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Biomedical subjects

C Cabrol

Publications and source records attributed to C Cabrol.

At least 271 records · Page 15Linked to original sources
PubMed1979

[Conduction disorders after aortic valve replacement. Apropos of 200 cases].

The following points become apparent after the study of 200 cases of aortic valve replacement:--Conduction defects are very common after this type of surgery, affecting one in three patients in this series;--Above all, the frequency of conduction defects of the left bundle branch (2/3 cases) must be underlined. They are much more common than complete atrioventricular block, bifascicular block or isolated right bundle branch block;--Diagnosed immediately after operation in almost all cases, regression is common (50%) especially of left anterior hemiblock;--The long term prognosis is good. There was no long or short term mortality due to this cause in this series;--Apart from traumatic lesions which are difficult to avoid when the aortic orifice is calcified, ischaemia of the conduction pathways due to insufficient myocardial protection probably plays a role in the aetiology of these conduction defects.

Aortic Valve↗
PubMed1979

[Results of open heart mitral commissurotomy in 85 patients].

Open heart mitral commissurotomy was performed in 85 patients between January 1973 and January 1976. This series comprised 38 patients with pure mitral stenosis and 47 patients with associated mitral and aortic or tricuspid lesions. Mitral commissurotomy, always complete, was associated with correction of mitral incompetence, either preexisting or peroperative, in 19 cases; in 44 cases with correction of an aortic lesion and in 10 cases with correction of a tricuspid lesion. The surgical mortality was 2.3 p. 100 (2 deaths); one post-operative myocardial infarction and one spontaneously regressive post-operative jaudice was observed. No cases of post-operative systemic embolism was observed. A short apical systolic murmur was detected in 12 cases. The results of this series together with those already published suggest that the indications of this operation should be widened and that it should be employed whenever the best immediate anatomical result and long-term prognosis are desired.

Adolescent↗
PubMed1979

[Coronary endarterectomy associated with coronary artery bypass in severe coronary artery disease. 50 cases].

The surgical indications of coronary endarterectomy were defined from a study of 50 cases in which endarterectomy was associated with aorto-coronary bypass surgery. This total represented 6 p. 100 of all the aorto-coronary bypass operations performed in the same period. Coronary endarterectomy was performed "on principal" for the right coronary artery, and "of necessity" for the left anterior descending artery. The special techniques of endarterectomy on the left anterior descending artery are described. Endarterectomy does not increase the operative risk and enables revascularisation of vessels unsuitable for bypass surgery. 85 p. 100 patients are asymptomatic with an average follow up period of 2 years after endarterectomy and aorto-coronary bypass graft of the right coronary artery.

Adult↗
PubMed1979

[Risks and median-term results of aortic valve replacement for calcifying aortic stenosis in 100 patients more than 70 years old].

100 patients with poorly tolerated calcific aortic stenosis underwent aortic valve replacement by the same surgical team (Starr-Edwards prosthesis: 52 cases, Bjäork prosthesis: 43 cases, Lillehei-Kaster prosthesis: 2 cases, and Hancock bioprosthesis: 3 cases) between July 1971 and April 1978. The hospital mortality was 17% and acute pulmonary oedema and cardiomegaly were poor preoperative prognostic factors. The late mortality was 14.5% with an average follow-up period of 25 months (range: 2 to 74 months). The survival rate expressed as an actuarial graph was 63.1 +/- 4% at 4 years. 90% of the patients operated move up at least one class in the New York Heart Association classification and 2/3 return to Stage I. The cardiothoracic ratio improved from 0.58 +/- 0.06 to 0.51 +/- 0.03 (p less than 0.02) and the Soko low-Lyon index from 40 +/- 13 to 25 +/- 6 (p less than 0.001). The main complication encountered at middle term was haemorrhage, observed in 17.5% patients. Comparison of the spontaneous outcome of the disease with the results of surgery favour surgical treatment of patients over 70 years old with poorly tolerated calcific aortic stenosis. The valve of choice should be the bioprosthesis when dependance on anticoagulant therapy and the associated risks of haemorrhage are taken into consideration.

Aged↗
PubMed1979

[Coronary lesions due to aortic valve disease. II -- Results and indications of aortocoronary bypass surgery].

454 cases of aortic valve replacement were studied: 217 had no significant coronary artery disease, 197 had associated aorto-coronary bypass surgery and 40 coronary artery disease without revascularization surgery:-- The early mortality in the three groups was 5.5%, 21% and 12.5% respectively, the only statistically significant difference being between the first two groups. -- The coronary artery disease was signigicantly more severe in the group which underwent associated aorto-coronary bypass surgery. The early mortality was significantly raised in the group without bypass surgery in cases with severe coronary artery disease (28%) and in the group with bypass surgery with unsuitable coronary artery lesions (35.5%). On the other hand, the long term survival and functional capacity of patients who underwent associated bypass surgery approached that of the non-coronary patients. Combined aortic valve replacement and coronary bypass surgery should therefore be continued in selected cases.

