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Biomedical subjects

P Jaumin

Publications and source records attributed to P Jaumin.

At least 55 records · Page 3Linked to original sources
PubMed1975

Comparative haemodynamic effects of glucagon and isoprenaline in the early postoperative period in cardiac surgery.

In order to study the haemodynamic effects of isoprenaline and glucagon in the immediate postoperative period, 16 patients who had single or multiple valve replacement or coronary artery bypass grafts were investigated. Measurements of cardiac index, stroke index, heart rate, arterial and right atrial mean pressures were made either before, during, or after the administration of both drugs. With the doses used, the inotropic effects of both drugs are similar, while the chronotropic action is statistically higher during isoprenaline infusion than after glucagon administration. This fact explains the greater increase in cardiac index after isoprenaline administration. Mean arterial pressure shows no significant changes after either drug, while right atrial mean pressure decreases significantly. Peripheral vascular resistance remained mostly constant. The activity of glucagon injected as a single bolus seems to be maximal 10 to 15 minutes after the injection and dissipates about 30 minutes later. The ideal dose of isoprenaline is between 0.8 and 2 mug/min. Within this range, the inotropic effect is maximal and the chronotropic and bathmotropic effects are limited. Above 2 mug/min, cardiac index and stroke index decrease, and arrhythmias become more frequent.

Adult↗
PubMed1975

[Orgainc tricuspid pathology in rheumatic valvulopathies].

Surgical observations show that organic tricuspid lesions are not uncommon: 3.2% among cases of valvular surgery, 9.5% among patients with combined mitral and aortic replacements. Pure stenosis is relatively rare (7 cases) but easy to diagnose: this lesion plays a protective role on pulmonary parenchyma. There is no symptom due to congestive lungs and few pulmonary post-operative complications among these patients. Organic tricuspid insufficiency, isolated or associated to stenosis is more frequent (18 cases) but more difficult to diagnose before surgery. There seems to be no protection of the pulmonary circulation. Pulmonary arterial hypertension, clinical and radiological features of congestive lungs and post-operative pulmonary complications are usual.

Adult↗
PubMed1975

[Rhythm disorders occurring after surgical closure of the interatrial communication].

A detailed evaluation is presented about the frequency and the type of arrhythmias following the surgical correction of 147 cases of atrial septal defects not associated with other congenital heart malformations. A total of 131 arrhythmias occurred in 84 patients. The nodal and the coronary sinus rhythms are the most frequently encountered after surgery, attaining 53,8% of all arrhythmias, while atrial fibrillation or flutter represented about 22%. The follow-up of these arrhythmias concerned the 3 month period immediately after surgery. After that time 20% of the arrhythmias occurring in the early postoperative period persisted. The frequency of arrhythmias increased with age, was relatively independent of the importance of the left to right shunt, the level of the mean pulmonary artery pressure and the sex of the patients; but statistically increased in patients in whom the correction was made with a patch. The authors concluded that there must exist at least two mechanisms to explain the occurrence of arrhythmias. A first one must be in relation to the surgical manipulation; the second, which is only an hypothesis, stipulates an alteration of the conduction pathways due to the auricular distention or the existence of a congenital anomaly of the conduction pathways.

Adolescent↗
PubMedDate not supplied

Idiopathic hypertrophic subaortic stenosis: long-term surgical results.

The results of surgery in 21 patients with I.H.S.S. are reported. Dyspnea, angina pectoris and syncope were the most common symptoms in decreasing frequency. Before the operation, 5 patients were in New York Heart Association's functional class II, 10 in class III and 6 in class IV. The mean resting peak systolic pressure gradient was 66 mm Hg in 20 patients and mean left ventricular end-diastolic pressure was 14 mm Hg in 19 patients. The ventriculoseptomyectomy accomplished through a transaortic approach is the procedure of choice. The operative mortality rate was 14% (3 of 21 patients). There were 2 late deaths from congestive heart failure. Any sudden death did not occur. The remaining 16 patients have been followed up for a mean of 75 months (range 12 months to 11 years), 11 patients are in functional class I, 4 in class II and 1 in class III. Complete left-bundle-branch block occurred in 3 patients. Our study with a long post-operative follow-up period, documents that surgery results in good to excellent alleviation of symptoms in survivors. The elevated pre-operative left ventricular end-diastolic pressure has a significantly poor prognosis. We currently recommend surgery for the symptomatic patients who have not responded to medical therapy, not late in the symptomatic course of the disease.

Adolescent↗
PubMedDate not supplied

Revascularization of the superior mesenteric artery.

From 1965 to 1973, 7 patients with severe chronic mesenteric vascular insufficiency have been successfully operated upon. Abdominal pain, weight loss and epigastric murmur were the most significant symptoms and signs in these diffusely atheromatous patients. Aortography with exposure in the lateral projection was essential for diagnosis and operative planning. Although two and often all three main splanchnic arteries were involved, revasculariztion of only the superior mesenteric artery restored normal hemodynamics. There was no operative mortality. Weight gain was dramatic and post-prandial pain disappeared in all patients. One patient diedone year and one half after the operation from an acute cerebro-vascular accidnet. Our surgical experience in this field, although small, is very gratifying and rewarding.

Aged↗
PubMedDate not supplied

A case of candida albicans endocarditis 3 years after an aortic valve replacement. Successful combined medical and surgical therapy.

The authors report a case of candida albicans endocarditis occurring 3 years after aortic valve replacement and bacterial endocarditis. They may attempt to the difficulty of the diagnosis, the successful combined surgical and medical treatment, the duration and the follow-up of the therapy and finally the aspect of the side effects of the used antifungal drugs.

Adult↗
PubMedDate not supplied

Surgical repair of coarctation of the aorta in infants under one year of age. Long-term results in 146 patients comparing subclavian flap angioplasty and modified end-to-end anastomosis.

Between July 1976 and February 1991, 146 consecutive infants underwent surgical repair of coarctation of the aorta. Age at operation varied from 2 days to 11 months (median 1 month). Ninety-two (63%) were less than 2 months. Isolated coarctation was present in 65 patients (group 1), associated ventricular septal defect in 49 patients (group 2) and complex anomalies in 32 patients (group 3). The majority (65%) were in a critical condition and 45 patients (31%) were artificially ventilated. Subclavian flap angioplasty was performed in 39 patients and resection and end to end anastomosis in 107 patients. Neither hospital mortality was significantly different between subclavian flap angioplasty (15%) and end-to-end anastomosis (18%) nor was the postoperative hypertension. Actuarial survival at 10 years were 100% for group 1, 94% for group 2, and 62% for group 3. Seventeen patients had recurrent coarctation. No significant difference was found in terms of types of repair or age at operation. As no major advantage in terms of mortality and morbidity to either technique was found, we recommend resection and end-to-end anastomosis. This technique not only relieves the obstruction whatever the level is but also eliminates the ductal tissue, preserves the subclavian artery and avoids the use of prosthetic material.

Age Factors↗