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Biomedical subjects

A Carpentier

Publications and source records attributed to A Carpentier.

At least 361 records · Page 20Linked to original sources
PubMed1977

The effect of coronary artery reperfusion on the extent of myocardial infarction.

The effect of the reperfusion on myocardial infarction has been studied in the rat in order to assess the possible reversibility of myocardial damage. The present study deals with reperfusion of experimental myocardial infarction in the rat. Two groups of animals were compared: one was subjected to permanent ischemia and the other was subjected to ischemia of variable duration 1) hour to 24 hours). The differences between infarction caused by permanent ischemia and the evolution of infarction following reperfusion were studied by means of histologic (121 specimens) histoenzymatic (56 specimens), ECG (100 specimens), techniques and study of the mcirocirculation (70 specimens). The size of the infarctions caused by temporary ischemia was found to be significantly smaller in 60% of the cases as compared to the infarctions caused by permanent ischemia. Histoenzymatic study (phosphorylase activity and succinodehydrogenase activity) confirmed the existance of a marginal zone extending over one third of the surface of the ischemic myocardium: reperfusion permitted the salvage of this zone and thereby diminished the extent of necrosis. The latter findings were further confirmed by the ECG study showing earlier regression of ischemic ST changes following early reperfusion. Microcirculatory changes secondary to anoxia may account for the fact that, in a certain percentage of the cases, early reperfusion does not prevent extension of infarction.

Animals↗
PubMed1977

[Constrictive fibrous endocarditis. Surgical treatment].

An anatomo-clinical entity, fibrous constrictive endocarditis can betreated srugically, and we carried out this procedure for the first time in 1971, since when we have used it seven times; it consists of an internal stripping of one or both centricles, with removal of one or both the mitral and tricuspid valves. The results were encouraging in the first two cases, and so good in the succeeding ones that this endocardial resection could be put forward as the treatment of choice for a condition whose aetiology is still unclear.

Adult↗
PubMed1977

[Choice of surgical method in the child or adult (excluding infants) suffering from coarctation of the aorta and severe cardiopathy].

A study of a serie of 45 cases of coarctation of the aorta associated with a severe cardiac lesion or malformation, and treated at a single operative session (18 cases) or in two consecutive stages (27 cases) has produced the following conclusions: --Treatment at a single operation is possible, usually at the cost of two consecutive surgical approaches, thus making the operation rather long. This plan, which has given good results in the 18 cases studied (only one death and no serious complications) should be adopted only for young patients who are well-balanced psychologically, and whose cardiac defect is well-compensated. --Treatment in two stages is a more reasonable course for the remainder of the patients, but it must be decided which lesion to treat first: this could be the coarctation if it is a difficult or poorly tolerated one and if the cardiac defect (especially when an aortic valve lesion) is well compensated. It will be the cardiac lesion if, by contrast, the coarctation is simple and well-tolerated, and the cardiac lesion is severe and decompensated (especially a mitral malformation with shunts and major pulmonary hypertension). Current techniques of open heart surgery allow us to employ extracorporeal circulation easily and safely with the coarctation still in place; this will then be treated later. In every case in which a two-stage treatment plan has been chosen, it should be carried out as a planned procedure so that the second stage of the operation is not put off unduly.

Adolescent↗
PubMed1977

[Congenital mitral valve malformations. Anatomical lesions and surgical treatment in paediatric age (author's transl)].

Congenital mitral valve malformations are diverse. When they present clinically in infancy medical treatment is often ineffective. Mitral valve replacement with prosthesis in children carries an high operative and postoperative risk. For these reasons the Authors have undertaken in 1972 a cooperative study which includes: 1) a surgical classification of the congenital mitral valve lesions; 2) a systematic attempt to repair the mitral valve. Over 43 observed cases, 18 have been operated upon. Eleven cases (61%) presented associated cardiac lesions. Hospital mortality was 16% (3 cases). There have been either mortality nor morbidity in the follow-up period. Eight cases have been recatheterized two years after the operation. The pulmonary artery pressure has significantly decreased and the mitral insufficiency disappeared almost completely. The classification, suggested by the Authors, is explained in details.

Angiocardiography↗
PubMed1976

Microcirculatory changes following early reperfusion in experimental myocardial infarction.

69 rats underwent temporary or permanent ligation of the left coronary artery and were studied by the injection of colloidal carbon following fixation-perfusion. 10 rats were using the same protocol and served as controls. Localized myocardial ischemia was accompanied by microvascular changes which produced capillary obstruction when blood flow was reestablished. This phenomenon of "no-reflow" was characterized by the presence of large non perfused areas seen after brief periods of ischemia (15 min). These areas were increased when the period of ischemia was lengthened. After 30 to 60 min of interruption of blood flow the non perfused area extended over the major portion of the ischemic area. During reperfusion the "no-reflow" phenomenon displayed during the first hour showing a transitory improvement in capillary perfusion which was soon followed by a progressive reexpansion of the non injected zones. After 24 hours of reperfusion, the latter zones were identical in their extent to those cases showing tissue necrosis following permanent ischemia. This "no-reflow" phenomenon appears to play a role in the evolution of the reperfused ischemic area by excluding certain areas from the benefits of reperfusion. The most probable factors involved in this process are: increased blood viscosity, endothelial changes peri-capillary edema and the contractile state of the myocardium. The incidence of these microvascular changes, using various methods of myocardial preservation during open heart surgery operations, as well as the present attempts directed towards metabolic therapy of myocardial anoxia, are under investigation.

