to pull back the burr.RESULTS:The patient was transferred for emergency surgery. The length of the RCA from its proximal third to the crux, including the stuck burr and the freshly implanted stent, had to be extracted.CONCLUSIONS:Physicians…
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Recanalization of a Challenging Chronic Total Occlusion of the Superficial Femoral Artery through the Profunda Femoris Using a Pure Retrograde Technique.


J Vasc Interv Radiol. 2016 Aug;27(8):1253-7.Zuffi A, Muller O, Biondi-Zoccai G, Turri M, Trana C, Iglesias JF, Fournier S  The transcollateral retrograde technique offers an alternative for increasing the success rates of SFA recanalization when standard antegrade approaches fail or other techniques—such as the use of rotational or directional atherectomy devices—are not feasible The use of low-profile 0.014-inch–compatible devices may allow higher crossing rates and greater safety. In summary, we describe successful recanalization of an SFA occlusion via a transcollateral approach with 0.014-inch low-profile coronary catheter and balloons.

Cardiac sarcoidosis with coeliac disease


Cardiovascular Medicine. 2016;19(04):128-131. Fournier S, Regamey J, Rotman S, Pruvot E, Hullin R. This case of cardiac sarcoidosis started with manifestation of a complete AV block in a 42 years old female without other cardiac dysfunction. Two years later, the patients presented with acute heart failure symptoms at the Emergency Department. The echocardiography at admission showed thinning and hyperdensity of the basal interventricular septum which is a rare but typical echocardiographic sign of cardiac sarcoidosis. Endomyocardial biopsy, PET-CT, and transbronchial biopsy confirmed the clinical suspicion of sarcoidosis. Of note, the patient also had celiac disease which can occur conjoint with sarcoidosis. After 5 months of immunosuppressive treatment with methylprednisolone and azathioprine the burden of inflammatory lesions was significantly reduced and the patient had improved to…
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The impact of fractional flow reserve and iFr on current PCI strategies


Cardiovascular Medicine. 2016;19(03):67-71. Fournier S, Muller O. Fractional flow reserve (FFR) measurement has become the gold standard for assessing myocardial ischemia and has been recommended to decide to perform or not a myocardial revascularization in both American and European guidelines. Indeed, large clinical trials have demonstrated that an evaluation of stenoses guided by FFR reduced death, nonfatal myocardial infarction and repeat revascularization (MACE) when compared to an evaluation guided by angiography only and that a percutaneous coronary intervention (PCI) with an optimal medical treatment was superior to an optimal medical treatment alone to reduce MACE in presence of pathological FFR. To measure a FFR, the use pharmacological vasodilator (usually adenosine) is necessary. To avoid its administration, iFR recently emerged with the identification of a “wave-free…
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