Search PubMed⌕ Search

Biomedical subjects

A Vacheron

Publications and source records attributed to A Vacheron.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Doppler echocardiographic evaluation of aortic valve prosthesis. Analysis of the reproducibility of pressure gradients and surface measurements].

Doppler echocardiography has become the method of choice for the evaluation of cardiac valve prostheses. In order to determine the reproducibility of the measurements of pressure gradient and valve surface area, 55 patients with aortic valve prostheses without clinical dysfunction and having at most a trivial regurgitation on color Doppler examination underwent a double evaluation during an average interval of 9 +/- 5 months. The maximum and mean pressure gradients were recorded and the valve surface area calculated using the continuity equation in all cases. The subaortic diameter was taken to be constant and equal to the external diameter of the prosthesis. No significant differences were found between the two evaluations of mean pressure gradient and valve surface area. The intra-patient variability was +/- 8 mmHg for the maximum pressure gradient, +/- 6 mmHg for the mean pressure gradient, +/- 0.33 cm2 for valve surface area calculated using the maximum velocities and +/- 0.44 cm2 when the velocity-time integrals were used. When expressed as a percentage, the mean coefficient of variation was 21 +/- 17% for the maximum pressure gradient, 21 +/- 18% for the mean pressure gradients, 21 +/- 15% for the valve surface area calculated using the maximum velocities and 22 +/- 14% when the ratio of velocity-time integrals was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[The "health booklet for hypertensive patients"].

Improving compliance with printed information in hypertensive patients has already been proved possible by previous studies. The "Hypertensive Patient Booklet" was devised in co-operation between Hoechst Laboratories and the French Cardiology Federation. This booklet is composed of simple and attractive information followed by charts for clinical and laboratory follow-up. The "Hypertensive Patient Booklet" is meant to strengthen the relationship between doctor and patient and to improve compliance which is low in about 50 p. 100 of patients with arterial hypertension.

Audiovisual Aids↗
PubMed1990

[Initial and mid-term results of coronary angioplasty in early post-infarction unstable angina].

The aim of this study was to assess the immediate efficacy and the medium-term risks and results of percutaneous transluminal coronary angioplasty (PTCA) in early post-infarction unstable angina. Thirty-six patients were included for a series of 248 consecutive PTCA procedures performed between December 1985 and January 1989. The average age was 56 years (range 35 to 84 years). The initial infarct was anterior (N = 16), inferior (N = 15), lateral (N = 5), without a Q wave (N = 22), transmural (N = 14) and treated by thrombolysis in 42 p. 100 of cases. The interval between initial infarction and PTCA was 16 +/- 3 days. A primary success was obtained in 33 cases (92%). One patient died of electromechanical dissociation at the beginning of the procedure. Two infarcts occurred due to acute coronary occlusions. None of the patients required emergency coronary bypass surgery. The specific risk of PTCA in early post-infarction unstable angina is acute coronary occlusion. This complication was observed in 9 patients (25%) and it required immediate repeat PTCA, associated with thrombolytic therapy in four cases. Coronary occlusion was more common in patients with transmural infarcts than in those without Q-waves (43% vs 14%; p less than 0.01) and in patients treated initially by thrombolysis compared with those not treated by thrombolysis (40% vs 15%; p less than 0.05). No fatalities or reinfarctions occurred during follow-up (average 9 +/- 8 months, range 2 to 35 months). A good clinical result was maintained in 71 per cent of patients treated by PTCA alone. Seven repeat PTCA procedures and 3 coronary bypass operations were performed during follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Is the prognosis of non-thrombolysed inferior infarction benign?].

Between 1978 and 1983, 2,970 coronary angiographies were performed at the Cardiology Clinic of Necker Hospital; 220 survivors of an initial Q-wave inferior infarction who had not received thrombolytic therapy were selected. The ejection fraction was 55 +/- 11 per cent, and the indexed end diastolic left ventricular volume was 108 +/- 29 ml/m2. The left anterior descending artery was diseased in 57 per cent of cases. The incidence of multivessel disease was 67 per cent. Two hundred and eleven patients (96%) were followed up for 79 +/- 22 months. The prevalence of cardiovascular events was: cardiac deaths: 22 (10%), recurrent infarction: 20 (9%), angina requiring coronary bypass surgery: 60 (28%), cardiac failure: 22 (10%). The 10 year actuarial survival was significantly lower in patients with an ejection fraction less than 45 per cent (46% vs 91%) and in patients with triple vessel disease (62% vs 92% and 88%). The survival was not lower in patients with stenosis of the left anterior descending artery.

Actuarial Analysis↗
PubMed1990

[Restenosis after transluminal coronary angioplasty. Clinical and therapeutic aspects].

