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Biomedical subjects

M Payot

Publications and source records attributed to M Payot.

54 records · Page 3Linked to original sources
PubMed1980

[Effect of dynamic exercise on left ventricular hemodynamics in obstructive cardiomyopathy].

The behavior of left ventricular (LV) outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) during dynamic exercise was studied in 9 patients during cardiac catheterization. Pressure measurements were carried out with high fidelity tip manometers and cardiac output was measured by the thermodilution method. Resting intraventricular pressure gradients varied from 5 to 75 mm Hg (mean 41 +/- 30 mm Hg) and all patients had postextrasystolic gradients of more than 100 mm Hg. Under supine bicycle exercise (mean work load 80 watts) heart rate increased from 74 +/- 9 to 97 +/- 10 min-1, cardiac output rose from 4.32 +/- 0.7 to 8.36 +/- 2.0 l/min, and LV intraventricular pressure gradient dropped significantly to 16 +/- 4 mm Hg. This improvement of LV outflow tract obstruction was associated with an increase in LV enddiastolic pressure from 14 +/- 5 mm Hg to 25 +/- 2 mm Hg, an augmentation of dP/dt max from 1225 +/- 300 to 1748 +/- 200 mm Hg/sec and a deterioration of systolic to diastolic pressure-time index ratio. These preliminary results indicate partial normalization of the LV outflow tract obstruction in HOCM during supine bicycle exercise; this favorable effect is probably due to an increased enddiastolic LV volume.

Adult↗
PubMed1979

[Echocardiography. Advantages and limitations related to unidimensional and bidimensional technics in real time].

Mode-M echocardiography is the most valuable non invasive technique in cardiology, but as a one-dimensional technique it displays the cardiac structure in an unfamiliar form without resemblance to the cardiac anatomy. Two-dimensional ultrasonic imaging of the heart overcomes this disadvantage. However, the definition of these scanners leaves much to be desired and becomes very poor when the stop-frame mode is used. The major disadvantages of the "multiscan" are the length of the multicrystal transducer, distortion of the picture, spurious echoes and verticalization. The sector scanner has smaller transducers fitting the "echocardiographic window" and permitting an apical, subxiphoid and suprasternal approach. However, with this system resolution is usually poor in the first anterior 3.5--4 cm after the thoracic wall. The mechanical scanner causes a vibrating sensation occasionally irritating to the patient. The electronic sector scanner has the widest angle and provides the best quality images. Unfortunately, its cost is markedly higher than that of other two-dimensional systems.

Aortic Valve↗
PubMed1978

Simulated tricuspid valve echoes in tricuspid atresia.

A case of tricuspid atresia with unusual echocardiographic findings is presented. The echocardiogram was successful in defining great artery interrelationships, ventricular looping, and cavity sizes. An echo pattern resembling the motion of a small tricuspid valve was observed; this was proven to be spurious at catheterization and necropsy. Caution should be exercised in diagnosing the presence of a tricuspid valve on the basis of atypical echoes from the tricuspid valve area.

Echocardiography↗
PubMed1978

The echocardiographic profile of patients after Mustard's operation.

In order to establish an echocardiographic profile of patients with simple transposition after Mustard's operation, we examined the M-mode records of 10 patients who were found to be free of significant abnormalities at follow-up cardiac catheterization. When compared with established normals, right ventricular wall thicknesses and cavity dimensions were increased, while left ventricular wall thicknesses and cavity dimensions fell below the mean. The wall thicknesses, cavity dimensions and ratios of right ventricular preejection period/ejection time and left ventricular preejection period/ejection time were appropriate for the physiologic role of the ventricles rather than their morphologic identity. In each patient, a portion of the intra-atrial baffle was identified behind the pulmonary root. There was variation in baffle position and baffle mobility within the group, as well as in individual echograms. A variety of valve motion abnormalities were noted; these included diastolic flutter of the atrioventricular valves in all 10 patients and systolic anterior motion of the mitral valve in six patients. Paradoxical septal motion was found in nine patients. Although only minimal or no left ventricular outflow gradients were found at catheterization, nine patients had narrowing of the left ventricular outflow tract, 10 had systolic flutter of the pulmonary valve and eight had early partial closure of the pulmonary valve. The finding of a large number of echocardiographic abnormalities in a group of patients with good hemodynamic results suggests that these echocardiographic features are to be expected after Mustard's opration. Furthermore, the reversal of the physiologic role of the ventricles must be considered when interpreting the echocardiographic dimensions and systolic time intervals.

Aorta↗
PubMed1978

[Hypoplastic syndrome of the left heart. Anatomo-echocardiographic correlations].

