{"id":7094671,"date":"2023-05-12T10:32:04","date_gmt":"2023-05-12T08:32:04","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=7094671"},"modified":"2023-05-12T10:35:07","modified_gmt":"2023-05-12T08:35:07","slug":"insuffisance-mitrale-un-nouveau-traitement-chirurgical","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\/","title":{"rendered":"Insuffisance mitrale\u00a0: un nouveau traitement chirurgical"},"content":{"rendered":"\n<p>La valve mitrale est l\u2019une des quatre valves du c\u0153ur qui contr\u00f4lent la circulation du sang. Compos\u00e9e de deux feuillets, elle s\u2019ouvre et se ferme sous la pression du muscle cardiaque. On parle d\u2019insuffisance mitrale ou de fuite mitrale lorsque la valve mitrale n\u2019arrive pas \u00e0 se fermer compl\u00e8tement ce qui provoque un reflux de sang du ventricule gauche vers l\u2019oreillette gauche. En absence de traitement, le c\u0153ur doit travailler plus intens\u00e9ment \u00e0 chaque battement pour pomper le sang ce qui l\u2019affaiblit progressivement. Quand l\u2019insuffisance mitrale devient s\u00e9v\u00e8re, il est n\u00e9cessaire de r\u00e9parer ou de remplacer la valve mitrale. Deux interventions sont traditionnellement propos\u00e9es, chacune d\u00e9pendant des atteintes du patient. En premi\u00e8re intention, est r\u00e9alis\u00e9e une chirurgie cardiaque \u00e0 c\u0153ur ouvert, sous circulation extra-corporelle, pour r\u00e9parer la valve mitrale ou bien pour la remplacer par une proth\u00e8se. Une seconde m\u00e9thode, moins invasive, consiste \u00e0 corriger la fuite mitrale par l\u2019implantation de clips mitraux. Le cardiologue introduit le clip dans la veine f\u00e9morale par le biais d\u2019un cath\u00e9ter et le remonte afin de le placer sur la valve mitrale. Le Dr G\u00e9raldine Allain, chirurgien cardiaque et thoracique, a initi\u00e9 une troisi\u00e8me m\u00e9thode\u00a0en mars dernier : le remplacement de la valve mitrale par voie transcath\u00e9ter avec la bioproth\u00e8se Tendyne. \u00ab\u00a0<em>C\u2019est une nouvelle technique sur laquelle nous commen\u00e7ons \u00e0 avoir du recul. Dans la litt\u00e9rature, les r\u00e9sultats sont tr\u00e8s encourageants. Nous l\u2019avons pratiqu\u00e9 pour la premi\u00e8re fois au CHU de Poitiers, le 2 mars dernier. Les premi\u00e8res proc\u00e9dures ont d\u00e9but\u00e9 en France en 2020 et, aujourd\u2019hui, une quinzaine de centres les r\u00e9alisent. Cette nouvelle m\u00e9thode s\u2019ajoute aux deux d\u00e9j\u00e0 propos\u00e9es au CHU, c\u2019est-\u00e0-dire, l\u2019op\u00e9ration \u00e0 c\u0153ur ouvert et l\u2019implantation de clips mitraux. Ces trois techniques se compl\u00e8tent et nous permettent d\u2019offrir une prise en charge adapt\u00e9e aux diff\u00e9rentes situations, de trouver la meilleure solution pour chaque patient <\/em>\u00bb. L\u2019intervention ne n\u00e9cessite pas de circulation extracorporelle. Ins\u00e9r\u00e9e dans un stent, la bioproth\u00e8se est implant\u00e9e sur la valve d\u00e9fectueuse, par le biais d\u2019un cath\u00e9ter sous contr\u00f4le de l\u2019\u00e9chographie. Pour cela, il est n\u00e9cessaire de faire une petite incision au niveau du thorax entre les c\u00f4tes. L\u2019intervention de mars a \u00e9t\u00e9 men\u00e9e par trois m\u00e9decins, le Dr G\u00e9raldine Allain, le Dr Elisa Larrieu-Ardilouze et le Dr Jamil Hajj-Chahine. Coordinatrice de cette nouvelle offre de soin, le Dr Allain souligne qu\u2019il s\u2019agit d\u2019une activit\u00e9 pluridisciplinaire\u00a0: \u00ab\u00a0<em>Pour la mise en place de cette proth\u00e8se, il y a effectivement les chirurgiens cardiothoraciques et les cardiologues interventionnels. Il y a aussi les \u00e9chographistes, le Dr Corinne Beaufort et le Dr Benjamin Alos, qui sont nos yeux et nous guident dans le positionnement de la proth\u00e8se. Et, bien \u00e9videmment, l\u2019\u00e9quipe d\u2019anesth\u00e9sistes-r\u00e9animateurs qui est pr\u00e9sente pendant la proc\u00e9dure et en p\u00e9ri-op\u00e9ratoire <\/em>\u00bb.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u2019insuffisance mitrale est, en Europe, une pathologie fr\u00e9quente puisqu\u2019elle constitue la deuxi\u00e8me valvulopathie n\u00e9cessitant une chirurgie apr\u00e8s\u2026","protected":false},"author":12,"featured_media":7095493,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[96],"tags":[],"class_list":["post-7094671","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>Insuffisance mitrale\u00a0: un nouveau traitement chirurgical - 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\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Insuffisance mitrale\u00a0: un nouveau traitement chirurgical - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"L\u2019insuffisance mitrale est, en Europe, une pathologie fr\u00e9quente puisqu\u2019elle constitue la deuxi\u00e8me valvulopathie n\u00e9cessitant une chirurgie apr\u00e8s le r\u00e9tr\u00e9cissement aortique. Le service de chirurgie cardiothoracique du CHU de Poitiers propose, depuis mars 2023, une nouvelle proc\u00e9dure pour traiter les valves mitrales d\u00e9faillantes.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.chu-poitiers.fr\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\/\" \/>\n<meta property=\"og:site_name\" content=\"Site du CHU de Poitiers\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-12T08:32:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-12T08:35:07+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2023\/05\/Doc-2-web-2-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"675\" \/>\n\t<meta property=\"og:image:height\" content=\"782\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Morgane Pr\u00e9maud\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Morgane Pr\u00e9maud\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"NewsArticle\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/\"},\"author\":{\"name\":\"Morgane Pr\u00e9maud\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#\\\/schema\\\/person\\\/c3b1c950cff7a774b33177b5cdabb2cb\"},\"headline\":\"Insuffisance mitrale\u00a0: un nouveau traitement chirurgical\",\"datePublished\":\"2023-05-12T08:32:04+00:00\",\"dateModified\":\"2023-05-12T08:35:07+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/\"},\"wordCount\":537,\"publisher\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/wp-content\\\/uploads\\\/2023\\\/05\\\/Doc-2-web-2-1.jpg\",\"articleSection\":[\"Non classifi\u00e9(e)\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/\",\"url\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/insuffisance-mitrale-un-nouveau-traitement-chirurgical\\\/\",\"name\":\"Insuffisance mitrale\u00a0: un nouveau traitement chirurgical - 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