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Normal heart and lungs "The pulmonary arteries are of normal caliber Pulmonary hypertension The pulmonary arteries are narrowed PULMONARY HYPERTENSION What is pulmonary hypertension? The heart is a complex organ composed of several chambers and blood vessels. It works closely with several organs, including the lungs. The right heart pumps oxygen-poor blood to the lungs through the pulmonary artery. Pulmonary hypertension develops when there is an increase in pressure in the pulmonary vessels. This increase in pressure directly affects the right heart, as it has to work harder to eject the blood. The right heart then becomes larger, its cardiac muscle thicker and less functional. As the disease progresses and the heart becomes increasingly overloaded, shortness of breath becomes significant, and lower limb edema appears. Pulmonary hypertension is secondary when it is caused by an underlying disease: a heart disease, lung parenchyma, or pulmonary vessels. When no cause can be established, it is referred to as primary pulmonary hypertension. How is pulmonary hypertension diagnosed? The diagnosis of pulmonary hypertension is suspected by cardiac ultrasound. To confirm the diagnosis, you will be offered a catheterization of the right heart chambers (more commonly called right catheterization or right KT) . Attached is the link for the Adult Right Catheterization . Attached is the link for the Pediatric Right Catheterization . Is it necessary to do the right heart catheterization ? It is important to do this for several reasons: Confirm or rule out the diagnosis of pulmonary hypertension. Determining the origin of pulmonary hypertension and paving the way for specific treatments Establish the surgical indication in cases of pulmonary hypertension secondary to congenital heart disease. Pulmonary hypertension Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us

EXPERTISE AT YOUR SERVICE Dr Réda JAKAMY Structural Interventional Cardiologist Contact : +212 (0) 6 22 22 26 31 info@jakamyheartcenter.com Jakamy Heart Center Welcome to Jakamy Heart Center! I was passionate about building this website to educate patients about interventional cardiology treatment options. The center's goal is to provide high-quality invasive cardiology services, with renowned physicians and surgeons, as well as qualified paramedics. We are committed to providing personalized care and the latest treatment options to our patients from birth to adulthood. I believe in fostering a supportive and compassionate environment for those seeking cardiac care. Learn more about the conditions we treat and how we can help you achieve a healthier heart. Learn more about us Diseases treated Coronary artery diseases Pulmonary Hypertension Degenerative calcified aortic valve stenosis Discover more SITE UNDER CONSTRUCTION Discover Insurance At Jakamy Heart Center, we understand the importance of easy, hassle-free insurance claims processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Don't hesitate to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance

Coronary stent The coronary stent is deployed and shown at actual size. Coronary stent A coronary stent is a flexible, deformation-resistant metal alloy. It is mounted on a balloon. Coronary stent The coronary stent is deployed after inflation of the balloon. CORONARY ANGIOPLASTY Why are you being offered angioplasty or coronary dilatation? You have abnormalities in the blood supply to the heart secondary to narrowing of the coronary arteries. A narrowing of these arteries can cause chest pain, while an obstruction can cause a heart attack. Your doctors have therefore decided that it is preferable to treat these abnormalities. Performing coronary dilatation The procedure is performed by inserting a catheter into the femoral artery (in the groin crease) or radial artery (at the wrist) and consists of dilating the narrowing(s) with an inflatable balloon. In the majority of cases, a stent is placed at this level. This is a type of metal mesh tube that is left in place and keeps the artery open. This stent is generally made of so-called “active” metal because it is covered with a medication intended to reduce the risk of recurrence of the narrowing when this risk is particularly high. The narrowing or occlusion may sometimes be impossible to cross or dilate. The risk of failure depends essentially on the complexity of the lesion. It is generally of the order of 2 to 5%, higher when the artery to be treated has been blocked for a long time. As with coronary angiography, the patient is monitored with a minimum stay of one full day. Dilatation of a blocked coronary artery Are there any risks associated with coronary dilatation? Despite technical progress in catheters, balloons, stents and the experience of doctors, coronary angioplasty, like any invasive or surgical procedure, carries a risk of incidents or accidents. Complications such as heart attack, serious heart rhythm disorders, stroke or coronary perforation are very rare. Exceptionally, emergency heart