Search PubMed⌕ Search

Biomedical subjects

G Hanania

Publications and source records attributed to G Hanania.

70 records · Page 4Linked to original sources
PubMed1976

[Spontaneous development of obstructive myocardiopathies].

49 cases of obstructive cardiomyopathy (37 of the sporadic type, 12 of the familial type), confirmed by phonomechanocardiographic, haemodynamic and/or angiographic investigation and followed up for more than 5 years (mean 7.5 years) without surgical intervention, form the basis of a study on the natural history of this condition. There were 19 deaths (39%), of which 7 were of the familial type (58%) and 12 of the sporadic type (32%). The actuarial survival curves, which were commenced at the time or the first clinical symptom or the date of the first hospitalisation, show that approximately one patient in two dies at or about the age of 40. In 6 cases, death occurred in patients who were greatly improved by medical treatment to the extent of remaining symptomfree up to the time of death. No factors could be found in the initial investigation (phonomechanocardiographic electrocardiographic, radiographic, haemodynamic and angiographic examination (phonomechanocardiographic, electrocardiographic, between the patients still alive and those who had died; each paramater studies had mean values which overlapped in the two groups. Only the age at which the first clinical feature appeared separated the two groups: those patients who died had their first symptom or sign of disordered function at a much younger average age (15.9 years) than the survivors (25 years). This study has confirmed the very serious nature of obstructive cardiomyopathy, especially the familial types, and those with a low age of onset. It emphasises the extreme difficulty in arriving at a prognosis in this condition.

Adolescent↗
PubMed1976

[Hemodynamic diagnosis of tricuspid insufficiency].

An analysis and comparison has been made of the value in the diagnosis and assessment of the degree of tricuspid incompetence of the following: the pressure curves of the right side of the heart, intracardiac phonocardiography and the venous dilution curves of ascorbic acid. The study was carried out on 49 patients, and a comparison made with selective right ventricular cineangiography, which was chosen arbitarily as a baseline. The information from the pressure curves and from intracardiac phonocardiography often contains errors of ommission or commission, but that from the venous dilution curves of ascorbic acid came out as the most reliable; these curves do tend to overestimate the degree of regurgitation, but they still allow us to reserve selective cineangiography, which is quantitatively a more precise method, for those cases in which the curves indicate a particularly severe degree of tricuspid incompetence.

Adolescent↗
PubMed1975

[Silent mitral insufficiency caused by partial dislocation of a Starr-Edwards valve. Apropos of 2 cases with 1 being successfully re-operated].

Silent mitral incompetence due to partial dislocation of the Starr-Edwards valve, leading to an apparently unexplained cardiac failure, has been observed in two patients, one two months and the other 35 months postoperatively. There was a fatal outcome in the first patient, no operation being carried out. Cardiac catheterisation with arteriography of the left anterior descending artery established the diagnosis, and led to a successful reoperation in the second case. It is therefore essential to carry out a haemodynamic and angiocardiographic investigation of any case who, after an initial trouble-free interval post-operatively, develops a deterioration of function which cannot be explained.

Adult↗
PubMedDate not supplied

[Medium-term follow-up after percutaneous aortic valvuloplasty in the elderly. Clinical study apropos of 102 cases].

Percutaneous transluminal balloon aortic valvuloplasty was introduced in 1985 and, owing to its sometimes dramatic short-term results, it has rapidly become a useful procedure in the management of aortic stenosis in elderly subjects. The purpose of this study was to determine its clinical results at medium-term and to identify possible prognostic factors in order to improve the selection of patients suitable for this technique. Between January 1986 and December 1987, 78 patients (30 men, 48 women, aged from 60 to 93 years, mean 80 +/- 6.7 years) totalling 85 procedures were selected among 102 dilatations on the basis of a primary success without complications. Dilatation was performed by a technique similar to that described by Cribier et al. The follow-up period was 10 +/- 5.7 months (range: 1 to 27 months). The aortic valve area increased from 0.47 +/- 0.15 cm2 to 0.77 +/- 0.23 cm2, i.e. from 0.29 +/- 0.09 cm2/m2 to 0.48 +/- 0.13 cm2/m2 as regards the indexed area. The hospital mortality rate was 3.3 p. 100. At the end of the follow-up period 55 p. 100 of the patients were in NYHA class I or II; 29 p. 100 had died, 10 p. 100 had undergone a second dilatation and 13 p. 100 had had aortic valve replacement. This distribution into functional classes and major cardiac events was not significantly different in the subgroup of patients with an aortic valve area greater than 0.9 cm2 or in the subgroup of primary failure. The patients who died for cardiac reasons were older (p less than 0.01), had a lower cardiac output before and after dilatation (p less than 0.001) and a lower ejection fraction after dilatation (p less than 0.05) or even before in case of early death (p less than 0.05). Mortality and morbidity therefore were high at medium-term and unrelated to the haemodynamic effect of dilatation. On the other hand, the left ventricular systolic function was determinant, mainly because it could improve or remain stable when initially altered. These results suggest that only patients for whom aortic valve replacement is truly contra-indicated and who have a limited alteration of left ventricular function should be selected for aortic valvuloplasty.

Aged↗