[Aorto-coronary bridging associated with aortic valve replacement. With reference to 14 cases (author's transl)].
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Biomedical subjects
Publications and source records attributed to G Guiraudon.
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A study on eleven dogs of the effects of increasing doses of dopamine on the left ventricular function. A description of the method which consists of a venous shunt connected to an extra-corporeal circuit and which allows modification simply and rapidly of the state of vascular refilling of the animal. The results differ according to the pressure-level of the refilling of the left ventricule. At low pressure, the dopamine increases the arterial pressure, the cardiac output and the systolic activity of the left ventricle for a reduced tachycardic effect. At higher pressure, the average aortic pressure is only slightly increased and the systolic activity is elevated without increase in cardiac output. These facts indicate dopamine in states of shock with a low pressure of refilling.
Intraventricular reentry has been prooved by pre-operative electrophysiological studies in two patients without coronary artery disease and resistant ventricular tachycardia. A simple ventriculotomy oriented by epicardial mapping during tachycardia was successfull with a background of 9 and 14 months respectively. In addition, delayed epicardial potentials put into evidence an intraventricular reentry in human myocardium. This new method holds promises for the treatment of some resistant ventricular tachycardia.
Analysis of a series of 10 cardiac transplantations confirmed that the reject phenomena have a paroxysmal course, the diagnosis of which is different according to the time occurence of the reject crises, whether early (acute early rejection) or late (late acute rejection or chronic rejection). Because of the early diagnosis based on the follow-up of the electrocardiogram, of coagulation, of the graft flow, overcome eight rejection crises on the 3 patients with middle-term survival.
Pacemaker implantation is seldom as a treatment of ventricular tachycardia after chronic myocardial infarction. In this new case, pacemaker implantation was successfull for over a year after partial surgery failure. A regular demand pacemaker with bipolar pervenous catheter inserted in the coronary sinus is to give atrial orthorhythmic pacing triggered by ventricular arrhythmias.
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