surgery may be necessary. Death is very rare. Restenosis - Scarring will occur in the areas that have been dilated. There is a risk that the narrowing will recur (called restenosis). If it does recur, further dilation may be performed. In some cases, bypass surgery may be considered. Puncture site complications - These have become rare. The most common complication is a hematoma that can persist for several days, but is usually harmless. More rarely, an artery may become blocked or injured and require surgical repair and/or a blood transfusion. Allergic complications - These are exceptional. Most often linked to iodinated contrast products or anesthetic products. If you have already had allergic manifestations, it is absolutely necessary to inform the doctor. Risk of radiodermatitis - This risk of skin burns is exceptional and linked to prolonged use of X-rays. What benefits can be expected from coronary dilatation? By allowing a greater blood supply to the heart muscle at rest and during exercise, coronary dilation reduces or eliminates angina pain and improves long-term outcomes. Antiplatelet treatment after dilatation To prevent the formation of clots, the placement of a stent requires the use of simultaneous treatment with two medications, the first being aspirin taken over the long term, the second being another more powerful medication given for 1 month to 1 year depending on your illness and the type of stent used. The taking of these medications and their prescription duration must be strictly respected unless otherwise advised by a doctor. If an operation is scheduled in the months following the dilatation, it is imperative that you discuss it with the doctor before the coronary dilatation. Balloon coronary angioplasty Coronary angioplasty with stent placement Our location Make an appointment LUH Ambassadors : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission Demande d'information

Aortic valve stenosis Narrowing of the aortic valve obstructs ejection from the left ventricle. Balloon dilatation of the aortic valve The balloon is inflated at the aortic valve to stretch it. Aortic valvuloplasty Angiographic image of aortic valve dilatation. AORTIC VALVE DILATATION in adults Why are you being offered aortic valve dilatation? The aortic valve is one of the four valves of the heart and separates the left ventricle (the heart's pump) from the aorta (the largest blood vessel in the body). It allows blood to pass from the heart to the rest of the body. Narrowing of the aortic valve prevents blood from flow normally and becomes responsible for symptoms such as shortness of breath, angina and heart failure. Aortic valve dilatation, also called aortic valvuloplasty, is proposed in case of aortic valve narrowing or stenosis. It is a procedure that can be considered in an emergency, because it is currently overtaken by the direct implantation of an artificial aortic valve percutaneously, commonly called TAVI for Transcatheter Aortic Valve Implantation. Performing Aortic Valve Dilatation: Your test will take place in the interventional cardiology unit. Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks. A small area of your groin will be shaved, which will be the access point for the procedure. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table. It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device. Your body will be covered with a large sterile drape. The doctor will perform a puncture under local anesthesia of the right or left femoral arterial and venous pathways. They will then insert the balloon catheter to dilate the heart valve. At this point, you may feel your heart rate increase. The valve dilation does not cause any pain. At the end of the procedure, the access points will be closed as much as possible with a percutaneous closure device. You will generally be discharged the day after the procedure following a transthoracic echocardiographic check. What are the expected benefits? The expected benefits of this therapeutic procedure are a rapid improvement in your symptoms (shortness of breath, chest pain, discomfort), an improvement in the contractility and functioning of your heart and, more generally, an improvement in your quality of life. However, this benefit does not last because the valve closes slowly to return to its basic state of narrowing after a year. This is why this procedure is only indicated in emergency situations or when a TAVI cannot be considered in a short time. Risks and side effects: The risks of the procedure are those of cardiac catheterization, coronary angiography , to which are added the potential risks linked to the dilatation of the valve itself. The potential complications linked to these therapeutic procedures are: cardiac rhythm disorders, vascular complications at the catheter insertion site (hematoma, perforation or arterial obstruction that may require surgical repair), myocardial infarction, embolization of valvular material or clots, aortic dissection (tear of the aortic wall), perforation of a heart chamber, stroke, renal failure, bleeding requiring transfusion, need for emergency surgery for aortic valve replacement, death. Aortic valve stenosis Aortic valvuloplasty Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission! Demande d'information

