[Prosthetic tubes equipped with valve heterografts].
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Biomedical subjects
Publications and source records attributed to C Planche.
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The authors report their experience of one-stage closure of poorly-tolerated ventricular septal defects in small children and babies. They use both extra-corporeal circulation and profound hypothermia. The results which they present have been very encouraging. They emphasise the fact that the closure is not complete after surgery, and that most of the murmurs which persist post-operatively disappear gradually. Of the neurological defects which were seen in two cases after surgery (one after profound hypothermia and one after extra-corporeal circulation) one resolved completely; in the other (in which there was a cardiac arrest followed by cardiac massage for one hour) certain intermittent visual defects have persisted. All of the other children can now be regarded as normal.
The authors present their 11 year experience of treating severe cases of obstructive cardiomyopathy which were resistant to medical treatment. They consider that myotomy is the simplest procedure (it is always effective) in this mysterious disorder for which it must be admitted that there is no treatment that is entirely satisfactory.
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The study of collagen fibers by X-ray diffraction, utilizing semiquantitative indices for appraisal of "structuration" and "orientation" was applied to 30 aortic valve grafts. These grafts, of pig origin, were studied in the fresh state, after tanning with aldehydes, and after having been implanted in patients for at least 18 months. It was shown that the collagen fibers are preferentially orientated parallel to the transverse axis of the valve cusps, and that this arrangement, enhanced by tanning, had a tendency to disappear in the post-implantation samples. The structuration index which concerns the fibril network was also augmented by tanning, and was found a little high or slightly diminished in post-implantation cusps. Evidence for a new compound, probably fibrin, was found in the diffraction patterns of implanted cusps, but crystallized calcium was noticeably absent.
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Report of the case of a 26-year-old male patient, presenting with left-sided thoracic pains combined with electrocardiographic changes. Coronary arteriography demonstrated the presence, during systole, of a long, semi-localized stenosis of the anterior interventricular artery. Operation consisted only in the section of the myocardial bridge enclosing the artery on 4 cm. The clinical and coronary arteriographic result was perfect. No report of a similar case could be found in the literature.
Report of the case of a 1-year infant, weighing 4 kgs, with a right pulmonary artery branching from the aorta combined with a wide patent ductus arteriosus. Reimplantation of this artery in the pulmonary artery trunk under extracorporeal circulation was followed by a spectacular result.
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