Early and late results in mechanical valvular replacement.
Explore the source record for details and available documents.
Disability Evaluation↗
Biomedical subjects
W Daenen
Publications and source records attributed to W Daenen.
The pseudocyst of the adventitia of the popliteal artery.
Explore the source record for details and available documents.
Adult↗
Experience with 100 consecutive anterior mediastinotomies in lung cancer.
Between January 1978 and March 1981, 100 anterior mediastinotomies were performed in patients with proven or suspected lung cancer. It was done 72 times in patients with a tumor of the left lung, all presenting with a normal mediastinum. Of those 72 patients, 59 had a tumor in the left upper lobe: 30.5% of the latter were found to have involved mediastinal lymphnodes (our yield in this location was 15.1% when using the cervical mediastinoscopy); 16 patients with a left upper lobe tumor had both an anterior negative cervical mediastinoscopy followed by an anterior approach: 4 became positive (25%). The anterior mediastinotomy was performed two times in patients with a suspect mediastinum: the mediastinoscopy was once positive, and once negative. It was done 26 times in patients with a radiologically manifest enlarged mediastinum (7 on the right side, 19 on the left side); in 24 patients the histological diagnosis was unknown. The anterior mediastinotomy was positive in all 26 cases. For the whole group we found positive nodes in 10 of 26, i.e. 38.5% of the patients despite normal findings at cervical mediastinoscopy. We would therefore recommend an anterior mediastinotomy in every patient with a suspect or an enlarged superior mediastinum in order to establish an histological diagnosis or exceptionally to check the operability. If the mediastinum is radiologically normal, the anterior approach has much more chance to yield a positive result than the cervical one when the tumor is located in the left upper lobe.
Humans↗
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↗
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↗
Total correction of tetralogy of Fallot following palliation.
Fifty three patients with Tetralogy of Fallot were totally corrected following palliation. Intracardiac repair was not adversely influenced by a Blalock Taussig shunt or a Waterston shunt which did not produce kinking of the RPA. The results were less satisfactory after correction following a Potts shunt or a Waterston shunt with kinking at the site of the anastomosis.
Adolescent↗
[Obstruction of the superior vena cava and right subclavian vein: a propos of 2 unusual cases].
Two uncommon cases of vein obstruction are presented. In the first case a syndrome of superior, caval vein obstruction was caused by idiopathic fibrous mediastinitis involving the vein wall, and creating a tumefaction in the lumen of the vein simulating the existence of a benign tumor (fibroma) of the wall. This tumefaction was removed by endvenectomy, and the venotomy was repaired by a pericardial patch. In the second case the obstruction of the right subclavian vein was caused by a stenosed valve without signs of inflammation nor consecutive thrombosis. Until the present day no other similar case of a stenosed valve in the right subclavian vein has been reported.
Constriction, Pathologic↗
[Surgical treatment of spontaneous pneumothorax].
Explore the source record for details and available documents.
Adolescent↗
Dobutamine stress echocardiography after heart transplantation.
Dobutamine stress echocardiography was performed in 28 heart transplant recipients to study its value in the detection and staging of transplant vasculopathy. Fourteen patients had angiographic evidence of coronary artery disease (group 1), and 14 had angiographically normal coronary arteries (group 2). The dobutamine stress protocol called for a dose increase of dobutamine every 3 minutes until the age-predicted maximal heart rate was achieved. In groups 1 and 2, the mean maximal dose of dobutamine was, respectively, 24 +/- 9 micrograms/kg min and 29 +/- 8 micrograms/kg min, and the mean rate-pressure product was, respectively, 12386 +/- 1777 mm Hg/min and 10753 +/- 1085 mm Hg/min at rest, increasing to 20987 +/- 4020 mm Hg/min and 19795 +/- 2728 mm Hg/min at maximal dose. No patient in group 1 or 2 had deterioration of global or regional wall motion under dobutamine stress. In group 1, seven patients had wall motion abnormalities at rest, normalizing in five of them under dobutamine stress. In group 2, four patients had wall motion abnormalities at rest, normalizing in all patients under dobutamine stress. Consequently, this protocol of dobutamine stress echocardiography is unsuitable for the early detection of transplant vasculopathy despite its proven value in the general population. Conversely, these data suggest that the functional sequelae of transplant vasculopathy are not necessarily prominent, despite the known angiographic underestimation of the extent of the disease.
Blood Pressure↗
Hemopump fails as bridge to transplantation in postinfarction ventricular septal defect.
From 1990, six patients were bridged to transplantation with a catheter-mounted axial flow pump (Hemopump). Indications were graft failure (two patients), postinfarction ventricular septal defect (two patients), myocarditis (1 patient), and myocardial infarction (1 patient). The 21F cannula, inserted via the groin, was used as a partial assist in four patients, and the 31F cannula, inserted via the ascending aorta, was used to assist the other two patients completely. Hemodynamic recovery was achieved in all patients (mean cardiac index rose from 2.1 L/gm/m2 to 3.85 L/gm/m2 after 1 hour assist). Sudden pump failure occurred in the two patients with postinfarction ventricular septal defect and a piece of necrotic tissue blocking the catheter was found. Both patients died. The other four patients were successfully bridged to transplantation. One of these patients died during his postoperative hospital stay; the three remaining patients were discharged and were well at follow-up (46, 40, and 3 months). The Hemopump device provides sufficient organ perfusion to be used as a bridge to transplantation. No conclusions can be drawn for the long-term use (longest run in this series was 102 hours). Postinfarction ventricular septal defect is a contraindication for the use of the Hemopump device.
Adolescent↗