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Biomedical subjects

C Cabrol

Publications and source records attributed to C Cabrol.

At least 163 records · Page 9Linked to original sources

[Pericardial hemolymphangioma. Apropos of a case].

A case of pericardial hemolymphangioma revealed by palpitations is reported. X-ray films of the chest provided a diagnosis of mediastinal tumour. Full evaluation was performed using echocardiography, computerized tomography of the mediastinum, coronary arteriography and cardiac ventriculography. The tumour could be removed in toto. Pericardial hemolymphangioma is a rare benign vascular tumour. It is often discovered accidentally during examinations for non-suggestive cardiac functional disorders. The threat of compression or invasion of adjacent structures and that of hemopericardium by bleeding make surgical excision mandatory.

Adult↗

[Heart-lung transplantation].

In this study the transplantation group of La Pitié Hospital, Paris, review heart-lung transplantation on the basis of data from the literature and of their own experience. Successively, the history, indications, pre-operative evaluation, donor selection, operative procedure with its immediate, mid-term and late complications, as well as treatment and post-operative follow-up are described.

Heart Transplantation↗

[Tight mitral stenosis caused by calcifications of the ring extending to the valves].

Three years after valve replacement for Monckeberg type aortic stenosis, a tight and poorly tolerated tight mitral stenosis is observed, secondary to massive calcifications of the ring extending to the valves. The diagnosis is made with Doppler sonography and hemodynamic examination. Excision of the calcifications is particularly difficult. An early death occurs. Calcifications of the mitral ring extending to the valves, either isolated or mainly associated with a calcified aortic stenosis, may be complicated by mitral stenosis. The latter, usually moderate, may be tight and require surgical treatment, of severe prognosis.

Calcinosis↗

[HLA A-B and DR in dilated myocardiopathies].

HLA A, B typing was performed in 90 patients (90 men, 10 women), and HLA DR typing in 49 patients with dilated cardiomyopathy in order to test the hypothesis that a particular genetic background may influence the immune response in that disease. No significant difference in phenotype frequency of the HLA A and B antigens was observed between patients and control population. In contrast, the HLA DR4 antigen was significantly more frequent among patients (40.8% vs 23.8%, p corrected less than 0.001). The results suggest that genetic factors play a role in the pathogenesis of dilated cardiomyopathy, and that since DR4 is frequently associated with auto-immune manifestations, a modified immune response is possible in dilated cardiomyopathy.

Adolescent↗

[The low-profile Liotta valve. Mid-term results].

We report the mid-term results obtained with 279 "low profile" Liotta xenografts implanted at the Hôpital de la Pitié, Paris, in 257 patients between February, 1981 and November, 1984. There were 86 aortic, 138 mitral, 11 triscupid and 22 mitral-aortic valve replacements. The wavy suture ring of the prosthesis makes it "low profile". The Liotta valve is of particular interest in certain anatomical situations such as aortic annulus more dilated than the supra-coronary aorta, or small right and left ventricular cavities. The overall operative mortality rate was 8.6%. The 236 survivors were followed up for 3 to 48 months, a total of 374.3 patients-years. The overall actuarial survival rate at 3 years is 92.2%. Although there were few thromboembolic accidents, about one-third of the patients remain under anticoagulant therapy (0.86 episodes for 100 patients-years). Globally, 98.1% of the patients are free of any thromboembolic accident. Deterioration occurred 29 and 44 months respectively after implantation in two patients aged 9 and 20 years (0.57 episodes for 100 patients-years). Three cases of endocarditis on prosthesis were observed. Altogether, almost 91.2% of the patients have had no complication for 3 years, and indeed they functionally improved, most of them now being in class I or II (aortic valve 97%, mitral valve 87.2%). Thirty-eight patients underwent repeated catheterization at rest and during exercise. Mean transvalvular gradient was 12.4 mmHg in aortic valve patients and 5.9 mmHg in mitral valve patients. Mean functional valve area was 1.6 cm in aortic valve patients and 2.1 cm in mitral valve patients, and it clearly increased during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Current problems in cardiac transplantation.

In conclusion, after almost 20 years of clinical application and due to much progress during that time by the pioneers of the method, cardiac transplantation is now a safe and reliable treatment for patients in intractable cardiac failure untreatable by other medical or surgical means. Several challenging problems remain to be resolved by the many active and excellent centers now engaged in this promising field.

Heart Transplantation↗

Renal response to volume expansion in heart-transplant and kidney-transplant recipients.

The renal excretion of an intravenous sodium load by ten heart-transplant recipients with (five patients) or without (five patients) moderate renal failure was compared with the results obtained in two matched control groups of ten kidney-transplant recipients with similar renal function. All patients were treated with prednisone and cyclosporine except, for the latter treatment, the kidney-transplant recipients without renal failure. A supplementary control group of five healthy subjects who did not receive any treatment was also included in the study. Fractional sodium and osmolal clearances were greater in heart-transplant than in kidney-transplant recipients for both the patients with and the patients without renal failure. These two parameters were also greater in heart-transplant recipients without renal failure than in healthy subjects. Free water clearance was smaller in the heart-transplant recipients than in the corresponding control patients. Fractional potassium clearance was not different from group to group. These results demonstrate that heart-transplant recipients excrete a greater fraction of the filtered sodium load than their controls. This increased fractional excretion of sodium cannot be attributed to the cyclosporine treatment or the moderate chronic renal failure which both have been taken into account in the comparisons. The unchanged blood pressure during the saline load and the high or normal plasma renin activity levels in the heart-transplant recipients make it also unlikely that the exaggerated natriuresis was the consequence of the higher blood pressure observed in these patients. The chronic cardiac denervation which is the consequence of surgery in these patients could play a role in the mechanism of the saline diuresis.

Adult↗

[Cardiac transplantation. Selection of patients and long-term results].

Performed for the first time in the world, in December 1967, by Barnard in Capetown, and for the first time in Europe by our team in April 1968, cardiac transplantation has now 20 years of clinical applications. A best selection of the recipients, a more precise selection of donors, refinements in surgical technique, a better and earlier diagnosis of post-operative complications, more effective therapeutic means especially cyclosporin, have brought us, from 1981, such major improvements that many teams were prompted to resume the procedure. In our experience of more than 400 transplants at La Pitié Hospital, a five-year follow-up shows that 70 p. cent of the patients are alive, having resumed a normal familial, social, professional and often sporting life. Much progress remains to be achieved, but this procedure now seems to be quite common if not routine, only limited by the insufficient number of donors.

Adult↗