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Biomedical subjects

P Bopp

Publications and source records attributed to P Bopp.

At least 37 records · Page 2Linked to original sources
PubMed1980

[The value and advantage of computer assisted tomography as compared to angiography in evaluating patency of aorto-coronary grafts].

Sixteen patients with 31 aorto-coronary grafts have been studied by CT and by coronary arteriography to compare the results of the two methods in the evaluation of graft patency or occlusion. Correlation of the two technics is excellent (100%). However, graft stenoses are not visualized on CT in its present state of technical performance and are the limiting factor for this noninvasive procedure. In patients with precordial pain and aorto-coronary grafts, CT should be done first to evaluate graft patency and only be checked by coronary arteriography if there is disagreement between the CT result and clinical assessment of the case.

Coronary Angiography↗
PubMed1980

[Overall and regional sensitivity of myocardial thallium-201 scintigraphy compared with the number and location of coronary lesions and the presence of previous myocardial infarction].

An evaluation is presented of (1) the overall sensitivity and specificity of 201Tl myocardial scintigraphy in 230 patients with suspected coronary artery disease and (2) the effects of the number and location of the diseased vessels, and the presence of previous infarction, on regional sensitivity in 151 patients. Overall sensitivity was 91% (80%, 95%, 97%) in patients with 1, 2 or 3 vessels respectively. Overall specificity was 81% or 89% if 7 patients with infarction and normal coronaries were excluded. In 80% of patients with one diseased vessel, in 41% of patients with 2 diseased vessels, and in only 24% with 3 diseased vessels were all lesions detected. 201Tl scintigraphy detected 52% of circumflex lesions as compared to 75% of right coronary and 74% of left anterior descending lesions. Of the 151 patients with proven coronary disease, 75 had a previous infarction. Overall and regional 201Tl sensitivity were greater (but not significantly) in this subgroup as compared to patients without myocardial infarction.

Adult↗
PubMed1980

[M-mode and two-dimensional echocardiography in evaluating mitral stenosis before and after commissurotomy].

A first group of 51 patients with pure or predominant mitral stenosis underwent M-mode (M) and two-dimensional (2D) echocardiography and cardiac catheterization (cath). After elimination of 3 incomplete cases, the series consists of 48 patients. 20 later underwent surgery. Quantitative correlations between M and cath are poor (r = 0.34, p less than 0.05); however, correlations between 2D and cath were excellent (r = 0.89, p less than 0.001). There were 4 major discrepancies between 2D and cath: 3 of these patients were operated upon and surgery confirmed 2D mitral valve area in all of them. 2D had served to diagnose all 6 cases of mitral calcifications seen at surgery; however, M provided 1 false negative and 5 false positive results with regard to diagnosis of calcifications. A second group consisted of 18 patients who had undergone mitral commissurotomy, 8 of these had a pre- and postoperative echocardiography. 10 also underwent postoperative cath. M appeared to be unable to predict correctly the presence or absence of a recurrence of mitral stenosis. Quantitative correlations between diastolic slope and mitral valve area at cath were poor. However, excellent correlations were found between 2D and cath, showing that 2D also serves to measure mitral valve area after commissurotomy.

Calcinosis↗
PubMed1980

Double inlet right ventricle. Report of a case and review of the literature.

A case of double inlet right ventricle in which both atrioventricular valves opened completely into the right ventricle is described. The left atrium communicated with the right ventricle by way of an opening low in the atrial septum and there was a large ventricular septal defect. The pulmonary trunk and aorta took their origin from the right and hypoplastic left ventricles respectively. The literature on this rare cardiac anomaly is reviewed and the morphological findings in this case are compared with those of the recorded cases. A short discussion of the possible embryogenesis is given.

Adolescent↗
PubMed1980

[Results of long term surgical treatment of isolated stenosis of the left descending coronary artery].

