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  • Cardiology
Cardiology

Cardiology

Cardiology

The cardiology department takes care of coronary pathologies (coronary emergencies 24 hours a day) , rhythm and conduction disorders, heart failure and valvular, muscular and malformative pathologies for adults and children in the 3 departments of Western Normandy.

The cardiology department takes care of coronary pathologies (coronary emergencies 24 hours a day) , rhythm and conduction disorders, heart failure and valvular, muscular and malformative pathologies for adults and children in the 3 departments of Western Normandy.

  • Consultations Consultations Consultations Consultations Consultations Consultations Consultations Consultations Consultations

    Coronary diseases

    Pr Farzin Beygui, Dr Mathieu Bignon, Dr Adrien Lemaitre, Dr Vincent Roule, Pr Rémi Sabatier, Dr Idir Rebouh

    Cardiac rhythm and conduction diseases

    Pr Paul-Ursmar Milliez, Dr Laure Champ-Rigot, Dr Virginie Ferchaud, Dr Pierre Ollitrault, Dr Arnaud Pellissier, Dr Célia Brejoux

    Heart structural diseases

    Dr Amir Hodzic, Prof Fabien Labombarda, Dr Eric Saloux
    Consultation schedule

    Heart failure transplant patients amyloidosis

    Dr Damien Legallois, Dr Katrien Blanchart, Dr Laurence Herrou, Pr Rémi Sabatier, Dr Maud Bonopera

    Pediatric Cardiology

    Pr Fabien Labombarda, Dr Pascale Maragnes, Dr Cynthia Cousergue

    Control of pacemakers · defibrillators · Cardiac Holter monitors

    Pr Paul-Ursmar Milliez, Dr Laure Champ-Rigot, Dr Virginie Ferchaud, Dr Pierre Ollitrault, Dr Arnaud Pellissier, Dr Célia Brejoux

    Heart transplant recipients circulatory support and SCAD

    Dr Katrien Blanchart, Dr Maud Bonopera, Pr Rémi Sabatier, Dr Anne-Flore Plane
    Consultation schedule

    Cardiac ultrasounds (trans-thoracic trans-oesophageal exercise and stress)

    Dr Amir Hodzic, Dr Mathieu Bignon, Pr Fabien Labombarda, Dr Arnaud Pellissier, Dr Vincent Roule, Dr Eric Saloux, Dr Maud Bonopera, Dr Cynthia Cousergue

    Stress test

    Dr Mathieu Bignon, Pr Rémi Sabatier, Dr Stéphane Cleron, Dr Philippe Delmas

      Composition of service

      • 2 University Professors Hospital Practitioners
      • 2 University Lecturers · Hospital Practitioners
      • 13 Hospital Practitioners
      • 4 Heads of clinics from universities, Assistants from hospitals
      • 6 Practitioners attached
      • 3 health executives
    • Our support

      Activities

      Cardiology Intensive Care Unit

      The USIC welcomes “cardiac” emergencies and all patients who require intensive and continuous care. It has the staff and equipment to provide care in the acute phase of cardiac pathologies, with permanent monitored surveillance as well as privileged access to the technical platform.

      Location
      Tour Côte de Nacre, level 20 , unit 30: 20 scoped beds
      Secretariat: 02 31 06 57 04 Nurse station: 02 31 06 44 11 / 02 31 06 44 16
      Limited visits (1 person) . Prohibited at least 15 years old.

      The conventional cardiology hospitalization unit

      This unit's mission is to welcome patients hospitalized for a cardiac pathology requiring a diagnostic evaluation, additional explorations, the implementation and/or adaptation of a treatment, or a surgical intervention.

      It also welcomes patients for scheduled short-stay operations:

      • implantology,
      • management of arrhythmias (beam exploration, ablation of atrial fibrillation, flutter, etc.) ,
      • management of coronary angioplasties, TAVI , FOP, CIA, mitraclips, etc.

