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G Babatasi

Publications and source records attributed to G Babatasi.

68 records · Page 4Linked to original sources
PubMed1996

[Cardiac transplantation. Evaluation of a consecutive series of 75 grafts].

OBJECTIVES: The global results of various series of heart transplantation (HT) are essential to assess the life expectancy provided by this technique. Due to the increasing graft shortage, it appears essential to very strictly candidates for HT. METHODS: From March 8, 1989 to December 7, 1994, 75 orthotopic Hts were performed in 62 men and 12 women (1 case of retransplantation). The mean age was 47.46 +/- 15.02 years (range: 2.5-66 years). Four patients were younger than 10 years and 22 were older than 60 years. Our series included more cases of ischaemic heart disease (36) than dilated cardiomyopathies (33), with a history of cardiac surgery in almost one quarter (20) of patients with ischaemic heart disease. RESULTS: The immediate postoperative survival rate was 94.7% with 3 deaths attributable to refractory pulmonary hypertension associated with graft failure and one death related to postoperative tamponade. Five other patients died during the following 3 months, increasing the mean global survival to 88%. After a mean follow-up of 2.1 years (maximum 5.8 years), the actuarial 5-year survival rate was 56.8%. Eleven patients died between 4 and 38 months (mean: 18.2 months). Two deaths were due to cancers, 4 were due to septicaemia, another 4 were due to rejection and finally 1 was due to meningeal haemorrhage. The frequency (19) of reoperations for clot removal was due to the large number of patients with a history of previous heart surgery (20). CONCLUSION: Strict recipient selection, possibly based on 123I-MIBG scintigraphy, the use of pulsatile circulatory assistance systems, improved CMV, morphometry and donor-recipient age matching, should optimize the results of a technique, whose efficacy is confirmed in this series.

Adolescent↗
PubMed1996

[Value of percutaneous carotid angioplasty before cardiac surgery].

Transluminal angioplasty (TLA) of asymptomatic carotid stenoses (> 85%) in patients candidates for coronary artery bypass graft for stable angina appears to be an interesting technique to evaluate in a population whose management is controversial. Between January 1993 and January 1995, 10 patients underwent Carotid TLA (CTLA) prior to coronary artery bypass grafts (mean: 17.4 days). The mean age was 71 +/- 4.3 years. Eight patients were classified as NYHA class II and two were classified as class III. The mean number of bypass grafts per patient was 2.7. Four patients presented contralateral thrombosis of the internal carotid artery. CTLA was performed under cerebral protection by means of a triple coaxial catheter. Six CTLA required a Strecker stent. The mean follow-up was 11.4 months, with no mortality. One patient presented with transient hemianopsia. All patients were reviewed at 4 months by follow-up angiography, followed by Doppler. Only one of the 10 patients reviewed required redilatation with complementary stenting and another patient required dilatation of the stent. Although the follow-up of this short series is brief, the results of CTLA are encouraging in this population with a high risk of morbidity and mortality (elderly patients, frequently bilateral carotid lesions, coronary bypass grafts with multiple arterial grafts.

Aged↗
PubMed1995

Aortopulmonary fistula: an uncommon complication in dystrophic aortic aneurysm.

Wall dissection is a typical complication in the evolution of Marfan aortic aneurysm and usually is associated with valve regurgitation. Formation of a fistula with adjacent structures is very uncommon. We report the case of a 32-year-old man who presented with the typical features of Marfan's syndrome, with chronic aneurysm of the ascending aorta and acute aortopulmonary fistula. Diagnosis was made preoperatively by aortography; operation was performed successfully. A review of the literature only shows a few cases of aortopulmonary fistula in atherosclerotic, syphilitic, or postendocarditis disease.

Acute Disease↗
PubMed1994

An animal model for the evaluation of graft thrombosis in the acute phase on carbon-lined PTFE prosthesis.

