Biomedical subjects

L Campeau

Publications and source records attributed to L Campeau.

At least 91 records · Page 5Linked to original sources

PubMed1975

Coronary artery grafting with the saphenous vein or internal mammary artery. Comparison of late results in two consecutive series of patients.

In two series of consecutive patients who underwent coronary artery grafting with the saphenous vein or the internal mammary artery (IMA), angiographic studies were conducted two weeks and one year after operation. The early patency rate was 91.8% in 184 vein grafts and 97.4% in 38 IMA grafts. Late patency was 93.1% in 143 vein grafts and 90.9% in 33 IMA grafts. Thus, the cumulative patency rate at one year was 84.9% for vein grafts and 88.3% for IMA grafts. The incidence of severe narrowing at the site of anastomosis was 2.2% in vein grafts and 7.9% in IMA grafts; the rate of occlusion of the distal limb of the recipient coronary artery was, respectively, 4.3 and 7.9%. Diffuse reduction in the caliber of grafts at one year was less frequent with IMA grafts (12.7 versus 6.6%). On the other hand, blood flow was significantly higher in vein grafts: 67.4 versus 45.2 ml per minute (p less than 0.001). Blood flow in IMA grafts whose caliber was larger than that of the recipient coronary artery was significantly higher than flow in IMA grafts with a caliber equal or inferior to that of the coronary artery: 63.1 versus 32.7 ml per minute (p less than 0.001). Although cumulative patency rates at one year were comparable in both series, because only one-third of the IMAs were larger than their recipient coronary arteries, flow was somewhat restricted in the other two-thirds. This suggests that the IMA does not constitute the better bypass conduit and, unless it is of large caliber, preferably should be used in the grafting of small coronary arteries or those with limited runoff.

Angiocardiography↗

PubMed1975

Postoperative changes in aortocoronary saphenous vein grafts revisited: angiographic studies at two weeks and at one year in two series of consecutive patients.

Comparison of aortocoronary saphenous vein graft status at two weeks and at one year was made in two series of patients. The early postoperative evaluation includes 122 patients of the first 138 operated in our institution (182 grafts) and 83 subjects from a second series of 100 patients operated after modifications of surgical techniques (184 grafts). The one-year follow-up study was obtained in 105 patients of the first series (154 grafts) and in 67 of the second (152 grafts). The patency rate at two weeks was not significantly different between the two groups: 86.3% vx. 91.8%. A marked decrease of steonses noted early at anastomotic sites was observed: 15% to 5.5% (P less than 0.025). The patency rate at one year improved from 67% to 85,5% (P less than 0.0005). Grafts having flows at operation of at least 50 ml/min had patency rates of 90% in both series. The patency in grafts with initial flows below 50 ml/min increased from 28% to 73% (P less than 0.005). The incidence of late localized graft stenoses greater than 40% decreased from 16.5% to 6% (P less than 0.025), and diffuse narrowing greater than 40% was found in only 12% of the patent grafts at one year in the second series as compared to 31% in the first (P less than 0.001). These improved results do not appear to have been influenced by selection favoring better distal run-off in grafted arteries nor by the introduction of sequential grafts to multiple coronary arteries in the second group. Modified surgical techniques may explain the improved results.

Adult↗

PubMed1975

[Correlations between the sub-maximal exercise electrocardiogram and selective coronarography: a critical study of positive criteria].

A critical study of the electrical criteria for coronary insufficiency was undertaken on the basis of a group of 150 patients who underwent a selective coronary arteriography and a submaximal effort electrocardiogram and free of any functional coronary insufficiency. The three following notions became apparent: -- a downward displacement of the J point is greater than or equal to 4 mm has a very high predicitive value (90%) for coronary insufficiency, whatever the slope of the following ST segment; -- anslowly ascending, rigid ST segment with a slope included between 0.1 and 1 mV/sec. has a value equivalent to that of the classical criterion: horizontal or descending slope of the ST segment greater or equal than 1 mm; -- the ischaemic index put formard by McHenry (J is less than or equal 1 - J + ST is greater than or equal 0) is not specific enough to be of practical value.

Coronary Angiography↗

PubMed1975

[Profil and course of complete obstruction of 3 coronary trunks].

In a series of 4000 patients subjected to coronary arteriography, 12 were found to have complete obstruction of three major coronary arteries, an incidence of 0.3 p. 100. The clinical manifestations did not follow a typical pattern. Although 9 had a previous myocardial infarction or heart failure, only 6 were incapacitated by angina or dyspnea. Except for one patient, the resting EKG was abnormal. Half had a markedly elevated resting end-diastolic pressure and gross abnormalities of left ventricular contraction. In spite of surgery in 7, with only one operative death, a yearly mortality rate of 20 p. 100 has been recorded during a 3-year follow-up. This extremely low survival rate, the severe functional impairment in half of the survivors, and the subsequent high yearly mortality rate, all suggest that surgery be considered before complete obstruction occurs in patients with significant disease of three coronary arteries. A 10 p. 100 yearly mortality rate reported in patients with triple vessel obstructions, also favours surgery in such patients with the hope of prolonging life, providing good distal runoff and satisfactory left ventricular contraction are present.

Adult↗

PubMed1974