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Biomedical subjects

D Guilmet

Publications and source records attributed to D Guilmet.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Rupture of post-infarction left ventricular aneurysm. Apropos of 2 cases treated surgically successfully].

Two cases of post-infarction anterior left ventricular aneurysm complicated by localised rupture into the pericardium are reported. The clinical features of these cases were severe cardiac failure, 10 days or more after initial necrosis posing the problem of myocardial failure due to extension of the infarct. The surgical indications were brought by left ventricular angiography performed under intra-aortic balloon pumping: in the first case the diagnosis had already been suggested by the detection of a hemopericardium on echocardiography. In both cases, the surgical procedure comprised aneurysmectomy with reinforcement of the ventricular wall with bands of Teflon. The postoperative period was complicated due to the very precarious hemodynamics at the time of surgery. The functional status of both patients is now very satisfactory.

Echocardiography↗
PubMed1982

[Calcifying obstructive disease of the descending thoracic aorta].

The authors present the first surgically treated case of calcifying obstructive disease of the descending thoracic aorta. The diagnosis was based upon the coexistence of an aortic isthmus coarctation syndrome together with massive calcifications seen by chest X-ray. The aetiology remains uncertain but the authors tend in favour of an atheromatous aetiology. Cure was obtained by simple surgical treatment.

Aorta, Thoracic↗
PubMed1981

[Surgical treatment of thoracic and thoraco-abdominal aneurysms involving the Adamkiewicz's artery. Usefulness of deep hypothermia (author's transl)].

The authors present a new surgical technique for the treatment of thoracic and thoraco-abdominal aneurysms involving the artery of the lumbar enlargement (Adamkiewicz's artery) at its point of origin. In two patients the aortic segment giving birth to the artery was accurately located by angiography and re-impaired under deep hypothermia and extracorporeal circulation.

Adult↗
PubMed1981

[Cold-induced paralysis of the phrenic nerve in open-heart surgery (author's transl)].

Cold-induced injury of the phrenic nerve after pericardial cooling during open-heart surgery has already been reported, but the post-operative consequences and long-term course of this complication have seldom been documented. Fifty cases (6.6%) of phrenic nerve paralysis were observed in a series of 750 patients undergoing open-heart surgery with topical cooling of the pericardium for myocardial protection. As infectious and respiratory complications (including atelectasis, bronchial obstruction, pleural effusion, pneumonia and bacteriaemia) were significantly more frequent (p less than 0.05) in these patients, assisted ventilation and intensive care were significantly more prolonged (p less than 0.01). Long-term follow-up of 42 patients (mean: 14 months; range: 3-42 months) showed inconstant and often incomplete regression of the paralysis. The complication can easily be prevented by using a plastic insulation pad during pericardial cooling and cold cardioplegia.

Cardiac Surgical Procedures↗
PubMed1980

[Ticlopidine in heart surgery with cardiopulmonary by-pass (author's transl)].

An interesting potential use of platelet aggregation inhibitors lies in the prevention of the thrombotic process originating in the oxygenator of the cardiopulmonary by-pass apparatus used in cardiac surgery. A 5-day course of ticlopidine HCl immediately before surgery results in a significant reduction in the thrombopenia usually observed and attributed to platelet aggregation and adhesion to the apparatus. Biological investigations have failed to show interference of the drug with coagulation factors, and no unwanted effect on per and post-operative bleeding was observed. Cardiopulmonary by-pass appeared in this study as an excellent model to test the clinical effectiveness of anti-aggregation compounds.

Adolescent↗
PubMed1980

[Surgery of the descending thoracic aorta. Partial derivation between the pulmonary and femoral arteries: 29 cases (author's transl)].

The authors report on 29 surgical operations on the descending thoracic aorta, where partial extra-corporal circulation was established between the pulmonary and femoral arteries, using a straight Rigg's cannula inserted into the pulmonary artery. The blood flow rate in the shunt was of the order of 1,5 l/min. Owing to the ease with which the cannula is inserted and removed and to the possibility of switching to total extra-corporeal circulation the authors prefer this technique to all other types of partial derivation.

Aorta, Thoracic↗
PubMed1980

[Replacement of the ascending aorta and aortic valve with re-implantation of the coronary arteries. Long-term results in 20 cases (author's transl)].