Rheumatic mitral stenosis Mitral dilatation Mitral valve balloon dilatation Mitral dilatation The image on the left shows the balloon used for mitral dilatation (on the right) in angiography. MITRAL DILATATION What is mitral dilatation? Mitral dilatation is a procedure aimed at relieving the blockage to the filling of your ventricle. Following rheumatic fever contracted in the past, the mitral valve located between the left atrium and the left ventricle has narrowed due to "fusions" of its commissures, causing difficulty during heart filling and clinically the shortness of breath you feel. How is mitral dilatation performed? Your test will take place in the interventional cardiology unit. Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks. You may wear your glasses, dentures, and hearing aids if needed. A small area of your groin will be shaved in case it is the access point for the procedure. You will be asked to go to the bathroom to empty your bladder (urinate) just before your test. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table. It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device. Your body will be covered with a large sterile drape. This examination is performed under X-ray control, at doses as low as possible. The doctor will administer a subcutaneous anesthetic in the vein of the right groin to reduce the sensation of pain. In some cases, general anesthesia will be performed, the goal of which is to guide the procedure using transesophageal echocardiography. The dilatation is performed using an inflatable balloon catheter via the femoral vein. This balloon is placed at the level of the mitral valve by passing from the right atrium to the left atrium after making an opening through the wall that separates these two atria (trans-septal puncture). The valve is then dilated by inflating the balloon to progressively larger sizes under echocardiographic control to achieve the best possible result. Can I take my usual medications before the test? You can take most of your usual medications the night before your test and on the day of the test. Your doctor will review with you the medications you are taking. If you have any doubts about a medication, you should notify the doctor before your visit. Can I eat and drink before this test? You must fast for 12 hours before the exam. Depending on the organization of the day, we try to respect the order and time of passage. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours. Are there any risks associated with mitral dilatation? Despite technical progress in equipment and the experience of doctors, mitral dilatation, like any invasive or surgical procedure, carries a risk of incidents or accidents: Allergic complications - Most often linked to the use of iodinated contrast product or local anesthetic. If you have ever had allergic reactions, it is essential to inform the doctor before the examination. Complications at the puncture site - These are rare. The most common complication is a hematoma which results in a bluish appearance, which can persist for several days but is usually without consequence. Exceptionally, surgical repair and/or a blood transfusion may be necessary. Cardiac complications - Mobilization of a clot that can lead to a stroke is exceptional. Injury to the heart envelope secondary to the creation of the hole between the two atria is rare and usually treated effectively by immediate drainage in the catheterization room (about 1%). Surgery is rarely necessary. A valve tear may occur (about 3% of cases). It is unpredictable but the risk is reduced by the use of echocardiography during the procedure. It may require surgery which is exceptionally necessary in an emergency. Failure of dilatation: The narrowing may be impossible to cross or dilate. The failure rate of the procedure is around 5 to 10%. In this case, a classic surgical intervention can always be considered in a second stage. What benefits can be expected from mitral dilatation? By allowing normal passage of blood between the left atrium and the left ventricle, mitral dilatation improves long-term outcomes and in particular reduces your shortness of breath. The progression of the disease means that the narrowing can recur at a distance. The average delay is 7 to 12 years. This restenosis can be treated by a new dilatation or surgery depending on the appearance of the valve. How long will I be in bed after the test? You must remain in bed for about two hours without bending the leg used for the puncture too much. The head of the bed can be slightly raised for eating. After 4 hours of bed rest, you will be able to get up. You will spend the night under observation. Mitral stenosis Mitral valve dilatation Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission! Demande d'information

