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Optimisation de la prise en charge des coeurs univentriculaires : approche chirurgicale et énergétique

Abstract : Univentricular hearts are congenital heart diseases, not compatible with life. Fontan transformed the prognosis of these patients by restoring a passive pulmonary circulation. Unfortunately, the long-term prognosis remains pejorative. To reduce the morbidity and mortality of these patients, we developed a surgical preconditioning protocol, allowing a percutaneous Fontan totalization, adaptive to pulmonary resistance and to the working capacity of the ventricle. We observed that the mitochondrial respiratory chains do not have the ability to adapt their energy production toward work. The desequilibrium of the Nitroso-redox balance will generate mitohormesis and hormesis, then will inevitably occur a poorly adaptive myocardial remodeling. The only way to improve the long-term prognosis of these patients is to increase the myocardial oxidative capacities of the single ventricle or to create a pulmonary pump.
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Submitted on : Friday, September 23, 2022 - 1:02:03 AM
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  • HAL Id : tel-03784314, version 1

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Sébastien Gerelli. Optimisation de la prise en charge des coeurs univentriculaires : approche chirurgicale et énergétique. Cardiologie et système cardiovasculaire. Université de Strasbourg, 2016. Français. ⟨NNT : 2016STRAJ106⟩. ⟨tel-03784314⟩

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