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Biomedical subjects

D Lellouche

Publications and source records attributed to D Lellouche.

At least 55 records · Page 3Linked to original sources
PubMed1975

[Evaluation of 2 years' experience with assisted circulation by diastolic counterpulsation].

The authors report their two years' experience of circulatory assistance by diastolic counter-pulsation with an intra-aortic balloon. This technique was used in 23 patients: 9 cases of cardiogenic shock due to acute myocardial infarction, 9 septal ruptures, 1 rupture of the papillary muscle of the mitral valve, 1 acute ventricular aneurysm, 2 high risk coronary arteriographies and 1 case of early post-infarction recurrent ischemia. It confirms the gravity of cardiogenic shock as, in spite of the frequent improvement in hemodynamic parameters under counter-pulsation, there was only one survivor. The efficacy is greater in cases of septal rupture, where the author obtained 3 survivors out of 6 operated cases. The security of the method and its innocuity permit one to carry out high risk coronary arteriography and extend the indications for circulatory assistance, to certain cases of unstable angina or early recurrent anginal following acute infarction.

Adult↗
PubMed1975

[Surgical correction of septal ruptures after recent acute myocardial infarct].

The problems which are raised by surgical correction of a rupture of the septum complicating an acute myocardial infarction are illustrated by a study of 15 patients admitted for resuscitation. Rarely (3 cases) the anatomical abnormality is well tolerated, and a "planned" secondary operative procedure can then be carried out. More often (12 cases) the severity of the circulatory sequelae makes urgent surgery mandatory; these very severe cases have benefited greatly from advances in medical resuscitation, assisted circulation, and operative techniques.

Acute Disease↗
PubMedDate not supplied

Computed tomography of thoracic aortic dissection: accuracy and pitfalls.

During a 5 year period, 137 patients with suspected acute aortic dissection were screened by CT. The radiologic diagnosis of dissection was made in 54 cases and eliminated in 76. There were seven false-negative CT examinations. Surgical and angiographic correlations or clinical follow-up were obtained with all patients.

Acute Disease↗
PubMedDate not supplied

[Implantable defibrillators. Sudden death: high risk].

INCIDENCE: The incidence of sudden death remains high. The basic causes are related to ischemic heart disease and heart failure. Automatic defibrillation is the best treatment, as first conceived and implanted by Mirovski twenty years ago. MARKERS OF RISK OF SUDDEN DEATH: Left ventricular dysfunction, functional class and spontaneous and induced ventricular hyperexcitability identify a high-risk population. THERAPEUTIC APPROACH: Drug treatments used in the post infarction period or for heart failure (beta-blockers, converting enzyme inhibitors and amiodarone) have demonstrated a certain efficacy in preventing sudden death. However, different therapeutic trials comparing the efficacy of defibrillators and drug treatments have demonstrated the 20 to 46% superiority of defibrillation in terms of reduced mortality.

Cause of Death↗
PubMedDate not supplied

[Implantable defibrillators. Role of the defibrillator in treatment and prevention of sudden death].

PROVEN EFFICACY: Several studies have demonstrated that implantable defibrillators improve survival in patients with a very high risk of sudden death. INDICATIONS FOR PRIMARY PREVENTION: The most obvious indication is for young patients with severe recurrent rhythm disorders and generally good left ventricular function. However, most of the candidates have severe left ventricular dysfunction due to post infarction ischemia or dilated cardiomyopathy who develop syncopal or hemodynamically poorly tolerated ventricular tachycardia or who have survived a first episode of sudden death. PROPHYLACTIC INDICATIONS: Automatic defibrillation should be proposed for patients with factors of risk of sudden death such as left ventricular dysfunction or infarction sequelae.

Adult↗
PubMedDate not supplied

[Enoximone and the therapeutic strategy in patients awaiting emergency cardiac graft].

Enoximone is a positive inotropic agent belonging to the group of phosphodiesterase F-III inhibitors. The drug was tested in 34 patients uncontrolled by sympathomimetic drugs and referred to our department for urgent heart transplantation or circulatory assistance. After insertion of a Swan-Ganzgatheter and a radial artery catheter for haemodynamic monitoring, enoximone was administered as a 15-minute intravenous bolus injection of 1 to 2.5 mg/kf every 8 hours, in addition to sympathomimetic agents. Clinical and haemodynamic improvement was observed after thirty minutes in 30 patients. The cardiac index rose from 1.82 to 2.67 l/min/m2 and the pulmonary wedge pressure fell from 30.8 to 18.9 mmHg. Systemic arterial resistance decreased from 2170 to 1520 dyn. s. cm-5, and pulmonary resistance from 5.5 to 4.6 Wood units (p less than 0.01 for all values). Four patients had no haemodynamic improvement and were put on circulatory assistance, using a Jarvik 7 total artificial heart in 3 of them and heterotopic circulatory assistance in one. After clinical investigation for contra-indication to heart transplantation, and as their improved haemodynamic status permitted, 12 of the 30 patients were considered suitable (group B) for heart transplantation. Transplantation was performed within a week of admission in 11 patients without any need for mechanical assistance. One of the group B patients who required implantation of a Jarvik 7 artificial heart died after 12 hours of assistance. Eighteen patients were considered unsuitable for transplantation (group A) and treated medically.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