Animals↗
PubMed1976

The surgical treatment of constrictive fibrous endocarditis.

Constrictive fibrous endocarditis is a pathological entity described by Loëffler in 1936. Its etiology is unknown. The clinical course is characterized by an evolution towards cardiac insufficiency leading rapidly to a fatal outcome. Moderen paraclinical investigations are necessary to assess the diagnostic. Caridac catheterization brings the proof of adiastole and angiogardiography reveals the shape of amputation of the ventricle with auriculoventricular regurgitation. The operative procedure consists of resection of the ventricular fibrosis including the valves and auriculo-ventricular valve replacement by a prosthetic valve. The disease affects both Caucasians and Negros. Our experience includes 5 cases. The indications for operation and their results are discussed.

Adult↗
PubMed1976

Emergency myocardial revascularization.

From 1969 to 1975, 175 patients with acute coronary insufficiency underwent emergency saphenous vein aorto-coronary bypass grafting (SVBG). The patients were divided into two groups: group I, unstable angina (165 patients) and group II, acute evolving myocardial infarction (ten patients). In group I, the hospital mortality was 8-4%, the incidence of post-operative myocardial infarction was 10-3%. Long-term follow-up was obtained for an average of 25 months, functional improvement was definite in the majority of the patients and actuarial survival curves show 87% patients alive at the end of 48 months. In group II, the hospital mortality was 30%; seven of ten patients had good results.

Adult↗
PubMed1976

[A rare case of endocardial fibroelastosis in the left atrium simulating mitral stenosis (author's transl)].

A rare case of primary endocardial fibroelastosis, involving only the left atrium, simulating mitral stenosis is reported; the clinical and hemodynamic features which led to the diagnosis of mitral stenosis are described. The authors discuss the data upon which a differential diagnosis between the two similar diseases can be established. The suggest that isolated fibroelastosis of the left atrium could have been developed slowly because of ipoxia of the left atrium for agenesia of the circumflex coronary artery. An operation of endotelial decortication of the left atrium is described.

Child, Preschool↗
PubMed1976

[Development of heterografts stenosis in the aortic or mitral position. Apropos of 2 cases].

From a series of 10 patients undergoing surgery with a homograft, two cases are reported in which stenosis of the graft occurred, one in the mitral and the other in the aortic position. The macroscopical appearances of the lesions showed sclerosis and calcification. In the case where histological material was available, there were marked changes in the collagen and elastin, disseminated calcified deposits in the valve, and inflammatory cellular changes over the surface, with a tendency to penetrations into the substance of the valve. One of the factors leading to these graft disorders is the type of chemical treatment which the valve undergoes; a combination of glutaraldehyde solution and oxidation using sodium metaperiodate would appear to be unsuitable in this respect. Emphasis is laid on the very particular clinical features of these two cases (stenosis and valvular incompetence), and on the difficulties in diagnosis of this condition.

Adolescent↗
PubMed1976

Congenital malformations of the mitral valve in children. Pathology and surgical treatment.

A systematic study of congenital mitral valve malformations was undertaken on a surgical basis in an attempt to develop techniques of valvular reconstruction adapted to the various lesions. Forty-seven children between the ages of 4 months and 12 years (average 6 years, 4 months) have been operated upon between January, 1970, and March, 1976. Valvular lesions were classified into four group: Group I, mitral insufficiency owing to valvular lesions: Group II mitral insufficiency with subvalvular lesions; Group III, mitral insufficiency and stenosis; Group IV, stenosis. Associated lesions (ventricular or atrial septal defects, coarctation, or aortic valve stenosis) were present in 31 patients (65 per cent) and were corrected during the same operation. Valve reconsruction was possible in 38 patients whereas valve replacement was necessary in 9 patients. In the valve repair group there were three operative deaths (8 per cent), no late deaths, one reoperation for residual ventricular septal defect, and one myocardial infarction. In the valve replacement group of 9 patients, there were three operative deaths, three late deaths, and one case of repeated embolization. Thirty-one of 38 patients in the valve repair group were classified into Functional Class I after the operation (86 per cent), 2 were in Class II, and one in Class III. Minimal or moderate regurgitation and cardiomegaly persisted in the majority of the patients. Pulmonary artery pressure significantly decreased, however, as demonstrated by postoperative catheterization in 17 patients.

Child↗