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Biomedical subjects

F Wellens

Publications and source records attributed to F Wellens.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Thrombosis of the Saint Jude Medical valve prosthesis in the aortic position: a diagnostic and surgical emergency.

Three cases of prosthetic thrombosis with the SJM mechanical bileaflet pyrolitic valve in the aortic position occurred in a series of 355 patients operated on over a four-year period (October 1978-September 1982). Symptoms and signs of inadequate left ventricular flow (with various degrees of aortic regurgitation) were marked and developed rapidly. The patient is usually aware of muffling of the valve sounds. Auscultation is typical (muffled or abolished valve sounds; appearance of a systolo-diastolic murmur). Echocardiogram and carotidogram are suggestive. Adequately oriented fluoroscopy is diagnostic. Emergency prosthetic replacement is life-saving. Long term, well controlled, anticoagulation with coumadin is advocated.

Aortic Valve↗
PubMedDate not supplied

Composite graft replacement of the aortic root and ascending aorta for annuloaortic ectasia.

Eighteen patients with annuloaortic ectasia were surgically treated during a six year period. Cystic media-necrosis was present in 17 patients, five of them presented with Marfan syndrome. All patients received a composite graft with reversed mitral Björk-Shiley or St-Jude prosthesis and reimplantation of the coronary ostia or venous bypass grafts. Combined profound selective hypothermia and hyperkalemic cardioplegia was the preferred myocardial protection technique. There was one early postoperative and two late deaths. The fifteen survivors, with a follow-up between 6 and 72 months did not present conduit related complications and clinical results are excellent; all patients are NYHA class I (11) or II (4).

Adult↗
PubMedDate not supplied

Cardiocutaneous fistula after left ventricular aneurysm repair. Case report and review of the literature.

Cardio-cutaneous fistula is a rare late complication of LV aneurysm repair related to the use of Teflon strips to bolster the suture line. Since bleeding occurs in half of the cases and there is no tendency to spontaneous healing, operation should be advised and should involve complete removal of all foreign material with the aid of CPB. We suggest that foreign body intolerance might be the main factor in the development of the lesion and infection a consequence of fistulisation through the skin.

Fistula↗
PubMedDate not supplied

Coronary artery fistula: an absolute surgical indication.

Two operated cases and an anatomical, clinical and therapeutic review of primary coronary artery fistula (CAF) are presented. The authors focus attention on the deleterious evolution of untreated CAF and on the higher morbidity and mortality of surgical treatment of CAF in the elderly. They recommend surgery for CAF even asymptomatic.

Adult↗
PubMedDate not supplied

Abdominal aortic aneurysm, an absolute surgical indication?

In a retrospective study, 155 patients operated for infrarenal abdominal aortic aneurysm during a 5.5-year period (jan. 1986-->oct. 1991) were reviewed. In our series, 111 patients underwent elective (EL) surgery, 44 patients had an emergency (EM) operation. Male/female ratio was 10/1. Mean age in the EL group and EM was 68.1 years and 71.82 years respectively (p < 0.05). In the EL group, 68 (= 61%) patients were asymptomatic. All patients in the EM group had symptoms: shock + syncope in 28 patients, acute back pain in 4 patients, acute abdominal pain in 12 patients. Aneurysm diameter > or = 8 cm was present in 33% of the EL group, but in 57% of the EM group. Early mortality for the EL and EM group was 3.6% and 23% respectively (p < 0.001). Major postoperative complications were present in 13% in the EL group, in 55% in the EM group (p < 0.001). During a 5-year follow-up of 135 patients (= 96%), 22 patients died. Cardiac problems (7/22) and cancer (5/22) were most prominent. 5-year survival for the entire group was 83%; EL (85%) and EM (76%) were not significant. None of the patients subsequently underwent an operation related to the abdominal aortic intervention.

Acute Disease↗