Forty-five carbon-lined (CL) and 45 standard (ST) 4 mm internal diameter polytetra-fluoroethylene (PTFE) grafts were implanted as aortic interposition in 90 rabbits. A pilot study of 20 animals: 10 CL and 10 ST grafts were used to develop microsurgical techniques, then 60 grafts were placed in 60 New Zealand rabbits with lower morbidity. The two hours graft patency (Doppler and angiographic studies) showed better patency rate in CL group (93% versus 80%). In 10 animals, platelet accumulation was investigated in vivo using gammacamera imaging after injection of autologous platelets labeled with Indium111. In vitro, radioactivity counting of the explanted midgraft sections at 2 hours revealed 6 times greater activity in ST grafts (6.60 +/- 1.98 x 10(3) platelets/mm2 versus 0.82 +/- 0.25 x 10(3) platelets/mm2; p < 0.05). Light microscopy found platelet and fibrin deposition (PFD) in nearly all ST grafts whereas PFD were found in only 13% of the CL grafts corresponding to those thrombosed (chi 2: 61.117, p < 0.001). Carbon-lining decreases platelet accumulation on PTFE grafts in the acute phase of a new experimental model.

Angiography↗
PubMed1993

[Subacute rupture of the free wall of the heart. Clinical echocardiographic and pathological aspects apropos of 10 cases].

Three distinct forms of rupture of the heart may be identified after myocardial infarction: sudden rupture with massive intrapericardial haemorrhage, and sudden death with clinical signs of electromechanical dissociation; rupture into the pericardium resulting in a false aneurysm, the treatment of which is surgical; subacute rupture which accounts for 30% of cases in which bleeding into the pericardium is slow and/or repeated. Over an 8 year period and in a series of 2,400 consecutive infarcts admitted to the intensive care unit, 10 cases of subacute rupture of the heart were diagnosed. They were 6 men and 4 women, with a mean age of 73.6 years. The clinical presentation was isolated chest pain in 5 cases, syncope alone in 2 cases and the association of pain and syncope in 3 cases. Six patients were in shock on admission. In two cases, shock developed after admission. The infarction was confirmed biologically by a significant elevation of creatinine kinase in 9 out of 10 cases. Transmural infarction was observed in 9 cases: the infarct was electrocardiographically non-transmural in 1 case. Emergency echocardiography showed pericardial effusion in all cases, usually moderate, but sometimes compressive with an intrapericardial echogenic mass suggesting a thrombus. Haemodynamic improvement was obtained by medication allowing cardiac catheterisation which showed adiastole in 3 cases. Coronary angiography was performed in 7 cases. In 5 of the 7 cases, apart from occlusion of the artery presumed to be responsible for the infarct, the coronary vessels were diffusely infiltrated without significant stenosis. Left ventriculography was performed in 7 cases. In 6 of the 7 cases regional akinesis was demonstrated: the 7th case showed dyskinesia of the anterior wall. In two cases, contrast medium was observed to fill the pericardium during ventriculography, indicating myocardial rupture. The diagnosis of subacute rupture, suggested by clinical and paraclinical (particularly echocardiography), was confirmed in 9 cases at surgery and in the 10th case at autopsy. Surgery consisted of repairing the rupture. In the last two cases, biological glue was used to reinforce the surgical repair. The clinical outcome was good after surgery in 6 cases with a follow-up of 5 months to 8 years. The diagnosis of subacute rupture should therefore be made on clinical and echocardiographic criteria, as these results suggest that surgery is often possible, with a good prognosis.

Aged↗
PubMed1993

Mapping of activation, recovery and activation-recovery intervals in the human heart.

Peroperative epicardial mapping of activation, recovery and activation-recovery intervals in the human heart has been performed in a group of 12 patients. These patients had the coronary disease but electrocardiograms with normal characteristics. For this mapping, 240 unipolar electrograms were simultaneously recorded with the system SATAPEC built in our laboratory. The results confirm the classical data obtained on the dog heart. In particular, it was well established that the duration of activation corresponding to activation-recovery intervals is shorter at the base than at the apex of the posterior surface of the heart. With SATAPEC it is very easy to obtain epicardial mapping of electrical activity in a few minutes during open heart surgery.

Coronary Disease↗
PubMed1993

[Value of the posterior route in the surgical treatment of popliteal aneurysm].

