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Biomedical subjects

J Y Neveux

Publications and source records attributed to J Y Neveux.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Surgical treatment of total abnormal pulmonary venous return. Value of the interaortico-caval approach].

Technical details concerning surgery of supracardiac total anomalous pulmonary venous return are still controversial. It seems to us that approaching the lesion through the cleft that exists between the aorta and the superior vena cava fulfills the two requirements of the surgical procedure: a wide anastomosis between the common pulmonary vein and the left atrium can be created on the heart in situ and therefore without any risk of anatomical distorsion, and the small size of atrial incisions reduces the risk of post-operative arrhythmias.

Aorta↗
PubMed1984

Anatomic correction of transposition of the great arteries associated with ventricular septal defect: midterm results in 50 patients.

From May 1977 to August 1982 50 patients who were 1.5 to 44 months old underwent anatomic correction of transposition of the great arteries (TGA) and closure of ventricular septal defect (VSD) at our institution. Thirty-nine patients underwent preliminary pulmonary arterial banding. Hospital mortality was 32%: four patients died as a result of technical problems, seven as a result of associated lesions, three of pulmonary hypertension, and two of left ventricular failure. Three other patients died after the first postoperative month (one of mediastinitis, one at reoperation for a residual VSD, and one of pulmonary hypertension). All 31 survivors are in excellent clinical condition and are in sinus rhythm after a mean follow-up period of 31 +/- 14 months. Twenty-five patients were reinvestigated by echocardiography (M mode and two-dimensional) and/or catheterization. Parameters of left ventricular contractility were within normal limits, but systolic aortic diameter was larger than normal (p less than .01). Seven patients had stenosis of the right ventricular outflow tract and five of these required reoperation. The two persistent problems with the anatomic correction of TGA associated with VSD are a relatively high operative mortality and secondary right outflow tract stenosis. However, use of this procedure results in better left ventricular function and fewer arrhythmias than does use of atrial repair techniques and also results in the use of the anatomically left ventricle as the systemic ventricle.

Cineangiography↗
PubMed1984

[Reoperations after surgical correction of tetralogy of Fallot].

Between 1970 and 1981, 40 patients (6%) were reoperated after surgical correction of Fallot's tetralogy. The average age of these patients was 7,5 years (range 2 months to 37 years). The usual anatomical form was present in 30 cases and severe forms accounted for the other 10 cases (pulmonary atresia with septal defect were excluded). The 40 patients were divided into 3 groups according to the anatomical lesions corrected at reoperation: Group I: 16 patients with a residual isolated VSD; Group II: 14 patients with one or two residual right heart anomalies (RRHA) but without a septal defect; Group III: 10 patients with a residual VSD and RRHA. The only clinical difference between the patients of these 3 groups was the delay of onset of symptoms: the patients with residual VSD (Groups I and III) often developed cardiac failure immediately, whilst in those without residual VSD (Group II) cardiac failure was usually observed secondarily. Four patients (10%) died early after reoperation (less than 1 month). Three others died later, two during a third operation. The total mortality was similar in the three groups. The surgical result was assessed clinically after an average follow-up of 4,5 +/- 3 years: patients with a residual isolated VSD (Group I) had the best long-term results. In 12 patients, M mode and 2D echocardiography showed normal left ventricular function but the ratio of end diastolic right ventricular and left ventricular dimensions was increased to an average of 0,72 +/- 0,2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Tetralogy of Fallot with congenital absence of a pulmonary artery. Apropos of 4 cases].