Patent ductus arteriosus PDA closure device Actual size of a ductus arteriosus closure device, a few millimeters. PDA closure The device is attached to the catheter which is positioned in the ductus arteriosus. It is deployed to occlude it. PATENT DUCTUS ARTERIOSIUS CLOSURE in pediatrics What is the patent ductus arteriosus? Patent ductus arteriosus is a birth defect that occurs when the ductus arteriosus, a normal connection between the aorta and pulmonary artery in the fetus, does not close properly after birth. Normally, this duct allows blood to bypass the lungs and go directly to the baby's system. However, after birth, blood must be oxygenated by the lungs, and the ductus arteriosus closes quickly, usually within a few days to two weeks . When the ductus arteriosus persists, some of the oxygenated blood, which should be redistributed to the rest of the body, returns to the lungs. This can lead to blood circulation problems and overload of the pulmonary system. So why is closure of the patent ductus arteriosus proposed? Restore normal circulation: Closing the ductus arteriosus restores normal blood circulation. Oxygenated blood can then be distributed efficiently throughout the body, without overloading the lungs. Preventing complications: Patent ductus arteriosus can lead to complications, such as lung infections, heart problems, and pulmonary hypertension . Closing the ductus arteriosus early reduces these risks. Improve quality of life: Closing the ductus arteriosus improves the patient's quality of life by avoiding the symptoms associated with this malformation. Depending on the medical assessment, catheterization of the right heart cavities may be proposed in advance to determine the indication for closure of the ductus arteriosus. Performing the Closure of the patent ductus arteriosus: The examination takes place in the interventional cardiology unit. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venous and arterial puncture in the groin and inserts a thin catheter. The catheter is guided to the heart. The device is deployed in the ductus arteriosus to block it. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check. What are the complications of a patent ductus arteriosus closure procedure? Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. Thrombosis of the artery can also occur. cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : Very rarely, displacement of the device or localized infection may occur. complications leading to death : they are very exceptional (<0.1%). It is important to note that these complications are rare, and the benefits of ductus arteriosus closure usually outweigh the risks. What benefits can be expected from patent ductus arteriosus closure? Closure of the patent ductus arteriosus offers several benefits for the child: Normal height and weight growth. Improved exercise capacity: The child will have no limitations when playing and running. Reduced susceptibility to viral infections: The child will have fewer episodes of viral infections. Closure of patent ductus arteriosus Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Assurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information

Coarctation of the aorta The narrowed aorta obstructs the flow of blood to the body's organs. Vascular stents a and b: Uncovered stents c and d: Covered stents e: Dilatation balloon Stenting of coarctation of the aorta Angiography images of aortic coarctation before and after stenting AORTIC COARCTATION STENTING in adults What is coarctation of the aorta? Coarctation of the aorta is an abnormal narrowing of the aorta, the large blood vessel that carries blood from the heart to the rest of the body. This limits blood flow to organs and lower limbs. It can be present from birth (congenital coarctation) or develop later in life. The heart has to work harder to push blood through the narrowed part of the aorta. Why are you being offered coarctation of the aorta stenting? Stenting helps reduce blood pressure in this area, relieving the heart and improving blood flow . It widens the narrowed area, allowing blood to flow more freely. This improves perfusion of the abdominal organs and lower limbs, reducing the risk of complications . Stenting aims to improve quality of life and reduce the risks of cardiac and vascular complications associated with coarctation of the aorta . Performing stenting of coarctation of the aorta: Your test will take place in the interventional cardiology unit. When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks. A small area of your groin will be shaved which will be the entrance route for the examination. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a narrow, hard table. It will be a little cold in the room. Around you, you will see X-ray machines and monitors. