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Biomedical subjects

G Champsaur

Publications and source records attributed to G Champsaur.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Congenital aortic valve stenosis. Long-term results after valvulotomy].

The cases of 73 patients undergoing valvulotomy for congenital valvular aortic stenosis between 1957 and 1982 were reviewed. Data was updated after recalling patients to the outpatient clinic and/or analysis of the results of a questionnaire sent to the patient's family doctor or cardiologist. Babies less than 12 months old at the time of surgery were excluded from the study. Operation consisted of valvulotomy under direct control with few associated procedures as the valvular lesion was isolated in 89 p. 100 of cases. 5 patients died in the first 30 postoperative days, an operative mortality of 5,4 p. 100. The follow-up period ranged from 1 to 25 years, with 15 patients having been followed up for over 10 years. 6 patients were reoperated with no operative mortality. 2 of whom have since undergone a second reoperation. Of the 59 patients not re-operated, 54 were class I and 5 class II of the NYHA. Of the latter group, 4 are candidates for aortic valve replacement for significant aortic regurgitation. The actuarial survival graph shows a 92.82 p. 100 probability of survival at 5 years, and 86.83 p. 100 at 10 years. Aortic valvulotomy remains a palliative operation which does not protect the patient from subsequent sudden death.

Adolescent↗
PubMed1985

[Coronary anomalies associated with the Williams-Beuren syndrome. Apropos of 2 cases].

Two coronary artery anomalies associated with the Williams-Beuren syndrome are reported. The first case was a 14 year old child with severe supra-aortic stenosis associated with severe hypoplasia of the ascending aorta; 2 D echocardiography and angiography showed a voluminous aneurysm of the left main coronary artery. Aortoplasty with a patch gave a good early result. The second case was a two and a half months old baby operated as an emergency after cardiac arrest and who died at the end of surgery. The baby had severe supra-aortic stenosis, occlusion of the left coronary ostium by the left anterior cusp which was abnormally adherent to the aortic wall with subendocardial infarction and reaction fibroelastosis. The frequency of coronary anomalies associated with the Williams-Beuren syndrome is probably underestimated. Because of their severity they must be looked for routinely, by echocardiography and angiography. Their tendency to progress is an indication for early surgical correction of severe supra-aortic stenosis.

Adolescent↗
PubMed1984

Indices of effectiveness of medical and surgical treatment in 40 cases of prosthetic valve endocarditis.

Forty patients with prosthetic valve endocarditis (PVE) presenting during a 12-year period at a single hospital were studied. Twenty-six were male and 14 female and ages ranged from 19 to 67 years. During the first six post-operative months, most episodes were caused by staphylococci (38%) and Gram negative bacilli (24%). Between 6 and 11 months no episodes were seen, but thereafter streptococci predominated (50%). The overall mortality was 58% (66% during first six months; 36% thereafter). Nine of 23 patients undergoing re-operation died, most deaths occurring in patients in cardiac failure prior to surgery. Eleven deaths occurred in the 17 patients treated with antibiotics alone. Six of these were pyrexial at death and all but one was infected by a virulent organism. The remaining five were apyrexial at death and all had staphylococcal PVE. Our findings suggest: (1) all cases occurring during the first six months should be initially treated as 'early' PVE; (2) in staphylococcal PVE, apyrexia may not mean cure; (3) the principal guides to prognosis in PVE are the patient's cardiac status and the nature of the infecting organism.

Adult↗
PubMed1984

[Course of the results observed in the 1st 100 coronary angioplasties performed in 96 patients. Experience in Lyons].

TCA is an original method of myocardial revascularisation which, when successful, enables coronary bypass surgery to be avoided. However, a certain number of failures and complications are inherent to the development of a new therapeutic technique. The object of this study is to analyse the evolution of our results with this technique to determine which factors changed as our experience increased. The methodology used was that initially described by A. Gruntzig. TCA was carried out 72 times on the left anterior descending, 20 times on the right coronary and 8 on the left circumflex coronary artery (72 single vessel, 28 multivessel disease). The primary success rate was 75% (72% for the first 50 and 78% for the second 50 procedures). Coronary bypass surgery was required within the first 24 hours of TCA in 7% of cases. Myocardial infarction (Q wave changes) was observed in 5% of cases. One patient died on the third day (occlusion of an aorto-coronary venous graft). In retrospect, taking into account the experience gained and the development of the material now available, a certain number of failures and complications could probably have been avoided. However, a certain number of complications seems to be unavoidable. TCA remains an inviting but not infallible alternative in the treatment of coronary artery disease and should be included in the medico-surgical management of this condition.

Adult↗
PubMed1984

[Value of prostaglandin E1 in cardiac malformations in the newborn infant].

