[Long-term results of total surgical correction in Fallot's trilogy].
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Child↗
Biomedical subjects
R Soyer
Publications and source records attributed to R Soyer.
Aortic valve replacement with Smeloff-Cutter prosthesis: 1 to 8 year follow-up.
Two hundred patients had an aortic valve replacement with the Smeloff-Cutter prosthesis between 1972 and 1980. One hundred and seventy six patients had aortic valve replacement alone (mortality 2.8%) and 24 patients had additional procedures. The overall mortality was 6.5%. One hundred and eighty seven patients have been followed up for from 4 months to 8 years (mean 33 months). The 14 patients who died later are analysed; half of these deaths were prosthesis related. There has been no instance of structural failure, ball variance or massive thrombosis in this series. All but 4 of the survivors showed functional improvement. We consider the Smeloff-Cutter valve a good choice for aortic valve replacement.
Adolescent↗
Traumatic rupture of the thoracic aorta with reference to 34 operated cases.
34 cases of traumatic rupture of the aortic isthmus have been operated on since 1963: 14 acute ruptures and 20 secondary false aneurysms. Diagnosis was confirmed by aortography. A special feature seen in cases of total transsection is described. Partial extracorporeal bypass was used in 29 cases and direct cross-clamping in 5 cases. Two techniques were used: direct end-to-end anastomosis in 9 patients and Dacron graft interposition in 25 cases. Primary end-to-end anastomosis more often was used in cases of early operation and partial rupture. Hospital mortality was 2 patients in the group of acute ruptures and 0 patient in chronic false aneurysm group. It was related to brain damage or sequelae of prolonged shock. Post-operative course was uneventful but 4 cases of respiratory failure and 4 cases of neurologic disturbances (2 brain dysfunctions and 2 spinal cord dysfunctions). These complications were transient and the patients recovered without sequelae. Clinical results have been recently appreciated in every long-term survivor (mean follow-up: 5 years) and are excellent. Angiographic controls undergone in 10 patients have shown no abnormalities.
Accidents, Traffic↗
Surgery for aortic dissection: 53 operated cases with 32 in the acute phase.
53 cases of aortic dissections were operated on between 1961 and 1975 in the Service of Cardiovascular Surgery at the Broussais Hospital, Paris (Prof. Ch. Dubost). The present study deals with 32 cases operated on in the acute phase. 31 originated in the ascending aorta and 1 in the descending aorta. Operative mortality was 50% (16/32), 4 patients died immediately following sternotomy. Operation consisted in replacement of the ascending aorta for the majority of type I and II dissections. When aortic insufficiency was present, a simple resuspension procedure was effective in 50% of cases. The authors prefer early operative intervention in type I and II dissections and medical treatment in type III dissections.
Acute Disease↗