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. General anesthesia will begin. The procedure involves dilating the narrowed area of the aorta and implanting a stent to prevent it from narrowing again. This procedure is performed under local anesthesia, but you will be sedated during dilation so as not to feel any pain. You will be asked to lie down for a few hours after the procedure. You will generally be discharged the day after the procedure. Are there any risks associated with coarctation of the aorta stenting? Despite technical progress and the experience of doctors, cardiac catheterization involves, as with any invasive or surgical procedure, a risk of incidents or accidents: Allergic complications: Most often linked to the use of iodinated radiological products or local anesthetics. If you have already experienced allergic manifestations, it is imperative to inform your doctor. Complications at the artery puncture site: This can range from a simple hematoma to a vascular injury requiring surgical repair and/or blood transfusion. Cardiac and vascular complications: During the examination, discomfort, chest pain, palpitations related to a rhythm disorder may occur. Serious complications are very rare. The risk of death is very low. What follow-up after stenting of coarctation of the aorta? Stenting requires taking antiplatelet treatment for a period of 6 months. No special physical or professional precautions are necessary after implantation of the prosthesis. This prosthesis also does not contraindicate any future exploration or intervention. Antibacterial prophylaxis will be offered in the event of risky extracardiac procedures during the 6 months following implantation of the prosthesis. A chest CT scan for monitoring will be offered to you at one year. Coarctation of the aorta Stenting of coarctation of the aorta Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission ! Demande d'information

Aortic valve stenosis Narrowing of the aortic valve obstructs ejection from the left ventricle. TAVI Biological artificial valve implanted at the level of the aortic valve. TAVI Biological artificial valve implanted at the level of the aortic valve. TAVI What is TAVI? The aortic valve is one of the four valves of the heart and separates the left ventricle (the heart's pump) from the aorta (the largest blood vessel in the body). It allows blood to pass from the heart to the rest of the body. Narrowing of the aortic valve prevents blood from flow normally and becomes responsible for symptoms such as shortness of breath, angina and heart failure. Treatment for this disease usually consisted of replacing the diseased valve with an artificial valve surgically, using "open heart" surgery. TAVI " Transcatheter Aortic Valve Implantation " is an alternative method that consists of placing an artificial biological valve at the level of your diseased aortic valve by passing through the femoral artery (in the groin crease). This innovative procedure is performed without surgical opening under X-ray control. This artificial valve is made of pericardium (a thin membrane that surrounds the heart) of animal origin (beef), reproducing the general shape of a normal aortic valve, fixed inside a tubular and expandable metal mesh (stent). This valve is compressed on an inflatable balloon mounted at the end of a tube (or catheter) and pushed to the heart under radiological monitoring, then placed at the level of the diseased aortic valve by inflating the balloon. Once in position, it is held in place by the sole force of expansion of the stent. The size is chosen according to the size of the aortic annulus (place where the stent will be deployed). What is the implantation method? To introduce the artificial valve to the heart, the right or left femoral arterial route is used. However, a femoral arterial caliber greater than 6 mm remains essential for this approach. The following additional tests are necessary before considering valve implantation: electrocardiogram, echocardiogram (ultrasound study of the heart allowing a detailed analysis of the condition of your heart and the aortic valve). It will be necessary to perform a coronary angiography (evaluation of the condition of the coronary arteries) and especially a CT scan of the aorta and the femoral and iliac arteries. These are tests carried out daily in cardiology. During these tests, the diameter of your aortic annulus (the structure to which the aortic valve is attached) and that of your femoral arteries will be calculated in order to determine if the arterial approach is possible. Only after these tests have been carried out will it be known whether the artificial valve can be implanted. Implantation of the bioprosthesis and hospital monitoring: The femoral artery is accessed by simple puncture and will be closed as far as possible by a percutaneous automatic closure system. After the valve is implanted, you will be admitted to the cardiology intensive care unit for monitoring. In this unit, blood tests will be performed daily and an echocardiogram will be recorded to check that the valve is functioning properly. You will then be transferred to the cardiology unit as soon as your condition is stable. The average hospital stay is 3 days. Expected benefits: Based on our current knowledge, and taking into account your clinical condition, the placement of this valve appears to be the best possible solution to improve your