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Biomedical subjects

F Cherrier

Publications and source records attributed to F Cherrier.

At least 73 records · Page 4Linked to original sources
PubMed1991

Proximal rupture and intracoronary entrapment of a rotating device during low-speed rotational coronary angioplasty.

While attempting to recanalize a right coronary artery obstruction by using a low-speed rotating catheter (Rotacs), proximal rupture of the catheter body occurred with entrapment of the blunt tip in the obstruction. To retrieve the device, it was necessary to severe the guiding catheter and the flexible tube of the Rotacs. At low-speed rotation the flexible segment of the catheter was then pulled back.

Angioplasty, Balloon↗
PubMed1991

Differential effects on right ventricular function of transient right, left anterior descending and left circumflex coronary occlusions during percutaneous transluminal coronary angioplasty.

Right ventricular function was studied by means of a thermodilution catheter before, during and after percutaneous transluminal angioplasty of the proximal right (group 1, n = 8), left anterior descending (group 2, n = 8) or left circumflex (group 3, n = 8) coronary artery. All patients had evidence of myocardial ischemia, with single-vessel disease affecting the proximal segment of one of the three major coronary arteries; no patient had had a previous myocardial infarction and all had normal cardiac function at baseline study. Cardiac index decreased during balloon inflation. Mean pulmonary artery pressure was unaffected in group 1 but increased in group 2 (from 19 +/- 5 to 31 +/- 11 mm Hg, p less than 0.01) and in group 3 (from 19 +/- 2 to 22 +/- 5 mm Hg, p less than 0.05). Right ventricular ejection fraction decreased from 62 +/- 9% to 52 +/- 10% (p less than 0.01) in group 1 and from 64 +/- 7% to 44 +/- 10% (p less than 0.005) in group 2, and returned to normal within 2 min after balloon deflation in both groups. In group 3, right ventricular ejection fraction was unchanged during balloon inflation (58 +/- 5% at baseline, 58 +/- 9% at 60 s, p = NS). Therefore, brief occlusion of the proximal segments of the left anterior descending or right coronary artery results in marked alteration of right ventricular performance that is probably caused by right ventricular free wall ischemia in the right coronary group and by the concomitant effects of septal ischemia and increased right ventricular afterload in the left anterior descending artery group.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1991

[Rotacs: a device used in coronary and peripheral arterial recanalization].

The authors report their preliminary results with the Rotacs system in the reopening of chronic coronary artery occlusion by low-speed rotational angioplasty. This system improves the percentage of coronary recanalisation in cases where it is impossible to pass the guide wire alone. It seems to be an effective, low-cost complementary tool for the treatment of this type of lesion.

Angioplasty, Balloon↗
PubMed1991

Early and long-term outcome after emergency coronary artery bypass surgery after failed coronary angioplasty.

From April 1980 to January 1990, among 2,576 percutaneous transluminal coronary angioplasty (PTCA) procedures, 100 patients (82 men and 18 women; mean age, 54 +/- 10 years [3.9%]) underwent emergency coronary artery bypass graft surgery. Before PTCA 56 had unstable angina, 34 had prior myocardial infarction, and 60 had single-vessel coronary artery disease. The mean time period from the onset of ischemia to surgical reperfusion was 147 +/- 16 minutes; 155 grafts were placed (1.5 grafts per patient). In-hospital mortality was 19%; operative mortality was significantly related to older age (59 +/- 9 versus 53 +/- 10 years, p less than 0.05), presence of unstable angina (74% versus 53%, p less than 0.05), and development of cardiogenic shock or necessity of cardiac massage before surgery (53% versus 16%, p less than 0.0001). In addition, 57 patients developed a Q wave myocardial infarction. For hospital survivors, overall survival at 7 years was 94% (Kaplan-Meier method), with three cardiac deaths during follow-up; two additional patients had late myocardial infarction, and four had late PTCA. At a mean follow-up of 55 +/- 38 months, 78% of the patients had no chest pain, and 80% reported no dyspnea. All patients received antiplatelet agents or oral anticoagulants; 34% had no antianginal medications. Among the 40 previously employed patients, 73% resumed work after surgery. All patients with cardiogenic shock or cardiac massage who survived the initial hospital period were alive at follow-up. After an initial critical period, the long-term clinical outcome of patients with emergency coronary bypass surgery after failed PTCA is satisfactory.

Angioplasty, Balloon, Coronary↗
PubMed1990

[Food habits in primary dilated cardiomyopathy].

In this prospective study the nutritional profiles of 21 consecutive male hospital in-patients with primary dilated cardiomyopathy were evaluated in order to determine whether these profiles differed from those foodstuff consumed during on week and recording of the daily consumption of alcoholic beverages during the year preceding hospitalisation. The duration of dangerous alcohol consumption (more than 60 g/day) was also recorded. In these 21 patients the mean calorie intake was 3,600 kcal/day, including 500 kcal/day provided by alcohol. The mean nutrient intakes were: proteins 90 g/day, fats 100 g/day and carbohydrates 300 g/day. The daily alcohol consumption exceeded 20 years. Compared with the control population, the patients with primary dilated cardiomyopathy had a diet that was not lacking in calories but showed insufficient fat intake. Alcohol consumption was unquestionably excessive and constituted a major risk factor for this particular disease.

