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Biomedical subjects

J Kachaner

Publications and source records attributed to J Kachaner.

At least 217 records · Page 12Linked to original sources
PubMed1979

[Surgical treatment of double outlet left ventricle].

Three young patients with double outlet left ventricle were operated on at the Centre chirurgica Marie-Lannelongue. There was one secondary death. The follow up period of the two survivors is 24 months and 8 months respectively. The diagnosis of this rare congenital abnormality is difficult because of the multiplicity of the anatomical changes and the diversity of the final clinical entity. This is reflected in the attempts at classification. These difficulties are increased by the high incidence of incomplete forms of the condition which gives rise, especially in vivo, to problems of terminology. Echocardiography provides valuable information in the diagnosis of these forms by showing the abnormal relationship between the interventricular septum and the origin of the great vessels. A complete work up is essential before any decision can be made on management. Particular importance is placed on the topographical and morphological features of the atria and ventricles, the connections of the aorta and pulmonary arteries, and the state of the pulmonary tract. Modern surgical techniques have made correction possible in most forms of the disease, but involves complex procedures which leaves doubts on their long term outcome.

Aorta↗
PubMed1979

[Supraventricular tachycardia in newborn infants and infants].

Four types of supraventricular tachycardia were identified in a retrospective study of 71 babies who presented under the age of 3 months. The arrhythmia originated in the atrium in the first two types (25% of cases, atrial tachycardia 10 cases, chaotic atrial tachycardia 7 cases). In the other types the arrhythmia originated at the atrioventricular node. Reciprocal rhythms were most common (62%) and those starting in the bundle of His the least common (5%). It is relatively easy to distinguish the different types which are important because treatment may vary. Overall 75% recover completely, 11% have sporadic recurrences and 10% have a chronic arrhythmia. The junctional varieties have the worst prognosis.

Arrhythmias, Cardiac↗
PubMed1978

[Long-term results of 156 Mustard operations for simple transposition of the great vessels].

156 children with simple transposition of the great vessels have been operated on by Mustard's technique between 1-6-1967 and 31-12-1976, with an immediate overall mortality rate of 8%. In the longterm, the 9% of late deaths and more especially the complications are regrettable; complications were either of severe arrhythmia (almost 30%) leading to 2 late deaths and 7 pacemaker implantations, or venous obstruction relating to problems with the patch (25%). Despite the improved techniques and consequent reduction in surgical mortality and late complications, longterm prognosis is still unsure because of the unknown fate of the intra-atrial partition, and that of the "passive" rhythms which are so commonly found after this type of surgery.

Adolescent↗
PubMed1977

[Determination of plasma digoxin in newborn infants. Practical applications].

Measurement of plasma digoxin concentrations in infants after three increasing dosage levels shows that the optimal dose of this glycoside in 20 microgram/kg/day, i.e. a loading dose of 20 microgram/kg followed every 8 hours by a maintenance dose of 7 microgram/kg. The plateau concentration achieved is 3.0 +/- 0,5 ng/ml 8 hours after the last administration. When digoxin levels exceed 5 ng/ml (overdosage, renal failure or low body weight), toxic manifestations occur.

Digoxin↗
PubMed1977

[Major cardiomegalies of the newborn].

Massive enlargement of the heart measured by cardio-thoracic ratio (C.T.R. greater than or equal to 0,75) was found in 17 neonates in the first ten days of their life. The diseases causing this rare anomaly (5% of all newborns with cardiac malformations) were: Ebstein's disease (6 cases), cerebral arterio-venous aneurism (6 cases), primary endocardial fibro-elastosis (2 cases), septic pericarditis, transposition of great arteries and pulmonary atresia with intact ventricular septum (1 case of each). A diagnosis scheme is proposed in order to recognize early tractable diseases and to avoid inadequate surgical indications.

Cardiomegaly↗
PubMed1977

[Cor triatriatum in infants. Four cases with two surgical successes].

Four cases of cor triatriatum are reported in 6 weeks to 23 months old infants. Two were associated with partial anomalous pulmonary venous connection and one with a mild aortic stenosis. Two were successfully operated on and are now normal children: one of these underwent surgery at 3 months with an hemodynamic control one year later. The two others died: the youngest because of an inadequate overloading transfusion, the other soon after pulmonary angiography. Problems in diagnosis and treatment of this rare but very tractable condition are discussed.

Female↗
PubMed1977

[2 cases of solitary pulmonary arteriovenous fistula presenting in the neonatal period].

Two case reports of pulmonary arterio-venous fistulae presenting in the neonatal period are described. One child had severe respiratory distress with cardiac failure and the other presented with cyanosis and a continuous murmur. In both, chest X-ray demonstrated a localised lesion and the presence of an arteriovenous fistula was confirmed by pulmonary angiography. Lobectomy cured both children.

Arteriovenous Malformations↗
PubMed1976

[Congenital bundle-of-his focal tachycardias. Cooperative study of 7 cases].

The authors described seven cases of supraventricular tachycardia with atrio-ventricular dissociation, associated with the activity of an automatic focus in the bundle of His. These tachycardias, which appear at birth or are discovered at a very young age, appear to be congenital and sometimes familial, and are always isolated, having no associated cardiac abnormality. They give rise to cardiac failure, which is more marked when the rate is high (180-260/mn) and particularly resistant to treatment. The most effective form of treatment is amiodarone, almost always used in combination with digitalis. The anatomical abnormality, which was studied in the first case, is a contricting fibrosis around the main trunk of the bundle of His, and the appearances are reminiscent of those found in conditions of congenital atrio-ventricular block.

Amiodarone↗
PubMed1976

[Results of Mustard's operation for transposition of the great vessels. Apropos of 81 cases of children who survived the intervention with a follow-up of from 1 to 6 years].

In a series of 81 children who survived to Mustard's operation, with a follow-up varying from 6 months to 6 years, there were 19% of secondary deaths, 19% of bad results, 29% of questionable results and only 33% of good results. The most frequent complications were: disturbances of cardiac rhythm and obstructions to pulmonary or caval venous return.

Adolescent↗