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Biomedical subjects

G Leroy

Publications and source records attributed to G Leroy.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Development of renal function in the transplanted patient with renal hypertension treated with enalapril].

We report our experience with a converting-enzyme inhibitor, enalapril, as antihypertensive agent in eighteen patients with hypertension after renal transplantation. Renal function was prospectively followed up. Six patients demonstrated an acute renal failure episode (defined by a 25% increase of serum creatinine during enalapril therapy). Renal failure was always reversible with interruption or dosage reduction of the drug. We recommend to start therapy with low dose and to closely monitor renal function.

Adult↗
PubMed1987

[Porcine valvular bioprosthesis. Results 6 years later].

Between January, 1977 and December, 1980, 128 porcine bioprostheses were implanted in 109 European patients hospitalized at the Boucicaut hospital, Paris: 47 were aortic valve replacements (AVR), 43 mitral valve replacements (MVR) and 19 dual valve replacements (DVR). The operative mortality rate was 11% (12 patients): MVR 21%, AVR 6.4%, DVR 0%. 3 patients were lost sight of. The mean follow-up period was 59.3 months (3-96 months). The overall survival rate at 6 years, including early deaths, was 74.4 +/- 8%: MVR 66.1 +/- 15%, AVR 84.9 +/- 10%, DVR 68.6 +/- 20%. Eighteen late deaths were reported (3.7% patient-years [PY]), 3 of which were due to the valve (0.6% PY). The probability at 6 years of escaping death due to the valve was 96.3 +/- 4%: MVR 96.9 +/- 4%, AVR 100%, DVR 87 +/- 17%. Complications associated with the valve were observed in 17 patients (3.5% PY); they were: degeneration in 2 (0.8% PY), thromboembolic accident in 2 (0.4% PY), haemorrhagic accident in 4 (0.8% PY), endocarditis in 5 (1% PY) and simple disinsertion in 2 (0.4% PY). The probability at 6 years of escaping a complication due to the valve was 80.7 +/- 10%: MVR 90.4 +/- 13%, AVR 81.8 +/- 13%, DVR 55.3 +/- 35%. The probability at 6 years of escaping death and re-operation due to the valve was 88.5 +/- 8%: MVR 96.0 +/- 6%, AVR 87.9 +/- 11%, DVR 60.2 +/- 37%. This study and those already published show that compared with mechanical prostheses, bioprostheses clearly reduce the incidence of thromboembolic and haemorrhagic accidents.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Auricular fibrillation: a cause of reversible myocardiopathy].

A chronic supraventricular tachycardia may alone be responsible for a picture of severe congestive cardiac insufficiency, which is totally reversible after return to a sinus rhythm. The two cases reported here emphasize this particular fact, the physiopathology of which still remains unknown. There is also a prognostic advantage to such cases: in the presence of a congestive cardiopathy with atrial fibrillation, apparently idiopathic, it is important to try to obtain a sinus rhythm and to study from a distance the left ventricular performance indexes which may return to normal after regularization of the rhythm.

Atrial Fibrillation↗
PubMed1986

[Value of echocardiography in the study of the embolic origin of a cerebral ischemic accident].

One hundred consecutive patients aged from 35 to 82 years (mean : 74 years) admitted to a Neurology unit for cerebral ischaemic accident of suspected embolic origin were examined by two-dimensional echocardiography, then divided into two groups. Group I patients (n = 24) had a cardiopathy detectable by ultrasound, such as valve disease (n = 5), ischaemic cardiopathy (n = 10), myocardial dilatation (n = 4) or hypertrophic obstructive cardiomyopathy (n = 1). Group II patients (n = 74) had no cardiopathy detectable by ultrasound. Among group I patients, a thrombus was detected in 3 cases (12.5%), and 16 patients (66.7%) had echographic signs of potentially emboligenic cardiopathy without thrombus, including mitral or aortic valve stenosis (5 cases), parietal ectasia (6 cases), severe abnormality in left ventricular contractility (4 cases) and left atrial dilatation (4 cases). No thrombus was visualized in group II patients, but 10 (13.2%) had signs of potentially emboligenic cardiopathy, including mitral valve prolapse in 6 and left atrial dilatation in 4 cases. Altogether, therefore, a potentially emboligenic cardiopathy was detected by echocardiography in 29% of these 100 patients, but it had already been diagnosed prior to this examination in 24%. A thrombus could be visualized in only 3% of the cases. It is concluded that echocardiography need not be systematically performed in all patients with cerebral ischaemic accident, but only in young patients in search of a cause amenable to curative or actively prophylactic treatment.

