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Biomedical subjects

C Dupuis

Publications and source records attributed to C Dupuis.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Obstructions to pulmonary ejection and restrictive interventricular septal defects].

The association of a restrictive ventricular septal defect with a pulmonary tract obstruction is rare and may cause diagnostic and therapeutic problems. The authors report their experience of such an association in 10 children. 3 had a tetralogy of Fallot (1 death), 4 a double-outlet right ventricle (2 deaths), and 3 a coarctation of the aorta with ventricular septal defect and pulmonary artery banding (no death). Prognosis depends on the type of malformation. It has improved with years because of sooner recognition of these malformations and better surgical technics and post-operative care.

Adolescent↗
PubMed1988

[Prognosis of Wolff-Parkinson-White syndrome in infants. Apropos of 31 cases].

The fate of 31 children (18 boys, 13 girls) whose Wolff-Parkinson-White syndrome (WPW) had been diagnosed before they were 2 years' old (mean 3.4 months) was investigated. The circumstances in which WPW was discovered were: evaluation of a heart disease in 9 cases, attack of orthodromic tachycardia in 16 cases (including one with cardiopathy), and routine electrocardiography in 6 cases. Type A WPW was the most frequent, being found in 20 patients of whom only 3 had a heart disease; type B WPW was present in 11 patients, and 7 of these had a heart disease. Mean follow-up was 5.9 years; 3 children died of other causes than WPW. In patients followed up for more than one year WPW disappeared in 65 p. 100 of the cases (11/17) in the absence of cardiopathy, and in only 14 p. 100 of the cases (1/7) in the presence of cardiopathy. In children who had suffered attacks of tachycardia WPW disappeared in 64 p. 100 of the cases (9/14). When WPW disappeared it was before the age of 1 year in 8 out of 12 cases. Only one child whose WPW had disappeared had further attacks of tachycardia (11 p. 100), while 3 children whose WPW persisted had short and widely spaced attacks (60 p. 100). This study confirms the high rate of spontaneous disappearance of WPW and the excellent prognosis of this syndrome in the absence of heart disease.

Electrocardiography↗
PubMed1987

Subclavian artery aneurysm secondary to a cervical supernumerary rib in a child.

A case of subclavian artery aneurysm secondary to a cervical supernumerary rib is reported in a 9-year-old boy. Such a complication in a cervical rib has never been reported in so young a child. The risk of inserting inextensible prosthetic material in a growing child led to regular supervision instead of an early surgical cure.

Aneurysm↗
PubMed1987

[Interauricular communication with severe pulmonary hypertension in children. Apropos of 9 cases].

The authors report 9 cases of atrial septal defect with sever pulmonary hypertension in 7 girls and 2 boys under 10 years of age. These cases represent 3.5% of the 255 cases of atrial septal defect in this age group seen at the Hopital Cardiologique of Lille between 1970 and 1985. Group I comprised 3 children with obstructive pulmonary hypertension from the start; two died, one is still alive after 3 years. Group II was composed of 3 children who presented, at first haemodynamic evaluation, with severe but non-obstructive pulmonary hypertension; the hypertension rapidly became obstructive in 2 of them despite digitalis-diuretic therapy; the third child died after surgical correction. The 3 children in group III had normal or slightly raised pulmonary arterial pressure at first haemodynamic evaluation; one of them initially had a right ventricle-pulmonary artery functional gradient of 45 mmHg, which did not prevent the subsequent development of obstructive pulmonary hypertension; the other 2 patients were operated upon 10 months and 4 years later respectively, as they presented with severe pulmonary hypertension; one of these 2 children died postoperatively, the third one developed obstructive pulmonary hypertension. Contrary to what is generally believed, severe pulmonary hypertension is not exceptional in children with atrial septal defect, and it has a poor prognosis. The mechanism underlying the development of this pulmonary hypertension is unclear, but individual susceptibility to excessive blood flow is probable, as is the role played by bronchopulmonary infections frequently noted in these patients' history.

Child↗
PubMed1987

[Anomalous origin of the left coronary artery. The form in infants].

Twenty-four cases of anomalous origin of the left coronary artery from the pulmonary artery are reported. These cases were collected over 27 years divided into three 9-year periods according to the years of the initial studies. The clinical aspects and diagnostic investigations (notably echocardiography, myocardial radioisotope imaging and various angiographic procedures) are reviewed; aortography seems to be, even now, the best exploratory method. Treatment is analyzed according to the periods of observations. From the earliest cases it may be concluded that ligation proved ineffective in infants and medical treatment often failed. Progressively, medical treatment with digitalis (now better controlled), potassium-sparing diuretics and vasodilators has become more effective. On the other hand, direct reimplantation of the left coronary artery onto the aorta has become the preferred surgical procedure. Among the 8 most recent cases (seen between 1977 and 1986), 4 were cured by medical treatment under the age of 3 and subsequent reimplantation. In the other 4 patients asystolia responded to medical treatment, and these children are now awaiting reimplantation.

Coronary Angiography↗
PubMed1986

Percutaneous transluminal balloon valvuloplasty in congenital pulmonary valve stenosis.