To assess the incidence and clinical presentation of restenosis after successful coronary angioplasty, and the short- and mid-term results of its treatment, 160 patients, who underwent a first coronary angioplasty between May 1987 and December 1988, were closely monitored. Restenosis is defined as a loss of 50% or more of the initial gain in area and/or 30% or more in diameter, or chronic coronary occlusion. These criteria were met in 43 patients (27%) within 5.1 months (1-6 months), on the average, after angioplasty. Restenosis was expressed as unstable angina in 51% of the patients, stable angina in 30%, and abnormal thallium myocardial scintigraphy under exercise in 14%. Myocardial infarction was never the revealing symptom. In 63% of the cases, the pain caused by restenosis repeated the initial angina. A second angioplasty was performed in 75% of the patients with a success rate of 93%, in the absence of an occlusion, and a 37% rate of further restenosis.

Angina Pectoris↗
PubMed1990

[Late occlusive thrombosis of mitral prosthesis with sinus rhythm. Report of two surgically treated patients].

Two cases are reported of late occlusive thrombosis of a mitral bioprosthesis with sinus rhythm. Two men were concerned (40 and 54 years of age), hospitalized for acute pulmonary oedema which was resistant to medical treatment, 3 years after replacement of a mitral valve (Carpentier Edwards No. 31 and Liotta No. 25). Catheterization showed that in both cases there was an average transmitral holodiastolic gradient greater than 25 mmHg. Emergency surgery revealed two anatomical forms of occlusive thrombosis: in one case, a localized red thrombus hindered the opening of a valve cusp; in the other, exuberant fibrin deposits lined the ventricular face of the valve cusps. There were no signs of degeneration of the bioprostheses and, in particular, there was no calcification. Both patients were asymptomatic 1.5 years and 3 years respectively after their operations. Late occlusive thromboses of mitral bioprostheses are exceptional (13 detailed cases collected from the literature).

Adult↗
PubMed1990

[Auricular flutter disclosing cardiac tumor].

It is unusual that an atrial flutter reveals a tumor of the atrium. Two cases are reported: one occurred in a patient with a myxoma of the left atrium, the other was found in a patient with a non-hodgkinian lymphoma of the right atrium. The diagnosis was made possible by sonocardiography in both cases. The transesophageal view improves the quality of the images. MRI provided further informations regarding the lymphoma. Modern techniques of cardiac imaging permit the early diagnosis and treatment of cardiac tumors which must be investigated in case of apparently isolated atrial arrhythmias.

Atrial Flutter↗
PubMed1990

[The hospital course of thrombolyzed myocardial infarction: role of bypass and angioplasty].

The frequency of indications for revascularization (bypass and angioplasty) after intravenous thrombolysis in myocardial infarction (MI) varies from 3.3% (Gissi) to 60% (Tami). Initial progress in 30 patients hospitalized consecutively for MI treated by thrombolysis (group A) was compared with that of 30 MI patients treated conventionally (group B) over the same period. There were no between group differences in age, sex, infarction history, bypass history, topography of infarction or extent of coronary lesions. Group A was characterized by a larger ejection fraction (51.7 +/- 9.2% vs 44.9 +/- 10%; p less than 0.05), a higher frequency of ischemic recidivism (33% vs 10%; p less than 0.05), and more frequent indications for secondary revascularization (50% vs 20%; p less than 0.02).

Adult↗
PubMed1990

[Cardiovascular disease prevention. Strategy of the French Federation of Cardiology].

In French, the main cause of morbidity and mortality is cardiovascular disease (37% of all deaths). Atherosclerosis affecting the coronary arteries, responsible for ever 100,000 cases of myocardial infarction a year, is the principal cause. High blood cholesterol, hypertension, cigarette smoking and diabetes are known causative factors. They must be detected and treated early, as soon as 20 years if possible and even earlier in high risk families. The results of clinical trials have demonstrated the beneficial effects of lowering blood cholesterol on the prevention of cardiovascular disease. The French Federation of Cardiology has started a campaign to educate the general population, the medical establishment and the public authorities. Its theme is 1989 was the value of detecting abnormalities of lipid metabolism and the notion of a moderate daily lipid diet (not more than 30% of total calorie intake with an equilibrium between saturated, polyunsaturated and monounsaturated fats). This campaign forms the basis of an essential policy of cardiovascular disease prevention which in the long term should be beneficial to the while population and contribute to the reduction of the costs of health care.

Aged↗
PubMed1989

[Kingella denitrificans endocarditis on an aortic valve prosthesis].

Kingella denitrificans is a Gram-negative bacillus which does not grow readily on the usual media. This organism, normally a commensal of the upper airways, may exceptionally be responsible for endocarditis. We report here the sixth case known in the literature. Cure was obtained with an intravenous combination of vancomycin and rifampicin.