The authors report about 4 cases of surgical treatment of popliteal aneurysms through a strictly posterior approach. In all cases, the aneurysm was asymptomatic and diagnosed during the assessment of a controlateral symptomatic popliteal aneurysm that was treated in a conventional manner (exclusion and interposition of a femoropopliteal prosthetic tube through a medial approach). The procedure is carried out with the patient in ventral decubitus, and it consists in a debridement and graft with direct anatomical interposition of a straight PTFE tube. The posterior approach has limitations as it does not allow craniad extension and applies only to sacciform or short fusiform aneurysms the upper pole of which does not extend beyond Hunter's canal. The graft was an 8-mm PTFE straight tube in all 4 cases. All patients had a dynamic bilateral control angiography made and none of them presented with symptoms. Three conventional restorations required later embolectomy for thrombosis of the prosthesis. In our opinion, the use of the posterior approach for the surgery of popliteal aneurysm is appealing-provided strict criteria (aneurysm size, scheduled surgery, prosthesis) are complied with--as it reduces morbidity, restores the anatomical course and allows reducing the rate of postoperative thrombosis, thus ensuring better long-term patency.

Aneurysm↗
PubMed1990

[Gastropericardial fistula. Review of the literature apropos of an original case].

The authors present a case of pneumopericarditis consecutive to a perforating gastric ulcer complicating a left, post-traumatic diaphragmatic hernia, evolving favorably after radical surgery. 52 cases of gastro-pericardial fistulas were reported in the literature, 42 of which related to benign pathology. The overall mortality rate for this disease was 85%, although the course was favorable in one patient out of two, whenever radical surgery had been resorted to. In order to ensure these patients the best chances for survival, treatment should combine pericardial drainage and case-adapted gastro-intestinal surgery in an intensive care setting.

Aged↗
PubMedDate not supplied

Aortic balloon entrapment complicating intra-aortic balloon counterpulsation.

Short-term balloon counterpulsation may be complicated by aortic balloon entrapment. We report a patient in whom video-coronary surgery was performed using beating heart anastomosis. This patient developed intra-aortic balloon (IAB) entrapment 4 days after initiation of the counterpulsation previously implanted for a preoperative low ejection fraction. No limb ischaemia was detected, but urgent removal of the balloon catheter is mandatory if blood is detected in the tubing connecting the balloon to the console, even in the presence of adequate function of the IAB assistance.

Aged↗
PubMedDate not supplied

Should mild-to-moderate and moderate ischemic mitral regurgitation be corrected in patients with impaired left ventricular function undergoing simultaneous coronary revascularization?