The findings on echocardiography and their anatomical correlations are reported in a group of 15 neonates with the syndrome of hypoplasia of the left side of the heart. The lesions which make up this syndrome could be defined precisely using echocardiography. In the major forms of this syndrome (10 cases), the correlation between the clinical and the echocardiographical findings was sufficient to establish the diagnosis, and to avoid the necessity for cardiac catheterisation without prejudice to the treatment plan. Characteristic findings in the major types were: --an aortic diameter less than or equal to 5 mm; --a left ventricle which was absent or had a diameter of less than 11 mm with an LV/RV ratio of less than 0.6; --a mitral valve which was absent or had a very abnormal form with multiple echoes. The differential diagnosis on echocardiography and the limitations of the method are discussed.

Diagnosis, Differential↗
PubMed1976

A new surgical approach for correction of partial anomalous pulmonary venous drainage into the superior vena cava.

Nine children with partial anomalous pulmonary venous drainage into the superior vena cava were operated upon. The technique consisted essentially of partitioning and enlargement of the superior vena cava. The partitioning was done in all but one patient, with a longitudinal suture starting above the highest pulmonary vein directing the pulmonary venous flow through the enlarged atrial septal defect into the left atrium. The anterior cavo-auricular tunnel was enlarged with a right atrial appendage-superior vena cava angioplasty. Follow-up studies were done between 1 and 3 years after surgery. The hemodynamic data were normal in 7 patients. In 8 children, the superior vena cava was unobstructed and its diameter was normal as demonstrated by cavograms. In all patients, the angiographic evaluation of the pulmonary venous return was normal. These results are encouraging and indicate that this new approach is superior to those which have previously been reported.

Angiography↗
PubMed1975

Neonatal intracranial hemorrhage in premature infants.

Since the advent of modern methods of neonatal care, intracranial hemorrhage in premature infants, which is usually intraventricular, is probably not as uniformly fatal as generally admitted and the survivors are likely to develop post-hemorrhagic hydrocephalus. This paper is a retrospective study of 11 premature babies born between 1968 and 1972 and diagnosed as having hydrocephalus secondary to neonatal intracranial hemorrhage. Nine of these are still alive and two have died, one at 3 and one at 17 months of age. Eight underwent permanant surgical drainage of hydrocephalus. The perinatal history, laboratory data, clinical evolution, and neurological outcome were studied. Two groups of infants were identified; those with signs of acute neurological deterioration in the neonatal period who had the most severe neurological sequellae (in four cases, periventricular lesions in addition to hydrocephalus were seen on the air study and in one case confirmed at autopsy) and those showing no obvious neurological signs in the neonatal period. Of this latter group, two appear to be developing normally. The therapeutic implications of the findings are discussed.

Brain↗
PubMedDate not supplied

Non-invasive imaging of the ring-sling complex in children.

The Ring-Sling Complex is an uncommon, congenital vascular and tracheobronchial malformation with a persistent high death rate. We report three patients in whom computed tomography (CT) and magnetic resonance imaging (MRI) were used for the preoperative diagnosis and for staging of the morphologic tracheal and vascular anomalies.

Child, Preschool↗
PubMedDate not supplied

Fatal rupture of an acquired aneurysm of the pulmonary artery: rare complication after surgical palliation of tricuspid atresia.

We report the case of a young woman who died from rupture of an aneurysmal dilatation of the left pulmonary artery. She suffered from tricuspid atresia type Ib and underwent a classic Glenn anastomosis at the age of 11 months; at 11 years a direct laterolateral anastomosis was constructed between the ascending aorta and the left pulmonary artery rather than a Fontan procedure for technical reasons. She subsequently developed severe pulmonary hypertension and an aneurysmal dilatation of the left pulmonary artery and was refused any further surgical correction.

Adult↗
PubMedDate not supplied

Congenital aneurysm of sinus of valsalva ruptured into right ventricle diagnosed by magnetic resonance imaging.

Rupture of a congenital aneurysm of the sinus of Valsalva is a rare congenital cardiac malformation. This case report describes a congenital aneurysm of the sinus of Valsalva which ruptured into the right ventricle in a 3-year-old girl. The exact route of the fistula through the cardiac walls and the localization of the rupture into the right ventricle was not completely defined by two-dimensional and color Doppler echocardiography and could be determined only by magnetic resonance imaging (MRI).

Aneurysm, Ruptured↗
PubMedDate not supplied

Transposition of the great arteries, pulmonary atresia, and multiple ventricular septal defects associated with multiple cardiac rhabdomyomas in a case of tuberous sclerosis.

Multiple cardiac rhabdomyomas are frequently associated with tuberous sclerosis. However, very few cardiac malformations have been described with tuberous sclerosis. We report an unusual case of tuberous sclerosis with cerebral and renal lesions associated with dextrotransposition of the great arteries, pulmonary atresia, patent ductus arteriosus, multiple ventricular septal defects, and parachute mitral valve deformity. After reviewing other cases of congenital heart diseases associated with tuberous sclerosis, emphasis is made on the potential influence of multiple rhabdomyomas developing very early during fetal life on final cardiac structures.

Abnormalities, Multiple↗