Adult↗
PubMed1990

[Current results of coronary transluminal angioplasty].

During the last few years, coronary angioplasty has been widely performed with excellent immediate results. The primary success rate now ranges from 85 to 97 per cent, with a mortality rate of 0.1 to 2.5 per cent, a 1 to 3 per cent rate of infarction and an 0.5 to 3 per cent of emergency bypass operation. However, disorders of repolarization and chest pain may be observed during the days which follow the angioplasty. The reasons for these manifestations are not always obvious, and the explanation provided by early exercise tests is not sufficiently accurate. In the short term, restenosis is the major problem, as it occurs almost invariably in 30 per cent of the cases, irrespective of the preventive method used. The long term results are very encouraging, and most patients remain symptom-free. This, of course, cannot be said of those cases where angioplasty fails: the long term survival is about the same as in the successful cases but coronary events are much more frequent. the socio-economic impact of coronary angioplasty is not easy to evaluate owing to the ever increasing cost of the procedure events are much more frequent. The socio-economic impact of coronary angioplasty is not easy to evaluate owing to the ever increasing cost of the procedure and to the extension of its indications. As regards the latter, the most important point is to decide whether subjects with multiple vessel lesions should be treated by angioplasty or undergo an aorto-coronary bypass; this problem can not be solved for the moment, but several multicentre randomized studies are in progress in search of an answer.

Angioplasty, Balloon, Coronary↗
PubMed1990

Role of previous angina pectoris and collateral flow to preserve left ventricular function in the presence or absence of myocardial infarction in isolated total occlusion of the left anterior descending coronary artery.

The aim of this study was to determine whether previous angina pectoris and collateral circulation influenced myocardial function after isolated coronary occlusion. In 58 consecutive patients, coronary angiography showed a complete isolated occlusion of the left anterior descending coronary artery; 43 patients (74%) had previous myocardial infarction. Duration of previous angina pectoris was defined as the time from the first ischemic symptom to the date of myocardial infarction or of coronary angiography in the absence of myocardial infarction. Left ventricular ejection fraction was measured on the 30 degrees right anterior oblique projection of the left ventricular angiogram. Collateral circulation was graded as follows: none or filling limited to side branches (group 1) and partial or complete filling of the epicardial arterial segment (group 2). Group 2 (40 patients) had higher ejection fraction (57 vs 38%; p less than 0.0001) and longer duration of previous angina pectoris (11 vs 0.1 months; p less than 0.002) than group 1 (18 patients). A longer duration of previous angina pectoris probably allows collateral development before coronary occlusion in 1-vessel coronary artery disease, thereby limiting myocardial damage.

Angina Pectoris↗
PubMed1990

Abstention from alcohol in dilated cardiomyopathy: complete regression of the clinical disease but persistence of myocardial perfusion defects on exercise thallium-201 tomography.

This case report describes a 43-year-old man with dilated cardiomyopathy reversed by abstention from alcohol over 1 year but with persistence of previous myocardial perfusion defects on exercise thallium-201 tomography. This suggests that despite the near normalization of left ventricular function, a permanent myocardial disease seems to persist.

Adult↗
PubMed1990

Methylergometrine-induced coronary artery spasm causing total occlusion of all three coronary arteries.

In a 58-year-old man with rheumatic mitral valve disease and nocturnal chest pain of recent onset, intravenous injection of 0.4 mg methylergometrine during coronary angiography resulted in the total occlusion of all three angiographically normal coronary arteries, with electromechanical dissociation. Intravenous isosorbide dinitrate failed to relieve coronary spasm which had to be treated by intracoronary administration of nitrates and nifedipine.

Coronary Angiography↗
PubMed1990

[Frequency of the onset of supraventricular tachyarrhythmias as a function of underlying heart disease].

The prevalence of inducible ventricular arrhythmias is related to the underlying pathology. This study was undertaken to determine the prevalence of supraventricular tachyarrhythmias (SVT), atrial tachycardia, flutter or fibrillation, sustained for over 30 seconds. Programmed atrial stimulation was used to deliver 1 or 2 extrastimuli during sinus and paced rhythm in 230 subjects without obvious cardiac disease (149 without and 81 with spontaneous SVT) and 432 patients with documented cardiac pathology (407 without and 25 with spontaneous SVT). The incidence of inducible SVT with respect to that of spontaneous SVT and in relation to cardiac pathology was as follows: (table; see text) The prevalence of inducible SVT in patients without spontaneous SVT was related to the type of pathology: (table; see text) These results show that in patients with spontaneous SVT the induction of the arrhythmia was facilitated by the presence of underlying cardiac pathology (sensitivity increasing from 67% to 88%). In patients without spontaneous SVT, the nature of the underlying disease was related to the prevalence of inducible SVT, the risk being major in SA block, right ventricular dysplasia and mitral valve prolapse (60-80%) and moderate in dilated CMP and myocardial infarction (35 to 40%).

