Search PubMed⌕ Search

Biomedical subjects

P Mathieu

Publications and source records attributed to P Mathieu.

At least 145 records · Page 8Linked to original sources

Endarterectomy of the left main coronary artery stenosis by a 'transpulmonary artery approach'.

For better visualization of the left main coronary artery, a new technique involving transection of the main pulmonary artery is described. With this new method it was possible to perform endarterectomy of the left main coronary artery in 35 patients from February 1981 to July 1987. The endarterectomy incision was closed with a pericardial or venous patch. We had no mortality, and 91% are free from angina at a mean follow-up of 31 months. Angiographic evaluation was performed in 19 patients revealing good patency of the left main artery. This procedure is safe, and we recommend it in isolated left main coronary artery stenosis without distal involvement and with good left ventricular function.

Adult↗

Significance of solitary spine abnormalities on technetium-99m bone imaging.

Solitary abnormalities located within the spine from 75 bone images with Tc-99m MDP were reviewed. For the sake of convenience, patients were grouped in three classes of age: 15-50, 51-65, and 66-90 years. In 67 cases, the diagnosis was apparent from clinical studies, x-ray examinations, or biopsies. In eight cases, no diagnosis could be made. The maximum percentage of lesion sites were within the lumbar spine (45 cases). Metastatic lesions were the most common solitary abnormalities within the spine (29.3%). Osteoporosis was second (24%) with the maximum percentage in age group 66-99 years (83%) with a greater female predominance (67%).

Adult↗

Ten year follow up of patients with single vessel coronary artery disease that was suitable for percutaneous transluminal coronary angioplasty.

The 10 year outcome of patients with single vessel coronary artery disease who underwent coronary angiography more than 10 years before and who would have been potential candidates for percutaneous transluminal coronary angioplasty had it been available then is reported. Long term follow up data were obtained in 96 (91 men, five women; mean age 48 years) of 105 consecutive patients with single vessel coronary artery disease (greater than 70% stenosis), judged suitable for coronary angioplasty. Fifty patients had coronary bypass surgery within six months of catheterisation (surgical group) and 46 were treated medically (medical group). At entry to the study more patients in the surgical group had unstable angina, but fewer had a previous history of myocardial infarction. Ten year survival was 91% and remained excellent in all the subsets analysed. Moreover, the quality of life of these patients was good. Over the 10 year follow up, 16 (36%) of the patients treated medically and 13 (26%) in the surgical group were admitted to hospital because of cardiovascular events (including late coronary surgery in four of the patients treated medically). Lastly, 54/69 (78%) of the patients who were employed before catheterisation resumed work and 29 (42%) were still employed 10 years later. Although these data must be interpreted with care because of the limitations inherent in all retrospective studies, it appears that the long term results of conventional medical or surgical treatment are excellent in patients with single vessel coronary artery disease in whom percutaneous transluminal coronary angioplasty is now an option.

Adult↗

[Percutaneous transluminal angioplasty. Is there still a role for the surgeon?].

Relating their own clinical experience and that of the medical literature, the authors examined the role of the surgeon in coronary angioplasty. Despite the considerable progress made in the management of accidents, they believe that one must be able to resort to surgery--even if the percentage of patients who undergo emergency surgery decreases significantly--in the form of a standby procedure organized according to the difficulty of the angioplasty. Moreover, the surgeon uses this technique during the procedure for additional revascularization above the graft on collateral arteries and angioplasty can and should be used in a higher number of cases as a supplement for coronary bypass procedures.

Angioplasty, Balloon↗

[10-year results of anastomoses of the left internal mammary artery to the anterior interventricular artery. Angiographic and radionuclide controls].

The long term patency of left internal mammary artery graft is better than that of saphenous vein graft. The aim of this study was to determined if this high patency rate was accompanied by a satisfactory myocardial perfusion. Among 143 patients treated with an internal mammary artery graft on the left anterior descending artery between 1972 and 1976, 42 patients underwent coronary angiogram and exercise tomoscintigraphy (thallium 201) over 10 years after surgery. The left internal mammary artery was patent in 92% without any atheromatous lesions. The myocardial perfusion in the area supplied by the left anterior descending artery was normal in 74%. A slight ischemia appeared during exercise in 19% without any clinical symptoms. This long term study shows excellent anatomical results correlated with a good myocardial perfusion during exercise in most cases.

Adult↗

[Rupture of a retro-esophageal diverticulum on a right aortic arch. Apropos of a case].