Total replacement of the ascending aorta and aortic valve using Bentall's technique was carried out in 20 patients with dystrophic (13 cases), chronic dissecting (4 cases) or acute dissecting (3 cases) aneurysm. Five patients died in the first month following surgery, but all patients operated upon for dystrophic aneurysm survived. The mean follow-up period for the 15 survivors was 39 months, and there was no late death. Thirteen patients are leading a normal life. Nine out of 14 control aortographies were performed 48 months on average after the operation. They showed normal and stable anatomical restoration of the aorta and coronary system. Total replacement of the ascending aorta seems to be the operation of choice for dystrophic aneurysm.

Adult↗
PubMed1980

Aortocoronary bypass with homologous saphenous vein: long-term results.

Between February 1973, and February, 1979, 27 homologous saphenous veins were used in 20 patients (mean age, 54 years). Seven fresh grafts were used less than 24 hours after severance. They were kept at a temperature of 4 degrees C in saline solution containing penicillin. Twenty cryopreserved grafts were used within a period of eight days to 2 months from severance. They were preserved in glycerol at a temperature of -40 degrees C. One patient (5%) died postoperatively. A perioperative myocardial infarction developed in 3 patients (15%). Average follow-up is 27 months. No late mortality was registered. Fifteen patients are free from symptoms, and 3 patients have residual angina with exercise. Control angiograms were made in 13 patients 1 to 68 months after operation; 17 homografts were seen. Early occlusion of 1 graft and late occlusion of 8 grafts were registered. The poor late patency rate does not seem to be related to either histocompatibility or technical conditions. Conversely, microscopic examination of several cryopreserved grafts showed that the mode of preservation resulted in deterioration of intimal and medial tissues of the vein. Therefore, it appears to us that the use of homologous saphenous veins should be avoided for coronary bypass.

Adult↗
PubMed1980

[Value of surgical approach to the vertebral artery in its extra-cranial segment. A case of aneurysm of the vertebral artery in C3 (author's transl)].

Long considered dangerous, surgical treatment of lesions of the vertebral artery in its extra-cranial course, may be viewed in parallel with angiographic techniques. Approach to the vertebral artery in its different segments, pre-operative arteriographic assessment, are discussed, and operative indications only mentioned. An aneurysm of the vertebral artery in C2-C3 was treated by exclusion and restoration of continuity by a sub-clavian vertebral vein graft in C1-C2.

Aneurysm↗
PubMed1979

[Aneurysm of the membranous septum, left ventricular-right atrial communication and arrhythmias].

An aneurysm of the membranous part of the interventricular septum associated with a complex congenital malformation of the endocardial cushions was diagnosed in a 39 year old woman who presented with syncope. Diagnosis was made by echocardiography and confirmed by angiography. The operative findings were: a double aneurysm of the membranous septum, a left ventricular--right atrial fistula and two hemivalves attached to papillary muscles. The usfulness of echocardiography in the diagnosis of aneurysm of the membranous interventricular septum and in the follow up of ventricular septal defects from which they arise is emphasised. The pathogenesis of the arrhythmias observed (accelerated idioventricular rhythm, reciprocating tachycardias and syncope possibly related to transient heart block) is discussed.

Adult↗
PubMed1979

[Dissecting aneursym of the ascending aorta after lateral clamping for aorto-coronary by pass (author's transl)].

Four cases of dissecting aneurysm of the aorta after lateral aortic clamping for aorto-coronary bypass are described. These accidents are rare but very serious. They often occur in hypertensive patients, and sometimes an aortic wall with a low elastic fibre content is found on histology. Surgery is that of dissecting aneurysm of the ascending aorta. However the severity of these accidents should lead to routine preventive measures during all aortocoronary bypass operations, in particular aortic anastomosis of the grafts under extra-corporeal circulation.

Aortic Dissection↗
PubMed1979

Use of biological glue in acute aortic dissection. Preliminary clinical results with a new surgical technique.

Use of a biological glue (GRF) is common in certain fields such as hepatic or renal surgery, but its use in vascular surgery, especially in acute aortic dissection, has not yet been reported. Our experience has demonstrated many advantages: The glue is very simple and safe to use. The aortic tissues are firmly reinforced and the sutures tighten immediately. The proximal aortic stump is anatomically reconstructed, and generally the aortic valve can be preserved and coronary reimplantation avoided. The preoperative and postoperative bleeding rates are low and the postoperative course generally is simple. The risk of maintenance or recurrence of the dissection process is reduced. Consequently, the hospital mortality rate can be reduced to about 10 percent and the long-term survival rate greatly improved.

Adult↗