CLINICAL ACTIVITY, A MAJOR HEALTH ISSUE
Pr Agnès Hartemann
ICAN gathers the scientific expertise of recognized teams (14 teams, 115 researchers) working in close linked with both international networks and clinical centers. The hospital is a referral center for medical and surgical care, clinical research and training in CMD. Clinical activity is considerable in cardiometabolic patients with a phenotypic diversity and being at different stages of their disease. ICAN has promised to bridge the gap between basic and clinical research in particular through flexible governance and optimal use of research valorisation.
The ICAN care and clinic division include:
- 256 beds: 72 in metabolism and 184 in cardiology including 26 in intensive care
- 4 catheter lab: angioradiology (2) / angioplasty and electrophysiology(2)
- 1 MRI specifically dedicated to obese subjects- 7 operating theatres including one “hybrid” room for joint interventional cardiology/surgery procedures
- 2 vascular radiology rooms , with one dedicated CV CT and one dedicated CV MRI
- Metabolic unit: body composition (DEXA), calorimetry, clamp studies
- Prevention unit: diet workshop, physical activity and smoking prevention .
- Since the creation of the ICAN Institute, dedicated space has been provided in the Cardiology Center for the administrative unit, a room for blood sampling and a dedicated room for research echocardiography. A room has been reserved for the assessment of body composition on the first floor. Finally, a large room has been provided on the basement level for clinical research assistants and project managers operating in the various clinical and translational research programs of the ICAN Institute.
The medical staff of ICAN care and clinic division includes 753 professionals (on average on 2012):
- 103 physicians full-time equivalent (including 26 professors)
- 650 full-time equivalent paramedical professionals.
THE HEART INSTITUTE
The cardiology department (Prs Michel Komajda, Gilles Montalescot, Claude Lefeuvre, Richard Isnard, Jean Philippe Collet, Gerard Helft, Daniel Thomas, Pierre-Louis Michel, Dr Françoise Hidden Lucet) is a referral center for the management of acute coronary events, complex heart failure, management of complex arrhythmias including ablation procedures, familial cardiac disorders including cardiomyopathies, long QT syndrome and Brugada syndrome and is also engaged in prevention. It hosts a reference center on cardiac familial disorders. It is a leading national center for the recruitment of acute coronary syndromes, advanced heart failure and familial cardiomyopathies and arrhythmias. The surgery unit (Prs Pascal Leprince & Alain Pavie) is the leading national center for heart transplantation and assist devices, and one of the leading centers in Europe for the surgery of the aorta. The general intensive care unit is specialized in the management of severe vital syndromes including a particular expertise on cardiogenic shock. A new building (bâtiment Sud) was opened in January 2011 which hosts 48 beds as well as two interventional radiology rooms, one cardiac CT and one cardiac NMR.
CARDIOLOGICAL PROCEDURES 2012
- Ablative procedures
- Heart surgery
- Perc valvle replacement
- Heart transplant
- Cardiac assistance / ECMO
ENDOCRINOLOGY METABOLISM NUTRITION PREVENTION DEPARTMENTS
In january 2014, the nutrition, endocrinology and diabetology departments will move from Benjamin Delessert and La Rochefoucault Liancourt buildings to the new hospital endocrinology building.
The nutrition unit (Prs A Basdevant, J-M Oppert, K Clément) is a reference centre for the medical and surgical management of severe obesities and adipose tissue disorders. The department is a “Reference center” for metabolic surgery, for morbid obesity and diabetes, in adults and adolescents. The cardiovascular prevention unit (Pr E Bruckert and Ph Giral) is dedicated to complex and severe dyslipidemia (i.e. homozygous hypercholesterolemia), metabolic syndromes, intolerance to lipid lowering agents, resistant hypertension and rare diseases (i.e. neurolipidosis). The Diabetology unit (Prs Agnès Hartemann, Fabrizzio Andreelli) is dedicated to type 1 and type 2 diabetes and their complications: diabetic foot, cardiopathy, nephropathy, neuropathy. The Endocrinology unit (Pr Ph Touraine) is involved in the management of hormone therapy in cardiovascular and metabolic diseases. A network is in charge of high risk pregnancy in patient with metabolic and vascular diseases: preconception management, pregnancy follow up and delivery. The Pediatric nutrition unit at Hôpital Trousseau (Prs J Ph Girardet and Tounian) is involved in obesity, diabetes and dyslipidemia in children and adolescent.
RARE DISEASES CENTERS
Hereditary Heart Diseases (Dr P Charron): cardiomyopathy (dilated, hypertrophic, restrictive, arrhythmogenic right ventricular) and arrhythmias (Brugada, long QT, ventricular tachycardia catecholergic Wolff-Parkinson-White family) exposure to the risk of heart failure and / or sudden death. The centre combines the activity of several hospitals i.e Lariboisière, A. Pare, HEGP, R. Debre and Necker. The teams have been pioneers in Europe for the initial description of disease, therapeutic innovation, genetic counseling and molecular diagnosis. Syndromic obesity (Dr C Poitou, Pr K Clément). The Nutrition Unit is part of the referral center rare disease “Prader Willi directed by Pr M Tauber (Toulouse). Partner 1 has helped to identify new forms of genetic obesities (i.e leptin/melanocortin pathways). 150 syndromic forms of obesity with no diagnosis are currently followed. Homozygote familial hypercholesterolemia (Pr E Bruckert) is a very rare autosomal dominant disease which if untreated, leads to early onset accelerated atherosclerosis and premature coronary death, usually between 15 and 20 y. LDL apheresis is an attractive treatment (first done in the department 30 years ago) with impressive effect on LDL-C reduction.