Adult↗
PubMed1990

[Changes in right ventricular ejection fraction in right coronary angioplasty].

In order to analyse the response of the right ventricule (RV) to transient myocardial ischaemia, the RV ejection fraction was measured using a new rapid response thermodilution catheter in 15 patients (14 men and 1 woman: average age 58 +/- 7 years) referred for percutaneous transluminal coronary angioplasty of a dominant right coronary artery. Only patients with single vessel disease with a proximal stenosis of the right coronary without a visible collateral circulation who had no previous history of myocardial infarction were included. Right heart catheterisation was performed with a rapid-response thermodilution catheter which enabled measurement of heart rate, cardiac index, RV end-diastolic and end-systolic volumes and RV ejection fraction. Angioplasty was carried out with the usual steerable balloon catheters. During balloon inflation, there was a slight increase in RV end-diastolic volume (from 78 +/- 11 ml/m2 to 85 +/- 13 ml/m2 at 60 seconds; p less than 0.01) and a large increase in RV end-systolic volume (from 29 +/- 8 ml/m2 to 35 +/- 8 ml/m2 at 30 seconds and 43 +/- 11 ml/m2 at 60 seconds, p less than 0.001) leading to a significant decrease in RV ejection fraction (from 62 +/- 8% to 56 +/- 6% at 30 seconds and 51 +/- 7% at 60 seconds; p less than 0.001). All parameters returned to basal values two minutes after the dilatation. Acute occlusion of the proximal segment of the right coronary artery is therefore associated with a marked change in right ventricular function which rapidly returns to normal after the coronary circulation is restored.

Aged↗
PubMed1990

[Prognostic value of two-dimensional echocardiography before aneurysmectomy in anterior aneurysm of the left ventricle].

The prognostic value of echocardiographic apical 4 chamber recordings was assessed retrospectively in 18 patients who underwent left ventricular aneurysmectomy following anterior wall myocardial infarction. After an average follow-up period of 2 years, 7 patients had died or remained in functional Classes III or IV (Group 1) and 11 patients had satisfactory clinical outcomes (Group 2). There were no significant clinical or coronary angiographic differences between the two groups. The left ventricular surface area, transverse diameter and fractional shortening of the surface were also comparable in the two groups. The surface area of the aneurysm was greater in patients in Group 1 (37.4 +/- 11.8 cm2 vs 21.1 +/- 15.8 cm2, p less than 0.05). However, the more discriminating parameters were those related to the non-aneurysmal contractile zones (NACZ). Patients in Group 1 had a smaller relative surface area of the NACZ than those in group 2; 6 of the 7 patients in Group 1 had NACZ of less than 40 per cent of the left ventricle compared with none of the patients in Group 2 (p less than 0.001). In addition, the function of the NACZ was significantly worse in Group 1: surface fractional shortening: 9.6 +/- 10.2% vs 32.6 +/- 8.3% (p less than 0.001); ejection fraction: 20.7 +/- 9.1% vs 41.6 +/- 6.1% (p less than 0.001). All patients in Group 1 and none in Group 2 had ejection fractions of the NACZ of less than 30 per cent. Therefore, the apical 4 chamber view provides valuable prognostic information in patients who are candidates for surgical resection of left ventricular anterior wall aneurysms.

Adult↗
PubMed1990

[Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1990

[Induction of supraventricular tachycardia (paroxysmal junctional tachycardia and atrial tachycardia) by esophageal stimulation].

Transesophageal stimulation is tending to replace endocavitary electrophysiological studies in the investigation and treatment of supraventricular tachyarrhythmias. The aim of this study was to determine the sensitivity of this technique in the evaluation of paroxysmal junctional tachycardia (PJT) and atrial tachycardia (AT). Fifty-eight patients with these arrhythmias (PJT, n = 23; AT, n = 35) were investigated under basal conditions and then during Isoproterenol infusions with a protocol using incremental atrial stimulation and programmed atrial stimulation delivering one and two extra-stimuli on two paced rhythms (400-600 ms). It was possible to induce the arrhythmia in the 23 patients with PJT either under basal conditions (n = 16) or during Isoproterenol (n = 7). A reentrant mechanism was suggested in 22 patients by the following findings: position of the auriculogramme with respect to the ventriculogramme, presence or absence of a delaying branch block, situation and morphology of the P wave in lead V1 compared with atrial activation recorded by the esophageal catheter. Atrial tachycardia was induced in 26 patients (74 per cent), 19 under basal conditions, 6 with Isoproterenol and once after carotid sinus massage. As a conclusion, we can say that the sensitivity of transesophageal stimulation is the same as for endocavitary stimulation.

Adolescent↗
PubMed1990

[Abnormal tricuspid flow in carcinoid heart disease. A case report].

A case of the carcinoid syndrome with right heart involvement is reported. Echocardiography showed diffuse right ventricular disease with a pathological tricuspid valve. Doppler recordings of forward tricuspid blood flow showed changes suggesting abnormal right ventricular filling, the mechanisms of which are discussed.

Carcinoid Heart Disease↗