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Biomedical subjects

P Vernant

Publications and source records attributed to P Vernant.

At least 73 records · Page 4Linked to original sources
PubMed1977

[Residual pulmonary hypertension after surgical correction of left-right shunts. Therapeutic implications (proceedings)].

Late closure of left to right shunts with pulmonary hypertension may leave residual pulmonary hypertension. To determine the best period for total repair, a large number of factors must be taken into account: --the spontaneous evolution of left to right shunts; --the prognosis or residual pulmonary hypertension after total repair; --the probability of total recovery after surgery of the various types of shunting, related to the age of operation. From these factors, it appears that: --the closure of atrial septal defects (where pulmonary hypertension is never major in the child) can wait till childhood or adolescence; --ductus arteriosus must be repaired before the age of 2 years; --in ventricular septal defects with pulmonary hypertension, the best chance of recovery is secured when surgery is performed between the ages of 1 and 2. Earlier intervention should be considered only if medical therapy is ineffective. After that period, it may leave pulmonary hypertension in being.

Adolescent↗
PubMed1977

Natural history of ventricular septal defect. A study involving 790 cases.

The development of 790 untreated patients affected by ventricular septal defect (VSD) has been the object of a 25-year study. Of these patients, 72% had had at least one catheterization; 13% had several. The mean observation interval is six years, and the average age at the latest data is 19.5 years. This study covers 4717 patient-years. For the entire population, the incidence rate or aortic regurgitation is 6.3% (4.3 for 1000 patient-years) and that of bacterial endocarditis is 3.7% (2.4 for 1000 patient-years). Twenty-five patients died, 15 of them between the ages of one and 39. Of the 499 cases with several clinical examinations, 71% remained stable. In 21%, changes suggesting some level of closure developed; in 7%, infundibular stenosis began to evolve and in 1% pulmonary vascular disease began to appear or became accentuated. These different rates are studied and discussed in relation to patients' age, VSD type, and various follow-up characteristics.

Adolescent↗
PubMed1977

[Long-term results of palliative operations and complete cure of tetralogy of Fallot].

714 cases of Fallot's tetralogy have been encountered over the last thirty years. A closed heart operation was undertaken in 472 patients. The mean age at operation was 5,1 years. In 87% of cases, a Blalock-Taussig anastomosis was carried out. The operative mortality was of the order of 3%. The operative risk was almost three times as large before the age of two years as after. The patients benefit by a demonstrable improvement of function after this operation, but it does not protect them from the complications of the condition (cervica abscess, Osler's disease, cerebro-vascular accidents) or from death. Open heart surgery was carried out in 403 patients. 161 as a primary procedure, and 242 after an initial palliative operation. The mean age at operation was 13.3 years. The operative mortality was 15%. The functional improvement was striking, and the patients appeared to be protected from the usual sequelae of the condition. On the other hand they cannot always be considered as cured: 16 died some time after the operation; 37% had pulmonary incompetence; 15% had a residual BSD; 8% had a block of both bundles, and 3% had a definitive atrio-ventricular block.

Age Factors↗
PubMed1976

[Ventricular septal defect with aortic failure (Laubry and Pezzi syndrome). Surgical indications and results. Apropos of 20 cases].

The association of aortic incompetence and ventricualr septal defect is rare, but justifies the regular supervision of all patients with VSD. It seems to be found more commonly in cases where the VSD is above the crista. Early operation appears to be justified, and in a large number of cases this avoids the progressive worsening of the aortic incompetence; this in turn leads to better results with the conservative surgical procedures.

Adolescent↗
PubMed1976

[Valve prostheses in children].

The results of 20 medico-surgical teams were combined to give a total of 93 patients aged less than 14 years, with a total of 94 replacement valves. The intra-operative and subsequent mortality rate, the complications and the results have been analysed. The best results are found amongst the severe rheumatic valve disorders in older children, while the worst are amongst the valvular malformations in the infant.

Adolescent↗
PubMed1976

[Hyperkinetic syndromes associated with hypothiaminemia and corrected by administration of vitamin B 1].

High-output states combining tachycardia, increased cardiac output and raised blood pressure are often seen in clinical practice with causes other than the classical ones (hyperthyroidism anaemia and arterio-venous fistulae). Noticing how these syndromes ressemble cardiac beri-beri, the authors looked for hypothiaminaemia in these patients. On the 25 cases studied, two were particularly interesting as there was frank hypothiaminaemia, and also as treatment with vitamin B1 corrected not only the biochemical disorder but also the clinical symptoms, and led to lessening of the trachyardia and a reduction in cardiac output and blood pressure.

Adolescent↗
PubMed1976

[A case of myocardiopathy with hypothiaminemia exacerbated by imiparmine].

The authors report a case of a lady of 45 years of age who presented with a cardiomyopathy with hypothiaminaemia which had been made considerably worse by treatment with imipramine. Once treatment with the antidepressant was stopped, her condition returned to its previous status. The very high plasma imipramine level recorded in his case is undoubtedly the reason for the cardiac toxicity. The mechanism and role of hypothiaminaemia have not far been explained logically.

Cardiomyopathies↗
PubMed1975

[Pericardial effusions and mediastinal radiotherapy. 4 cases].

The authors report 4 cases of chronic pericardial effus-ons appearing several months after high dose mediastinal irradiation for Hodgkin's disease. They describe their clinical characteristics and course. The difficulties of differential diagnosis are mentioned, in particular recurrence of malignancy and tuberculosis. They stress the reserved long term prognosis and the absence of any specific therapeutic approach. The increasing use of madiastinal radiotherapy suggests that the incidence of such manifestations will increase.

Adrenal Cortex Hormones↗