[The significance of creatine kinase isoenzyme MB in the diagnosis of myocardial infarct after coronary surgery].
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Biomedical subjects
Publications and source records attributed to P Puel.
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Basing themselves on 24 cases of aneurysm of the ascending aorta with gross aortic incompetence, the authors give an account of their personal experience of this condition. They emphasise: -- the problems of aetiology posed by this annular dilation of the aorta with its associated elastic tissue dystrophy which is seldom apparent except at histological examination of the aortic wall at percuaneous biopsy; --the operative problems which confront the surgeon, especially because the orifices of the coronary vessels are in the very centre of the aneurysm. The detail their modest surgical experience, and emphasise the advantages of using Bentall's operation systematically; it seems that this is likely to be the operation of choice in the future.
The authors report 12 cases of aneurysm occuring in anastomoses in 9 operated patients. The delay of onset of these lesions was long, 9 years on average. The fraquency appears low, slightly greater than 1 p. 100 in all arterial plastic operations. Among the 10 treated lesions half were false aneurysms due to breakdown of the suture and half were true aneurysms due to progression of the arterial dystrophy. All cases were treated by dissection and insertion of a new prosthesis between the old prosthesis and a healthy area, beyond the anastomosis. Out of 9 patients, there were 8 good immediate results and one failure due to infection at the level of the prosthesis. Among the various methods of prevention, avoiding infection may be the most important.
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Already users of a method of functional assessment of the muscular circulation in the patients with peripheral artery disease by Xenon 133, the authors propose a radical modification of the performance of the exercise test. A quantified exercise test leads to a new and more objective interpretation of the radio-active tracer elimination curve. This new method permits the measurement of the total quantity of blood which passed during the hyperhaemic stage and its time distribution. The aim of this test is to form an opinion on the tenacity and the efficiency of the supplementary mechanisms when there is an occlusion of the arterial axis.
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