Right aortic arch with retro-oesophageal left subclavian artery usually is an asymptomatic vascular abnormality. The evolutive potential of the associated retro-oesophageal diverticulum is unknown. Complications caused by the malformation are rare, but they may be extremely severe. A case of ruptured diverticulum in an adult patient is reported. The vascular abnormality, as well as the rupture, were confirmed by computerized tomography (CT) and angiography. Complications of retro-oesophageal diverticula are due to these formations being transformed into aneurysms, with compression of the oesophagus, dissection of the aorta or rupture. Such accidents raise the problems of detection of the abnormality, long-term surveillance of the diverticulum (facilitated by CT) and decision to be made when signs of transformation develop (resection of the diverticulum under extracorporeal circulation).

Aorta, Thoracic↗

Histological cartilage changes in a rabbit model of osteoarthritis.

The anterior cruciate ligament was severed in the right knee of 36 rabbits which were then killed 12 weeks after surgery. Changes in water content and fixed charge density were correlated with the surface area of induced cartilage fibrillation. Histological changes including cartilage hypertrophy, reduced cell density, matrix alterations, cystic lesions, and enlarged perichondrocytic lacunae were found to precede cartilage fibrillation. The observed histological changes are in agreement with an enzymatic degradation of articular cartilage in osteoarthritis.

Animals↗

[Emergency coronary surgery after transluminal coronary angioplasty].

Twenty-five patients underwent emergency coronary arterial bypass surgery immediately after attempted percutaneous transluminal coronary angioplasty (PTCA). The average time between the onset of PTCA complication and revascularization was 90 min (30-120 min). The surgical indications, the anaesthesia and the perioperative intensive care were analysed. No acute complication was observed during the anaesthesia. Peroperative findings defined two groups: the first "organic" (coronary arterial dissection and/or occlusive coronary thrombi; n = 15), the second "functional" (coronary arterial spasm; n = 10). The rate of perioperative myocardial infarction was significantly higher in the "organic" group. In this group, at the end of the cardiopulmonary bypass, a higher number of patients required circulatory assistance and/or an antiarrhythmic agent, as well inotropic drugs.

Anesthesia, General↗

Bone imaging in a case of chronic fluorine intoxication with mineral water.

A patient with chronic fluorine intoxication from mineral water demonstrated an abnormal intense uptake of Tc-99m MDP in the whole spine, the bone metaphyseal regions, and the sternum ("tie sternum"). Results of a bone biopsy revealed an intense osteomalacia and a high fluorine concentration. Bone imaging performed one year after the patient stopped drinking mineral water was normal.

Adult↗

[10-year outcome of patients with isolated anterior interventricular stenosis technically accessible to coronary angioplasty].

Between April 1972 and March 1976, 70 patients were found to have an isolated stenosis of the left anterior descending artery at coronary angiography which could have been treated by coronary angioplasty, had the technique been available at that time. A questionnaire was sent to these patients and 65 (93 p. 100) replies were received 9 to 13 years after initial coronary angiography. They provided information about 61 men and 4 women with an average age of 48.1 +/- 8.4 years. Thirty eight patients had undergone surgery and 27 were treated medically, each group having distinct clinical characteristics. The 10 year survival rate was excellent (91 p. 100) and was high in both groups. The quality of life was good: 56 p. 100 claimed to be in good or very good health and 67 p. 100 were improved with respect to their functional state at the time of coronary angiography; only one quarter of these patients had been readmitted to hospital for cardiac problems during the follow up period, and 76 p. 100 of patients in work before the coronary angiography had returned to work. This date illustrates the excellent results of classical medical and surgical management of potential candidates for coronary angioplasty for isolated left anterior descending artery stenosis.

Adult↗

[Quantitative study of experimental osteoarthritic lesions in the rabbit. Value for the study of anti-osteoarthritis drugs].

Section of the anterior cruciate ligament of the right knee was performed in 20 rabbits which were sacrificed 3 months later. During that time, 10 animals were treated with a proteino-polysaccharide compound. The importance of cartilage destruction was evaluated by measuring the articular surfaces and the surface of the fissured areas using an automatic image analyzer; osteophytes were measured by a volumetric study. The percentage of the fissured areas appears to be without correlation with the osteophytosis, the increase of the water content or the decrease of glycosaminoglycans following the procedure. In animals which were treated, the extent of the fissure is significantly reduced but the biochemical and histometric modifications are not too different from those of the reference group.

Animals↗