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Biomedical subjects

J P Binet

Publications and source records attributed to J P Binet.

At least 145 records · Page 8Linked to original sources
PubMed1979

[Pulmonary stenosis with intact ventricular septum. Surgical experience in 200 cases, excluding the neonatal period].

Experience over 10 years, studying two groups of patients (group I: 79 cases aged between 2 months and 2 years, group II: 151 cases aged over 2 years) has shown that the operative prognosis of severe forms is now the same as in simple forms. Interest is now focused on the long term function of the right ventricle with regard to the surgical procedure. The main discussion in management is between isolated pulmonary commissurotomy, whatever the anatomical form, and operations such as we perform which associate ventricular resection with or without an infundibular patch in severe cases. The possible causes of late ventricular dysfunction are discussed, especially the muscular resection, the operative myocardial protection and the preoperative myocardial sclerosis. The good results observed in this series as opposed to the doubt as to the cause and variability of late ventricular dysfunction do not justify a change in our management at present.

Adolescent↗
PubMed1979

[Complete correction of Fallot's tetralogy with a Waterston shunt].

The influence of a Waterston shunt on the mortality in complete correction of Fallot's tetralogy varies from series to series. Some authors believe that it has no influence and others, on the contrary, believe it plays an important role to the point of recognising a particular premonitory syndrome of pulmonary hypertension and a low output state. This divergence of opinion in patients with comparable lesions is surprising, and cannot always be explained by poor surgical indications (irreversible pulmonary hypertension) or by problems of surgical technique. In our experience the conditions of cardiopulmonary bypass are of prime importance and we believe that the common factor in surgical failure is poor myocardial protection. This point of view is suggested by our present results in the correction of moderate and severe forms of Fallot's tetralogy under cardioplegia and seems to be reinforced by the results of extensive repair in forms with a Waterston shunt, said to be high risk procedures, that is to say with considerable asymmetry of the pulmonary vascularisation by stenosis of the right main pulmonary artery.

Adolescent↗
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

[Digestive complications of surgery for aortic coarctation].

The complications of surgery for coarctation have been studied by examining the case notes of 284 survivors. 37 (12%) of them had intestinal complications and 15 other complications. The predisposing factors are the treatment of the abdominal complications are analysed.

Abdomen↗
PubMed1979

[Ascending aortic aneurysm with mucoid infiltration of the media and aortic leaflets. Pathogenic hypotheses- surgical consequences].

The theoretical and practical problems posed by aneurysms of the ascending aorta with mucoid infiltration of the Media and the aortic leaflets are discussed with reference to two suggestive cases. These histological changes are not specific for Marfan's syndrome, the relation with which is very inconstant. Incomplete replacement of the affected tissues risks a recurrence which is especially serious when the sinus of Valsalva is involved. Therefore, total replacement of the ascending aorta with aortic valve replacement and reimplantation of the coronary arteries is generally indicated. Histology of the excised tissues should be performed routinely with specific stains for mucopolysaccharides. Close follow-up of operated patients with this condition is recommended, especially those with only partial replacements.

Adult↗
PubMed1978

Ductus arteriosus sling: report of a newly recognised anomaly and its surgical correction.

Surgical exploration of a 7-week-old infant with a diagnosis of 'pulmonary artery sling' (left pulmonary artery arising from the right) revealed the true nature of the abnormality to be persistence of the ductus arteriosus which connected the right pulmonary artery to the aortic isthmus. This malformation has not been described previously. It has the same symptomatology as 'pulmonary artery sling' and it may be treated by surgical ligation and division. We suggest the term 'ductus arteriosus sling' to describe this rare congenital anomaly.

Aorta, Thoracic↗
PubMed1978

[Cor triatriatum associated with a ventricular septal defect in infancy. 2 cases treated surgically].

Although rare, the diagnosis of cor triatriatum in its classical form is usually made pre-operatively. The association with a large ventricular septal defect, as in the two cases reported here, masks the clinical and haemodynamic signs. In one case it was the echocardiogram and cineangiography which led to pre-operative diagnosis. The surgical correction of the two lesions was done successfully in one stage. In our second case, lack of recognition of the cor triatriatum led to the death of the patient in a low output state, following closure of the ventricular septal defect.

Cineangiography↗
PubMed1978

[A new anatomo-clinical entity? The left superior vena cava obstructing the interior of the left atrium in association with a left-right shunt. Apropos of 2 cases].

The association of a left-right shunt with obstruction to the pulmonary venous return must not be ignored. Failure to recognise this may be fatal post-operatively. We have described here what we believe to be a new cause of supra-mitral obstruction: an abnormal left superior vena cava. The echocardiogram was essential in the diagnosis, and allowed us to establish, after surgical correction, that all abnormalities of the left auricle had disappeared.

Echocardiography↗
PubMed1978

[Angina pectoris and muscular bridges on the anterior interventricular artery. Apropos of 3 operated cases].

A relationship between ischaemia of the myocardium and a muscular bridge over the anterios descending artery has now been demonstrated. The authors report three cases in which the severity of the clinical features was sufficient to justify surgical division of the muscular bridge without touching the underlying artery. Progress remained satisfactory after a follow-up period of 1.5 to 3 years. The opportunity is taken to discuss the role of the muscle bridge in causing pathology in the coronary arterial system.

Adult↗
PubMed1978

[Aberrant left pulmonary artery. Apropos of 5 operated cases].

The authors report 5 cases of aberrant left pulmonary artery undergoing surgery with 3 successful results and 2 failures; 4 of the 5 operations were carried out through a sternal split with either extra-corporeal circulation or circulatory arrest and profound hypothermia. The authors have reviewed the cases reported in the literature which amount to 78, 51 of which have been operated on surgically, the condition having been corrected in only 34 of them. They have studied particularly the incidence of associated tracheo-bronchial lesions which are themselves the reason for the seriousness of the condition, as well as the longterm results and the possible incidence of thrombosis in the anastomosis. By contrast with the views of Sade, the authors are optimistic about the results which have been obtained in the survivors.

Abnormalities, Multiple↗
PubMed1978

[An unusual type of mid-ventricular obstruction. A discussion of the findings].

The authors report a case of left-sided mid-ventricular obstruction which was completely different from the usual type of obstructive cardiomyopathy, and had asymetrical hypertrophy of the septum demonstrable both by angiocardiography and macroscopically. Complete clinical and haemodynamic recovery followed left ventricular myectomy with replacement of the mitral valve (one year's follow-up).

Angiocardiography↗