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Biomedical subjects

R Ponlot

Publications and source records attributed to R Ponlot.

68 records · Page 4Linked to original sources
PubMedDate not supplied

[Risk factors in surgery of the abdominal aorta].

Surgical risk factors of abdominal aortic disease. Between January 1, 1982 and October 1986, 327 surgical repairs were performed on abdominal aortic obstructive diseases and aneurysms at the St. Luc University Hospital. 150 pre-, per- and postoperative data were collected retrospectively for each patient. Ninety-one per cent of patients were smokers, 57.5 per cent had heart disease, 43 per cent arterial hypertension, 51 per cent peripheral vascular disease and 28 percent had obstructive lung disease. Concerning cardiac morbidity, the post-operative infarction rate was 4.4 per cent in patients who had previously suffered from an infarction, and 1.9 per cent in patients with no previous infarction. Post-operative angina-ischemia rate were respectively 23 and 4.7 per cent. Two hundred and thirty two elective operations resulted in 6 deaths (2.6 per cent) while 95 emergency operations resulted in 34 deaths (35.8 per cent). The causes of the death and the post-operative complications are detailed. The decrease of the morbidity and the mortality rates inherent to this pathology depends on an early diagnosis and surgical treatment by a team, knowledgeable of this pathology, who are able to prevent and correctly treat the complications, especially those affecting the cardiovascular system.

Adult↗
PubMedDate not supplied

Comparative results after endarterectomy of the internal carotid artery performed with or without a shunt.

One hundred endarterectomies of the internal carotid artery have been performed from March 1984 to December 1985; 50 were carried out with a Javid shunt, and 50 were performed without using a shunt. There was no peroperative or hospital deaths. Five operations performed with the use of a shunt and 4 performed without a shunt were followed by a central nervous system deficit. The frequency of central neurological complications is thus not statistically different, but the time of onset and the likely cause of the deficit are different.

Aged↗
PubMedDate not supplied

[Pulmonary embolectomy. Clinical experience].

Between 1969 and 1984, twenty-three patients underwent an emergency pulmonary embolectomy under extracorporeal circulation in the Catholic University of Louvain (UCL), Department of Cardiovascular and Thoracic Surgery. The aim of this paper is to delineate the indications of this procedure. Patients were 23 to 70 years old. Diagnosis of Pulmonary Embolism was made according to clinical signs, ECG and Chest X Ray with Swan-Ganz catheter insertion into the pulmonary artery and the help of pulmonary angiogram if time permitted. The surgical technique is briefly described. Four patients died during the immediate postoperative period and three died later. The sixteen survivors all enjoy a normal life.

Adult↗
PubMedDate not supplied

[Coarctation of the aortic isthmus in the adult].

Forty four patients over the age of eighteen operated upon for coarctation of the aorta from 1962 to 1983 at our institution were followed for one to 21 years (mean 13 years 3 months). Hypertension was found in 86% of the patients and 82% were preoperatively symptomatic. There were three late deaths. During the follow-up period, drug resistant hypertension persists in 31% of the patients at rest and/or exertion and 18% have functional symptoms. These data emphasize the importance of early diagnosis and treatment for patients with coarctation of the aorta.

Adolescent↗
PubMedDate not supplied

Correction of tetralogy of Fallot after Waterston shunt.

The authors have reviewed their experience concerning twenty-seven patients who underwent intracardiac repair of Fallot's Tetralogy after a previous Waterston shunt. They are divided into 4 groups according to the classification of Shinebourne, Anderson and Bowyer. The risk factors are analyzed in group 1 patients in whom primary total correction is contra-indicated and in whom the mortality at repair is high in presence of kinking of right pulmonary artery. The type of surgery is still debatable. For the symptomatic patients of the other groups, primary total correction at any age seems, at this time, to be the treatment of choice. The contra-indications are an anterior descending coronary artery arising from the right coronary artery or associated complex anomalies which would make total correction difficult.

Aorta↗
PubMedDate not supplied

Early surgery for severe aortic regurgitation.

One hundred and fourteen consecutive patients who underwent aortic valve replacement (AVR) for isolated aortic regurgitation (AR) from 1965 to 1981 are presented. Sixty eight (60%) were preoperatively in NYHA class I-II and 46 (40%) were in NYHA class III-IV. Eighty-two patients had left and right heart catheterization prior to the operation and the severity of regurgitation was assessed angiographically in 93% of those in functional class (FC) I-II. Left ventricular (LV) end-diastolic volume index and end-systolic volume index were elevated even in the mildly symptomatic patients (156.1 and 61.0 ml/m2 respectively). The ratio of LV end-systolic pressure to LV end systolic volume index was diminished in the FC I-II patients. Two patients in FC III died in hospital (operative mortality: 1.7%) and there were 21 late deaths with a 5-year survival of 82.7%. Late survival differed significantly between patients who were preoperatively in FC I and II or III and IV (P less than 0.03). These data suggest that severe AR with altered LV function is an indication for early operation regardless of the presence of absence of symptoms.

Adolescent↗
PubMedDate not supplied

Horseshoe kidney and abdominal aortic aneurysm.

Three cases of horseshoe kidney associated with an abdominal aortic aneurysm are reported. The pathology, diagnosis and management are discussed. The review of the literature indicates that successful treatment depends on an accurate knowledge of the blood supply to the kidney.

Aorta, Abdominal↗
PubMedDate not supplied

[Risk factors, postoperative mortality and morbidity in pulmonary surgery].

In this retrospective study, the influence of preoperative risk factors on mortality and morbidity after pulmonary surgery is analysed. Sixty-five consecutive pulmonary resections are studied and compared with data from the literature. Age and lung function abnormalities are well known risk factors but a severe selection minimizes their negative effects: a good cardio-circulatory condition and the prediction of an acceptable postoperative lung function allows a mortality reduction down to 5% and minimizes the frequency of postoperative respiratory insufficiency. The importance of a good preoperative training of the patient and of the early detection and immediate treatment of any postoperative complication are stressed.

Aged↗
PubMedDate not supplied

Surgical treatment of mitral stenosis.

Analysis of 239 patients who underwent a commissurotomy for mitral stenosis (196 closed technique, 43 open technique). Total operative mortality was 2%. Long term follow-up is illustrated by an actuarial survival curve and long-term functional results are studied up to 15 years after operations. It allows the authors to consider commissurotomy alone as a good palliative procedure with good functional results in the majority of cases. However, in view of the collected data, they now elect to restudy all the patients 6 years after the primary correction and to perform a heart catheterization to consider appropriate reoperation in some cases.

Adult↗
PubMedDate not supplied

Tricuspid valve surgery.

Our purpose was to study the long-term results of the tricuspid valve replacement. It is obvious that tricuspid annuloplasty (Kay, De Vega) has its place in the treatment of functional tricuspid insufficiency that accompanies mitral or mitral and aortic valve disease. The Carpentier ring appears justified for some cases. However tricuspid valve replacement can be the operation of choice for some patients. Our study demonstrated that the Björk-Shiley and Starr-Edwards prostheses remain good substitutes in tricuspid valve surgery and that the long-term results are better than it was anticipated a decade ago.

Adult↗