Aortic Valve Insufficiency↗
PubMed1979

[Retrospective study of recent variations in patient recruitment for aorto-coronary bypass surgery and the prognostic significance of new therapeutic propositions].

Seventy four records of aorto-coronary bypass surgery have been examined. Three groups were made up, succeeding each other in time, characterised by changes in factors of gravity, therapeutic solutions and early clinical results. Five patients underwent peroperative haemodynamic assessment in order to attemps to define the role of nitroglycerine used during this period. The results obtained were such that it is reasonable to suspect the existence of potentialisation of therapeutic benefits under the influence of nitroglycerine for injection, in patients previously treated with beta-inhibitors.

Coronary Artery Bypass↗
PubMed1979

The surgical management of ventricular tachycardia.

A better understanding of the mechanisms of chronic ventricular arrhythmias has led to the development of new surgical techniques for their management with promising results. Simple ventriculotomy is particularly useful in idiopathic ventricular tachycardia (19 cases). Ventricular tachycardia complicating myocardial infarction may be a special indication for an encircling subendocardial ventriculotomy (12 cases).

Chronic Disease↗
PubMed1979

[Conduction abnormalities after single heart valve replacement (author's transl)].

A total of 300 patients were operated upon for heart valve disease by the same surgeon. The affected valve was the aortic in 200 cases and the mitral in the other 100 patients. The tricuspid valve, coronary arteries, and myocardium were not involved. This report attempts to define the frequency progression, prognosis, and significance of conduction abnormalities which appear during the course of this operation. In 35 cases, of which 16 were post-operative deaths, a histological examination of the conduction pathways was possible. The conclusions to be drawn from these observations are: Conduction abnormalities after single aortic or mitral valve replacement are frequent (1 out of 3 patients).

Aortic Valve↗
PubMed1979

[Dimensions of the aortic ring. Anatomic and surgical study of 2 series of patients].

Both surgical (236 aortic valve replacements) and anatomical (62 dissections) studies have defined the aortic annulus diameter. Measurements (23.5 mm for women; 26 mm for men) are more considerable than established values. Furthermore, surgical study allows the authors to compare these results to several variables, more especially corporeal surface and stature: the height's increase perhaps explains the large sizes discovered.

Aorta↗
PubMed1978

[Aneurysms of the ascending aorta; total replacement with reimplantation of the coronary arteries (author's transl)].

The replacement of the entire aorta and the aortic valve is the procedure of choice in aneurysms involving the aortic annulus. This method, which necessitate the reimplantation of the coronary arteries, is, however, sometimes difficult and carries a greater operative risk of bleeding problems. Our experience of 15 such cases lead us to propose some modifications (such the use of an independent coronary conduit and the atrial drainage of the peri prosthetic space) in order to make the operation simple and safer.

Aortic Aneurysm↗
PubMed1978

Encircling endocardial ventriculotomy: a new surgical treatment for life-threatening ventricular tachycardias resistant to medical treatment following myocardial infarction.

Ventricular tachycardias occurring after myocardial infarction (MI) and resistant to medical treatment were successfully treated in 5 patients by encircling endocardial ventriculotomy. All patients had a history of MI. The delay between MI and ventricular tachycardias ranged from 1 month to 8 years. A reentrant mechanism was demonstrated by laboratory studies. Under cardiopulmonary bypass, the left ventricle was entered through the thin fribrous scar. Encircling endocardial ventriculotomy was carried out from the inside of the ventricle, through the whole thickness of the normal myocardium, and along the border of the endocardial fibrosis, which delineated the area of diseased myocardium. The ventriculotomy was placed in the free wall or in the septum or in both of these locations. It was repaired and the left ventricle was closed. Drug therapy was discontinued after operation. No ventricular tachycardias recurred during a follow-up period of 6 to 24 months. The effectiveness of encircling endocardial ventriculotomy is explained by the exclusion of the entire diseased area, especially the border zone and the septum. This technique is useful in any location of MI.

Cardiopulmonary Bypass↗
PubMed1978

[Surgical treatment by valve replacement and aorto-coronary bypass in mitral valve insufficiency caused by chronic dysfunction of the posterior papillary muscle].

Nine patients with cardiac failure which was refractory to medical treatment, and which was caused by chronic malfunction of the posterior papillary muscle, as a result of a myocardial infarction, were studied by cardiac catheterisation and coronary arteriography. The mean pulmonary capillary pressure was 31+/-16 mm of mercury with a nu wave at 51+/-27 mm of mercury. The end diastolic volume was increased (141+/-68 ml/m2) and the ejection fraction lowered (0.40+/-0.13). The left ventricle had overall hypokinesia in 5 patients and akinesia of the inferior wall, representing 21+/-24% of the end diastolic perimeter, in 3 others. All these patients had significant lesions of two or three of the main coronary trunks. At operation lengthening of the posterior papillary muscle and/or the cordae was found. All patients had a replacement mitral valve of the Starr-Edwards type, associated with an aorto-coronary bypass of the anterior descending artery. The operative mortality was zero. At a mean follow-up period of 21 months, there had been no late death, and all the patients were improved.

Aged↗