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Biomedical subjects

G Faivre

Publications and source records attributed to G Faivre.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Echographic rediscovery of an anatomical structure: the Chiari network. Apropos of 16 cases].

In 1897, the anatomist Chiari described a structure in the right atrium connected to the Eustachian valve identified as the embryological vestige of the right valve of the sinus venosus. This structure was then forgotten. Recently, Werner described the echocardiographic appearances. During 1981, 1 600 consecutive patients underwent 2D echocardiography and the right atrium (RA) was visualised in several incidences. Abnormal RA echos fulfilling the echocardiographic criteria of the Chiari network were detected in 16 cases. The 2D echo appearances were as follows: a fine, mobile echo crossing the RA at right angles to its long antero posterior axis; arising from the anterior border of the orifice of the inferior vena cava, variably attached to the RA walls (lateral, superior, interatrial septum). The recordings were made from the transverse parasternal and apical or subcostal 4 chamber views. An M mode recording of this structure usually guided by the sector scan was made in 13 patients. This showed a fine curvilinear echo animated by antero-posterior vibrations during the cardiac cycle situated behind the anterior tricuspid leaflet. The pathological associations of the 16 patients in whom the Chiari network was demonstrated were as follows: 5 congenital cardiopathies including 3 ASDs, 1 isolated abnormal pulmonary venous drainage, 1 complex case comprising 1 ASD and 5 acquired lesions: aortic endocarditis; chronic cor pulmonale, idiopathic atrial fibrillation, pericarditis and coronary artery disease. Six patients did not appear to have cardiac disease. This structure was confirmed at surgery in 2 cases: the operative findings were a fine network of filaments stretching from the orifice of the inferior vena cava (Eustachian valve) to the RA walls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Natural development of old heart valve disease].

The authors report the natural history of 36 patients with end-stage valvular disease defined by the presence of a functional stage IV and/or a 0.60 and/or dilatation of the LA 90 mm and/or dilatation of the LV 70 mm and/or increase in the systolic PAP 80 mmHg and/or a decrease in the EF of 0.45. 11 patients are alive with a mean survival of 36.8 months (30.5%) and 25 have died after a mean interval of 7.8 months. The prognosis is very poor for aortic valvular disease (14 deaths out of 16 cases), but there were only 3 deaths out of 10 patients with isolated mitral valve disease.

Adult↗
PubMed1982

[Effects of isosorbide dinitrate injection on acute myocardial infarction. A haemodynamic and gamma-angiographic study (author's transl)].

The haemodynamic and gamma-angiographic effects of isosorbide dinitrate (ISDN) injection were evaluated in 18 patients with recent myocardial infarction by measuring diastolic (DPAP) and systolic (SPAP) pulmonary artery pressures, diastolic (DAP) and systolic (SAP) systemic arterial pressures, cardiac index (CI) and heart rate (HR). Total ejection fraction (EF) was measured by radionuclide angiography. Within the first hour of treatment, there was a significant fall in DPAP (from 25.11 +/- 6.5 to 18.3 +/- 6 mmHg), SPAP (from 47 +/- 11.5 to 36.6 +/- 10 mmHg) and SAP (from 140 +/- 27.8 to 123 +/- 20 mmHg). Changes in DAP, CI and HR were not significant. The drug produced a significant increase in EF (from 32.6 +/- 15 to 35.3 +/- 15 p. cent). On the basis of these results the patients could be divided into three categories: -- Group I patients (n = 5) with EF greater than 45, in whom the haemodynamic effects (fall in DRAP from 20.8 +/- 4.2 to 16.3 +/- 3 mmHg) and the gamma-angiographic effects (increase in EF from 53.8 +/- 6 to 58.6 +/- 3 p. cent) were favourable. -- Group II patients (n = 5) with EF less than 40, in whom the haemodynamic effects (fall in DRAP from 29 +/- 8.5 to 17.8 +/- 6 mmHg) and the gamma-angiographic effects (increase in EF from 23 +/- 9 to 34 +/- 7 p. cent) were still favourable. -- Group III patients (n = 8) with low EF, in whom there were no significant changes in haemodynamic effects (DPAP from 25.3 +/- 3 to 23.4 +/- 5 mmHg) and gamma-angiographic effects (EF from 26 +/- 6 to 25 +/- 5 p. cent). This group corresponds to cases with very extensive necrosis of unfavourable outcome (4 deaths). One may therefore consider that the lack of effectiveness of ISDN in subjects with left ventricular failure and low EF is of poor prognosis and requires more aggressive therapy.

Adult↗
PubMed1982

[Effect of adenosine triphosphoric acid (ATP) on accessory conduction bundles].

The effects of an injection of 40 mg of ATP were studied in 48 subjects with an overt or latent preexcitation syndrome. The results showed that the slowing of anterograde or retrograde conduction by ATP was not specific for nodal conduction. This phenomenon was observed in conduction through Kent bundles with long refractory periods and the possibility of preexcitation due to the association of James and Mahaim fibres should also be considered.

Adenosine Triphosphate↗
PubMed1982

[Danger of sinoatrial block and the use of antiarrhythmic agents in myocardial infarcts].