      Location
      Côte de Nacre tower, level 20 , unit 10: 30 telemetered beds
      Secretariat: 02 31 06 57 04 Nurse station: 02 31 06 48 73

      The outpatient cardiology unit (day hospital)

      This unit aims to take care of patients requiring:

      • performing coronary angiography or cardiac catheterization, both for diagnostic purposes and for monitoring the progress of a pathology or treatment.
      • rhythmological care (ablations, electrophysiological explorations, CEE , etc.) and implantology (pacemakers, defibrillators, implantable Holters, etc.)
      • This unit also welcomes patients whose examinations are scheduled during the day as part of the pre-operative assessment.

      Patients are summoned following the request of a liberal or hospital cardiologist. The programmed and ambulatory nature of the activity makes it possible to avoid the constraints of conventional hospitalization and to disturb the family or professional life of the patients to a minimum.

      In the case of patients coming from outlying hospitals, their examination is carried out the day before returning to their original department after the necessary post-examination monitoring time. This mode of hospitalization also allows better responsiveness to needs with a rapid response time.

      Location
      Côte de Nacre Tower, level 20 , unit 20: 12 armchairs and 6 beds
      Secretariat: 02 31 06 57 04 Nurse station: 02 31 06 48 74

      The Cardiac Failure Treatment Unit ( UTIC ) and Cardiomyopathy and Valvulopathy Assessment Unit (UVAC)

      The UTIC 's mission is to provide care for adult patients with heart failure ( HF ). HF for normal pressures.

      This unit has the following main objectives:

      • to take care of patients requiring a period of hospitalization to initiate, continue, readjust treatment in connection with an IC ,
      • optimize the paths of patients with heart failure in a coordinated manner within the cardiology department,
      • to monitor and assess patients in conjunction with city doctors (general medicine and cardiologists) , cardiac rehabilitation centers and SCADs and thus seek to reduce re-hospitalizations,
      • to participate in clinical research projects on heart failure in order to improve its management.

      Follow-up consultations on D7 are offered in order to assess and sustain the actions initiated during care in the care unit.

      Location
      Côte de Nacre tower, level 19 , unit 20: 22 beds
      Secretariat: 02 31 06 57 04 Nurse station: 02 31 06 57 09

      The interventional technical platform

      Within the technical cardiology platform, equipped with 4 intervention rooms, the team provides quality services according to the updated standards of the most modern techniques ( coronarography, angioplasty/stent, CIA, Mitra clip, TAVI , ablations, implantology ) . Responsive 24 hours a day, the platform brings together cutting-edge skills to offer patients optimal care and also participate in research and university teaching missions.

      Location
      Tour Côte de Nacre, level 20 , unit 40.

      Clinical follow-up at home and follow-up of transplant recipients

      This home remote monitoring device for chronic heart failure is based on collecting and sending data via an application from a tablet. It is covered by health insurance as part of the STEPS program.

      He organizes, according to a validated clinical protocol, a relationship of follow-up and education of the patient on a daily basis which includes both:

      • The monitoring parameters relating to his state of health
      • Appropriate advice and information on hygiene and dietary rules and compliance with treatment,
      • Advice and encouragement for the pursuit of exercise retraining at home.

      The functionalities are customizable to each individual by the care team and reactive according to the parameters entered by the patient himself.

      This follow-up makes it possible to reduce the risk of re-hospitalization after decompensation, by making the patient an actor and active in the follow-up of his disease. It participates in improving the patient's knowledge of the disease, its treatment and the rules of hygiene and diet. It also allows the patient to learn to recognize the warning signs of his disease.

      *source: website basse-normandie-sante.fr

      Location
      Tour Côte de Nacre, level 19 , unit 40.
      Secretariat: 02 31 06 58 04 06 10 52 45 79

      The cardiology outpatient consultation platform

      Location
      Tour Côte de Nacre, level 1 Functional explorations

      Pathologies

      Inter-Auricular Communication (AIC)

      Atrial septal (ASD) is a congenital heart condition that is characterized by a defect in the constitution of the interatrial septum (wall separating the upper chambers of the heart, ie the left atrium and the right atrium) of variable shape and size. This abnormal hole generates an excessive passage of blood from the left atrium (high pressure) to the right atrium (low pressure) , which is referred to as a shunt. Indeed, the blood pressure on the left side of the heart being higher than that on the right side, the blood flows permanently towards the right auricle through this opening and can be responsible for a dilation of the auricles and the right cavities. Over time, the abnormality increases the risk of pulmonary arterial hypertension, congestive heart failure, arrhythmia and stroke. The indication for CIA closure is retained in the event of a major shunt, right ventricular dilation and the appearance of symptoms such as dyspnoea or reduced physical capacity.