The results of medical and surgical management of isolated stenosis (greater than or equal to 50%) of the left anterior descending artery were compared retrospectively in a series of 124 consecutive patients. 57 patients were managed medically (Group I). 28 (49%) presented with angina and 36 (63%) with a previous myocardial infarction. The stenosis was greater than 90% in 38 patients (67%) and was associated with severe left ventricular dysfunction in 28 patients (49%). The average ejection fraction was 53.8 +/- 2.5%. 67 patients were managed surgically (Group II): 58 (87%) presented with angina and 28 (42%) with previous myocardial infarction. The stenosis was greater than 90% in 58 patients (87%) and associated with severe left ventricular dysfunction in 19 patients (28%). The average ejection fraction was 61.7 +/- 2.4%. The average length of follow-up was 41.9 +/- 4.1 months in Group I and 46.2 +/- 3.5 months in group II. 6 patients died in Group I, 5 of a cardiac cause, compared to 4 patients (3 of a cardiac cause) in Group II, with an operative mortality of 1.6%. One patient in Group I had a new myocardial infarction compared to 6 in Group II, 3 of which (4.4%) occurred in the perioperative period. Angina regressed after therapy in 23 patients (40%) in Group I and in 48 patients (72%) in Group II (p < 0.01). Angina was unchanged or became more severe in 12 and 5 patients respectively. 34 patients (60%) on drug therapy were able to resume their professional activities as opposed to 26 (42%) in the surgical group (p < 0.05). It would therefore appear that surgery for isolated stenosis of the left anterior descending artery does not significantly reduce mortality, or prevent recurrence of myocardial infarction, but it does significantly improve anginal pain. The same conclusions are obtained when the patients are classified in different sub groups, "operable" patients or those with previous myocardial infarction or with poor left ventricular function. Finally, the surgical indications were "good" in 21 patients, symptomatic with a proximal stenosis greater than 75%, good ventricular contraction on angiography, an ejectionfraction of at least 50%, and good arterial run-off. In these cases surgery was successful with regression of anginal pain in 19 patients (90%) but complicated by secondary infarction in two of them. These results were better than those obtained in the other operated patients, in which the surgical indications were judged retrospectively to have been "inadequate". Therefore, in isolated stenosis of the left anterior descending artery, aorto-coronary bypass surgery should be reserved to patients with "good surgical indications".

Angina Pectoris↗
PubMed1980

[Interventricular septum. Angiographic and echocardiographic correlations].

The diastolic thickness of the interventricular septum was measured by echocardiography and by biventricular angiography in 48 patients (40 male, 8 female) with age ranging between 15 and 67 years (average 44.4 years). These patients were classified in four groups according to clinical and paraclinical parameters:--normal subjects (29 cases),--patients with concentric hypertrophy (5 cases),--patients with asymmetrical septal hypertrophy without obstruction (4 cases),--patients with hypertrophic cardiomyopathy with obstruction under basal conditions or under stress (10 cases). Biventricular cineangiography was performed in 70 degrees left anterior oblique projection after measuring the intracavitary pressures. Analysis was performed by projecting the film and reproducing one or several diastolic frames on paper. Septal thickness was measured at the two levels suggested by Redwood. The septum was then divided into 5 parts and the thickness measured at the corresponding 4 levels. The values obtained were then corrected for magnification artefact. Qualitative comparison of the results obtained by echocardiography and angiocardiography showed a good correlation in 35 cases (73%) and less significant correlations in the other 13 cases (27%). The poorest correlations were observed in the groups of patients with concentric or asymmetrical hypertrophy without obstruction. Of these 13 cases, angiography confirmed the clinical diagnosis in 6 cases. In the remaining 2 cases, echocardiography and angiocardiography gave divergent diagnoses which also differed from the clinical diagnosis. The quantitative correlations between the echocardiographical and angiocardiographic measurements of diastolic septal thickness were quite satisfactory in most patients. The correlation improved when the echocardiographical measurement was compared to an average of the 4 angiographical measurements; (R = 0,74; p < 0.001). The correlation was poorer in groups 2 and 3 in patients with concentric or asymmetrical hypertrophy without obstruction. The disadvantages and limitations of these two methods are discussed. Possible ambiguity in the identification of segments of the septum measured by the two methods may be a significant factor especially in cases of asymmetrical hypertrophy.

Adolescent↗
PubMed1979

Effect of doxapram on control of breathing in cats.

The effects of doxapram infusion (0.25 mg.kg-1. min-1) were studied in cats anaesthetized with pentobarbitone (35 mg . kg-1 intraperitoneally). Cats were studied breathing 50 per cent oxygen and the responses to two concentrations of inspired carbon dioxide were measured. Doxapram infusion increased pulmonary ventilation by increasing both tidal volume and respiratory frequency, and also caused increases in the volume inspired in the first 0.5 second after the onset of an inspiration (V0.5) and the pressure generated in the airway 0.5 second after the onset of an inspiration when the airway had been occluded (P degrees 0.5). V 0.5, P degrees 0.5 and the mean inspiratory flow rate (VT/VI) were essentially equivalent indices of inspiratory drive. Doxapram infusion did not alter the effective impedance of the respiratory system (P degrees 0.5/V 0.5). Doxapram infusion increased the ventilatory response to carbon dioxide. The slope of the ventilatory response to carbon dioxide was increased and the response line was shifted to the left. We conclude that the increase in pulmonary ventilation caused by doxapram infusion is due almost entirely to increased inspiratory neuromuscular drive (P degrees 0.5).

