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Biomedical subjects

A Goudard

Publications and source records attributed to A Goudard.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Treatment of recent traumatic ruptures of aortic isthmus (author's transl)].

We recommand the following procedure: --positionment of the patient allowing the simultaneous approach of left pleural cavity and left femoral vessels. --aortic liberation far away of the isthm, in a diffuse hematoma. --medullar protection by femoro-femoral extra corporeal circulation. --recovery of aortic continuity either by direct suture or by interposition of an prosthetic tube, the sutures being largely supported by mediastinal cellular tissue. We have used this technique in 5 patients, with a good result in all cases.

Aorta, Thoracic↗
PubMed1979

[Reintervention on heart valve prostheses. Apropos of 78 cases].

78 patients with one or more prosthetic heart valves were reoperated on between 1972 and 1978, and comprised 12% of the work load of valvular surgery. There were two postoperative periods in which the incidence of reoperation was high: the first year, 38%, and the period between the 5th and the 8th year, 41%. The main causes of reoperation could be divided into two groups: those common to all valves with paravalvular leaks (25%), endocarditis (12%) being the principal causes, and those associated with particular valves: deterioration of Beall prosthesis 33%, and thrombosis mainly affecting the Bjork and Beall prostheses (25%). The operative mortality was 12%. The fact that urgent operation is required in severe cases is underlined. In the light of these results, the surgical indications of reoperation should be discussed at an earlier stage. These indications are based essentially on the clinical condition of the patient and objective confirmation by further investigation should not delay the operation, which, in our experience, has never been unnecessary.

Adolescent↗
PubMed1978

[Stenosis of the thoraco-abdominal aorta by endovascular calcification, with hypertension. Surgical treatment (author's transl)].

A case of a 24 year-old man in whom, following acute pulmonary oedema complicating hypertension known for a period of three years, stenosis of the thoraco-abdominal aorta produced by a large calcification within a zone of the aorta with an inflammatory appearance was demonstrated. This case is included within the context of the aortic syndrome. Operation led to normalisation of blood pressure immediately afterwords, but there was moderate hypertension 56 months later.

Adult↗
PubMed1977

[The mitral apparatus and surgery of sub-valvular aortic stenosis].

The authors present three eases of subvalvular aortic stenosis caused by an abnormality of the mitral valve mechanism which required placement of a prosthetic valve. They describe the types of mitral valve abnormality which are reported in the literature to have caused obstruction to the aortic outflow tract. They analyse the criteria for diagnosis of this condition, and the surgical treatment. The placement of a prosthetic mitral valve does not always remove the obstruction to the aortic outflow, especially if there is an abnormality in the position of the mitral ring.

Adolescent↗
PubMed1976

[Shivering during recovery after cardiac surgery under extracorporeal circulation. Inconveniences and methods of prevention].

Among 109 subjects who had undergone cardiac surgery under ECC, the authors recorded 50 (45 p. 100) who suffered from shivering during the coming round period. Comparing the series of patients who shivered, with that of the subjects who did not shiver, the authors demonstrate in the first case, an increase in cellular metabolism, the cardiac index, heart rate, central venous pressure and cardiac work. They subsequently note the apprearance of mixed acidosis and an increase in the lactate-pyruvate ratio. Certain patients, in whom the cardiac output did not keep up with the metabolic demand considerably increased the arterio-venous oxygen difference. Blood loss is increased as well as coagulation time showing a more intense heparin rebound. The study of the drugs used during anesthesia showed that the patients who had received chlorprotixene, as the neuroleptic, a neuroleptic with adrenolytic properties, had a very decreased frequency of shivering in comparison with those who had received droperidol. The placing of the patient at the end of the intervention on a heating mattress, combined with the administration of chlorprotixene during anesthesia, prevented the appearance of shivering.

Adult↗
PubMed1975

[2 cases of respiratory assistance with a membrane oxygenator].

The authors report two cases of artificial ventilation with the assistance of a membrane oxygenator that was used, on the one hand, in the case of a 'malignant pneumopathy' and, on the other hand, in the case of a cardio-respiratory failure after a complete mending of a tetralogy of Fallot. Recovery was obtained in the second case. They specify the method and the watching of anti-coagulation. They insist upon the merit of a re-injection of oxygenated blood into the ascending aorta. They recall the necessity to lay down instructions according to very strict criteria, by taking into account the degree and the visceral repercussions of hypoxia and the reversibility of lung lesions in so far as it is a matter of a very heavy palliative therapy upon whose efficiency it is difficult to pass a judgment.

Adult↗
PubMed1975

[Human cardiac transplantation. Apropos of a case followed for more than 6 years].

A cardiac transplantation was performed on November 28, 1968. This was the only one undertaken at Marseilles. After a survival period, now exceeding 6 years, the patient has had an almost normal activity. The course of this patient, the follow-up elements, the incidents and complications during this period were analysed. It was insisted upon the interest of following up the coagulation tests for the preclinical detection of rejection or menacing rejection. Practically uninterrupted heparin treatment during the 6 years might have been an element for this prolonged survival.

Adrenal Cortex Hormones↗
PubMed1975

[Early repair of congenital cardiopathies under extracorporeal circulation. Apropos of 158 surgical cases under the age of 5].

A great number of congenital heart diseases are now amenable to treatment before school age. A homogeneous experience of 158 cases operated upon made it possible to make the follow remarks:--The operative mortality before the age of 1 year remains high, in view of the difficulties of ressuscitation, but mainly because of the severity of the heart disease to treat. --Between the ages of 1 and 5 years, the risk decreased with experience, and for the heart diseases most frequently encountered, lethality fell to 2.8% for the last 4 years. One may thus accept to perform, not only necessity operations, but principle operations before school age. The schematic indications in relation with each heart disease were analysed.

Cardiac Surgical Procedures↗