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Biomedical subjects

P Vouhe

Publications and source records attributed to P Vouhe.

36 records · Page 2Linked to original sources
PubMed1982

[Surgical treatment of subvalvular aortic obstructions. A new approach].

Approaching the region below the aortic valve is notoriously difficult. The new technique described, derived from the Konno-Restan technique, provides wide exposure of the infra-aortic canal through the right ventricle, the aorta and the septum. Experiments on animals have shown that it entails no risk of heart damage. This technique was used on one patient with sub-aortic fibromuscular tunnel with excellent post-operative results.

Aorta↗
PubMed1982

[Aortic insufficiency caused by incomplete rupture of the ascending aorta. Conservative surgical treatment].

Commissural disorganisation secondary to incomplete rupture of the ascending aorta was found at surgery for massive aortic incompetence in a young man with previous hypertension. The lesions were repared by a conservative procedure with an excellent result 3 years after surgery. Incomplete spontaneous rupture of the ascending aorta occurs in the same terrain as dissection of the aorta (hypertension, aortic media necrosis) of which it represents a minor form. It may remain asymptomatic but it is usually complicated either by secondary intrapericardial rupture, by aortic aneurysm or by aortic incompetence due to valvular prolapse. When valvular prolapse is associated with another lesion which aggravates the regurgitation (aortic valve disease, aortic ring dilatation) aortic valve replacement should be performed with a prosthesis; on the other hand, when commissural disorganisation giving rise to valvular prolapse is the cause, a conservative procedure may be envisaged.

Adult↗
PubMed1979

[Technical development in aortocoronary bypass: multiple outlet saphenous vein graft].

The technique of multiple outlet saphenous vein grafting with one or several alternating lateral anastamoses was used in 43 patients over a one year period; over half the patients had triple vessel disease, one third had double vessel disease; a total of 128 coronary arteries were revascularised 2.9 arteries per patient, with 60 side to side anastamoses, 1.4 per patient. The technique of this type of bypass necessitates paying particular attention to avoid kinking or twisting of the graft. The blood flow through multiple outlet graft is on average significantly greater than in the classical types of graft, and is one of the main points in favour of this technique and in keeping the graft permeable in the long term. The short term results of this technique are good with a hospital mortality of 4.6% and a peri-operational infarction rate of 6.9%, figures which are comparable with the results of classical bypass grafting techniques in multivessel coronary artery disease.

Adult↗
PubMed1978

[Resections of the left ventricle in the surgical treatment of parietal sequelae of myocardial infarct].

Resection of left ventricular tissue seems to be playing an increasing part in the treatment of the sequelae of myocardial infarction. In a total of 700 patients who underwent surgery for some aspect of coronary atherosclerosis, 40 underwent resection of left ventricular tissue. In the majority of cases, diagnosis rested on left ventricular cine-angiography and in 3 cases this had to be carried out as an urgent procedure with circulatory assistance using diastolic counter-pressure (DCP) from an intra-aortic balloon. A selective contrast technique for the two coronary arteries was used whenever possible. The surgical anatomy of the lesions indicates a difference between a localised dyskinesia and diffuse dyskinesia, the latter having a severe effect on left ventricular function. In a group of localised dyskinesias, the territory supplied by the anterior descending artery was by far the most frequently affected. Resection of left ventricular tissue was associated with a myocardial bypass revascularisation procedure in 9 cases, valve repair in 7 cases, and closure of a septal perforation in 3 cases. The total inpatient mortality rate is still quite high (23.1%) because of the severity and widespread nature of the coronary disease. However, the mid-and long-term results are good, the criteria being functional improvement and the actuarial 4-year survival rate.

Adult↗
PubMed1978

[The "small aortic ring." Hope for a surgical solution].

The "small aortic ring" was until recently an unresolved problem for surgeons operating on the aortic valves. It used to contraindicate valve replacement in the child, and sometimes led to the insertion of too small a valve in the adult. Some hope of a solution has appeared in the form of three new techniques: enlargement of the aortic ring over the mitral valve, aorto-ventriculoplasty, and apico-aortic shunt. Two adults have had the ring enlarged above the mitral valve with good results in both cases. Five children have had an aorto-ventriculoplasty with good results in two cases, post-operative atrio-ventricular block in one, and two deaths, one early and the other late. These deaths appear to be more closely related to the severity of the initial lesion and to the degree of decompensation of the myocardium than to the operation itself. There are advantages and problems with this technique. An attempt has been made to systematise indications for treatment as a function of the lesions and the state of the patient.

Adolescent↗
PubMedDate not supplied

Right atrial myxoma: an unusual cause of intracardiac right-to-left shunt.

A case of a right-to-left intracardiac shunt caused by a right atrial myxoma is reported. Sudden hypoxaemia was the unique symptom. Measurement of Pao2 while the patient breathed pure oxygen demonstrated the presence of a shunt. Right heart catheterization showed a patent foramen ovale and a pressure gradient between the right atrium and the right ventricle, and between the right and the left atria, explaining the shunt. Cineangiography demonstrated a right atrial myxoma, which was surgically removed. This case report illustrates how a step-by-step diagnostic procedure, based on pathophysiology, may lead to such unexpected findings.

Adult↗