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Biomedical subjects

S Chauvaud

Publications and source records attributed to S Chauvaud.

105 records · Page 6Linked to original sources
PubMed1980

Reconstructive surgery of mitral valve incompetence: ten-year appraisal.

Between January, 1969, and January, 1978, 551 patients with mitral incompetence were treated by a system of reconstructive techniques. Mitral valve incompetence was classified into three types according to leaflet pliability; type I normal leaflet motion, 150 cases; type II, leaflet prolapse, 213 cases; and type III, restricted leaflet motion, 188 cases. Associated tricuspid valvular disease was present in 174 cases (31.5%) and was treated by prosthetic ring annuloplasty. The operative mortality rate was 4.2% (16/377) in the mitral group and 14% (25/174) in the mitral-tricuspid group. Follow-up data are available in 341 patients from 1 year to 10 years (average 4 1/2 years). The late mortality rate was 7% (24/341). Actuarial curves including hospital mortality rate show an 82% survival rate at 9 years in the mitral group and a 79% rate in the mitral-tricuspid group. Thirty-seven patients (11%) underwent reoperation mainly for residual (17) or recurrent (16) mitral incompetence. Thromboembolism occurred in 12 patients for an embolic rate of 0.6% per patient-year, even though 48% were not given anticoagulants. Acorrding to the New York Heart Association (N.Y.H.A.) classification, 76% (207/270) of the patients were in Class I, 19% (51/270) were in Class II, 4% (10/270) were in Class III, and 0.7% were in Class IV (2/270). Results of postoperative catheterization and angiocardiography are available in 52 patients. Comparison between the various groups shows that the best results were obtained in type II mitral incompetence, followed by type I and type III mitral incompetence. This experience demonstrates that predictable and stable long-term results have been achieved by techniques of valvular reconstruction with a low incidence of thromboembolism. Reproducibility of the techniques is a limiting factor which can be overcome by adequate training and progressive experience. Patient selection is based on the valvular disease rather than age, physical condition, or cause of valvular disease.

Adolescent↗
PubMed1978

Conservative management of the prolapsed mitral valve.

Prolapsed leaflet is the result of ruptured chordae, elongated chordae, or ruptured papillary muscle. Various techniques adapted to each of these lesions were developed, and repair of 213 prolapsed mitral valves was performed between 1969 and 1977. There were 109 patients with ruptured chordae treated by quadrangular resection of the prolapsed leaflet; 103 patients with elongated chordae were treated by either a "sliding plasty" of the papillary muscle or a "shortening plasty" of the chordae; and 1 patient with ruptured papillary muscle was treated by reimplantation. The great majority of patients had an associated annular dilatation or deformation requiring the use of a Carpentier ring to remodel the annulus and reinforce the repair. The operative mortality was 4% and the late mortality, 3%. There were 6 reoperations, 3 of which occurred within 1 year. Thromboembolic complications occurred in only 1 patient (0.5%), even though the majority of patients received no anticoagulation treatment. Actuarial curves demonstrated a 91% survival at 8 years.

Adult↗
PubMed1978

[A case of subannular aneurysm of the left ventricle].

The authors present a case of sub-annular aneurysm of the left ventricle in a child of 7. It was associated with aortic incompetence, a ventricular septal defect, and coarctation of the aorta which were discovered during investigation of streptococcal septicaemia. As a first stage procedure, the aortic valve was repaired, the aneurysm was excised, and the ventricular septal defect closed. At a later stage, the coarctation was resected. The question of whether this lesion was congenital or acquired is discussed. After one year, the result remains satisfactory.

Aortic Coarctation↗
PubMed1977

Detection of hepatoma in liver cirrhosis.

The analogic liver scintigram using 99mTc sulfur colloid in cirrhotic patients does not permit determination of the nature of the areas of decreased uptake. Scintigrams with 67Ga citrate generally show increased activity in cases of hepatoma. In some cases, however, 67Ga citrate is less concentrated in neoplasic tissue, and it is not possible to detect a tumoral lesion in a cirrhotic liver. This is why we used double isotope scintigraphies with 67Ga citrate and 99mTc sulfur colloid, with digital subtraction, after simultaneous recording of 99mTc and 67Ga data on magnetic tape by means of an interface. In our series of 22 patients, the comparison of the results obtained by this double isotope technique with histology showed no false positive in substraction scintigrams. There was one false negative because of the lack of significance in the subtracted image for one of the six patients with cancer of the liver. For three of the six patients with hepatoma, the gallium scintigram showed an increased uptake in the tumor area. For the three other cases, the gallium uptake was equilibrated throughout the liver scintigraphy. It was therefore in cases where the gallium scintigram showed no increased activity that the subtraction technique was of greatest value, for it permitted the diagnosis of hepatoma in two cases.

