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Biomedical subjects

C Dubost

Publications and source records attributed to C Dubost.

At least 109 records · Page 6Linked to original sources
PubMed1981

[Pre-operative detection of parathyroid adenomas with ultrasound echography (author's transl)].

Pre-operative ultrasound echography (USE) was performed in 24 patients with primary hyperparathyroidism. Surgical exploration showed 23 adenomas and was negative in 2 cases. USE gave 14 true positive, 3 false positive, 4 true negative and 6 false negative results. The specificity of the method was 79% and its sensitivity 93%. These figures are similar to those of recently published series. USE is a delicate but rewarding technique. In the hands of sonographists trained in cervical ultrasonography, it might eventually be used routinely to localize parathyroid tumours prior to surgery.

Adenoma↗
PubMed1981

[Coronary surgery combined with peripheral vascular surgery. Apropos of 10 cases].

Coronary artery surgery may be envisaged in the context of diffuse arterial disease, especially in association with lesions of the cerebral and lower limb axes. The object of this paper is to advance the concept of coronary surgery coupled with peripheral vascular surgery. Ten patients underwent double revascularisation (coronary and peripheral vessels) between 1977 and 1979. In Group I (5 patients) coronary surgery was coupled with simultaneous cerebral revascularisation (1 aorto-brachiocephalic bypass and 4 endarterectomies). Group II comprised 5 patients undergoing simultaneous coronary and aorto-bifemoral bypass surgery. No operative deaths or serious complications were observed in this short series. The practical conclusions are in favour of widening the indications for simultaneous coronary and cerebral revascularisation. However, the indications for coronary surgery coupled with lower limb revascularisation must be precise and, therefore, more limited.

Aged↗
PubMed1981

[Atrioventricular discordance. Results of a series of 34 operations].

From 1968 to 1980, 34 patients with atrioventricular discordance underwent intracardiac repair. Thirty three patients had a ventriculoarterial discordance (corrected transposition) and one patient had a double outlet right ventricle. The age at operation ranged from 12 months to 59 years (mean 19 years). The lesions were ventricular septal defect (26 cases), pulmonary stenosis (22 cases), atrioventricular valve anomalies (20 cases). Lesions were associated in 80% of the cases. Ventricular septal defect and pulmonary stenosis were combined in eleven patients. Seven patients had had palliative operations. Pulmonary stenosis was mostly of subvalvular type and treated with a conduit. A patient with double outlet right ventricle and pulmonary atresia had a conduit on the left pulmonary artery because the right one was non-functional. Ventricular septal defects were closed through the right A-V valve, and the stitches placed on the free edge of the defect. The tricuspid valve (systemic) was replaced in 10 cases. Hospital mortality was 38% but only 3 out of 14 (21,4%) patients operated upon since 1975 have died. Late mortality was 24% (5 patients) related to conduction problems in 3 patients. Three patients were reoperated with good results. Out of twelve patients with a long-term follow-up, eleven have a good functional result. 7 patients with preoperative A-V block and 3 patients with atrial fibrillation had pacemakers implanted. 16 patients had postoperative A-V block. The incidence of conduction problems is now reduced with the use of conduit for subvalvular pulmonary stenosis.

Adolescent↗
PubMed1981

New surgical approach to aortic dissection: flow reversal and thromboexclusion.

With the aim of decreasing the complications and mortality associated with the current techniques for aortic dissections, we have developed an operation which consists of bypassing the dissected aorta and creating flow reversal in the dissected segment. Seven patients with either acute (five) or chronic aortic dissections (two) were operated upon successfully, with no early or late deaths. Three transient postoperative complications were encountered: low cardiac output, hemiparesis, and renal insufficiency. Postoperative arteriography was performed in five patients and demonstrated exclusion of the dissected lesions by thrombosis following flow reversal in the descending aorta. Follow-up is available from 2 to 28 months (average 13 months), with no long-term complications.

Adult↗
PubMed1981

Surgical treatment of constrictive fibrous endocarditis.