      Thanks to the development of percutaneous techniques, the closure of the AIC using an occlusion device introduced by a catheter is now the most widespread technique. The operator introduces a closure system through the femoral vein at the fold of the groin. The collapsed device, introduced into the heart through the catheter, unfolds to close the CIA. Small residual shunts that remain after the procedure often close over time as endothelial tissue covers the device. ASD closure by interventional cardiac catheterization is increasingly seen as a routine treatment requiring a very short hospital stay and the consequences of which are simple.

      The Permeable Foramen Ovale (PFO)

      The PFO is defined by the persistence, after birth, of a communication between the two auricles, a kind of tunnel potentially responsible for an intracardiac passage of venous blood in the arterial blood. Normally this septum is closed at birth but can sometimes have a small opening called the Foramen Ovale. This communication, essential during fetal life, is obliterated after birth in the vast majority of cases.

      Unlike AICs, this is not an orifice due to lack of substance, but rather a defect in the joining of the septa primum and secondum , which form the interatrial septum of the adult heart.

      When the PFO remains permeable with a right-to-left shunt, associated with an aneurysm of the interatrial septum, it may be a factor favoring cerebrovascular accident ( CVA ) .

      The examination which makes it possible to identify the PFO is the transoesophageal echography (TEO) with a test of bubbles highlighting a passage of microbubbles in the left auricle after the injection by peripheral venous way.

      TEE is used to assess the anatomy of the interatrial septum and to identify the presence of an aneurysm. PFO can be responsible for arterial embolism, unexplained and recurrent stroke, hypoxia not correctable on oxygen, decompression syndrome in divers and migraine not relieved by treatment. Its discovery may lead to discussion of percutaneous closure by means of a prosthesis comprising 2 discs (there are several prosthesis references) ensuring complete closure of the shunt.

      THE RISKS ?

      As in any cardiac and vascular intervention there can be complications. These complications are most often benign. The expected long-term benefits far outweigh the risks of these procedures.

      The percutaneous aortic valve ( TAVI )

      Aortic stenosis is a disease of the elderly, especially men over 70 years old. The surface of the aortic orifice narrows which hinders the ejection of blood by the left ventricle. When the obstruction is critical, it is necessary to intervene if this obstruction is the cause of the symptoms you feel (shortness of breath, chest tightness, malaise, fatigue, etc.) because there is a risk of hospitalization and death.

      Rhythm and conduction disorders

      Atrial (or atrial) fibrillation ablation

      It is the most complex rhythm disorder. It is not organized and regular, but is instead the result of a very rapid, disordered and chaotic electrical activation of the atria. Unlike most other tachycardias, its ablation cannot be reduced to the destruction of a single target (such as an electrical source or an abnormal conduction zone) . It is an electrical anomaly affecting all of the atrial tissue that must be treated. The areas most frequently involved are most often found in the left atrium (LA), and more specifically at the junction of the LA and the pulmonary veins. Over time and with the repetition of fibrillation attacks, certain areas of the atria deteriorate and themselves become sources of fibrillation. In some cases, these areas require additional treatment to that of the pulmonary veins.

      Atrial fibrillation evolves over time towards crises that are generally more and more prolonged. It can cause serious complications, which vary according to the terrain and the risk factors of each patient. These complications are dominated by the risk of cerebral vascular accident by poor emptying of the atria in fibrillation and stagnation of blood which can then clot. Fibrillation can also cause all stages of heart failure, from simple fatigue or shortness of breath on exertion to severe damage to the heart muscle with severe signs of heart failure.

      Overall, fibrillation is believed to cause mortality comparable to that of myocardial infarction, diabetes, or high blood pressure. In addition to the prognostic severity of the disease, the effects of arrhythmia-related symptoms on morale and quality of life can be as great as those of a serious disease such as cancer.