Aortic Valve↗
PubMed1989

Spontaneous calcific cerebral embolus from a calcific aortic stenosis in a middle cerebral artery infarct.

Calcific emboli from a calcific aortic stenosis is an uncommon event, usually following local trauma, as from cardiac surgery or left heart catheterization or as a sequel to bacterial endocarditis. We report what we believe to be the first case of a spontaneous calcareous emboli demonstrated by cranial computed tomography. In this patient, systemic hypertension and mild aortic insufficiency may have caused increasing mechanical forces acting on the aortic cusps and may have precipitated embolism.

Aged↗
PubMed1989

[Holter monitoring and silent myocardial ischemia].

Angina is not a very sensitive indicator of myocardial ischaemia. In patients with coronary disease 75 percent of ischaemic episodes are asymptomatic. Holter monitoring enables such silent episodes to be detected in daily life, this method becoming more sensitive when pursued for several days. The procedure is facilitated by a new generation of Holter recorders fitted with microprocessors that digitalize electrocardiograms. Silent episodes occur in the same circumstances as painful episodes, with a peak of incidence between 6 a.m. and noon, but they are often somewhat shorter. In patients with stable angina, as in those with unstable angina and after infarction, silent ischaemia is of poor prognosis. Holter monitoring therefore is useful in patients with known coronary disease to identify subjects at risk and to evaluate the effectiveness of anti-ischaemic treatments.

Coronary Disease↗
PubMed1989

[Coronary bypass after thrombolysis].

Owing to the development of transluminal angioplasty, coronary bypass surgery has now well-defined indications in patients who underwent thrombolysis. It may need to be performed in an emergency, but fortunately this only occurs in a few cases: in case of occlusion of the left main coronary vessel or equivalent lesions, when thrombolysis has failed and in case of failure of angioplasty with obliteration of large vessel and a still viable myocardium, and when the patient continues to suffer or shows signs of heart failure. The operative risk and the risk of haemorrhage then reach 10 p. 100. The installation, prior to surgery, of an intra-aortic counterpulsation system is useful in case of shock or left ventricular failure. Delayed coronary bypass is indicated mainly in case of three-vessel lesions with a less than 40 p. 100 ejection fraction, in case of stenosis of the left main coronary vessel or equivalent lesions, and in patients whose lesions are not amenable to angioplasty on a good caliber vessel, with a still viable myocardium. The operative risk in such cases is distinctly lower (2.4 p. 100). The long-term results obtained confirm the value of coronary bypass surgery when it becomes necessary after thrombolysis.

Coronary Artery Bypass↗
PubMed1989

[Drug-induced cardiovascular complications].

Many drugs, including those prescribed in cardiology, can induce adverse cardiovascular side effects. Most of the anti-arrhythmia drugs have a negative inotropic action and proarrhythmic effects. Estroprogestative contraceptive drugs favor thromboembolitic events and increase the incidence of hypertension. Due to the risk of coronary insufficiency, substitutive hormonotherapy in hypothyroidism must be introduced gradually. Tricyclic anti-depressive drugs and neuroleptics can induce orthostatic hypotension. However, all these adverse effects can usually be avoided if every drug-specific contra-indication is respected, if doses are individually adjusted to the patient's age and physical condition and if the patient is closely monitored.

Anti-Arrhythmia Agents↗
PubMed1989

[10-year outcome of aortocoronary bypass. Apropos of a consecutive series of 114 patients].

The cases of 114 consecutive patients undergoing saphenous vein coronary bypass surgery over 10 years ago were reviewed. The perioperative mortality was 2.6% and the incidence of non-fatal myocardial infarction in the same period was 6.1%. The 10 year survival rate was 80%; the most important prognostic factor for survival was left ventricular function (89% vs 51%; p less than 0.001). Other significant prognostic factors were the degree of revascularization (p less than 0.05) and the severity of the coronary artery disease (p less than 0.05). The incidence of recurrent ischaemia during follow-up depended mainly on the quality of myocardial revascularisation (p = 0.003). Taking into account the high proportion of patients with single vessel disease in this series (38.6%), our results were comparable with other reported studies of the same subject and the same period (1970-1976).

Adult↗
PubMed1989

[Value of vasodilator treatment in beginning cardiac insufficiency].

Two cooperative studies, from the Veterans Administration in 1986 and the Consensus Study in 1987 clearly assessed the beneficial prognostic effect of vasodilator therapy in congestive heart failure. Nevertheless, the results obtained are still limited, and the mortality rate remains at about 36% at 1 year under enalapril therapy. Experimental, hemodynamic and clinical data have proved the value of early vasodilator administration, especially of an angiotensin-converting enzyme inhibitor in congestive heart failure of new onset or asymptomatic. Inhibition of the renin-angiotensin-aldosterone system and decrease in catecholamines improve left ventricular function and increase survival.

Heart Failure↗