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Biomedical subjects

E Hazan

Publications and source records attributed to E Hazan.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Importance of echocardiography in the evaluation of surgical results in the tetralogy of Fallot].

M mode echocardiography was performed one year after surgical correction of Fallot's tetralogy in 32 patients (average age: 2, 7 years). All patients were asymptomatic without treatment and the average cardiothoracic ratio was 0,56 +/- 0,03. Echocardiographic indices of left ventricular function distinguished 4 patients with myocardial dysfunction (2 cases of poor myocardial protection and 2 double Blalock-Taussig anastomoses). Right ventricular diastolic internal dimensions were increased in 75 % cases. The ratio of right to left ventricular internal dimension was used to classify patients into three groups: Group I (ratio Less Than 0,70) 17 patients; Group II (ratio 0,70 Greater Than 0,80) 4 patients, and Group III (ratio Greater Than 0,80) 11 patients. This ratio was not related to the age of the patient of surgery or to the type of patch used on the right ventricular outflow tract but was related to the pressures recorded at operation after correction. A ratio Greater Than 0,80 was strongly suggestive of a significant residual abnormality which was often curable. Echocardiography has become an essential investigation in the follow up of Fallot's tetralogy after surgical correction: a right: left ventricular ratio Less Than 0,70 obviates the need of control catheterisation. On the other hand, a ratio Greater Than 0,80 is a strong indication for cardiac catheterisation even in the absence of clinical abnormalities.

Child↗
PubMed1981

[Anatomic correction of transposition of the great vessels with interventricular communication. A series of 24 consecutive operations].

The results of surgical correction at arterial level in 24 cases of transposition of the great arteries with ventricular septal defect are reported. The majority of children (19/24) had undergone previous pulmonary artery bonding between the ages of fifteen days and 3 months (average 1,5 months). Surgical correction was performed on average 14 months later. This consisted of repair of the ventricular septal defect and arterial shift to reestablish ventriculoarterial concordance with reimplantation of the coronary arteries. In the last 9 cases no prosthetic materials were used on the right outflow tract. The operative mortality was 9/24 (6 of the first 12, and 3 of the last 12 cases). The cause of death was due to associated lesions, congenital (coarctation of the aorta, mitral valve malformation), or iatrogenic related to previous surgery (stenosis of the right ventricular infundibulum). Left ventricular failure was common despite preparation with pulmonary artery banding and merited systematic treatment mainly with arterial vasodilator therapy and prolonged ventilatory assistance. The surviving children are asymptomatic without treatment. Control catheter studies did not show any significant abnormality except in one case of pulmonary hypertension. The exceptional quality of these results, the absence of prosthetic material and the hope of reducing avoidable mortality justify this approach to surgical cure of the malformation. Preparation by pulmonary artery banding and the use of this method in "simple" forms of transposition are questions which remain open to discussion.

Child, Preschool↗
PubMed1981

Anatomic correction of transposition of the great arteries.

A new technique of anatomic correction of transposition of the great arteries with ventricular septal defect is presented. The procedure described, which avoids the use of a prosthetic conduit in the reconstruction of the pulmonary outflow tract, has been used in nine consecutive patients. Six remain alive and well 4 to 24 months postoperatively. Details and illustrations of the technique utilized are presented. Avoiding the use of a prosthetic conduit in the procedure re-established the basic appeal of arterial correction of transposition of the great arteries with ventricular septal defect.

Heart Septal Defects, Ventricular↗
PubMed1980

Anatomical correction of transposition of the great arteries.

This method of true anatomical repair of transposition of the great arteries (TGA) avoids the transection and suture of the coronary arteries and does not require any tubes of foreign material. Because the transection goes through the infundibulum under the aortic annulus, the complete aortic root together with the coronary arteries and a muscular subvalvular rim can be sutured to the pulmonary annulus. The technical simplicity of this procedure allows its application in TGA with intact ventricular septum in the newborn when the left ventricular pressure is still high or after the left ventricle has been "prepared" by previous banding of the main pulmonary artery.

Aorta↗
PubMed1980

Surgery of post-myocardial infarction scars. Early and late results in 70 patients.

Immediate and late postoperative results in 70 patients undergoing resection of a true left ventricular aneurysm (50 patients) and of an asynergic area (20 patients) are presented. The operative mortality was 14 per cent. Predicted survival by actuarial methods was 80 per cent at one year after operation and 65 per cent at six years. Functional improvement was obvious with most of the survivors falling in NYHA class I or II. Factors influencing operative mortality were the clinical indication for operation and the anatomical lesion. Late postoperative results were better for true aneurysms than for asynergic areas. An asynergic area was usually associated with multiple coronary vessel lesions and a diffusely ischaemic myocardium. An aneurysm was often associated with a single coronary vessel disease and with good function of the non-infarcted myocardiun.

Adult↗
PubMed1980

Is right bundle branch block aviodable in surgical correction of tetralogy of Fallot?

Right bundle branch block (RBBB) is usually considered almost unaviodable after repair of teralogy of Fallot (TOF). By modifications of the standard technique, its frequency has been decreased to 32% in a series of 1000 consecutive patients. These modifications are: (1) a very short right ventricular incision avoiding the ventriculotomy-induced RBBB pattern; (2) an infundibular resection limited to the septal attachment of the infundibular septum; and (3) closure of the ventricular septal defect with a patch sutured to the very edge of the muscular septum, avoiding injury to the right bundle along the right aspect of the septum. No patient in this series sustained permanent complete atrioventricular heart block. Among patients with RBBB, five had a left anterior hemiblock. Postoperative intraventricular conduction was related to age at operation: The incidence of RBBB was significatively higher in infants. The beneficial effects of a low incidence of postoperative RBBB after repair of TOF are not known.

Adolescent↗
PubMed1980

[Myocardial infarction in an infant without coronary artery birth anomalies].

The anomalous origin of the left coronary artery is almost the only cause of neonatal myocardial infarction. Other rare causes have been proposed when haemodynamic studies have shown a normal coronary tree. An 18 months old child, born prematurely at the 6th month of pregnancy (in a moribund condition), presented with a postero lateral myocardial infarction and congestive cardiac failure resistant to drug therapy. Angiography showed anormal coronary tree, massive mitral incompetence and a left ventricular aneurysm. The mechanical complications of the infarct were treated surgically with a good result, 2 years postoperatively. The possible aetiologies of the infarction are discussed: embolism, thrombosis, blood disorder, infection, and cardiorespiratory failure at birth in a premature baby. This case shows that the complications of myocardial infarction in childhood may be treated surgically without coronary revascularisation when the coronary arteries are normal. The exact cause of the infarction remain uncertain.

Coronary Vessel Anomalies↗
PubMed1979

[Complete correction of Fallot's tetralogy in infants. Preliminary results].

Complete repair was undertaken in 28 infants with severe forms of tetralogy of Fallot because severe cyanosis or anoxic spells. Age at operation ranged from 8 days to 11 months (mean: 4,4 months). Among the 24 cases without any other intracardiac defect, there were 6 early deaths related in 4 cases to a wrong indication or a technical error. Re-investigation was performed in 14 out of the 18 survivors from 3 weeks to 6 months post-operatively: the result is good in 10 cases, fair in 1 case, and poor in 3 cases requiring twice a reoperation with 1 further death and 1 good final result. More accuracy in selecting the surgical patients and improvement in operative techniques should result in a further decrease of our early mortality rate. Primary complete repair should therefore become a substantial alternative to the palliative shunts which results seem to be hazardous in the more severe types of the defect.

Age Factors↗