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P Tollenaere

Publications and source records attributed to P Tollenaere.

11 recordsLinked to original sources
PubMed1996

Long-term results after aortic valve replacement with the Mitroflow pericardial valve.

From September, 1986 through December, 1989, 121 patients underwent aortic valve replacement with the Mitroflow pericardial valve. There were 70 males (58%) and 51 females (42%), with an average age of 71 years (range 50-85 years). Reported here are the long-term results from these patients. Concomitant cardiac procedures were performed in addition to aortic valve replacement in 38 patients (31%); Coronary artery revascularization in 27 patients (22%); 4 patients (3%) had combination aortic/mitral valve replacement; mitral valve reconstruction in 4 patients (3%) and 3 patients (2%) had other additional procedures. Following surgery, standard postoperative examinations were performed every six month for 2 years; then yearly thereafter. At these times valvular function assessed echocardiographically. Current follow-up extends to 7 years (mean = 5 years) for surviving patients. Postoperative mortality for all observation period is as follows: Early deaths (> or =30 days postop) = 6 patients (5%), late death (>30 days) = 18 patients (15%). Valve-related causes of death included cerebral insult (thromboembolism) in two patients (one 10 months, other 15 months postoperatively). Postoperative valve-related morbidity included prosthetic endocarditis (1 patient) one year postoperatively; degenerative prosthetic failure (1 patient) 27 months postop; cusp tear (1 patient) with minimal hemodynamic changes after four years. In the patients with endocarditis and failure, a second successful operation corrected the problem. Also, in two patients antithrombolitic therapy related hemor-rhage occurred (one 9 months, the second 11 months postoperatively). This therapy was a result of atrial fibrillation, and we do not recommended it. In conclusion, we find that the Mitroflow pericardial heart valve gives adequate long-term results, especially in elderly patients with a small aortic ring, with very satisfactory quality of life.

Aged↗
PubMed1996

Emergency aortocoronary bypass grafting after failed percutaneous transluminal angioplasty versus elective bypass grafting.

From January 1980 through July 1994 fiftyseven patients underwent emergency coronary bypass grafting (CABG) after unsuccessful percutaneous transluminal angioplasty (PTCA), (Group I). This group was compared with a cohort of 57 patients, who underwent elective coronary bypass grafting (Group II). The 2 groups were compared in the rate of perioperative myocardial infarction, amount of blood loss, rethoracotomy because of bleeding, use of blood units and products, and length of stay in the intensive care unit. The data of both groups were retrospectively analyzed. Significant differences were observed: Perioprative myocardial infarction in group I was 18 patients (31%) versus 2 patients (3%) in group II (p<0.0008). Amount of blood loss was higher (p<0.038), and the use of packed red blood cells was higher too (p<0.000) in group I. The length of stay in the intensive care unit was longer (p<0.000) in group I. Six rethoracotomies (10%) occured in group I versus 0 in group II. There were no hospital mortalities in either groups. We conclude there is a significant increase in morbidity in patients with emergency CABG after failed PTCA than patients who underwent elective CABG.

Angioplasty, Balloon, Coronary↗
PubMed1995

Heart diseases following mediastinal irradiation: surgical management.

Twelve patients underwent cardiac surgical procedures after having previously received irradiation of the mediastinum for various types of malignancies (Hodgkin's disease, carcinoma of the breast and seminoma). The patients' ages ranged from 39 to 69 years (mean 57 years); nine patients were female and three male. The average length of time from radiation to surgery was 15 years (3-24 years interval). The patients were divided into two groups according to the type of heart disease: Group I included seven patients who developed coronary artery disease (CAD) despite minimal risk factors. Three asymptomatic patients developed sudden myocardial infarction. In two patients the myocardial infarction was complicated (with ventricular septal defect in one and ventricular septal defect plus ventricular aneurysm in the other). All seven patients were surgically managed. Internal thoracic artery (ITA) was used in three patients as a conduit of myocardial revascularization. There were two hospital deaths in this group. The five patients in Group II underwent aortic valve replacement for aortic stenoses. Prior to the irradiation, none of the patients had a documented history of rheumatic fever, bacterial endocartitis, significant murmur, etc. There were no deaths in this group. Intraoperative findings for both groups included thickening and/or fibrosis of the ascending aortic wall, coronary arteries and aortic valve tissue. Epicardium was whitish colored and thickened.

Adult↗
PubMed1985

[Constrictive pericarditis as a late complication of heart operations].

Constrictive pericarditis is a rare complication of previous cardiac surgery, the rate of incidence being approximately 0.1 to 0.3%. Until now about 60 cases have been documented. With increasing frequency of surgical procedures, especially bypass operations, cardiac surgery plays a major role in the etiology of pericardial constriction. In our own series of 12 consecutive pericardiectomies previous cardiac surgery was in 4 cases responsible for the constriction. These cases are presented in detail. A correct diagnosis is difficult and - as in our own cases - often not noticed for a long period of time because the symptoms are obliterated by the primary heart disease and the previous operation. In our own patients the diagnosis was eventually established by echocardiography and then confirmed by right sided heart catheterization. Due to the late diagnosis the results of pericardiectomy - considered the method of choice - were only poor. Two patients, both in a very bad overall condition, died soon after surgery. The remaining 2 patients recovered satisfactorily. Regarding the pathogenesis, hematomas seem to play a leading role in the development of subsequent pericardial fibrosis. Typically the patients present symptoms of a prolonged pericarditis soon after the original surgical intervention. The time between cardiac surgery and the development of constrictive features varies between weeks and years. The postoperative course of patients with excessive postoperative bleeding or larger pericardial effusions should be watched carefully, keeping the possibility of later pericardial constriction in mind.

Aortic Valve↗
PubMed1981

The significance of coronary topography for operative technique and tactics in multiple myocardial revascularization with jump-grafts.

Aortocoronary bypass procedures for proximal lesions are accepted with widely documented excellent results, but are still controversial in their application for diffuse disease. However, failures of the single graft technique to small coronary branches with marginal flows are markedly reduced by the jump technique. In our experience with 447 angiographic controls from April 1978 to December 1980, the jump-graft patency rate was 87.8% versus 84.9% for single grafts, and as high as 96.3% in the subgroup of multiple jumps (sequential grafts). The sequence of the anastomoses as far as the individual flow is concerned significantly influences the results of the jump-graft technique.

Adult↗
PubMed1980

Endarteriectomy of the left coronary artery (LCA) as a supplementary surgical means of myocardial revascularization with aortocoronary vein bypass procedure.

In order to establish a satisfactory vein bypass anastomosis during myocardial revascularization, 2 findings are of special importance: the local wall quality and the actual lumen of the coronary artery, both altered by the arteriosclerotic disease. In certain cases, with diffuse triple vessel disease, the intraoperative decision for an endarteriectomy as a supplementary surgical means appears to be a logical consequence. In our own patient group of 50 restudied patients with an endarteriectomy of the LCA, we had a patency rate of 72%; in a subgroup it was as high as 84%, if performed locally and under full vision. Compared with extended core extraction, the latter technique only showed minor vessel irregularities proximal and distal to the bypass anastomosis and thus, in a long-term view, it opens up additional revascularization possibilities for severe coronary artery sclerosis.

Aged↗
PubMed1975

[Cardiac surgery].

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Cardiac Surgical Procedures↗