Biomedical subjects

P O Roquebert

Publications and source records attributed to P O Roquebert.

6 recordsLinked to original sources

PubMed1997

Coronary artery stenting without anticoagulation, aspirin, ultrasound guidance, or high balloon pressure: prospective study of 1,051 consecutive patients.

Between March 1994 and November 1995, 1,212 coronary stents were implanted in 1,051 consecutive patients at our institution with the following protocol: daily pre- and poststenting treatment with ticlopidine 500 mg without aspirin, implantation under angiographic guidance, without ultrasound, with semi-compliant balloons inflated at 10 bars. Stenting was indicated after failure of balloon angioplasty (bail-out, dissection, elastic recoil) in 27% of the patients and considered as elective (de novo, restenosis, chronic occlusion, saphenous vein grafts) in 73% of the cases. During the 30-day follow-up period, stent thrombosis occurred in 11 patients (1.0%) and vascular access-site complications in three patients (0.3%). Thirteen patients (1.1%) died, 10 from previous left ventricular failure, 3 (0.3%) from subacute thrombosis. Multivariate analysis revealed that the size of the last balloon used was associated with subacute stent thrombosis Thus, in nonselected patients, placement of coronary stents may be safely achieved without use of warfarin, post procedural heparin, high balloon pressure, or ultrasound guidance. Antiplatelet therapy with ticlopidine and angiographic guidance result in a stent thrombosis rate of 1% and a vascular complication rate of 0.3%.

Adult↗

PubMed1996

Retrograde left main stenting.

Percutaneous transluminal coronary angioplasty of protected left main coronary artery stenosis is usually performed by an antegrade approach. In this case report, we describe left main coronary artery stenting by a retrograde approach through a saphenous venous graft in a patient in whom the antegrade approach was considered less appropriate due to chronic ostial occlusion.

Aged↗

PubMed1996

[Antiplatelet therapy during coronary endoprosthesis placement].

Coronary stent implantation is today a catheterisation laboratory routine procedure for de novo lesions and less frequently for bail-out situations. Antithrombotic pharmacological regimens based upon coumadin have filed to prevent sub-acute stent thrombosis. The use of new antiplatelet therapy (ticlopidine alone or in association with aspirin) have reduced the sub-acute thrombosis rate to 1%. Routine combining heparin is not useful. The benefit of ultrasound guided stenting or high pressure balloon expansion is not demonstrated in the thrombosis prevention. New pharmacological approaches inducing fibrinogen platelet receptor antagonists (antii GP IIb-IIIa) may extend stent implementations more especially in acute coronary syndromes.

Angioplasty, Balloon, Coronary↗

PubMed1995

[Bipolar transseptal radiofrequency ablation of posteroseptal bundle of Kent. Apropos of a case].

The posteroseptal localisation of accessory pathways is sometimes responsible for important difficulties for radiofrequency current endocavitary ablation. Some authors have reported the exceptionally rare use of the transseptal bipolar mode for ablation of this type of accessory pathway. The authors report the case of a patient in whom failure of unipolar radiofrequency ablation at the tricuspid and then mitral annulus was followed by immediate success when the bipolar mode was used. The value of recording with the transseptal dipole at the ablation site is emphasised.

Adult↗

PubMed1994

[Radiofrequency treatment of permanent tachycardia caused by reciprocating rhythm].

Permanent tachycardia by reciprocal rhythm is an arrhythmia due to macro-reentry using the normal conduction pathways in anterograde direction and an accessory atrioventricular pathway, most often posteroseptal, in retrograde direction. It is sometimes worrying because of its chronicity and the deterioration in left ventricular function with which it may be associated. A case is reported of permanent tachycardia by reciprocating rhythm treated by radiofrequency. The diagnostic value, already shown by other authors, of stimulation of the upper part of the interventricular septum to confirm the participation of an accessory atrioventricular pathway in the tachycardia circuit is mentioned, and the need for extensive mapping, because of the recent description of non-postero-septal accessory pathways, is stressed.

Electrocardiography↗

PubMed1987

[Hemodynamic effects of propofol used alone for the induction of anesthesia].

Haemodynamic effects of propofol were studied during induction of anaesthesia, in 20 patients undergoing abdominal aortic replacement. Eight of them suffered from coronary arterial disease. Propofol was used at a dose of 2 mg X kg-1. During 5 min after propofol administration, no drug was administered. Neither plasma expansion nor tracheal intubation were carried out. Haemodynamic changes were: 17% decrease in systolic arterial pressure, and 13% decrease in diastolic arterial pressure, associated with a 12% decrease in cardiac output and 7% decrease in systemic vascular resistances; no change in heart rate in spite of the decrease in arterial pressure; and a mild increase in diastolic pulmonary arterial pressure. Left ventricular systolic work and rate pressure product decreased, suggesting a favourable incidence in coronary disease by lowering myocardial oxygen consumption. Nevertheless, it must be considered that, in the group studied, patients with coronary disease receiving beta-blocking drugs were excluded. So, mild haemodynamic changes observed here have to be confirmed in patients suffering from more severe coronary arterial disease.

Aged↗