Carcinoma, Hepatocellular↗
PubMed1977

[Surgical treatment of the double outlet right ventricle with pulmonary stenosis. Apropos of 7 cases].

The double outlet right ventricle is a rare malformation, and its surgical correction has been well defined. The authors present seven cases of double outflow of the right ventricle and stenosis of the pulmonary outflow. If the technical problems of those variants with a subaortic septal defect seem to have been overcome, those with a subpulmonary ventricular septal defect present a much more difficult problem. Of the seven cases presented, the authors report the death of one patient who had a right ventricle with a double outlet associated with pulmonary stenosis and a sub-pulmonary ventricular septal defect. The post-operative course of the other 6 patients, who had a subaortic ventricular septal defect, was simple. One patient suffered secondary dehiscence of the repaired septal defect, and was reoperated on. The maximum follow-up period has been 7 years.

Adolescent↗
PubMed1977

[Ostium primum and mitral cleft and aortic subvalvular stenosis. Apropos of 2 operated cases].

The two case reports are of children of 10 and 8 years of age with an ostium primum defect, with a mitral cleft and a stenotic fibrous ring below the aortic orifice. In the first case, the cause of the obstruction to left ventricular ejection was found at catheterisation, and in the second case it was an operative finding. In both cases there were large gradients, about 100 mmHg. The subaortic blockage was resected in both cases. A review of the literature has not revealed any similar case.

Cardiomyopathy, Hypertrophic↗
PubMed1975

Electrocorticographic distrubances after portacaval shunt in the rat: a quantitative evaluation.

Electrocorticographic recordings were analyzed in two groups of Wistar rats with end-to-side portacaval shunt and sham portacaval shunt. The main electrical abnormalities observed in the shunted rats concerned slow wave sleep. Quantitative evaluation of these disturbances was made by measuring the duration of spindles normally present in this phase of sleep. Longer duration of the spindles appears to be a reliable index of electrocorticographic disorders after portacaval shunt in the rat.

Animals↗
PubMed1975

Early recovery of albumin synthesis after liver transplantation.

The delay necessary for an orthotopic transplanted liver to recover in normal activity has never been defined. This is of great importance whenever liver transplantation is considered in patients with severe liver insufficiency. This delay was studied in dogs using albumin synthesis and BSP clearance as tests of liver function. Albumin synthesis was normal as early as 2 h following graft revascularization while BSP clearance was not yet normal by this time. It is suggested that transplanted livers will be rapidly able to corect metabolic disorders and above all coagulation problems in patients with terminal hepatic failure.

Albumins↗
PubMedDate not supplied

Dynamic cardiomyoplasty: a new approach to assist chronic myocardial failure.

The concept of 'reconstructive cardiac surgery' using a stimulated autologous skeletal muscle has been investigated in this research. Our approach has been to investigate the substitution or reinforcement of a ventricular wall by a contractile tissue. The experiments have demonstrated the feasibility of this technique and the long-term adaptability and adequate electrophysiological properties of the Latissimus Dorsi flap transferred to a heterotopic position over the heart. Long-term biocompatible fatigue resistant muscle stimulation has become possible in experimental and clinical cases as a result of the development of specially designed electrodes and the use of a progressive sequential stimulation protocol to adapt the skeletal muscle to a cardiac support function. Autologous pericardium treated with glutaraldehyde was found to be a suitable material to close the ventricular cavity. Cardiomyoplasty with autologous skeletal muscle to restore ventricular contractility seems to be a valid alternative in addition to current methods of treatment for irreversible myocardial failure.

Animals↗
PubMedDate not supplied

[Atypical pulmonary localization of Takayasu's disease].

Takayasu's disease preferentially involves the aorta and its branches. Extension along the pulmonary artery is much more rare. The case presented here is that of a young woman presenting with bilateral involvement of the pulmonary arteries, consisting of hypoplasia on the right and dilatation on the left. The investigation was completed by a study of the collateral vascularization in the right lung and by a lung scan. Right ventricular failure was the condition which led to the diagnosis of the disease. The abdominal aorta and the right renal artery are also involved, which led us to consider the pulmonary lesions as being part of Takayasu's disease. The aortic and renal involvements were asymptomatic and there were no signs of progression of the disease.

Adult↗