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Biomedical subjects

J Acar

Publications and source records attributed to J Acar.

At least 253 records · Page 14Linked to original sources
PubMed1977

[The risk of hemorrhage versus the thromboembolic risk in patients with prosthetic valve].

376 adults were followed up for between 2 and 153 months after surgery (mean: 3.8 years); all of them, with the exception of 8, received anticoagulant treatment. The results were subjected to statistical analysis using several tests. Thromboembolic complications occurred in 16 per 100 after 5 years, and 8.5. per 100 of them were fatal. Among the factors favoring this complication are the type of valvular disorder (the rate of throembolism being 4 times greater with mitral valve defects), the type of prosthesis, and the efficiency of the anticoagulant therapy (the risk of thromboembolism being four times greater in those patients whose treatment has been inneffective). Against the vitamin antagonists must be set the haemorrhages: the incidence of lethal haemorrhage in this series was 6.4 per 100 patients per treatment year. There was a proven hypoprothrombinaemia to below the desirable level in two thirds of these cases, and in one case out of four an additional predisposing factor could be demonstrated. Haemorrhage and thromboembolism are together responsible for one in four of the late deaths. In order to reduce the mortality, several solutions are considered, one of which is to utilise anti-aggregation treatment. However, the vitamin K antagonists remain an essential part of treatment in the majority of cases; it can only be justifiable to withhold them in those patients in whom the risks of haemorrhage are for various reasons considered to be too high. The introduction of biological valves or of valves with a lessened risk of embolism is highly desirable in such cases.

Adolescent↗
PubMed1976

[Importance of echocardiography in aortic valve disorders].

It would seem that, despite certain limitations, echocardiography may be considered to be an important method of investigation in the diagnosis and prognosis of aortic valve disease. Quantitative measurements may possible study of the progression of the lesions. Nevertheless, echocardiography only appears to be a simple technique and emphasis should be placed on the importance of a complete investigation as well as the quality of the recordings to be studied.

Aortic Valve↗
PubMed1976

[Results of a hemodynamic study of valve diseases surgically treated with prosthesis].

The haemodynamic status after valve replacement surgery and the preoperative haemodynamic parameters have been studied for their predictive value in a series of 217 patients who have had aortic, mitral or mitro-aortic valve replacements; all cases had a preoperative catheterisation, and 132 had a postoperative catheterisation at an average of 15 months postoperative. The following conclusions have been drawn from the study: 1. The operation (which consisted of replacement with a Starr valve with Silastein ball-valve in 8 cases out of 10) resulted in a substantial, and statistically significant, improvement in the minor circulation pressures and in the cardiac index. The ejection fraction also increases in most cases. 2. The increase in the cardiac index is significantly greater in aortic stenosis than in aortic incompetence, and in the aortic group than in the mitral group. 3. Improvement is early, and occurs within the first few weeks, in the aortic group; it occurs more gradually in the mitral group, in whom serial catheterisations show a gradual decrease in the pulmonary arterial and capillary pressure and an increase in the cardiac index which may be progressive until the second postoperative year. 4. Analysis of the mean values of the various parameters as a function of the clinical findings, and of the incidence of failures and early or late deaths from haemodynamic changes, has failed to show that the preoperative haemodynamic picture has a statistically significant predictive value.

Adolescent↗
PubMed1976

[Development of heterografts stenosis in the aortic or mitral position. Apropos of 2 cases].

From a series of 10 patients undergoing surgery with a homograft, two cases are reported in which stenosis of the graft occurred, one in the mitral and the other in the aortic position. The macroscopical appearances of the lesions showed sclerosis and calcification. In the case where histological material was available, there were marked changes in the collagen and elastin, disseminated calcified deposits in the valve, and inflammatory cellular changes over the surface, with a tendency to penetrations into the substance of the valve. One of the factors leading to these graft disorders is the type of chemical treatment which the valve undergoes; a combination of glutaraldehyde solution and oxidation using sodium metaperiodate would appear to be unsuitable in this respect. Emphasis is laid on the very particular clinical features of these two cases (stenosis and valvular incompetence), and on the difficulties in diagnosis of this condition.

Adolescent↗
PubMed1976

[Cineangiocardiographic evaluation of mitral valve lesions. Validity of the method according to 100 angio-surgical correlations].

In order to assess their validity, the findings on left bidirectional cineventriculography have been compared with the operative findings in 100 patients with mitral valve disease. This method of investigation has been shown to be a reliable one for the precise and complete evaluation of mitral valve lesions. The information which it provides about the morphology and kinetics of the valve, the site of any calcification, the state of the suspensory apparatus, and the degree and cause of any mitral incompetence often has a decisive influence on the indications for surgery and the choice of operation.

Adolescent↗
PubMed1976

[Cineangiography in adult mitral valve disease. 41 cases of comparison of anatomical with radiological findings (author's transl)].

During the course of their preoperative assessment, 41 patients with severe mitral valve disease underwent left ventricular cineangiography, AP and lateral at rapid speed (100 images per second). This gave a particularly precise anatomical and physiopathological inventory of the lesions, as was confirmed by preoperative findings. The presence of mitral stenosis was confirmed in all cases and an indication of its degree in the majority.

Adult↗