Nine cases of major ventricular arrhythmia (tachycardia (VT), fibrillation (VF), torsades de pointe) are reported in patients with sequellae of myocardial infarction but without residual angina or cardiac failure. --Six of these disturbances of excitability occurred after a bradycardia due to sino atrial block (SAB) which favoured the breakthrough of abnormal automatic foci. This form of the bradycardia-tachycardia syndrome was demonstrated by endocavitary electrophysiological exploration.. These were the only cases of major ventricular arrhythmia observed in a series of 88 SABs. Reputedly benign, they illustrate the potential gravity of a conduction defect in patients with sequellae of myocardial infarction. --Three other cases of abnormal ventricular excitability complicating the administration of 1 mg/kg of Ajmaline to test for paroxysmal block after myocardial infarction. These were the only cases of VT observed in a series of 800 Ajmaline tests. The three patients have had no further episodes of VT after 1 year's follow-up. On the other hand, in 43 Ajmaline tests without VT in patients with myocardial infarction, 6 cases of VT and 1 lethal VF were later observed. This demonstrates the lack of significance of episodes of VT during Ajmaline tests, the depressant action of the drug on intracardiac conduction favouring the initiation of reentry. In conclusion, a history of myocardial infarction exposes the patient to the risk of major ventricular arrhythmias in SAB, the detection of which should indicate pacemaker therapy from the first symptoms. The use of an intravenous antiarrhythmic agent should be avoided as it may aggravate arrhythmias. However, the arrhythmia is of no prognostic significance.

Aged↗
PubMed1982

[Arterial spasm of the lower limbs caused by pheochromocytoma].

The authors report the case of a 66-year-old man hospitalised with a clinical picture of stage III arterial disease of the lower limbs. Aortography revealed complete spasm of both popliteal arteries and a right adrenal tumour. Excision of the phaeochromocytoma led to the disappearance of symptoms of obliterative arterial disease and normalisation of Doppler results. The role of catecholamines in spasm is discussed.

Adrenal Gland Neoplasms↗
PubMed1981

[Values of the effective anterograde refractory period of the bundle of His].

The effective refractory period of the His bundle (ERP.H), the longest H1, H2 interval not followed by a V2 ventricular complex, was measured in 45 cases during the electrophysiological investigation of 500 Patients by premature atrial stimulation techniques. The patients were divided into two groups according to the result: Group I: 22 patients with syncope, a spontaneous HV interval greater than 60 ms, greater than 100 ms after Ajmaline or infrahisian block with atrial pacing at less than 150 bpm. Group II: 23 patients without these abnormalities. The ERP.H was significantly different (p less than 0,001) in the two groups with valves greater than 400 ms in Group I and less than 400 ms in Group II. It is suggested that in the absence of other electrophysiological abnormalities an ERP.H of 400 ms or over may be an indication for permanent pacing in patients with Stokes-Adams attacks. The finding of an ERP.H of over 400 ms is associated with severe infrahisian block. However, the ERP.H depends on the ERP of the AV node which must be shorter to calculate the refractory periods of the His bundle, and, above all, on the basal sinus cycle. The ERP.H decreases with shorter sinus cycles and cannot be calculated when the sinus cycle is less than 600 ms. Conversely, the critical value of 400 ms is not valid for cycles longer than 1000 ms as cycles of that length are associated with lengthening of the ERP.H. The regression of infrahisian block during programmed atrial pacing after Atropine does not seem to be a reliable method of distinguishing between physiological and pathological atrioventricular block.

Ajmaline↗
PubMed1981

[A new radioisotopic method of studying local ejection fractions. Application to the study of abnormalities of left ventricular contraction].

The authors describe a new method of segmental analysis of the left ventricle by equilibrium gamma cinecardiography. The left ventricle in the left anterior oblique projection was divided into 16 triangular sectors with reference to the centre of gravity of the radioactivity of the end diastolic frame. The following parameters were calculated for each sector (the spatial equivalent of a quarter of an orange): end diastolic, end systolic and ejection activity and the regional ejection fraction. The percentage of normal and asynergic regions was deduced. The end diastolic activity of regions with ejection fractions of over 0,47 was compared to the total end diastolic activity to obtain the percentages. This method of segmental division has the advantages of being completely automatic, based entirely on an objective reference calculated by computer and of giving very reproductible quantitative results. The clinical applications in a series of I400 patients examined by this method were numerous (the detection of dyskinesia in acute myocardial infarction). It was particularly useful in chronological and follow-up studies (exercise scintigraphy before and after glyceryl trinitrite).

Cardiac Output↗
PubMed1981

[Prognosis of chronic post-traumatic thoracic aorta aneurysms in 15 patients (author's transl)].

False chronic post-traumatic aneurysms of the ascending aorta were detected in 15 patients. These aneurysms were false because only a few cells were present in their walls: it is only after survival for more than 3 weeks tht one can speak of chronic aneurysms, and only 5% of the injured patients survived for this period of time. The lesions show marked progression for one year, but rupture of apparently quiescent aneurysms may occur up to 20 years after the initial injury. The prognosis of these lesions is therefore comparable with that of other aortic aneurysms. Cardiovascular surgery has progressed to such an extent, and the risks are so low (0% in this series), that surgical correction should be systematically considered.

Adolescent↗