Animals↗
PubMed1979

[Permeability of venous aortocoronary bypass 5 years later].

47 consecutive patients who had undergone aorto-coronary venous bypass surgery (mean: 1.6 graft per patient) have been investigated after a mean follow-up period of 5 years and 9 months (range: 44-108 months). 52 grafts out of 73 were found to be patent (71 p. 100), the best patency rate being shown by grafts on the LAD artery (27/32 = 85 p. 100). Long-term graft patency may be associated with an improved left ventricular ejection fraction; 77 p. 100 of the total patients experienced a lasting clinical benefit from the operation.

Adult↗
PubMed1979

[Bidimensional echocardiography in evalulation of mitral and aortic stenosis].

The aim of this study was to compare the results of unidimensional and cross-sectional echocardiography and cardiac catheterisation in the assessment of mitral and aortic stenosis. 21 patients with mitral stenosis, 21 patients with aortic stenosis and 21 patients without valvular disease were studied by unidimensional and cross-sectional echocardiography and cardiac catheterisation. Although unidimensional echocardiography in the external cardiac investigation of choice for the qualitative diagnosis of mitral stenosis, a better assessment of the severity of the stenosis is obtained with cross-sectional echocardiography. The valve surface measured by cross-sectional echocardiography correlates well with the value obtained by catheterisation with the application of the Gorlin formula (r = 0.85). Cross-sectional echocardiography is therefore an important advance in the external assessment of mitral stenosis. The aortic valve can only be measured in one third of cases of aortic stenosis with unidimensional echocardiography, whilst this measurement can be performed in 90 p. 100 of cases with cross-sectional echocardiography. The values obtained in 9 patients with severe aortic stenosis were 3.7 +/- 0.7 mm/m2, in 7 patients with moderate aortic stenosis: 5.4 +/- 0.8 mm/m2 and in 5 patients with mild aortic stenosis: 6.8 +/- 1,2 mm/m2. There is a clear demarcation between the different groups if the average values are compared. Therefore cross-sectional echocardiography gives reliable semi-quantitative assessment of the severity of aortic stenosis.

Adult↗
PubMed1979

[Congenital absence of the circumflex artery. Association with an infarction without coronary disease].

A 31 year old man had a congenitally absent circumflex coronary artery, one of the least described of all the congenital abnormalities of the coronary arteries. Before confirmation of the diagnosis, an ectopie circumflex artery was excluded by the two angiographical signs observed by Page and by non-selective coronary arteriography. This abnormality was thought to have played a role in myocardial infarction in this young patient without coronary risk factors and with no obvious coronary artery narrowing on coronary arteriography.

Adult↗
PubMed1978

[Visual identification of Doppler sounds in gas embolisms].

The method of choice for the early detection of air metabolism during neurosurgical operations in a sitting position is that of continuous cardiac auscultation using Doppler effect ultrasound apparatus. In the present study, involving 15 patients, an air embolism was produced by the injection of 2 ml of CO2 into the right heart and acoustic changes were recorded on paper using a photographic process. These optical changes, although variable, were invariably present and characteristic of aire emboli and represent an additional element in early diagnosis.

Adult↗
PubMed1977

[Prognosis for coronary patients with low ejection fraction. Comparison between a medically and a surgically treated group].

Two groups of coronary patients whose ejection fraction was depressed (less than or equal to 0.30) were studied. Twelve patients received drug treatment only and 25 others underwent surgery. Life expectancy appears to be slightly improved in the surgical group, but the differences are not statistically significant. Since operative mortality is relatively low (8%) and clinical improvement following surgery may be impressive, a revascularization procedure should be considered even in patients with markedly impaired ventricular function.

Coronary Disease↗
PubMed1977

[Asymmetric septal hypertrophy. Echocardiographic and angiographic diagnosis].

Three cases of symptomatic asymmetric septal hypertrophy are reported. The echocardiogram allows a reliable diagnosis; it entails no risk to the patient and it may be repeated during the course of the disease. Associated with biventricular angiocardiography, the echocardiogram represents the method of choice in detecting these lesions.

Adult↗