Between 1971 and 1980, 20 patients with fibrous endocarditis were treated by resection of ventricular endocardium and replacement of the atrioventricular valve. There were 13 male and seven female patients whose ages ranged between 12 and 58 years. Thirteen were white and the remaining seven were black Africans. Nine presented a right-sided form, five a left-sided one, and six presented involvement of both ventricles. The role of hypereosinophilia is discussed in the etiology of the disease. The operation was performed according to the techniques we had developed in our first operative case-excision of the atrioventricular valve. Complete resection of the endocardium, and valvular replacement. There were three operative deaths. Complete atrioventricular dissociation was observed in seven of our patients. particularly in those with right-sided endocarditis. At late follow-up, we have not observed any case of recurrence of the disease. On the basis of our experience and the results previously published in the literature, we believe that endocardiectomy is the best current treatment of this disease.

Adolescent↗
PubMed1981

[Mitral incompetence as presenting feature of idiopathic left ventricular aneurysm (author's transl)].

A further case of the exceptionally rare condition of idiopathic left ventricular aneurysm is reported in which the lesion was detected in a most unusual manner. The patient, a young 22-year-old negro woman, had been admitted for investigation of a mitral incompetence. The true diagnosis was established by angiography, which demonstrated a large multilobular left ventricular aneurysm, also communicating with the left auricle, this being the cause of the mitral incompetence. Surgical correction of the lesion suppressed the mitral leak without touching the normal mitral apparatus.

Adult↗
PubMed1980

[Bridge grafting between the ascending and lower thoracic aorta using the right side approach (author's transl)].

We describe a method aimed at reconstituting the thoracic aorta by means of a graft located on the right side of the heart. The method is original in that the graft is entirely intra-thoracic and not thoraco-abdominal, as in previously reported similar operations, its advantages are demonstrated by reference to one case where it was used for the treatment of a relapsed congenital atresia of the aortic arch.

Adolescent↗
PubMed1980

[Secondary hyperparathyroidism: subtotal parathyroidectomy versus total parathyroidectomy with parathyroid autotransplantation (author's transl)].

Between 1967 and 1978, among more than 1 000 patients under haemodialysis, 66 who had severe secondary hyperparathyroidism, underwent parathyroidectomy (PTx). Subtotal PTx's were performed in 57 patients and total PTx's immediately followed by autotransplantation of parathyroid gland fragments in 9 patients. The patients operated upon by these two methods since 1976 were compared. Among the 10 patients who had undergone subtotal PTx recurrence of severe biological hyperparathyroidism was observed in four cases and permanent hypoparathyroidism in two cases. Among the 9 patients with total PTx and immediate autotransplantation only one was considered as suffering from recurrent hyperparathyroidism on account of increased plasma parathyroid hormone concentrations; none of the other patients in this group had hypoparathyroidism. On follow-up, the clinical and radiological findings were comparable in both groups. At the present moment, our choice of surgical method remains arbitrary. Total PTx with immediate autotransplantation is carried out in all cases of reexploration of the neck, in patients who do not comply with the proposed medical treatment and when surgery reveals grossly enlarged parathyroid glands. In all other cases we continue to perform subtotal PTx.

Humans↗
PubMed1980

[An unrecognised cause of hypercalcaemia: hypercalcaemia-hyocalcluria syndrome].

A 32-year-old man with insulin-dependent diabetes secondary to chronic calcifying pancreatitis of alcoholic origin in whom hypocalciuria (22 to 88 mg/24 hours) was discovered by chance, renal function being normal. Plasma phosphate levels were between 25 and 35 mg/l and the level of parathyroid hormone was at the upper limit of normal. Cervicotomy led to the discovery of three parathyroid glands which were removed. Their weight was increased and their histological appearance normal. The fourth parathyroid was not seen. Hypercalcaemia and hypocalciuria were found during the operation and persis 3 years after, with none of the usual causes being found. This patient has a certain number of characteristics reminiscent of familial hypercalcaemia-hypocalciuria syndrome: high plasma calcium levels associated with low calciuria despite normal renal function and a plasma parathyroid level normal in most cases. The physiopathology of this syndrome remains unknown. Its course is benign, without renal complications. Partial parathyroidectomy is ineffective.

Adult↗