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Biomedical subjects

A Carpentier

Publications and source records attributed to A Carpentier.

At least 343 records · Page 19Linked to original sources
PubMed1980

[Myocardial protection during ischemic cardiac arrest. Hemodynamic study of the effects of allopurinol in a cardioplegic solution].

The effects of the addition of 20 mg sodium allopurinate to a litre of ionic cardioplegic solution were studied. The experimental model was the working isolated perfused rat heart in oxygenated Krebs-Henseleit solution. The cardiac outputs were compared after 1 hour of ischaemia with three different methods of myocardial protection; group I: protection by hypothermia at 4 degrees C, group II: protection by ionic cardioplegic solution A, group III: by ionic cardioplegic solution B (with 20 mg Allopurinol). The results were expressed in percentage of the preischemic cardiac output. The best results were obtained in group III, especially after 15 minutes recovery (80.7 +/- 4.5 p. 100 at 15 minutes, 90.6 +/- 3.1 p. 100 at 30 minutes., 88.3 +/- 4.6 p. 100 at 1 hour). The results in group II were significantly better than in group I after 10 minutes recovery. Myocardial protection bu ionic cardioplegia associated with hypothermia at 4 degrees C gives a better post ischaemic recovery than hypothermia alone. When allopurinol is added to the cardioplegic solution, the protection is increased. These effects are similar to the haemodynamic effects of allopurinol on ischaemic myocardium together with the possible limitation of experimental myocardial infarction with regression of the oedema that has been observed with this drug.

Allopurinol↗
PubMed1980

Reconstructive surgery of mitral valve incompetence: ten-year appraisal.

Between January, 1969, and January, 1978, 551 patients with mitral incompetence were treated by a system of reconstructive techniques. Mitral valve incompetence was classified into three types according to leaflet pliability; type I normal leaflet motion, 150 cases; type II, leaflet prolapse, 213 cases; and type III, restricted leaflet motion, 188 cases. Associated tricuspid valvular disease was present in 174 cases (31.5%) and was treated by prosthetic ring annuloplasty. The operative mortality rate was 4.2% (16/377) in the mitral group and 14% (25/174) in the mitral-tricuspid group. Follow-up data are available in 341 patients from 1 year to 10 years (average 4 1/2 years). The late mortality rate was 7% (24/341). Actuarial curves including hospital mortality rate show an 82% survival rate at 9 years in the mitral group and a 79% rate in the mitral-tricuspid group. Thirty-seven patients (11%) underwent reoperation mainly for residual (17) or recurrent (16) mitral incompetence. Thromboembolism occurred in 12 patients for an embolic rate of 0.6% per patient-year, even though 48% were not given anticoagulants. Acorrding to the New York Heart Association (N.Y.H.A.) classification, 76% (207/270) of the patients were in Class I, 19% (51/270) were in Class II, 4% (10/270) were in Class III, and 0.7% were in Class IV (2/270). Results of postoperative catheterization and angiocardiography are available in 52 patients. Comparison between the various groups shows that the best results were obtained in type II mitral incompetence, followed by type I and type III mitral incompetence. This experience demonstrates that predictable and stable long-term results have been achieved by techniques of valvular reconstruction with a low incidence of thromboembolism. Reproducibility of the techniques is a limiting factor which can be overcome by adequate training and progressive experience. Patient selection is based on the valvular disease rather than age, physical condition, or cause of valvular disease.

Adolescent↗
PubMed1980

[Acute dissection of the descending aorta with ischemia of the limbs. Value of an axillofemoral bypass operation (author's transl)].

The authors describe a case of acute dissection of the descending aorta with continuation into the abdominal aorta, producing severe ischemia of the lower limbs and sensory-motor disturbances. An axillo-bi-femoral by-pass operation was performed leading to a revascularization syndrome with anuria and local edema. Good results were still apparent after one and a half years and the patient had started work again. Though a palliative operation, not treating the dissection, axillofemoral by-pass surgery appears to be indicated for distal ischemic lesions when the thoracic affection does not require urgent surgical invention.

Aortic Dissection↗
PubMed1979

[Remote results of ostial coronaritis surgically treated].

This study comprises 15 patients operated for syphilitic coronary ostial stenosis by Dubost's team between 1959 and 1975. Three operative deaths (20%) were observed. Three other late deaths occured, but only one of his coronary pathology. Of the nine survivors, seven have been reviewed and five have undergone control coronary angiography. The long term results of the 9 survivors, reviewed from 3 1/2 to 11 years after operation, illustrate the difficulties of disobliteration of the right coronary ostium, the necessity of changing the aortic valve systematically when incompetent and the maintenance of the good results obtained by this surgery.

Adult↗
PubMed1978

Conservative management of the prolapsed mitral valve.

Prolapsed leaflet is the result of ruptured chordae, elongated chordae, or ruptured papillary muscle. Various techniques adapted to each of these lesions were developed, and repair of 213 prolapsed mitral valves was performed between 1969 and 1977. There were 109 patients with ruptured chordae treated by quadrangular resection of the prolapsed leaflet; 103 patients with elongated chordae were treated by either a "sliding plasty" of the papillary muscle or a "shortening plasty" of the chordae; and 1 patient with ruptured papillary muscle was treated by reimplantation. The great majority of patients had an associated annular dilatation or deformation requiring the use of a Carpentier ring to remodel the annulus and reinforce the repair. The operative mortality was 4% and the late mortality, 3%. There were 6 reoperations, 3 of which occurred within 1 year. Thromboembolic complications occurred in only 1 patient (0.5%), even though the majority of patients received no anticoagulation treatment. Actuarial curves demonstrated a 91% survival at 8 years.

Adult↗