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Biomedical subjects

A Deloche

Publications and source records attributed to A Deloche.

At least 109 records · Page 6Linked to original sources
PubMed1983

[Value of digital angiography via a vein in the diagnosis of an atheromatous aneurysm of the subrenal aorta ruptured into the inferior vena cava].

Fistulisation of an atheromatous aneurysm of the aorta into the inferior vena cava is a rare type of rupture. Emergency surgery is required following its diagnosis. A case of this type is reported where a diagnosis was obtained without delaying surgery using a new radiological technique: numerical angiography via a venous approach. By virtue of its simplicity, reliability and safety, this technique is of great value in the emergency investigation of rupture of an atheromatous aneurysm of the aorta.

Angiography↗
PubMed1981

Experimental myocardial infarction in the rat as a quantitative model for the study of anti-ischemic interventions.

The identification of metabolic and drug interventions able to reduce myocardial injury after coronary artery occlusion requires experimental models. The rat model of ischemic injury is technically simple, unexpensive, informative and accessible to quantitative studies. In this present study, 41 rats underwent temporary myocardial ischemia of variable duration using left coronary artery ligation. They were sacrificed at 48 hours, and the heart was immediately frozen in liquid nitrogen. Serial 8 micrometer sections of known intervals were tested for succinodehydrogenase (NBT stain). Gross sectional areas measured planimetrically were utilized to calculate total myocardial volume (Vmyocardium) and infarcted myocardial volume (Vinfarct) with the aid of a programmable calculator. The data showed a linear regression for Vinfarct/Vmyocardium according to the time of ischemia (p 0,001). We suggest to test the efficiency of metabolic and drug interventions on the regression curve of the necrotic tissue using a multiple linear analysis. Since ischemic changes evolve more rapidly in this model, the intervention under study should be set up at the time of coronary artery occlusion.

Animals↗
PubMed1981

[Coronary surgery combined with peripheral vascular surgery. Apropos of 10 cases].

Coronary artery surgery may be envisaged in the context of diffuse arterial disease, especially in association with lesions of the cerebral and lower limb axes. The object of this paper is to advance the concept of coronary surgery coupled with peripheral vascular surgery. Ten patients underwent double revascularisation (coronary and peripheral vessels) between 1977 and 1979. In Group I (5 patients) coronary surgery was coupled with simultaneous cerebral revascularisation (1 aorto-brachiocephalic bypass and 4 endarterectomies). Group II comprised 5 patients undergoing simultaneous coronary and aorto-bifemoral bypass surgery. No operative deaths or serious complications were observed in this short series. The practical conclusions are in favour of widening the indications for simultaneous coronary and cerebral revascularisation. However, the indications for coronary surgery coupled with lower limb revascularisation must be precise and, therefore, more limited.

Aged↗
PubMed1981

New surgical approach to aortic dissection: flow reversal and thromboexclusion.

With the aim of decreasing the complications and mortality associated with the current techniques for aortic dissections, we have developed an operation which consists of bypassing the dissected aorta and creating flow reversal in the dissected segment. Seven patients with either acute (five) or chronic aortic dissections (two) were operated upon successfully, with no early or late deaths. Three transient postoperative complications were encountered: low cardiac output, hemiparesis, and renal insufficiency. Postoperative arteriography was performed in five patients and demonstrated exclusion of the dissected lesions by thrombosis following flow reversal in the descending aorta. Follow-up is available from 2 to 28 months (average 13 months), with no long-term complications.

Adult↗
PubMed1981

Surgical treatment of constrictive fibrous endocarditis.

Between 1971 and 1980, 20 patients with fibrous endocarditis were treated by resection of ventricular endocardium and replacement of the atrioventricular valve. There were 13 male and seven female patients whose ages ranged between 12 and 58 years. Thirteen were white and the remaining seven were black Africans. Nine presented a right-sided form, five a left-sided one, and six presented involvement of both ventricles. The role of hypereosinophilia is discussed in the etiology of the disease. The operation was performed according to the techniques we had developed in our first operative case-excision of the atrioventricular valve. Complete resection of the endocardium, and valvular replacement. There were three operative deaths. Complete atrioventricular dissociation was observed in seven of our patients. particularly in those with right-sided endocarditis. At late follow-up, we have not observed any case of recurrence of the disease. On the basis of our experience and the results previously published in the literature, we believe that endocardiectomy is the best current treatment of this disease.

Adolescent↗
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↗