Search PubMed⌕ Search

Biomedical subjects

C Planche

Publications and source records attributed to C Planche.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Endocardial fibroelastosis: prenatal manifestation of aortic valve stenosis].

A diagnosis of fibroelastosis was made in a 33-week-old fetus, based on the echocardiographic features of a marked impairment of left ventricular contractility and hyperechogenicity of the endocardium. Fibroelastosis was associated with an aortic stenosis. There was no evidence of hydrops fetalis. Prenatal detection of this severe congenital heart disease allowed its early management in an intensive care unit. Heart failure due to closure of the ductus required the use of prostaglandin, then a surgical aortic valvulotomy was performed. There was no postoperative problem, and one year after surgery the infant is doing well. His left ventricular contractility is normal, and echocardiographic features of fibroelastosis are no more present. Prenatal diagnosis, use of prostaglandin and increasing safety of neonatal cardiac surgery have improved the prognosis of this serious association.

Aortic Valve Stenosis↗
PubMed1985

Age-related changes of action potential plateau shape in isolated human atrial fibers.

Because the frequency of atrial arrhythmia increases dramatically with age in humans, we investigated age-related changes of cellular electrical activity in human atrial fibers, utilizing standard microelectrode techniques. Twenty-four atrial samples, uniformly exhibiting fast responses, were selected. Patients were in two different age groups: 10.0 +/- 7.0 mo and 54.4 +/- 9.7 yr. Although mean maximum diastolic electrical potential did not significantly differ, the two groups showed marked dissimilarities in action potential (AP) shape. Adult-type APs always exhibited an initial notch followed by a low-level prolonged plateau, whereas APs of the young were more triangular and had a short plateau approaching zero potential. 4-Aminopyridine (0.5 mM) markedly increased the level of the adult AP plateau without suppressing the initial notch, which disappeared after further addition of caffeine (10 mM). The simultaneous action of the two drugs changed an adult-type AP into a young type. The drug effects were much less marked in young atria. Our results suggest that an age-related increase in transient outward currents can account for the differences in plateau shape described. Moreover, age-related differences in plateau configuration in response to a period of rest suggest a faster repriming kinetic of these currents in adults.

4-Aminopyridine↗
PubMed1985

[Surgical closure of interventricular communications before 2 years of age. Long-term clinical and electrocardiographic course].

The long-term follow-up of the first 100 children under 2 years of age, presenting with ventricular septal defect (VSD) who underwent surgical closure between 1972 and 1976 at the Centre Chirurgical Marie-Lannelongue, was studied. Only cases with isolated VSD were taken into account except for 18 cases with ductus arteriosus related to operation and 41 cases with atrial septal defect (ASD) or persistent foramen ovale. This study included clinical and electrocardiographic investigations focused on the long-term follow-up of conduction disorders. Clinical tolerance was excellent with only one Eisenmenger's syndrome induced by a residual VSD. Three secondary cases of aortic regurgitation without present functional repercussions were observed. Conduction disorders were considered as unchanged or even improved. There were no sudden death, no secondary atrioventricular block (AVB), no trifascicular block even after one case with transitory immediate postoperative AVB.

Age Factors↗
PubMed1984

[Outcome of infants operated on for aortic coarctation before 3 months of age].

Between January 1966 and June 1982, 177 infants less than 3 months of age underwent surgical cure of coarctation of the aorta. Seventy-one percent had associated cardiac lesions not including a patent ductus arteriosus. With the cure of the coarctation either by resection anastomosis or angioplasty, 45% underwent associated surgical procedure, mainly pulmonary artery banding. Early mortality was 26% for the last 4 years of the study. Early deaths, significantly correlated with the severity of the preoperative heart failure and the importance of pulmonary hypertension, were not correlated with an associated heart disease. Of the 95 survivors operated on before December 31, 1981 and with a long follow-up, 18 died later on. Late deaths are related with associated cardiac malformations. Thirty-nine (41%) of the survivors had recurrent coarctation. This was correlated with the year of surgery and not with the surgical technique. In cases with coarctation of the aorta surgical cure should not be withheld before age 3 months, when there is heart failure, with or without associated cardiac malformations. The mortality, even in isolated coarctation (6%), the occurrence of sudden deaths after good surgical repair, the frequency of recoarctations lead to suggest that in infants under 3 months of age, careful supervision and conservative medical treatment should be considered, if the coarctation is isolated and well tolerated.

