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Biomedical subjects

C de Riberolles

Publications and source records attributed to C de Riberolles.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Assisted circulation by external heterotopic prosthesis as a bridge to heart transplantation].

Eleven patients aged 7 to 58 years were placed on assisted circulation with Pierce (2 cases) or Abiomed (9 cases) external prosthetic ventricles as a bridge to cardiac transplantation. The indications were terminal cardiac failure following cardiomyopathy (7 cases), decompensated ischemic heart disease (3 cases) and subacute post-transplantation rejection (1 case). The duration of the assisted circulation ranged from 24 hours to 11 days. All patients were transplanted but 3 died after transplantation (27%). The circulatory assistance was satisfactory in all patients as shown by the regression of clinical signs of low cardiac output and the normalisation of diuresis. The complications observed during assisted circulation and after cardiac transplantation were: haemorrhage (36%), infection (27%) and thromboembolism (9%). These preliminary results with a 72% post-transplantation survival rate, show that both systems are effective "bridges to cardiac transplantation". The Abiomen device is excellent value for money and relatively simple to install and represents a good compromise between the sophisticated techniques of circulatory assistance and the problems of the cost of health care.

Adolescent↗
PubMed1989

[Hancock pericardial prosthesis. Intrinsic dysfunctions].

The frequency of primary dysfunction of 432 Hancock pericardial bioprosthesis was evaluated during a mean follow-up period of 53.1 months per patient. This frequency was 3.20% valve-year in mitral valve prosthesis and 0.92% valve-year in aortic valve prosthesis. Only one case of calcification was noted. Dysfunction was usually due to tearing of one or several pericardial cusps (25 cases), occasionally to tissue retraction (4 cases). Pathological examination of the explanted valves showed fibrin formation followed by organization into fibrous tissue in the host, retracting or fragilizing the pericardial valvular tissue. A preliminary study of the same group had led to discontinuation of Hancock prosthesis. The long follow-up period makes it possible to compare the results obtained with those of pericardial prosthesis of the same generation, to stress the need for echocardiographic monitoring of the implanted valves and to hope that new techniques of pericardial valve fitting will improve the mechanical reliability of prosthesis which, from the point of view of thrombogenesis and haemodynamics, have unquestionable advantages.

Adolescent↗
PubMed1988

[Brucella endocarditis caused by reinfection of an aortic Starr valve. Apropos of a case with a favorable development after valvular replacement].

We report the case of a 36-year old male patient who was admitted for subacute endocarditis on an aortic prosthetic valve implanted 14 years previously for endocarditic valve regurgitation; no pathogen had been isolated at that time. Nine blood cultures were positive for Brucella abortus. The conventional antibiotic therapy did not prevent the formation of an abscess below the aortic annulus. A third antibiotic combination (quinolone and rifampicin) resulted in pyrexia prior to surgery. An atrioventricular block initially noted raised the problem of an associated myocarditis. The risk of Brucella infection existed before the first operation, and five serological tests were positive for that organism between the two episodes, which makes reinfection highly probable. This is the third case of Brucella endocarditis on a prosthetic valve. Its originality lies in its mechanism.

Adult↗
PubMed1985

[Antenatal cardiac surgery. Creation of an experimental model of pulmonary stenosis in the fetus and repair in utero].

An experimental model of pulmonary stenosis was created in ewes, fetus and repaired before birth by making use of the materno-foetal circulation. Eighteen ewes fetus underwent pulmonary artery banding at an average of 87 +/- 8 days' gestation (normal 135-145 days). All were reoperated before term at 132 +/- 6 days' gestation. They were divided into two groups : group I (7 fetus) was used to evaluate the experimental model of pulmonary stenosis by measuring right ventricular pressures (80 +/- 16 mmHg compared to 58 +/- 10 mmHg in control models), and the increase in right ventricular mass (2.8 +/- 0.5 X 10(-3) g vs 1.9 +/- 0.2 X 10(-3) g), left ventricular mass (2.2 +/- 0.3 X 10(-3) g vs 1.8 +/- 0.4 X 10(-3) g) and septal mass (1.8 +/- 0.3 X 10(-3) g vs 1.3 +/- 0.2 X 10(-3) g). In group II (11 fetus) the pulmonary stenosis was repaired by total clamping and patch repair. After repair and during the days just before birth, the ventricular masses decreased (RV = 2 +/- 0.3 X 10(-3) g; LV = 1.8 +/- 0.4 X 10(-3) g; septum = 1.8 +/- 0.3 X 10(-3) g) approaching values of normal control fetus. This experimental model shows that it is possible to correct cardiac lesions in utero by making use of the materno-fetal circulation and that antenatal repair of an arterial obstruction can rapidly reverse the reactional ventricular hypertrophy.

