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Biomedical subjects

G Stalpaert

Publications and source records attributed to G Stalpaert.

At least 55 records · Page 3Linked to original sources

Persistent atrio-ventricular canal. Case report of an unusual intermediate form.

A case is described, which presented the following combination of anomalies: An interatrial and interventricular septal defect, absence of a cleft in the aortic leaflet of the mitral valve and in the septal leaflet of the tricuspid valve. The latter leaflet was underdeveloped and presented several perforations. On the bases of the characteristic electrocardiographic, angiocardiographic and anatomical findings this anomaly was considered to be an intermediate form of a common atrioventricular canal. Total repair was successfully performed utilizing the technique of Rastelli and McGoon.

Female↗

[Abdominal aneurysms: long-term results].

437 patients who underwent surgery for abdominal aortic aneurysm have been studied. Of these, 206 patients (medium age 63 years) had elective surgery, 231 patients (medium age 73 years) had acute surgery. The five-year survival rate was 65% for the elective group and 40% for the acute group, but these percentages are influenced by the perioperative mortality. When the survival curves of the 198 survivors of elective surgery and the 153 survivors of acute surgery were compared with these of a demographically similar population, we noted lower survival probabilities than for the standard population in the elective group, whereas the patients who underwent emergency surgery have similar survival probabilities as the standard population. The influence of age is especially related to the perioperative period and arteriosclerosis is the most determining factor for long time survival.

Acute Disease↗

[Surgical treatment of lungcancer five-year survival. Major surgical complications (author's transl)].

In the period 1961--1971, 41 patients with a squamous-cell carcinoma were operated upon. The absolute 5-year survival is 47.6% for the lobectomy and 20% for the pneumonectomy. In the period 1971--1976 (6 years), 211 resections for carcinoma (all types) were performed including 19 cases of squamous cell carcinoma, operated in 1971 and also studied in the first part of the work. They represent only 15.2% of all the hospitalized lungcancer patients. The lobectomy/pneumonectomy ratio is 60/40. The postoperative mortality is respectively 4% and 9.5% and the major surgical complications (bleeding, broncho-pleural fistula, empyema) are 0.8% and 3.6%. The causes of postoperative death are examined. Remarkable is the low incidence of bronchial fistulisation: 1 in 211 resections for malignant tumors, i.e. 0.47%. These results are discussed and compared with the literature.

Belgium↗

Surgical treatment of acute, massive lung embolism. Results and follow-up.

Between 1970 and 1984 the diagnosis of acute, massive lung embolism was made 30 times in our department. In 29 patients the clinical diagnosis was correct and a Trendelenburg operation under extra-corporeal circulation was performed. In 18 cases there was an operation in the immediate preoperative course. In 1 case there was a combination of operation and the use of contraceptives. 3 cases were immobilized by a plaster of Paris cast. In 4 cases the use of oral contraceptives and in 3 patients the history of chronic recurrent lung embolism were evident. The mean immobilisation time was 15 days. In 24 cases the diagnosis was made only on the base of the clinical anamnesis, and examination, E.C.G. and chest radiography. In 4 cases angiography and in 1 patient the scintigraphy confirmed the diagnosis. Preoperatively 28 patients were in severe shock. One patient was operated electively. 14 patients needed external cardiac massage. In all cases clots were found in the left pulmonary artery, 28 in the right pulmonary artery, in 3 cases clots in the right atrium, 3 in the right ventricle and three in the inferior caval vein. Nine De Weese caval vein clips were inserted and one Mobin-Uddin filter. Postoperatively 18 patients were alive and well without sequelae. Two patients developed a cerebro-vascular accident (CVA) with one complete recovery. Ten patients died. Postoperative treatment consisted of I.V. heparin administration immediately after surgery and 6 months of oral anticoagulants. Except for chronic recurrent lung embolism the pulmonary function tests were excellent postoperatively without recurrence of the disease.

Acute Disease↗

The patient's perspectives after aortofemoral grafting for occlusive disease.

The late results of aortofemoral grafting for aortoiliac occlusive disease in 371 patients are presented. Late survival (30% after 15 years) was primarily dependent on age at the time of surgery and the presence of atherosclerotic heart disease on subinguinal atherosclerotic involvement. The majority of late deaths (42%) was due to atherosclerotic disease. With a mean follow-up period of 7 years the late complication rate was 29%. Late thrombosis was responsible for 66% of the late complications and a subsequent redo-operation was necessary in 24% of the patients. Age at the time of surgery and the presence of femoropopliteal occlusive disease were the most important factors. Regarding the late mortality rate of 45%, it is recommended that follow-up in these patients should be directed not only to late graft complications but also to other manifestations of generalized atherosclerosis.

Adult↗

[Infrarenal abdominal aneurysms. Course and their effect on perioperative mortality. A 23-year study].

The perioperative mortality rate in elective aneurysmectomy progressively declined to 2%; despite the fact that the percentage of patients with risk factors has increased. Important is that this perioperative mortality is not related to the age of the patients. In acute situations the perioperative mortality has increased to 30 à 50%. This can be explained by the increasing number of ruptured aneurysms and the influence of increasing age at the time of surgery. These results support the concept of elective resection of abdominal aortic aneurysms.

Aged↗

[Inflammatory aneurysms].

Inflammatory aneurysms are not so frequent, etiology and pathogenesis are uncertain. Resection can be a problem because of the dense inflammatory fibrous reaction. Preoperative diagnosis may be possible with the aid of intravenous urography and CAT-scan. The treatment of choice is an aortic replacement followed by uni- or bilateral ureterolysis and omentoplasty to cover the entire vascular reconstruction and protect the ureters.

Aged↗