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Biomedical subjects

C H Chalant

Publications and source records attributed to C H Chalant.

At least 37 records · Page 2Linked to original sources
PubMed1984

Factors influencing postoperative survival in aortic regurgitation. Analysis by Cox regression model.

From 1965 to 1981, 114 patients underwent aortic valve replacement for severe aortic regurgitation in our institution. Catheterization was performed preoperatively in 103 patients. Follow-up was possible in 98% of the survivors. Long-term survival was significantly different between patients in preoperative Functional Class I-II and those in Class III-IV (p less than 0.03); those with a preoperative cardiothoracic ratio less than 0.64 versus greater than or equal to 0.64 (p less than 0.001); and those with a preoperative ejection fraction greater than 0.50 versus less than or equal to 0.50 (p less than 0.03). A multifactorial analysis was used to identify the dominant preoperative prognostic variables affecting survival. Three of the 13 parameters examined simultaneously were found to independently influence survival rates: cardiothoracic ratio (p = 0.001), strain pattern on the electrocardiogram (p = 0.072), and left ventricular end-systolic pressure (p = 0.127). After stratification of the population into two groups according to preoperative functional class, the predictive variables were cardiothoracic ratio (p = 0.014), strain pattern (p = 0.050), and acute/chronic form of aortic regurgitation (p = 0.034). This statistical analysis enabled us to derive a mathematical equation for predicting an individual patient's probability of survival. We found a close fit between the survival rate predicted by the mathematical model and the observed survival rate.

Adolescent↗
PubMed1982

Review of 387 isolated mitral valve replacements by the Model 6120 Starr-Edwards prosthesis.

Between February, 1965, and July, 1980, 387 patients underwent an isolated mitral valve replacement with the non-cloth covered Starr-Edwards ball valve (Model 6120) at the University of Louvain. The mean age of the patients was 48.765 years. The overall operative mortality was 6.1%. The mean age of the patients who died was 52.3 years and all but four were in New York Heart Association (NYHA) Functional Class III or IV. The actuarial survival rate is 78% at 5 years after operation, 72% at 10 years, and 70% at 13 years. The overall incidence of thromboembolic complications is 3.4% per patient-year with a total follow-up of 1,675 patient-years. Valve dysfunction has never occurred, and endocarditis, hemolysis, and paravalvular leakage have never reached a significant incidence. Hemodynamics investigations show a residual diastolic gradient of 6.6 mm Hg for the size 3M valves and 7.92 mm Hg for the size 2M valves. These current data over an extended follow-up interval (15 years) indicate that the Starr-Edwards Model 6120 prosthesis continues to perform satisfactorily in terms of mortality and morbidity, and there have been no instance of late failure due to valve dysfunction.

Adult↗
PubMed1979

Twelve year results with a caged-ball mitral prosthesis.

Over a 12 year period in 230 patients mitral valve replacement was performed using the model 6120 Starr-Edwards prosthesis. Operative mortality was 6.5%, mean follow-up of the operative survivors was 3.9 years. Estimated late survival rate was 80% at 5 years and 73% at 12 years. 38% of late deaths were considered valve-related. Under routine anticoagulation thromboembolism occurred at a rate of 4.7% per patient-year with a fatal thromboembolic incidence of 1.4% per patient-year. In comparison with data available on other currently used prosthetic valves it appears that the rates of valve-related complications are quite similar, with the 6120 Starr-Edwards model being subject to the longest follow-up.

Belgium↗
PubMed1975

[Conduction disorders in aortic valve diseases].

Among 304 cases of aortic valvulopathies studied for surgical selection, the authors have found a high incidence of conduction disturbances (16% in aortic stenosis and 18,4% in aortic regurgitation). The conduction defects are mostly intraventricular among stenosis isolated or associated to regurgitation and mostly atrio-ventricular among pure aortic insufficiencies. The highest incidence (30%) being found in patients with bacterial endocarditis acute or healed. The incidence of conduction disturbances increases with age, with the presence of valvular calcifications, of left ventricular strain or failure, of coronary insufficiency and angina... practically with the duration and the severity of the valvular disease. Surgical risk is heavier and natural prognosis poorer in valvulopathies with conduction disturbances. But these disturbances never contraindicates surgery : it is sometimes necessary to insert a pacemaker with or without valvular replacement mostly in aortic stenosis with infrahisian conduction defects. During hemodynamic investigation of such cases one must be ready to stimulate the heart, particularly during right heart catheterization of patients with complete left bundle branch block.

Adult↗
PubMed1975

[Prognosis and treatment of bacterial endocarditis. Review of 70 cases].

The long term results of medical and surgical treatments have been reviewed in 70 cases examined during the last 8 years. In 24 of them, bacterial endocarditis developed after valvular replacement. Antibiotic treatment was administered during at least 6 weeks. Determinations of the minimum inhibitory concentration of the antibiotic and of the bactericidal power of the serum were considered as the most important laboratory controls. In the post-operative cases with prosthetic valves, numerous pathogenic organisms were found, including gram (minus) bacilli and monilia, which may partly account for the high mortality in this group. Despite surgical reinterventions, 20 of the 24 patients died. For the gram (+) cocci, prognosis is however statistically worse (at the 99% confidence limit) when prosthetic valves are present. Out of the 46 patients without prosthetic valves, 31 (68%) had a favourable bacteriological and haemodynamic evolution; in this group, gram (minus) bacilli and monilia were never found to be the pathogenic organisms. For streptococci infections, recovery was obtained in 73% of the cases (24 out of 33). Percentages of long term recovery are very similar in mitral (67%) and aortic (69%) valvular involvment, but the frequency of surgical indication was very different in either group. In cases of aortic valvular disease, valvular replacement was indicated for bacteriological or haemodynamic reasons in 19 of the 20 patients who recovered. Amongst the 9 patients who died, 6 were not operated upon. Valvular replacement is by far less frequently necessary in cases of bacterial endocarditis on the mitral valve : one prosthetic valve amongst 8 patients who recovered. Finally, the authors discuss the place of surgery in the treatment of bacterial endocarditis. According to their experience, recent improvement in the prognosis of the disease seems to depend more on the surgical approach of the problem than on the discovery of new antibiotics.

Anti-Bacterial Agents↗