Animals↗
PubMed1983

[Tetralogy of Fallot with congenital absence of a pulmonary artery. Apropos of 4 cases].

Four patients aged between 3 1/2 and 16 years were treated surgically for tetralogy of Fallot associated with congenital absence of the left pulmonary artery. This absence, suspected from the chest X-ray, was confirmed preoperatively by angiography of the right and left cavities, aortography, left pulmonary wedged venography and radionuclide scan and substantiated by intraoperative exploration. Congenital absence differs physiopathologically from acquired destruction of a pulmonary branch. In all four patients, repair was performed exclusively on the right branch, without any attempt to introduce a valve in the pulmonary outflow tract and without regard for normal recommendations concerning acquired branch lesions. The only patient to retain a high right ventricular pressure was the one whose pulmonary ring looked sufficiently large to warrant preservation. In all four cases, the postoperative course was uneventful, and the clinical condition is very satisfactory with a follow up of two to twenty-four months. The conclusion would seem to be that the association of tetralogy of Fallot with congenital absence of the left pulmonary artery ascertained with certainty preoperatively, in no way modifies therapy.

Abnormalities, Multiple↗
PubMed1983

[Direct pulmonary embolectomy without extracorporeal circulation. 5 cases].

Five patients underwent pulmonary embolectomy without cardiopulmonary bypass. All had recent embolism completely obstructing the right branch of the artery but usually leaving the left branch open or almost totally free. In all patients fibrinolytic drugs were formally contra-indicated. Thoracotomy was performed through the right lateral approach. The embolus was completely removed; there were no post-operative complications and the results on follow-up are excellent.

Adult↗
PubMed1983

[Complete atrioventricular canal associated with a tetralogy of Fallot. Results of surgical treatment. Apropos of 4 cases].

Complete atrioventricular canal with tetralogy of Fallot is a rare occurrence (8%). Diagnosis rests on the association with Down syndrome and on data from EKG, ultrasonography and angiography. The high operative risk explains why radical surgery is done at an older age (9 years) than in the usual form of complete atrioventricular canal without associated anomalies (33 months) and why antecedent surgical palliation with anastomotic procedures is so frequent (68% of the cases reported in the medical literature). The same surgical procedure was done in all patients: closure of the defects with two separate patches lined with pericardium, suture of the mitral cleft and relief of the infundibular and pulmonary obstruction without valvulation.

Abnormalities, Multiple↗
PubMed1982

[Results of the repair of isolated coarctation of the aorta during the 1st 6 months of life, Apropos of 46 cases].

Between 1972 and 1978, forty-six infants under six months of age underwent surgery for isolated coarctation of the aorta. These forty-six patients represent 32% of the total number of infants aged less than six months who had surgery for coarctation of the aorta during the same period. At the time of operation, 41% were aged less than one month and the youngest was five days old. The main cause for surgery was heart failure in infants under one month (14/19) and severe systemic hypertension (150 to 300 mm Hg) in the one to six month age group (18/27). Overall mortality rate in our series was 17%. Six of the eight infants who died were under one month of age. Recoarctation occurred in 31,5% of infants; in eight cases the first surgical procedure had been done before one month of age. A second procedure was necessary in four cases. Early surgical repair of severe coarctation diagnosed during the first six months of life leads to functional improvement and avoids residual hypertension. After repair, the main risk is recoarctation.

Aortic Coarctation↗