Aortic Coarctation↗
PubMed1983

Subvalvular aortic stenosis: long-term surgical results.

Seventy-six patients, with a mean age of 11.6 years, presenting with congenital subvalvar aortic stenosis were operated upon between 1965 and 1979. Seventy had moderate subvalvular stenosis. Eighty-eight percent had myotomy combined with resection of the obstruction. Five patients (6.6%) died postoperatively. Of 48 survivors followed up between 6 months to 13 years postoperatively (mean 4.2 years), 4 underwent reoperation and 2 of them died. Survival at 5 years and 10 years was 96% and survival without reoperation at 5 years and 10 years was 91%. When last seen, 90% of the patients were asymptomatic, left ventricular hypertrophy on ECG had disappeared in 63%. No patient had atrioventricular block. Two thirds of the patients had no systolic thrill and of 13 patients recatheterized (3.2 years follow-up) 9 had a peak systolic gradient below 50 mmHg. If, postoperatively 60% of the patients had aortic insufficiency versus 31% preoperatively for the whole period, this percentage fell to 33% after 1976. As subaortic stenosis is a progressive disease and late surgical results are correlated to preoperative peak systolic gradient, early surgery is recommended. Close postoperative follow-up is needed since recurrence of aortic stenosis is possible (and acquired aortic insufficiency may persist).

Adolescent↗
PubMed1983

Perirenal space implantation of permanent cardiac pacemakers in infants and small children.

Permanent pacemakers were implanted in 40 children aged one day to 17 years. A new technique, necessitating thoracotomy and lumbotomy, is described briefly. Indications were surgical block in 22 (55%) and congenital block in 18 (45%) patients. Five of 40 (12.5%) died. Reoperation was required 4 times: for electrode problems (3), and wound problem (one). No late infection or wire fractures were noted. The time paced ranged from 7 days to 37 months. All of these patients received lithium units.

Adolescent↗
PubMed1983

Tricuspid atresia. Results of treatment in 115 children.

We present our experience in the management of tricuspid atresia in 115 children. The anatomic data are categorized as follows: type I, 83.5%, type II, 16.5%. Type IB is the most frequent, representing 63.5% of all the cases. Each patient was operated upon one to four times. The age at first operation ranged from 10 days to 20 years. The first operation was a shunt in 94 children, a Fontan operation in four, and banding of the pulmonary artery in 17. Hospital mortality for the first operation was 12.2%, significantly higher in children under 6 months and in those having Waterston shunts. Potts and Blalock-Taussig operations give low long-term mortality; although few (six) have been done, Potts shunts also seem to give good long-term palliation in this series. The Glenn anastomosis is a good operation when performed after a systemic-pulmonary arterial shunt. The Fontan operation was performed in 24 children (hospital mortality 16.6%). There have been no late deaths after the third month postoperatively. Mean follow-up for this operation is only 2 years, but 88% of the survivors lead a normal life, two thirds of them receiving no treatment. There has been one reoperation for stenosis of a Dacron conduit with a good result. Late arrhythmias are well tolerated. In conclusion, the Fontan procedure is a good operation, but palliative procedures still allow good long-term survival.

Actuarial Analysis↗
PubMed1982

[Aberrant subclavian artery in infants. Division and reimplantation into the common carotid artery through cervicotomy (author's transl)].

In infants, merely dividing an aberrant subclavian artery (ROSCA) through left-thoracotomy may result in severe cerebral circulatory disorders by vertebrobasilar arterial steal. The authors report on 3 cases where reimplantation of the ROSCA into the common carotid artery reproduced a normal brachiocephalic arterial trunk and resulted in normal revascularization. In 2 of these 3 cases, the ROSCA was approached through a right cervical incision, divided in the mediastinum, behind the oesophagus, and reimplanted by latero-lateral anastomosis into the right carotid artery. In the third case the same approach was preceded by left thoracotomy for easier division of the ROSCA close to the aorta. The three operations were uneventful and no complication occurred, except for transient and mild left hemiparesis without sequelae in one patient.

Aorta, Thoracic↗
PubMed1978

[An unusual type of mid-ventricular obstruction. A discussion of the findings].

The authors report a case of left-sided mid-ventricular obstruction which was completely different from the usual type of obstructive cardiomyopathy, and had asymetrical hypertrophy of the septum demonstrable both by angiocardiography and macroscopically. Complete clinical and haemodynamic recovery followed left ventricular myectomy with replacement of the mitral valve (one year's follow-up).

Angiocardiography↗