Four patients aged between 3 1/2 and 16 years were treated surgically for tetralogy of Fallot associated with congenital absence of the left pulmonary artery. This absence, suspected from the chest X-ray, was confirmed preoperatively by angiography of the right and left cavities, aortography, left pulmonary wedged venography and radionuclide scan and substantiated by intraoperative exploration. Congenital absence differs physiopathologically from acquired destruction of a pulmonary branch. In all four patients, repair was performed exclusively on the right branch, without any attempt to introduce a valve in the pulmonary outflow tract and without regard for normal recommendations concerning acquired branch lesions. The only patient to retain a high right ventricular pressure was the one whose pulmonary ring looked sufficiently large to warrant preservation. In all four cases, the postoperative course was uneventful, and the clinical condition is very satisfactory with a follow up of two to twenty-four months. The conclusion would seem to be that the association of tetralogy of Fallot with congenital absence of the left pulmonary artery ascertained with certainty preoperatively, in no way modifies therapy.

Abnormalities, Multiple↗
PubMed1983

[Rupture of a dissecting aneurysm of the ascending aorta 10 years after therapy of coarctation. Apropos of a case of a 10-year-old girl].

This is a rare but life-threatening association. After surgical repair of a coarctation, delayed aneurysm of the ascending aorta may occur, with dissection in some instances. The case we report exemplifies this possibility. Surgical repair is difficult. Data from the medical literature is consistent with the speculation that the aneurysm is not an acquired lesion above the coarctation but a distinct disease of the aortic wall which runs an independent course but which may be promoted by the arterial hypertension. The course and prognosis are so serious that, in spite of its low prevalence, patients should be screened at regular intervals for this condition by ultrasonography of the ascending aorta.

Aortic Dissection↗
PubMed1983

[Acute renal vein thrombosis after malposition of a Mobin-Uddin filter].

Renal malposition of Mobin-Uddin filters is exceptional. In the few cases published the patients were asymptomatic; they were operated upon for fear of an eventual nephrotic syndrome. In the case reported here, however, an emergency operation was imposed by the severity of the clinical signs. Since the operation is simple and since renal thrombosis might have important immediate or late consequences, all filters malpositioned in the renal vein should be surgically removed.

Emergencies↗
PubMed1983

[Tricuspid surgery and tetralogy of Fallot. Observations apropos of 14 case reports].

14 patients underwent tricuspid surgery after radical surgery of tetralogy of Fallot using cardiopulmonary bypass. This series represents 11.5% of all patients with tetralogy of Fallot who were operated on during the same period (1970-1982). Two different pictures were seen: tricuspid pathology may be coincident with tetralogy of Fallot, with surgical repair being done during the same procedure; it may be discovered later on, resulting from trauma of the tricuspid valves, an overlooked valvular malformation, or a residual or recurrent ventricular septal defect. As tolerance is poor because of postoperative right ventricular insufficiency, tricuspid insufficiency must be promptly diagnosed and cured, either during radical surgery of the tetralogy of Fallot or as soon as it becomes clinically patent in the postoperative course.

Adolescent↗
PubMed1983

[Pulmonary valvulotomy or valvulectomy with simple clamping of the vena cava in infants and young children].

In infants and young children pulmonary valvulotomy or valvulectomy under simple clamping of the vena cava is the treatment of choice for pulmonary valve stenosis with normal interventricular septum. The technique, performed without cardiopulmonary bypass, is described. In 40 patients operated upon, the peri-operative mortality was 10% and short-term clinical results were satisfactory.

Constriction↗
PubMed1983

[Complete atrioventricular canal associated with a tetralogy of Fallot. Results of surgical treatment. Apropos of 4 cases].

Complete atrioventricular canal with tetralogy of Fallot is a rare occurrence (8%). Diagnosis rests on the association with Down syndrome and on data from EKG, ultrasonography and angiography. The high operative risk explains why radical surgery is done at an older age (9 years) than in the usual form of complete atrioventricular canal without associated anomalies (33 months) and why antecedent surgical palliation with anastomotic procedures is so frequent (68% of the cases reported in the medical literature). The same surgical procedure was done in all patients: closure of the defects with two separate patches lined with pericardium, suture of the mitral cleft and relief of the infundibular and pulmonary obstruction without valvulation.

Abnormalities, Multiple↗