INTRODUCTION: Mitral valve regurgitation (MR) occurring as a result of myocardial ischemia and global left ventricular (LV) dysfunction predicts poor outcome. This study assessed the feasibility of mitral valve (MV) surgery concomitant with coronary artery bypass grafting (CABG) in patients with mild-to-moderate and moderate ischemic MR and impaired LV function. MATERIALS AND METHOD: From January 1996 to July 2000, 49 patients (group 1) and 50 patients (group 2) with grade II and grade III ischemic MR and LV ejection fraction (EF) between 17% and 30% underwent combined MV surgery and CABG (group 1) or isolated CABG (group 2). LVEF (%), LV end-diastolic diameter (EDD) (mm), LV end-diastolic pressure (EDP) (mmHg), and LV end-systolic diameter (ESD) (mm) were 27.5 +/- 5, 67.7 +/- 7,27.7 +/- 4, and 51.4 +/- 7, respectively in group 1 versus 27.8 +/- 4, 67.5 +/- 6, 27.5 +/- 5, and 51.2 +/- 6, respectively in group 2. Groups 1 and 2 were divided into Groups 1A and 2A with mild-to-moderate MR (22 [45%] and 28 [56%] patients, respectively) and groups 1B and 2B with moderate MR (27 [55%] and 22 [46%], respectively). In group 1, MV repair was performed in 43 (88%) patients and MV replacement in 6 (12%) patients. RESULTS: Preoperative data analysis did not reveal any difference between groups. Five (10%) patients in group 1 died versus 6 (12%) in group 2 (p = ns). Within 6 months after surgery, LV function and its geometry improved significantly in group 1 versus group 2 (LVEF, p < 0.001; LVEDD, p = 0.002; LVESD, p = 0.003; and LVEDP (p < 0.001) improved significantly in group 1 instead of a mild improvement in Group 2). The regurgitation fraction decreased significantly in group 1 patients after surgery (p < 0.001). There was an inverse strong correlation between postoperative forward cardiac output and regurgitation fraction (p < 0.001). LVEF and LVESD improved significantly in group 1 versus group 2 patients (p = 0.04 and p = 0.02, respectively). The cardiac index increased significantly in group 1 and 2 (p < 0.001 and p = 0.03, respectively). LV function and geometry improved significantly postoperatively in group 1B versus group 2B (LVEDD, p = 0.027; LVESD, p = 0.014; LVEDP, p = 0.034; and LVEF, p = 0.02), instead of a mild improvement in group 1A versus group 2A (LVESD, p = 0.015; LVEF, p = 0.046; and LVEDD and LVEDP, p = 0.05). At follow-up, 4 (67%) of 6 patients undergoing MV replacement died versus 5 (11.5%) of 43 patients undergoing MV repair in group 1 (p = 0.007). The overall survival at 3 years in Group 2 was significantly lower than group 1 (p < 0.009). CONCLUSION: MV repair and replacement-preserving subvalvular apparatus in patients with impaired LV function offered acceptable outcomes in terms of morbidity and survival. Surgical correction of mild-to-moderate and moderate MR in patients with impaired LV function should be taken into consideration since it yields better survival and improved LV function.

Aged↗
PubMedDate not supplied

[Value of cardiac scintigraphy with I123 meta-iodobenzylguanidine in congestive heart failure. A review].

Heart failure is accompanied by major disturbances of the functioning of the sympathetic nervous system: global overactivation and local modifications of the adrenergic system. 123I-MIBG cardiac scintigraphy is an isotope technique investigating presynaptic adrenergic function. The cardiac uptake of MIBG is decreased during heart failure, reflecting a reduction of norepinephrine reuptake by cardiac presynaptic nerve endings. Alteration of presynaptic function occurs early and plays an important role in the pathogenesis of the deterioration of heart failure. 123I-MIBG cardiac scintigraphy allows in vivo assessment of the myocardial adrenergic reserves of patients with congestive heart failure. It should be proposed in all patients with severe ventricular dysfunction to help define the indications for heart transplantation.

3-Iodobenzylguanidine↗
PubMedDate not supplied

[Leiomyosarcoma of the heart and great vessels].

Leiomyosarcomas (LMS) of the heart are exceptional primary malignant tumours with a catastrophic prognosis and a mean survival measured in months. Extensive radical surgical resection clearly remains the most appropriate treatment. We report three cases observed over a 3-year period, consisting of an LMS of the inferior vena cava, an LMS of the pulmonary artery trunk and an LMS of the left atrium. The first case was treated by radical resection and reconstruction by autologous vein graft of the cavorenal junction, the second case was treated by extensive resection and prosthetic reconstruction of the pulmonary artery bifurcation and the third case was treated by a first radical resection of the left atrium, requiring total cardiectomy and orthotopic heart transplantation for local recurrence at the sixth month. The survical was significantly improved compared to other treatment options (chemotherapy, radiotherapy). The first patient is still alive without recurrence at two years; the second died 12.5 months after the surgical procedure and the medium-term follow-up of the transplanted patient revealed cerebral and hepatic metastases nine months after transplantation. The authors review the literature concerning these extremely rare malignant tumours. Recent progress of diagnostic investigations, such as spiral CT with reconstruction, MRI, positron emission tomography (PET), are now able to establish the diagnosis more rapidly and therefore allow more radical surgical resection. This resection, possibly combined with venous reconstruction, must be associated with adjuvant therapies. Heart transplantation should be considered among the treatment options for leiomyosarcomas of the heart, in order to improve the poor prognosis of these lesions affections a young population.

Brain Neoplasms↗