Adult↗
PubMed1986

[Hemodynamic evaluation of the Carpentier-Edwards porcine bioprosthesis and the Hancock pericardial bioprosthesis in aortic position].

Forty-four asymptomatic patients were catheterised at Boucicaut Hospital 9.5 months after aortic valve replacement to assess the haemodynamic performances of 21 Hancock pericardial (HP) and 23 porcine Carpentier-Edwards (CE) (standard model) bioprostheses, implanted in the aortic position. Left heart catheterisation was performed from a femoral approach; the simultaneous gradient was measured by planimetry and the functional valve surface area calculated at rest and after exercise. The resting calculated surface area of the HP was greater than that of the CE bioprostheses (equation: see text). The transvalvular pressure gradient was lower in the HP than in the CE group (7.8 +/- 4 vs 15.3 cf243 6 mmHg; p less than 0.005). After exercise (15 patients) the calculated surface area increased with the increased transvalvular blood flow in both groups but at each flow rate the calculated valve surface area was greater in the HP group. The haemodynamic performance of the CE bioprosthesis is inferior to that of the HP bioprosthesis, especially in the smaller models. However, the CE bioprosthesis would seem to be mechanically more reliable in the long term than the HP bioprosthesis has since been withdrawn from the market.

Adult↗
PubMed1986

[Allopurinol toxicity. Apropos of 1 case].

Allopurinol is widely used in the treatment of hyperuricemia. Unusual (78 cases published up to 1984) but severe toxicity includes renal, skin and hepatic involvement. We report a new case of serious toxic manifestations with acute interstitial nephritis. We stress the need to adapt the daily dosage of the drug to the glomerular filtration rate and to interrupt drug administration rapidly if allergic manifestations develop.

Acute Disease↗
PubMed1984

[Myocardial infarction in young subjects].

The annual incidence of myocardial infarction (MI) before 40 years of age is 10 times less frequent than that in patients of all ages, and 10 times less frequent in women than men. The severity and extensiveness of lesions demonstrated by coronary arteriography are significantly less in a young patient with an infarction than an elderly patient. Significant isolated coronary artery stenosis is encountered 10 times more frequently before age 35 than after age 50; 15 percent of young patients have no significant stenosis and 8 to 14 percent have entirely normal coronary artery circulation, depending on the study. There appears, then, to be two pathogenetically distinct varieties of MI in the young patient: approximately one-half of cases exhibit multiple sclerosis seen with typical coronary artery atherosclerotic disease; the remainder, which are almost specific for young patients, represent a single obstruction due most often to the rapid development of a thrombosis on an otherwise normal vascular tree. Coronary artery spasm resulting in complete arterial occlusion is certainly involved, nevertheless its frequency must be further defined.

Adult↗
PubMed1984

[Myocardial infarction in the young subject: a medium-term clinical and coronary angiographic study in 40 patients under 36 years of age. Comparison with coronary angiographic data of myocardial infarction in patients after 50 years of age].

A series of 40 myocardial infarctions, occurring in patients under 36 years of age was studied retrospectively (Group I: mean age 31.3 years). The medium term results of coronary angiography in this group were compared with those of 60 myocardial infarctions after 50 years of age (Group II: mean age 56.6 years). Group I had a clear male predominance (92.5%), a high incidence of smoking (69%), hypercholesterolaemia (69%); myocardial infarction was the first manifestation of their disease in 54% and it was often extensive (42%). A comparative angiographic study between the two groups showed: 1) Less widespread lesions in Group I, as assessed by the number of main arteries stenosed (p less than 0.001), the coronary index (p less than 0.01) and the mean coronary score using Friesinger's method (p less than 0.01). 2) A higher incidence of subnormal coronary angiogrammes in Group I (absence of 50% stenosis) (15%) and of single vessel disease (40%): compared with Group II in which multivessel disease was observed in 86.5% of cases. 3) Collateral circulation was less common in Group I (p less than 0.01). On the other hand, a comparative study of regional and global left ventricular function showed no difference between the two groups. Two subgroups were distinguished in Group I: in one subgroup, multiple lesions similar to those found in Group II, suggestive of premature coronary atherosclerosis (52.5%); the other group (47.5%) presented unilocular lesions i.e. focal mono-arterial lesions compatible with other causes of infarction (thrombosis and/or spasm). These patients were younger (p less than 0.05) and had significantly fewer cardiovascular risk factors (p less than 0.01). Despite the fact that the coronary lesions were limited, the myocardial damage was comparable with the other groups as the collateral circulation was much less developed (p less than 0.02). These appearances were only observed in 3.5% of patients in Group II. The study of the angiographic outcomes of these two types of lesions should show a difference and could contribute to the understanding of their mechanisms.

Adult↗