symptoms and reduce the risks of your disease in a more sustainable way. The expected benefits of this therapeutic procedure are a rapid improvement in your symptoms (shortness of breath, chest pain, discomfort), an improvement in the contractility and functioning of your heart and, more generally, an improvement in your quality of life. Risks and side effects: The risks of the procedure are those of cardiac catheterization, coronary angiography , aortic valve dilatation (a test that has been performed for many years), to which are added the potential risks associated with the implantation of the valve itself. The potential complications associated with these therapeutic procedures are: cardiac rhythm disorders, vascular complications at the catheter insertion site (hematoma, perforation or arterial obstruction that may require surgical repair), myocardial infarction, embolization of valve material or clots, aortic dissection (tear of the aortic wall), perforation of a heart chamber, stroke, renal failure, endocarditis (infection on the valve), valve displacement, leakage around the valve, valve dysfunction, bleeding requiring transfusion, need for emergency surgery for coronary artery bypass grafting or aortic valve replacement, death . Aortic valve stenosis TAVI Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission! Demande d'information

Patent foramen ovale Opening of the patent foramen ovale with passage of blood from the right atrium to the left atrium. Double disc device for closing PFO PFO device, composed of a flexible metal alloy (Nickel and Titanium). PFO closure with a double disc device PFO closure device is used to close the PFO. CLOSURE OF THE PATENT FORAMEN OVALE (PFO) Why are you being offered a closure of the PFO? The foramen ovale is a passage in the septum separating the two atria of the heart present at the embryonic stage of life and which closes spontaneously shortly after birth. It may happen that this closure does not occur or reopens (this is called a "patent" foramen ovale) and is responsible for symptoms in adulthood, the most serious of which is stroke, a neurological complication requiring closure of the PFO to prevent a recurrence. Performing the closing gesture: Your test will take place in the interventional cardiology unit. When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks. A small area of your groin will be shaved which will be the entrance route for the examination. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a narrow, hard table. It will be a little cold in the room. Around you, you will see X-ray machines and monitors. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. General anesthesia will begin. The procedure involves implanting a device comprising two metal mesh discs connected by a small connector and positioned on either side of the septum between the two atria to make it watertight. This flexible device is implanted by cardiac catheterization via a puncture of the femoral vein. This procedure is performed with ultrasound guidance (usually via transthoracic or transesophageal route), requiring general anesthesia or simple sedation. In more than 80% of cases, communication between the two atria disappears completely just after the implantation of the device. In other cases, the closure will be effective in the following weeks. You will be asked to lie down for a few hours after the procedure. You will generally be discharged the day after the procedure after a transthoracic ultrasound scan. Can I eat and drink before this test? You must be more than 12 hours before the exam. We try to respect the order and time of passage according to the organization of the day. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours. What are the expected benefits? In large-scale studies, PFO closure combined with antiplatelet therapy reduces the risk of recurrent stroke by approximately 60% compared with antiplatelet therapy alone (most commonly low-dose aspirin). What are the risks involved? Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks: Allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. Cardiovascular complications during the hospital period: they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge: the most common complication is the occurrence of palpitations linked to a rhythm disorder (<5% of cases): generally early (first weeks) and transient, this arrhythmia may require an action or additional treatment if it persists. Much more rarely (<0.5% of cases), the formation of clots on the device or a displacement of the device may occur. Complications leading to death : these are very exceptional (<0.1%). What follow-up after the device implantation? The implantation of the device requires taking antiplatelet treatment for a minimum period of 6 months, which is generally continued at a lower dose in the long term. No special physical or professional precautions are necessary after implantation of the device. This device also does not contraindicate any future exploration or intervention. Antibacterial prophylaxis will be offered in the event of risky extracardiac procedures during the 6 months following implantation of the device. An ultrasound follow-up will be offered between 6 and 12 months to ensure the absence of significant residual communication between the 2 atria. Patent foramen ovale closure Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Vérifier votre assurance Request for informations Contact us thank you for your submission ! Demande d'information

