Biomedical subjects

C Acar

Publications and source records attributed to C Acar.

131 records · Page 8Linked to original sources

PubMedDate not supplied

Traumatic ventricular septal defects. Report of 3 cases with tricuspid valve rupture in 2 cases.

Traumatic ventricular septal defects (TVSD) are rare complications of cardiac trauma. This report describes 3 cases of TVSD secondary to penetrating trauma in 2 patients and to blunt trauma in one case. Echocardiography confirmed the diagnosis in all cases. Surgical correction was performed in the 3 cases. In 2 patients associated tricuspid trauma was present requiring tricuspid valve repair.

Adolescent↗

PubMedDate not supplied

[Circulatory assistance by aorto-ventricular shunt. A new implantation technique].

This technique is original in that it involves a single site (the ascending aorta) easily accessible to cannulation. Following lateral clamping of the ascending aorta, a bifurcate Dacron prosthesis is anastomosed. The draining cannula is introduced through one of the branches of the prosthesis and manually guided through the aortic sigmoid leaflets down to the left ventricular ejection outlet. The perfusion cannula is introduced through the outer branch of the prosthesis. The end of this cannula is positioned at the origin of the prosthesis to avoid a possible bend in the fork. This technique is a simple and effective means of providing left ventricular support.

Anastomosis, Surgical↗

PubMedDate not supplied

[Ascending aortic ectasia. New reinforcement technique].

Enlargement of the ascending aorta associated with dystrophic aortic incompetence frequently progresses to aneurysm and its complications. This potential course can be prevented by using a simple technique including insertion of a Mersuture net covering the entire ascending aorta, associated with local application of gelatin-resorcin-formalin glue.

Adhesives↗

PubMedDate not supplied

Cardiac assistance by atrial or ventricular cardiomyoplasty.

Dynamic cardiomyoplasty was conceived to enhance cardiac performance by assisting myocardial contraction. Technically, this procedure consists of placing a pedicled latissimus dorsi muscle flap around the heart and subsequent muscle electrostimulation in synchrony with ventricular systole. Three types of dynamic cardiomyoplasty can be considered. (1) Atrial or ventricular reinforcement is accomplished by wrapping the latissimus dorsi muscle flap around the heart to support hypokinetic or akinetic areas secondary to congenital or acquired diseases. The atrial reinforcement may be performed to improve atrial output after Fontan-type procedures. (2) Ventricular substitution is performed to replace a portion of the ventricular wall. Autologous pericardium is used to create a neoendocardium and facilitate hemostatic closure of the ventricle. The pedicled latissimus dorsi is then secured to replace the resected myocardium. (3) The two previous techniques of ventricular substitution and reinforcement are combined. This reconstructive procedure, which normalizes the ventricular geometrical shape, is particularly useful after extended cardiac resections, such as is done in treatment of large ventricular aneurysms, cardiac tumors, or echinococcal cyst formations. At present, improvement in ventricular function has been obtained in 12 patients at our institution. Preoperative severe cardiac dysfunction was present in all of these patients (New York Heart Association functional class III or IV). Postoperative echocardiography, multigated acquisition scan, and hemodynamic studies demonstrate an improvement in ventricular function and no impairment of ventricular compliance by the muscle flap. After a mean follow-up period of 18 months, all patients are in functional class I or II. We believe that dynamic cardiomyoplasty prolongs and improves the quality of life of patients suffering from severe chronic and irreversible myocardial dysfunction by improving ventricular contraction and limiting cardiac dilatation.

Assisted Circulation↗

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↗