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Objective: Diffuse coronary artery disease makes cardiac surgeons hesitant regarding whether coronary artery bypass grafting (CABG) surgery is feasible or not. Coronary artery reconstruction using the internal thoracic artery (ITA) allows bypassing of coronary arteries with diffuse atheromatous plaques without systematically resorting to endarterectomy. The aim of the present study was to evaluate the medium-term results of coronary artery reconstruction. Methods: All patients undergoing coronary artery reconstruction using the ITA between 1999 and 2002 (233 patients) were included in the study. The mean age was 61.9 ± 9.8 years. Two hundred and eighty-one coronary artery reconstructions using the ITA were performed (mean length 3.6 ± 2 cm) for 514 CABGs. Coronary artery reconstruction using the ITA was associated with endarterectomy in 48 cases (17%). Results: In-hospital mortality was 2.6%. Follow-up data were compiled in December 2008. Mean follow-up was 73.4 ± 16.7 months. The actuarial survival rate at 7 years was 89.3 ± 2.1%, and 88% of patients were free of major cardiac events at 7 years. Conclusions: Coronary artery reconstruction gives comparable medium-term results to conventional coronary surgery, even though it is indicated for patients with more severe lesions.

Background Biological therapies have changed the landscape of pharmacological management of ulcerative colitis (UC). However, a large proportion of patients do not respond to biologics, lose their response over time or present adverse drug events. This study aims to assess therapeutic response and treatment persistence to adalimumab, infliximab and vedolizumab, three agents widely used in a tertiary referral centre of Saguenay-Lac-Saint-Jean (Quebec, Canada). Methods We conducted a retrospective population-based study with a thorough review of patient’s medical charts. Adults at UC diagnosis, with current or past use of adalimumab, infliximab or vedolizumab were included in the study. Clinical data were collected in order to assess response phenotypes and persistence to treatment. Kaplan Meier curves were performed to assess treatment persistence and predictors for discontinuation were assessed using Cox regression analyses. Results A total of 134 patients were included in this study. For the cases exposed to adalimumab, infliximab and vedolizumab, 56.9%, 62.5% and 47.5% were responders, respectively. Median persistence rates (95% CI) were 8.0 (3.3-12.8), 13.4 (9.3-17.5) and 3.4 (1.0-5.8) years for adalimumab, infliximab and vedolizumab, respectively. Increased persistence rates were observed in biologic-naïve in comparison to biologic-experienced patients treated with infliximab, but no such effect was observed for adalimumab or vedolizumab. Overall, 61.9% of cases had adverse drug events and of these, six lead to treatment discontinuation. Conclusion This study presents long-term treatment persistence data with adalimumab, infliximab and vedolizumab showing that more than half of cases treated with these biologics remained on treatment at least 12 months after initiation.

OBJECTIVES The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR. METHODS This retrospective study enrolled 500 consecutive patients treated by TC-TAVR (n = 100) or TF-TAVR (n = 400) with percutaneous closure between January 2018 and January 2020 at the Nantes University Hospital. The primary end-point was the occurrence of cardiovascular death and cerebrovascular events at 30 days. RESULTS The mean age was 79.9 ± 8.1 in the TC group and 81.3 ± 6.9 (P = 0.069) in the TF group. The TC group had more men (69% vs 50.5%; P = 0.001) and more patients with peripheral vascular disease (86% vs 14.8%; P < 0.0001). Cardiac characteristics were similar between the groups, and the EuroSCORE II was 3.8 ± 2.6% vs 4.6 ± 6.0%, respectively (P = 0.443). The 30-day mortality was 2% in the TC group versus 1% in the TF group (P = 0.345). TC-TAVR was not associated with an increased risk of stroke (2% vs 2.5%; P = 0.999) or major vascular complications (2% vs 4%; P = 0.548). More permanent pacemakers were implanted in the TF group (14.9% vs 5.6%; P = 0.015), and no moderate or severe aortic regurgitation was observed in the TC group (0 vs 3.3%; P = 0.08). TC-TAVR was not associated with an increased risk of mortality or stroke at 30 days (odds ratio 1.32; 95% confidence interval 0.42–4.21; P = 0.63) in the multivariable analysis. CONCLUSIONS No statistically significant differences between TC-TAVR and TF-TAVR were observed; therefore, TC-TAVR should be the first alternative in patients with anatomical contraindications to the femoral route.

stiffness and pulse wave velocity / Aorta and carotid arteries 137 (0.94 to 1.01) p = 0.096; Obesity OR = 0.47 (0.29 to 1.77) p = 0.003 and Diabetes OR = 2.41 (1.15 -5.05) p = 0.020. Conclusions: According to the results obtained, genetic polymorphisms variables were not in the multivariate analysis equation to determine the increase of the PWV, which can be explained either by being included in the selected variables such as hypertension, or on the other hand, they may not have enough strength to remain in the equation. So, according to this study, PWV has much more to do with behaviors and traditional risk factors than the genetic heritage.P883 Endothelial dysfunction, pulse wave velocity and augmentation index are correlated in subjects with systemic arterial hypertension?