Balloon catheter Multi-lumen catheter for performing right heart catheterization Right heart catheterization The catheter is introduced into the different right heart chambers to take pressure and angiography measurements. RIGHT HEART CATHETERIZATION in pediatrics What is right heart catheterization? Right heart catheterization, abbreviated as RHC, is a procedure performed to check the functioning of your heart muscle. During this procedure, readings of cardiac and arterial pressure are taken, and blood samples are collected to measure oxygen levels in the heart. This examination is useful for identifying the cause of pulmonary hypertension, determining its treatment, and deciding on heart surgery in the case of congenital heart diseases. Should the child be kept fasting? Absolutely. For children under 16, the examination is performed under general anesthesia to prevent them from moving during the examination. It is imperative that they fast for at least 6 hours for solids and 3 hours for liquids. We try to do the children first so as not to leave them fasting for a long time. Performing pediatric straight catheterization: Pediatric right catheterization is performed in the catheterization room. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venipuncture in the groin and inserts a thin balloon catheter. The catheter is guided to the different heart chambers, to take pressure measurements and take a few milliliters of blood for analysis. Depending on the initial results, they may need to be repeated a second time under high oxygen therapy combined with nitric oxide. At the end of the procedure, gentle compression is applied for about ten minutes at the groin level and then a pressure bandage is applied. The child is monitored in the recovery room until full consciousness is regained and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of choking. Discharge can be done the same day 4 hours after the end of the procedure. Are there any risks with right heart catheterization? Straight catheterization is safe and usually well tolerated, but there are still some risks. There may be bleeding at the insertion site, as well as pain and bruising. Additional heartbeats or palpitations (rapid heartbeats) may occur at the time the catheter is placed in the heart. It is very rare for this to cause problems, or to persist after the test is completed. The risk of serious complications is very rare (less than 1%). General anesthesia for congenital heart disease itself has its share of complications, but when the indication for right catheterization is established, the benefit of the examination far outweighs the risks. Cardiac catheterization Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission! Demande d'information

Obstructive hypertrophic cardiomyopathy Hypertrophic cardiomyopathy: the left ventricle is hypertrophic and has an obstruction at its exit to the aorta. Alcohol septal ablation Injection of ethanol into the septal artery to induce a localized infarction and relieve the obstruction to the aortic outflow tract. SEPTAL ABLATION What is septal ablation? Alcohol septal ablation is a technique aimed at treating obstructive hypertrophic cardiomyopathy. This procedure is performed if the symptoms are too severe to be managed with medication. In obstructive hypertrophic cardiomyopathy, there is a thickening of the septum (the wall) that separates the ventricles of the heart, which eventually obstructs general blood flow. Alcohol septal ablation induces a very small controlled heart attack in the area where the heart tissue is abnormally thick. During alcohol septal ablation, the damaged tissues are destroyed and replaced by thinner scar tissue, allowing normal blood flow to be restored from the heart. How is an ablation procedure performed? A local anesthetic is injected at the catheter insertion site. The patient is also given a blood thinner and a sedative, if necessary. A contrast agent is also given to help doctors guide the catheter inside the body using real-time X-rays and echocardiography. A thin catheter (tube) with a balloon at the end is inserted into a blood vessel in the groin and then guided to the heart using imaging techniques. When the catheter reaches the blocked artery, the balloon is inflated to stop blood flow. A small amount of pure alcohol is then injected through the catheter into the artery to destroy excess tissue blocking circulation. The patient may feel some discomfort or mild chest pain during this part of the procedure. A few minutes later, the balloon and catheter are removed. The patient then remains under observation in the hospital for a few