{"id":23824951,"date":"2024-01-11T14:58:19","date_gmt":"2024-01-11T13:58:19","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=23824951"},"modified":"2024-01-11T14:58:21","modified_gmt":"2024-01-11T13:58:21","slug":"cardiologie-interventionnelle-utilite-dune-salle-doperation-hybride","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/cardiologie-interventionnelle-utilite-dune-salle-doperation-hybride\/","title":{"rendered":"Cardiologie interventionnelle\u00a0: utilit\u00e9 d\u2019une salle d\u2019op\u00e9ration hybride"},"content":{"rendered":"\n<p>Le CHU de Poitiers dispose d\u2019une salle hybride depuis 2017, date d\u2019ouverture du centre cardio-vasculaire. Il s\u2019agit d\u2019un espace r\u00e9unissant les caract\u00e9ristiques d\u2019une salle de cardiologie interventionnelle avec des syst\u00e8mes d\u2019imagerie et les contraintes d\u2019un bloc op\u00e9ratoire. La salle hybride combine des moyens d\u2019imagerie tr\u00e8s performants et des cartographies en 3D tr\u00e8s pr\u00e9cises. Ces moyens permettent des fusions d\u2019images (superposition des images de l\u2019angiographie r\u00e9alis\u00e9e en temps r\u00e9el par l\u2019op\u00e9rateur avec celles du scanner ou de l\u2019\u00e9chographie trans-oesophagienne ETO ou de la cartographie \u00e9lectromagn\u00e9tique) dans une salle qui peut \u00eatre transform\u00e9e imm\u00e9diatement en bloc op\u00e9ratoire traditionnel si besoin. Dans cette salle hybride, interviennent des rythmologues interventionnels, des cardiologues interventionnels, des chirurgiens cardiaques et des chirurgiens vasculaires, avec ou sans anesth\u00e9siste en fonction de l\u2019intervention. Elle permet aux cardiologues de r\u00e9aliser des interventions mini-invasives tr\u00e8s techniques \u00e0 travers des ponctions cutan\u00e9es, guid\u00e9es par l\u2019imagerie. La salle hybride offre, de plus, l\u2019avantage de pouvoir prendre aussit\u00f4t en charge, chirurgicalement, un patient en cas de complication lors de la proc\u00e9dure interventionnelle plut\u00f4t que de perdre du temps \u00e0 le transf\u00e9rer dans un bloc op\u00e9ratoire. <em>\u00ab\u00a0Ce sont des outils indispensables pour la m\u00e9decine moderne<\/em>\u00a0\u00bb, pr\u00e9cise le Pr Luc Christiaens, chef du service de cardiologie et chef du p\u00f4le c\u0153ur poumon vasculaire. Gr\u00e2ce \u00e0 la salle hybride, le service de cardiologie a d\u00e9velopp\u00e9 plusieurs techniques interventionnelles parmi lesquelles le TAVI (Trans Catheter Aortic Valve Implantation) qui est l\u2019implantation d\u2019une proth\u00e8se biologique, fix\u00e9e sur un stent dans la valve aortique malade, par voie art\u00e9rielle f\u00e9morale sous anesth\u00e9sie locale pour la majorit\u00e9 des patients de plus de 75 ans, ou contre indiqu\u00e9s \u00e0 un traitement chirurgical conventionnel. Il s\u2019agit d\u2019une activit\u00e9 tr\u00e8s importante au CHU de Poitiers. 284 y ont \u00e9t\u00e9 r\u00e9alis\u00e9es en 2022. Cette salle hybride a permis \u00e9galement de d\u00e9velopper au sein du CHU les fermetures de foramen ovale perm\u00e9able (FOP, d\u00e9faut de la cloison entre les deux oreillettes pouvant \u00eatre en cause dans des accidents vasculaires c\u00e9r\u00e9braux), les occlusions de l\u2019auricule gauche (mise en place d\u2019une proth\u00e8se qui permet de r\u00e9duire le risque d\u2019accident vasculaire et d\u2019embolie syst\u00e9mique d\u2019origine cardiaque chez les patients ne pouvant recevoir d\u2019anti-coagulant), la pose de mitraclip (r\u00e9duction des fuites mitrales par pose de clip sur la valve mitrale par voie endovasculaire). Ces trois interventions se pratiquent en passant par une veine f\u00e9morale avec en simultan\u00e9 un contr\u00f4le par l\u2019\u00e9chographie trans-oesophagienne \u00a0sous anesth\u00e9sie g\u00e9n\u00e9rale. La pose de bioproth\u00e8se mitrale par voie trans-cardiaque est r\u00e9alis\u00e9e dans cette salle par un bin\u00f4me chirurgien cardiaque et cardiologue interventionnel. En 2023 le service de cardiologie y a r\u00e9alis\u00e9 les premiers cas de d\u00e9nervation r\u00e9nale pour traiter les hypertensions art\u00e9rielles r\u00e9sistantes et dans un avenir proche, la pose de clip sur la valve tricuspide sera \u00e9galement propos\u00e9e. Concernant la rythmologie, cette salle hybride permet la r\u00e9alisation de la majorit\u00e9 des ablations de fibrillation atriale dont les indications, comme pour le TAVI, augmentent avec le vieillissement de la population. La mise en place de longues proth\u00e8ses r\u00e9alis\u00e9es sur mesure pour r\u00e9parer l\u2019aorte thoracique et abdominale est \u00e9galement effectu\u00e9e dans cette salle par l\u2019\u00e9quipe chirurgicale.<\/p>\n<p>En fait, le terme hybride pour cette salle illustre, d\u2019une part, la possibilit\u00e9 de convertir imm\u00e9diatement en en salle d\u2019op\u00e9ration conventionnelle et, d\u2019autre part, la possibilit\u00e9 de d\u2019associer des images multimodales pour faciliter et s\u00e9curiser le geste th\u00e9rapeutique. Pour r\u00e9pondre \u00e0 l\u2019augmentation constante des actes pratiqu\u00e9s dans cette salle, au d\u00e9veloppement des techniques percutan\u00e9es et \u00e0 la demande de recours r\u00e9gionale, le CHU se dotera d\u2019une deuxi\u00e8me salle hybride fin 2024.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Le service de cardiologie a d\u00e9velopp\u00e9 ces derni\u00e8res ann\u00e9es de nouvelles techniques de cardiologie et de rythmologie interventionnelle qui permettent\u2026","protected":false},"author":12,"featured_media":23825473,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[96],"tags":[],"class_list":["post-23824951","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-non-classifiee"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cardiologie interventionnelle\u00a0: utilit\u00e9 d\u2019une salle d\u2019op\u00e9ration hybride - Site du CHU de Poitiers<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/cardiologie-interventionnelle-utilite-dune-salle-doperation-hybride\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cardiologie interventionnelle\u00a0: utilit\u00e9 d\u2019une salle d\u2019op\u00e9ration hybride - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Le service de cardiologie a d\u00e9velopp\u00e9 ces derni\u00e8res ann\u00e9es de nouvelles techniques de cardiologie et de rythmologie interventionnelle qui permettent de r\u00e9aliser des proc\u00e9dures complexes par voie percutan\u00e9e, de r\u00e9duire les dur\u00e9es d\u2019hospitalisation sans n\u00e9cessit\u00e9 de r\u00e9adaptation ult\u00e9rieure. 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