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Biomedical subjects

J Kachaner

Publications and source records attributed to J Kachaner.

At least 199 records · Page 11Linked to original sources
PubMed1981

[Prolonged Q-T interval with functional A-V block in neonates and young infants (author's transl)].

A prolonged Q-T interval (0.56 to 0.70 s.) with second degree A-V block was present in 5 children. Auscultation in utero (2 cases) or at birth (1 case) and syncopal attacks at 15 days and 2 months of life led to the discovery of the arrhythmia which was complicated with torsades de pointes. One patient died at 1 month of age; another is treated with propranolol and an internal pacemaker; the last 3 recovered, either spontaneously or with propranolol. The originality of this syndrome of unknown etiology is due to the A-V block, secondary to delayed repolarization (prolonged Q-T interval). Torsades de pointes and ventricular fibrillation are the main risks. Treatment includes beta adrenergic blocking agents associated with a temporarily implanted pacemaker. In a few cases, the internal pacemaker has to be left permanently.

Adrenergic beta-Antagonists↗
PubMed1981

[Anatomic correction of transposition of the great vessels with interventricular communication. A series of 24 consecutive operations].

The results of surgical correction at arterial level in 24 cases of transposition of the great arteries with ventricular septal defect are reported. The majority of children (19/24) had undergone previous pulmonary artery bonding between the ages of fifteen days and 3 months (average 1,5 months). Surgical correction was performed on average 14 months later. This consisted of repair of the ventricular septal defect and arterial shift to reestablish ventriculoarterial concordance with reimplantation of the coronary arteries. In the last 9 cases no prosthetic materials were used on the right outflow tract. The operative mortality was 9/24 (6 of the first 12, and 3 of the last 12 cases). The cause of death was due to associated lesions, congenital (coarctation of the aorta, mitral valve malformation), or iatrogenic related to previous surgery (stenosis of the right ventricular infundibulum). Left ventricular failure was common despite preparation with pulmonary artery banding and merited systematic treatment mainly with arterial vasodilator therapy and prolonged ventilatory assistance. The surviving children are asymptomatic without treatment. Control catheter studies did not show any significant abnormality except in one case of pulmonary hypertension. The exceptional quality of these results, the absence of prosthetic material and the hope of reducing avoidable mortality justify this approach to surgical cure of the malformation. Preparation by pulmonary artery banding and the use of this method in "simple" forms of transposition are questions which remain open to discussion.

Child, Preschool↗
PubMed1981

[Treatment of ventricular septal defects with pulmonary hypertension in infancy (author's transl)].

188 infants presenting with ventricular septal defects associated with pulmonary hypertension underwent early surgical treatment. Overall death rate was 10% (6% since 1979 and even 0% in case of single defects operated on between the ages of 6 and 12 months). Surgical results were excellent in 48 controlled cases operated on during the 1st year of life. When surgery was performed later, risk of residual pulmonary hypertension remained in cases with equal pressure levels. Our results suggest that all the infants who do not respond properly to medical treatment must be operated on and that those with a major pulmonary hypertension have to be operated on during there second semester of life.

Heart Septal Defects, Ventricular↗
PubMed1979

[Complete correction of Fallot's tetralogy in infants. Preliminary results].

Complete repair was undertaken in 28 infants with severe forms of tetralogy of Fallot because severe cyanosis or anoxic spells. Age at operation ranged from 8 days to 11 months (mean: 4,4 months). Among the 24 cases without any other intracardiac defect, there were 6 early deaths related in 4 cases to a wrong indication or a technical error. Re-investigation was performed in 14 out of the 18 survivors from 3 weeks to 6 months post-operatively: the result is good in 10 cases, fair in 1 case, and poor in 3 cases requiring twice a reoperation with 1 further death and 1 good final result. More accuracy in selecting the surgical patients and improvement in operative techniques should result in a further decrease of our early mortality rate. Primary complete repair should therefore become a substantial alternative to the palliative shunts which results seem to be hazardous in the more severe types of the defect.

Age Factors↗