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Biomedical subjects

R Suy

Publications and source records attributed to R Suy.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Surgical treatment of acute, massive lung embolism. Results and follow-up.

Between 1970 and 1984 the diagnosis of acute, massive lung embolism was made 30 times in our department. In 29 patients the clinical diagnosis was correct and a Trendelenburg operation under extra-corporeal circulation was performed. In 18 cases there was an operation in the immediate preoperative course. In 1 case there was a combination of operation and the use of contraceptives. 3 cases were immobilized by a plaster of Paris cast. In 4 cases the use of oral contraceptives and in 3 patients the history of chronic recurrent lung embolism were evident. The mean immobilisation time was 15 days. In 24 cases the diagnosis was made only on the base of the clinical anamnesis, and examination, E.C.G. and chest radiography. In 4 cases angiography and in 1 patient the scintigraphy confirmed the diagnosis. Preoperatively 28 patients were in severe shock. One patient was operated electively. 14 patients needed external cardiac massage. In all cases clots were found in the left pulmonary artery, 28 in the right pulmonary artery, in 3 cases clots in the right atrium, 3 in the right ventricle and three in the inferior caval vein. Nine De Weese caval vein clips were inserted and one Mobin-Uddin filter. Postoperatively 18 patients were alive and well without sequelae. Two patients developed a cerebro-vascular accident (CVA) with one complete recovery. Ten patients died. Postoperative treatment consisted of I.V. heparin administration immediately after surgery and 6 months of oral anticoagulants. Except for chronic recurrent lung embolism the pulmonary function tests were excellent postoperatively without recurrence of the disease.

Acute Disease↗
PubMedDate not supplied

The patient's perspectives after aortofemoral grafting for occlusive disease.

The late results of aortofemoral grafting for aortoiliac occlusive disease in 371 patients are presented. Late survival (30% after 15 years) was primarily dependent on age at the time of surgery and the presence of atherosclerotic heart disease on subinguinal atherosclerotic involvement. The majority of late deaths (42%) was due to atherosclerotic disease. With a mean follow-up period of 7 years the late complication rate was 29%. Late thrombosis was responsible for 66% of the late complications and a subsequent redo-operation was necessary in 24% of the patients. Age at the time of surgery and the presence of femoropopliteal occlusive disease were the most important factors. Regarding the late mortality rate of 45%, it is recommended that follow-up in these patients should be directed not only to late graft complications but also to other manifestations of generalized atherosclerosis.

Adult↗
PubMedDate not supplied

[Infrarenal abdominal aneurysms. Course and their effect on perioperative mortality. A 23-year study].

The perioperative mortality rate in elective aneurysmectomy progressively declined to 2%; despite the fact that the percentage of patients with risk factors has increased. Important is that this perioperative mortality is not related to the age of the patients. In acute situations the perioperative mortality has increased to 30 à 50%. This can be explained by the increasing number of ruptured aneurysms and the influence of increasing age at the time of surgery. These results support the concept of elective resection of abdominal aortic aneurysms.

Aged↗
PubMedDate not supplied

Aorto(ilio)popliteal grafting by the obturator route using the human umbilical vein graft.

Over a 5 year period, the human umbilical vein (HUV) graft has been used for 16 aorto(ilio)popliteal reconstructions by the obturator foramen route. 69% of the operations has been performed for multilevel disease with the femoral arteries completely unsuitable for reconstruction. One patient died after operation and one early thrombosis could be repaired by thrombectomy and reconstruction of the distal anastomosis. With a mean follow-up period of 15 months (range 1 to 54 months) there were 2 late occlusions (2 years patency rate 73.3%). Another 2 patients returned with ischemic restpain due to progression of distal disease in the presence of a patent graft. It is concluded that the HUV graft represents a very satisfactory prosthesis for long aorto popliteal reconstruction and that a primary obturator graft is justified in the selected patient with multilevel disease and a very poor profunda femoris connection.

Aged↗
PubMedDate not supplied

[Inflammatory aneurysms].

Inflammatory aneurysms are not so frequent, etiology and pathogenesis are uncertain. Resection can be a problem because of the dense inflammatory fibrous reaction. Preoperative diagnosis may be possible with the aid of intravenous urography and CAT-scan. The treatment of choice is an aortic replacement followed by uni- or bilateral ureterolysis and omentoplasty to cover the entire vascular reconstruction and protect the ureters.

Aged↗
PubMedDate not supplied

Five-year survival in operated lung cancer.

A total of 1,001 patients with a confirmed diagnosis of lung cancer were treated at the University Hospital Pellenberg - Leuven in the five-year period 1970-1974. One hundred and sixty-four patients (16.4%) were operated and 152 underwent surgical resection of their pulmonary lung lesion. The influence of factors as histology, type of resection, age, staging, anatomic localization of the tumor on the five year survival are considered. The survival was 34.2% for all types of resected tumors, ranging from 42.0% for the lobectomies in squamous cell carcinoma to 0% in small cell carcinoma. The operative (30 days) mortality is included in the statistical follow-up. This mortality was 8.6% for the pneumonectomies and 4.3% for the lobectomies.

Adult↗
PubMedDate not supplied

Total pericardectomy for chronic constrictive pericarditis. Early and late results.

The early and late results of total pericardiectomy, performed over a 17 years period in 39 patients with chronic constrictive pericarditis, are presented. The overall operative mortality was 18%. With growing surgical experience and anesthesiological improvement, the operative morality of 26% during the first 12 years decreased to an acceptable 6.2% during the last 5 years. The cumulative 5 and 10 years survival rates were respectively 73% and 68%. Ninety-three percent of the surviving patients were classified in functional class I or II (NYHA classification), while preoperatively 90% of these cases belonged to class III or IV. Viewing these results it is concluded that the tendency towards early surgery should be encouraged, especially because the chronic state is accompanied by several deleterious effects.

Adolescent↗
PubMedDate not supplied

Uremic pericarditis. Treatment by limited pericardiectomy.

Between 1963 and 1979, limited pericardiectomy through left anterolateral thoracotomy was performed in 14 patients with uremic pericarditis. Two patients died after operation and one patient presented an early recurrence. Within a mean follow-up time of 3.3 years there were 7 late deaths but no recurrences or no cases of constrictive pericardidis. After reviewing the literature, it is concluded that the best early and late results in uremic pericarditis are obtained with pericardiectomy through an anterolateral thoractomy, the subxiphoid approach with creation of a pericardial window being a good alternative in critically ill patients.

Adult↗
PubMedDate not supplied

The expanded polytetrafluorethylene (PTFE) graft as a vascular substitute.

Ninety-one PTFE grafts (63 Gore-Tex and 28 Impragrafts) were used to bypass an occluded femoropopliteal artery in eighty-six patients. Ischemic rest-pain usually combined with ulcerative lesions or gangrene was the operative indication in 56 patients. In 58 percent the outflow was limited to at most 1 crural artery. The distal anastomosis was located to the distal popliteal artery in 38 reconstructions and to the tibioperoneal trunc or one of the crural arteries in 27 reconstructions. Postoperative angiography was performed in 18 patients. The incidence of early thrombosis is very high namely 47% within 3 months and 57% within 6 months. Limited outflow and thrombus apposition, as demonstrated by some angiograms, are the major reasons of the early occlusion.

Aged↗