From March 1984 to September 1986, 49 transluminal balloon valvuloplasties (TBVs) were performed in 44 consecutive patients with congenital pulmonary valve stenosis, aged 1 day to 60 years. Seventeen of the patients were infants aged less than 1 year, five of whom were neonates. The peak systolic gradient was greater than 50 mm Hg (mean, 80.0 mm Hg) in 36 patients and was less than 50 mm Hg (mean, 35.4 mm Hg) in eight. A single balloon catheter was used in 41 cases, and two balloon catheters were used in eight cases. In patients with a gradient greater than 50 mm Hg, the mean right ventricular peak systolic pressure was reduced from 99.8 to 51.8 mm Hg, and the mean transvalvular gradient was reduced from 80.0 to 22.4 mm Hg. In infants and neonates, the mean right ventricular pressure expressed as a percentage of systemic pressure decreased from 122.2% to 63.5%. Follow-up cardiac catheterization 1 to 17 months later (in 19 cases) revealed no significant change in the right ventricular systolic pressure (which had decreased from 53.0 to 48.5 mm Hg) or the peak systolic pressure gradient (which had decreased from 29.0 to 24.5 mm Hg), in comparison with the changes seen immediately after TBV. Thus, TBV is an effective method of relieving pulmonary stenosis in patients of all ages, including neonates.

Journal Article↗
PubMed1986

[Congenital subclavian steal syndrome. Apropos of 14 cases. Review of the literature].

Fourteen cases of the congenital subclavian steal syndrome are presented with a review of 99 cases in the literature. This abnormality is usually asymptomatic and a fortuitous finding (clinical: asymmetric blood pressure; radiological: investigation of an associated cardiovascular malformation). The possible malformations are numerous and may be diagnosed by angiography: however, they can be suspected from three simple investigations, clinical examination indicating the side of lower blood pressure, chest X-ray and barium swallow. Seventy one per cent congenital subclavian steal syndromes are associated with a right-sided aortic arch, the steal being then almost always left-sided via a left subclavian artery anomaly. In this group, a left subclavian artery isolated from the aorta represents about a half of the cases. A cardiac malformation is present in one out of two cases and a patent ductus arteriosus uniting the left subclavian artery and the left pulmonary artery is observed in one out of four cases. Twenty nine per cent of congenital subclavian steal syndromes are associated with a left-sided aortic arch. In these cases the abnormalities usually involve the aortic arch (57% of cases) or a right or left subclavian artery. Therefore, in this group, there is no preferential side for the subclavian steal which can be right, left or bilateral. These abnormalities usually only require medical surveillance. When they become symptomatic, vertebro-subclavian revascularisation is justified. The presence of a subclavian steal may have surgical implications: it is important to exclude a subclavian steal before performing a Blalock anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1986

[Aneurysm of the sinus of Valsalva in children and young adults. Apropos of 9 cases].

Nine cases (7 boys and 2 girls) of aneurysm of the sinus of Valsalva (SVA) diagnosed before 19 years of age are reported. Group 1 comprised 5 children aged 5 to 14 years without rupture of the aneurysm; 3 had an associated ventricular septal defect (VSD). The diseased sinus was the right anterior sinus in 4 cases and the posterior sinus in one case. The diagnosis was made by 2D echocardiography, performed in 3 patients for follow-up of a VSD and in 2 patients to investigate a systolic murmur. Group 2 comprised 4 patients under 19 years of age with SVA which ruptured into in the right heart cavities. One of these patients had a known right anterior SVA diagnosed at angiography performed to investigate a VSD when the child was 4 years old. The rupture occurred suddenly when the child was 14. These cases of SVA involved the right anterior sinus with rupture into the right ventricle (3 cases) and the posterior non-coronary sinus with rupture into the right atrium (1 case). A rupture syndrome was observed in 3 of the 4 patients with pulmonary oedema in 2 cases. The authors emphasise the rarity of SVA diagnosed before rupture and the low frequency of rupture before adulthood. Echocardiography is certainly the best method for diagnosing the condition and for following up these patients.

Adolescent↗
PubMed1986

[Continuous electrocardiographic recording with the Holter method in children. Indications and results].

There are relatively few reported studies of continuous electrocardiographic recordings by the Holter method in children. We report our experience of 296 24-hour recordings in 160 patients (average age 10.5 years), investigated for suspected or known cardiac arrhythmias. One hundred and ten patients (68.75%) had no organic heart disease and 6 patients (3.75%) had acquired lesions. Eighty-three patients (52%) were symptomatic. Sixty-three patients (39%) had normal recordings; 97 patients (61%) had a total of 126 arrhythmias. There were 45 cases of atrioventricular block, 24 cases of sinus node dysfunction, 39 cases of supraventricular arrhythmias and 18 cases of ventricular arrhythmias. Overall, 47.6% of these rhythm disturbances were diagnosed by Holter monitoring. This technique was particularly valuable in the diagnosis of arrhythmias in symptomatic patients, patients with arrhythmogenic cardiac lesions and in the detection and surveillance of postoperative arrhythmias in congenital heart disease, of pacemakers, of congenital atrioventricular block and of the chronic arrhythmias of childhood.

Adolescent↗
PubMed1985

Percutaneous balloon angioplasty in an infant with obstructed total anomalous pulmonary vein return.

This is a report of successful dilation of stenosis of the common trunk in a case of total anomalous pulmonary vein return into the left superior vena cava in a 3 month old infant. Percutaneous angioplasty was performed with a 6 mm diameter balloon catheter. Right ventricular systolic pressure decreased from 96 to 60 mm Hg, mean pulmonary vein pressure decreased from 26 to 14 mm Hg and left ventricular systolic pressure increased from 70 to 90 mm Hg.

Angioplasty, Balloon↗