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Biomedical subjects

M Amiel

Publications and source records attributed to M Amiel.

At least 109 records · Page 6Linked to original sources
PubMed1979

Diverticulosis of the left ventricle.

Nine patients, 4--60 years old, had single or multiple left ventricular outpouchings, best seen during diastole, and believed to represent congenital diverticula. The 14 diverticula, 5--28 mm long, were either along the diaphragmatic or anterior ventricular wall. Only one patient had his diverticulum surgically removed; the wall was lined by thick endocardium surrounded by normal myocardium. The lesions did not produce local or systemic complications. All patients had normal chest radiographs. The material suggests that left ventricular diverticula not associated with midline anomalies are perhaps not very rare and should be distinguished from cardiac aneurysm.

Adolescent↗
PubMed1979

[Anomaly of the origin of the circumflex artery. Effects on the risk of mitral and mitro-aortic valve replacement].

An anomalous circumflex coronary artery arising from the main right coronary artery is an added risk in mitro-aortic valve replacement. The infortunate history of a patient with an anomalous circumflex artery visualised on pre-operative cineangiography who underwent a double valve replacement is reported. The first 10 post-operative days were uncomplicated with no haemodynamic disturbances. Thereafter, major ventricular arrhythmiad 54th post-operative days) without signs of myocardial infarction, which were responsible for her death. On autopsy a large anomalous circumflex artery arising from the main right coronary artery was shown. In its course, posterior to the aorta, it was literally wedged between the rigid sewing rings of the two prosthetic valves. No thrombus was found within, and there were no myocardial lesions. The only apparent cause of the arrhythmias and death of the patient was the compression of this large circumflex artery.

Adult↗
PubMed1979

[Principles of analysis and the value of coronaro-ventriculography in coronary surgery].

The examination which precedes any operation for revascularisation of the myocardium, coronaro-ventriculography, which has become a routine examination in specialised centres, should gain even further in reliability by anatomical examination of the vessels which it is used to study in vitro. A perfect knowledge of the distribution of the vessels (the numerous and sometimes unrecognised variations are a source of diagnostic error) and of the characteristics of the lesions (atheromatous in most cases) is essential for the accurate interpretation of a coronary arteriogram. Difficulties in analysis of the latter are numerous and the physician interpreting the examination should be fully aware of them before any decision regarding surgery is taken. Ventriculography routinely analyses, zone by zone, the contours of the left ventricle. In certain cases this segment study is associated with overall analysis of ventricular volumes and stroke fraction.

Coronary Angiography↗
PubMed1977

[The late results of aorto-coronary by-pass surgery. Minimum of 4 years follow-up (author's transl)].

Of 340 patients undergoing aorto-coronary surgery over a period of 6 years, the 136 cases in which there was a minimum follow-up of more than 4 years were analysed from the standpoint of the results. Overall amount annual postoperative mortality was low, less than 2,5%, even though the majority of patients undergoing surgery suffered from rest angina and had double or triple coronary stenoses. Analysis of prognostic parameters reveals the importance of the quality of the left ventricule, whilst age, sex, risk factors, the site of the bypass, the number of stenoses and the type of angina had little or no statistical influence on postoperative mortality. Six years after operation, there remained 66% of excellent results and 60% of the patients were able to work. One hundred and forty eight follow-up coronary arteriograms were carried out (including 33 repeated). During the first year after operation (184 by-passes examined) the percentage of permeability of the grafts was 84,8%. Later (86 bypasses examined) this fell significantly to 74,4% but 86,3% still had at least one permeable by-pass. Repeat late studies after four years showed the stability of the result. Investigation into the causes of postoperative infarctions ans analysis of the results in terms of the number of by-passes carried out in relation to the number of coronary stenoses, indicate that multiple by-passes should be avoided when technical conditions are difficult, with a narrowed coronary network and of little functional value.

Adult↗
PubMed1977

Effect of methylglucamine salts of iocarmic and iothalamic acids on hemodynamics, acid-base equilibrium and coagulation.

The effects of electrolytes, osmolality, pH, PaO2, PaCO2, hematocrit, blood volume and coagulation occurring after a rapid intra-aortic injection of a monomer and a dimer (salts of methylglucamine of the iothalamic and iocarmic acids) were compared. The effects of the monomer agreed with previous results but the effects of the dimer differed from those reported in the literature.

Acid-Base Equilibrium↗
PubMed1977

[Concomitant Prinzmetal angina and coronary angina. Angiographic study in 13 patients (author's transl)].

Is coronary spasm the explanation for the paroxysmal myocardial ischaemia of Prinzmetal angina? Although considered adventurous two or three years ago, this hypothesis has been supported by the publication of approximately 15 cases in which the cause and effect relationship seemed to be proven by spasm seen on coronary arteriography at the same time as a typical attack. The authors report 13 cases of this type (the first of which was published in 1972). Spasm occurred in a normal coronary system in 3 cases, whilst in 2 cases there were only non-stenotic plaques of atheroma. In 8 cases, spasm occurred at the site of or distant from a significant atheromatous lesion. In 8 cases, spasme involved the right coronary whilst in 3 cases the A.I.V. was affected and in 2, two of the three main coronary trunks. In the light of their experience, the authors stress two points: --in many cases, nitroglycerine alone is not sufficient to relieve the spasm, and only the in situ injection of papaverine had a constant effect; --it is essential to opacify both coronary systems during a typical attack in order to obtain proof of spasm.

Adult↗