days. Afterwards, he must limit his activities for a few months, until complete recovery. Follow-up visits are scheduled to assess healing and heart function. What are the risks of septal ablation? Despite technical progress in catheters, balloons, and the experience of doctors, percutaneous septal ablation, like any invasive or surgical procedure, carries a risk of incidents or accidents. Complications such as heart attack, serious heart rhythm disorders, stroke or coronary perforation are very rare. Exceptionally, emergency heart surgery may be necessary. Death is very rare. Puncture site complications - These have become rare. The most common complication is a hematoma that can persist for several days, but is usually harmless. More rarely, an artery may become blocked or injured and require surgical repair and/or a blood transfusion. Allergic complications - These are exceptional. Most often linked to iodinated contrast products or anesthetic products. If you have already had allergic manifestations, it is absolutely necessary to inform the doctor. Conductive risk - the septal region to be ablated is close to the conduction pathways of the heart and the risk of a high degree conduction disorder requiring the implantation of a pacemaker is not negligible and is 10%. Obstructive hypertrophic cardiomyopathy Alcohol septal ablation Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information

Normal heart Pulmonary atresia with intact ventricular septum The communication between the right ventricle and the pulmonary artery is closed. Blood goes from the right heart to the left heart through the foramen ovale. The ductus arteriosus is the only source of vascularization of the pulmonary circulation. Coronary stent Actual size of a stent used to keep the ductus arteriosus open. DUCTUS ARTERIOSIS STENTING in the newborn What is the ductus arteriosus? The ductus arteriosus is a normal connection between the aorta and the pulmonary artery in the fetus, allowing blood to bypass the lungs and go directly to its organs. However, after birth, blood must be oxygenated by the lungs, and the ductus arteriosus closes quickly, usually within a few days to two weeks. In some congenital pathologies (such as the example on the right of pulmonary atresia with intact ventricular septum ) affecting the pulmonary circulation, the lungs do not receive enough blood flow which causes desaturation in the newborn with a risk of death in the very short term. The ductus arteriosus then allows to maintain a sufficient supply of blood flow to the pulmonary circulation. To keep it open, stenting of the ductus arteriosus can be proposed. So why is ductus arteriosus stenting proposed? There are three ways to maintain sufficient flow to the pulmonary circulation: drug method: prostaglandin infusion. The advantage is the absence of invasive procedures. The disadvantage is the countless side effects of the medication. It is not advisable to leave it for more than a week. Interventional method: stenting of the ductus arteriosus. The advantage is that it is an invasive procedure without surgery. The disadvantage is the complications of the femoral arterial route. Surgical method: Blalock surgery. The advantage is that it is the oldest method. The disadvantage is the complications of surgery. Stenting of the ductus arteriosus in surgically risky situations may be the best alternative. Procedure for Stenting the Arterial Duct: The examination takes place in the interventional cardiology unit. The child is laid flat and placed under general anesthesia to prevent movement during the procedure. The doctor performs an arterial puncture in the groin area and inserts a thin catheter. The catheter is guided to the heart. The stent is deployed in the arterial duct to keep it open. At the end of the procedure, pressure is applied to the groin area for about ten minutes, and a compressive bandage is placed. The child is monitored in the recovery room until they fully regain consciousness and are then returned to their parents. Feeding is only allowed two hours after the end of the procedure. What are the complications of a ductus arteriosus stenting procedure? Despite the experience of the operators and the significant technical progress concerning catheters and prostheses, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma, which results in a bluish appearance that is usually harmless and disappears after a few days. Sometimes, a vascular injury may require surgical repair or transfusion. Thrombosis of the artery may also occur. Complications leading to death : They are not rare, but the natural evolution of these pathologies leads to death in the very short term in the absence of intervention. Stenting remains a life-saving procedure. What benefits can be expected after ductus arteriosus stenting? Stenting of the ductus arteriosus allows normal height and weight growth, to be expected for a few months, after the next surgical step of correction of the congenital heart disease. Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission ! Demande d'information map