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Biomedical subjects

A Carpentier

Publications and source records attributed to A Carpentier.

463 records · Page 26Linked to original sources
PubMedDate not supplied

From valvular xenograft to valvular bioprosthesis (1965-1977).

The development of a bioprosthesis was generated by recognition of its important potential advantages over a mechanical prosthesis. Considerations of choices of animal and tissue sources, preparation procedures, and patient applicability led researchers from the allograft to xenograft, and then to the valvular bioprosthesis. At the present time, glutaraldehyde-preserved xenograft valves appear to be a reasonable alternative in valvular replacement. Their limited durability must be weighed against the disadvantages of a mechanical prosthesis in deciding which to use.

Animals↗
PubMedDate not supplied

One stage correction of coarctation of the aorta associated with intracardiac defects in infancy.

A two stage surgical approach is usually prepared for symptomatic babies affected by coarctation of aorta associated with intracardiac defects, the preliminary operation being the resection of the coarctation. One stage correction has been attempted in six patients, ranging from 2 to 24 m. of age and from 3,2 to 9,7 Kg. of weight. The associated lesions were a large V.S.D. (3 patients), a V.S.D. with pulmonary stenosis, a mitral stenosis and a mitral insufficiency. The coarctation was approached through a left thoracotomy and the intracardiac defect through a midline sternotomy incision, after the patient was turned around. All patients survived and did well following the double procedure. The two-stage surgical approach is unnecessary and probably unadvisable for patients with coarctation of the aorta and associated intracardiac lesions.

Aortic Coarctation↗
PubMedDate not supplied

Traumatic rupture of the thoracic aorta with reference to 34 operated cases.

34 cases of traumatic rupture of the aortic isthmus have been operated on since 1963: 14 acute ruptures and 20 secondary false aneurysms. Diagnosis was confirmed by aortography. A special feature seen in cases of total transsection is described. Partial extracorporeal bypass was used in 29 cases and direct cross-clamping in 5 cases. Two techniques were used: direct end-to-end anastomosis in 9 patients and Dacron graft interposition in 25 cases. Primary end-to-end anastomosis more often was used in cases of early operation and partial rupture. Hospital mortality was 2 patients in the group of acute ruptures and 0 patient in chronic false aneurysm group. It was related to brain damage or sequelae of prolonged shock. Post-operative course was uneventful but 4 cases of respiratory failure and 4 cases of neurologic disturbances (2 brain dysfunctions and 2 spinal cord dysfunctions). These complications were transient and the patients recovered without sequelae. Clinical results have been recently appreciated in every long-term survivor (mean follow-up: 5 years) and are excellent. Angiographic controls undergone in 10 patients have shown no abnormalities.

Accidents, Traffic↗
PubMedDate not supplied

[Comparative vasoreactivity of the radial, internal mammary and gastroepiploic arteries. Implications in coronary surgery].

Recently, satisfactory results were obtained in a series of patients in whom the radial artery was used as a conduit for coronary artery bypass. However, spasm of this conduit was observed in four percent of patients. The aim of this study was to analyze the vasoreactive properties of the radial artery and to compare them to those of the internal mammary and the gastroepiploic arteries. Human radial (56 from n = 15 patients), internal mammary (77 from n = 20 patients) and gastroepiploic (41 from n = 12 patients) arteries ring segments were mounted on a strain gauge in oxygenated, normothermic, Krebs solution at optimal resting tension. With potassium chloride (100 mM) serving as the control, the dose response curves to norepinephrine, serotonin and thromboxane A2 mimetic were obtained, hence permitting to assess force of contraction and sensitivity. Functional endothelium was assessed by acetylcholine. Smooth muscle-dependent relaxation was assessed by sodium nitroprusside. The radial artery had stronger contractions to potassium chloride than the other vessels. The radial and the gastroepiploic arteries with endothelium presented a higher contraction force than the internal mammary artery in response to norepinephrine and serotonin. The gastroepiploic artery had a lower sensitivity to thromboxane A2 mimetic compared to the two other vessels. This increased reactivity of the radial artery explains its propensity to spasm and emphasizes the need for antispastic drugs and platelet inhibitors when the radial artery is used for coronary artery bypass.

Aged↗
PubMedDate not supplied

[Experimental model of pulmonary bipartition with bilateral lobe transplantation in dogs and application to clinical medicine].

The crucial need for donors of paediatric or small sized organs has been a great obstacle to overcome in organ transplantation in children or small adults. Some progress in adapting size of the donor organs has been achieved with surgical procedures for reducing the size of donor organs, partial transplantation (single lobe of the liver or the lung) and liver partition, offering a partial solution to the insufficient supply of paediatric organs. We propose an experimental model in the dog of lung partition associated with monolateral (series I) or bilateral (series II) lobe transplantation. The results have been encouraging both in terms of quality of healing and in morphological and functional adaptation of the transplanted lobes, allowing us to apply this technique of lung partition and bilateral lobe transplantation in human patients. The outcome has been excellent in the first case after 18 months follow-up.

Animals↗
PubMedDate not supplied

Surgery for aortic dissection: 53 operated cases with 32 in the acute phase.

53 cases of aortic dissections were operated on between 1961 and 1975 in the Service of Cardiovascular Surgery at the Broussais Hospital, Paris (Prof. Ch. Dubost). The present study deals with 32 cases operated on in the acute phase. 31 originated in the ascending aorta and 1 in the descending aorta. Operative mortality was 50% (16/32), 4 patients died immediately following sternotomy. Operation consisted in replacement of the ascending aorta for the majority of type I and II dissections. When aortic insufficiency was present, a simple resuspension procedure was effective in 50% of cases. The authors prefer early operative intervention in type I and II dissections and medical treatment in type III dissections.

Acute Disease↗