Prostaglandin E1 (PGE1) was administered to increase ductus patency in 26 neonates who present a cyanotic heart disease with right ventricular obstruction (1st group, 13 cases) or congestive heart failure with left ventricular outflow obstruction (2nd group, 13 cases). Clinical improvement occurred in all but the oldest infant in the first group. The efficacy of PGE1 is inconstant in the second group, but medical status was very poor before treatment. We could usually reduce the dose of PGE1 but in no case we could stop the drug before surgery. Surgery could be delayed several hours or days to get an hemodynamic and biologic satisfactory condition and even a few weeks until the infants and their pulmonary arteries had grown (1st group). Side effects are common but relatively minor.

Ductus Arteriosus↗
PubMed1982

[Use of valved tubes in the treatment of ventriculo-pulmonary discontinuity. Long-term results].

Forty five patients, 2 months to 42 years of age, had valved tubes implanted for ventriculo-pulmonary discontinuity. The underlying malformations were: certain forms of Fallot's tetralogy (16 cases), transposition of the great arteries with ventricular septal defect and pulmonary stenosis (8 cases), truncus arteriosus (9 cases), double outlet right ventricle (6 cases), other malformations (4 cases). Hospital mortality (at 30 days) was 31% (14 cases). This was mainly due to technical difficulties related to the large number of palliative procedures and to irreversible pulmonary hypertension, present in 43% of cases with fatal outcomes. Thirty one patients were followed up for 6 months to 7 years (mean 3 +/- 1,6 years). There were 3 late deaths, one during reoperation for a residual shunt. All survivors underwent clinical assessment with hemodynamic control in 17 cases (15 routine control catheterisations). To date it has only been necessary to change one valved tube: a good result was obtained.

Adolescent↗
PubMed1981

[Remote results of corrective surgery for aortic coarctation in newborn infants and infants].

A review of 122 cases of symptomatic coarctation of the aorta in neonates and infants confirmed the need for early corrective surgery in the majority of cases, in relation to the usual coexistence of associated cardiovascular malformations. The operative risk in the newborn up to one month of age was very high (42 %) but fell very sharply thereafter (5%). Restenosis was the principal late complication (36 %), persistent hypertension being rare in this age group. The risk of restenosis (not a significant vital risk during secondary surgery) should not weigh in the balance against life saving surgery where clinical deterioration is observed despite medical therapy or due to associated malformations.

Age Factors↗
PubMed1981

[Haemodynamic effects of dopamine, sodium nitroprusside and the association dopamine-sodium nitroprusside. Comparison of their effects after extra-corporeal circulation under deep hypothermia for congenital heart defects in infants and small children (author's transl)].

Heart rate, cardiac index measured by thermodilution, systolic diastolic and mean arterial pressure, mean left and right atrial pressures, were measured immediately before and after 30 minutes of dopamine infusion at a rate of 7 micrograms/kg/minute, then after 30 minutes of nitroprusside infusion at a rate of 0.5 micrograms/kg/minute, and after 30 minutes of association dopamine-nitroprusside at the same doses. The statistical analysis shows that the best enhancement in the cardiac output is observed (P less than 0.01) after the association dopamine-nitroprusside, with a diminution of systemic vascular resistance (P less than 0.05) however less important than that observed with sodium nitroprusside alone (P less than 0.025).

Child, Preschool↗
PubMed1980

[Anomalous origin of the left coronary artery from the pulmonary artery. Treatment by left subclavian-left main coronary artery anastomosis].

The technique of left subclavian-main left coronary artery is described as the treatment of anomalous origin of the left coronary artery from the pulmonary artery, without the aid of cardiopulmonary bypass, which, however, remains on standby. Through a left postero-lateral thoracotomy, the left main coronary artery is detached from the main pulmonary artery with a cuff of pulmonary wall after lateral clamping of the pulmonary artery. Tapes are encercling the pulmonary artery and the descending thoracic aorta, making them ready for an eventual connection to the standby bypass, in case the coronary clamping is not well tolerated. The anastomosis between the left subclavian artery dissected free and the prepared left main coronary artery is then possible and easy even in a small infant. This technique has been used in three infants aged three to thirty months without any mortality nor particular morbidity.

Child, Preschool↗
PubMed1980

[Palliative treatment of transposition of the great vessels. Indications and results. (author's transl)].

From 1973 to 1977, 93 infants (63 newborns) with d-TGA were treated with Blalock-Hanlon operation. All children had Rashkind atrioseptostomy at birth. 65 infants with isolated TGV were operated upon with two deaths (3%) and without any complication. 18 patients with TGV and VSD were treated with Blalock-Hanlon operation and Pulmonary Artery Banding and resulted in 5 deaths (28%). The other 10 cases had complex lesions. The overall operative mortality is 8.6%. The late mortality is 3.5%. The authors conclude that the Blalock-Hanlon operation is a safe procedure even in complex lesions. This kind of surgery does not seem to induce any arythmias but the authors did not perform any 24 hours ECG recording. This type of surgery makes the repair (Mustard operation) easier since the atrial septum is already removed.

Heart Septal Defects, Ventricular↗