      Treatment varies but essentially consists of either compartmentalizing the atria with radiofrequency lines, or electively treating areas that appear to be pathological and responsible for maintaining the arrhythmia.

      Ablation by radiofrequency probe: during the operation under anesthesia, a probe is introduced into the femoral vein of the lower limb, then routed to the heart. The end of the probe burns small areas of the heart responsible for the arrhythmia.

      The cavities traversed by the catheter are reconstructed in 3 dimensions by a specific computer system which then makes it possible to move the probes and identify the areas to be treated with very high precision. The objective of the operation is a true electrical disconnection between the atrium and the ventricle.

      After the intervention and awakening, postoperative monitoring in a continuous care unit may be necessary, but hospitalization is generally short, 2 to 3 days.

      Percutaneous closure of the left auricle

      Atrial fibrillation (AF) is the most common cardiac arrhythmia and carries a significant cardio-embolic risk that increases significantly with age. Indeed, irregular heartbeats can generate the formation of blood clots (or thrombi ). The latter then risk moving in the general circulation and clogging an artery, in particular at the level of the brain: this is the cerebral vascular accident ( CVA ). However, it turns out that the thrombi at the origin of thromboembolic accidents in non-valvular AF are preferentially formed in the left auricle in more than 90% of cases. This appendage, located on the surface of the left atrium, in the form of a small pocket or protrusion, varies from person to person and has no particular function.

      In the event of atrial fibrillation, anticoagulant treatments aim to thin the blood in order to prevent the formation of clots and therefore the risk of stroke . However, they can be the cause of sometimes serious bleeding. Occlusion of this appendix, by a percutaneous closure system using a special prosthesis, offers an alternative to treatment with anticoagulants in people at high risk of bleeding.

      This procedure is performed under general anesthesia percutaneously. The material is routed to the right atrium by catheterization, by puncturing the right femoral vein (at the fold of the groin) . Then by a puncture of the transseptal wall (the partition between the 2 atria) under echocardiographic and/or fluoroscopic control, the left atrium is accessed as far as the left auricle. The prosthesis is then implanted at the neck of the auricle: first the distal part is deployed, which takes up a position in the neck of the auricle like a plug, then the gradual withdrawal of the delivery catheter frees then the proximal disc of the prosthesis, which will expand over the orifice of the auricle and cover it.

      Once the prosthesis is in place, the clots can no longer migrate from this auricle and the risk of stroke is considerably reduced. The anticoagulant treatment can then be reduced or stopped a few months after the intervention.

      The intervention is rapid followed by a passage in the recovery room before returning to the care unit. It is a procedure that requires an average of 2 to 3 days of hospitalization.

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    Locate / contact service

    Cardiology

    Côte de Nacre Hospital

    Avenue de la Côte de Nacre
    CS 30001
    14033 Caen cedex 9


    Cardiology

    Service Secretariat


    Level GPS accessCar park Hall
    Consulting
    Côte de Nacre Tower
    Level : 1
    GPS access: Côte de Nacre
    Car Park: Car Park 2
    North Entrance Côte de Nacre
    Intensive care
    Côte de Nacre Tower
    Level : 20
    GPS Access: Main
    Car Park: Car Park 1
    Main Entrance of Caen Normandy University Hospital
    Outpatient hospitalization
    Côte de Nacre Tower
    Level : 20
    GPS Access: Main
    Car Park: Car Park 1
    Main Entrance of Caen Normandy University Hospital
    Conventional hospitalization Heart / Vessels
    Côte de Nacre Tower
    Level : 20
    GPS Access: Main
    Car Park: Car Park 1
    Main Entrance of Caen Normandy University Hospital
    Heart Failure Treatment Unit
    Côte de Nacre Tower
    Level : 19
    GPS Access: Main
    Car Park: Car Park 1
    Main Entrance of Caen Normandy University Hospital
    Clinical follow-up at home and follow-up of transplant patients
    Côte de Nacre Tower
    Level : 19
    GPS Access: Main
    Car Park: Car Park 1
    Main Entrance of Caen Normandy University Hospital