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Biomedical subjects

Y Bouvrain

Publications and source records attributed to Y Bouvrain.

At least 55 records · Page 3Linked to original sources
PubMed1976

[Temporary mechanical cardiocirculatory assistance in an adolescent suffering from subacute cardiac failure].

A case is reported of subacute carciac failure during the course of a non-obstructive cardiomypathy in an adolescent. When the exacerbation of cardiac failure, which was accompanied by severe arrhythmias, failed to respond to medical treatment, the combination of a veno-arterial bypass and membrane oxygenator with diastolic counter-pressure from an intra-aortic balloon was tried with success. A reasonable remission was obtained by this means, but the young patient died 8 months later from cardiac failure which proved resistant to treatment.

Acute Disease↗
PubMed1976

[Pathogenesis of arrhythmias in acute myocardial infarction].

Over the last few years, much experimental work has been done to try and elucidate the pathogenesis of disorders of rhythm in myocardial infarction. The role of bradycardia during the first few hours has been discussed, and the use of atropine has been criticised. Some light has been thrown on the importance of the Purkinje network in the infarcted zone. Some new concepts have been applied to the disturbances in exchange across membranes. The authors present the results of a series of experiments on the action of lactate and that of acidosis. The latter is responsible for upturns in the descending phase of the action potential these can cause re-excitation, and give rise to responses containing 2, 3 and even more propagated action potentials.

Acid-Base Equilibrium↗
PubMed1976

[Isolated ventricular tachycardia without patent cardiopathy].

The authors have made a further study of the case notes of 49 patients who were followed up for several years with isolated ventricular tachycardia occurring in a heart which was otherwise healthy; such tachycardias are also called essential or idiopathic. First they define the criteria necessary for the diagnosis of essential ventricular tachycardia: -- an arbitrary age criterion (less than 45 years in men and 50 years in women) which seeks to exclude the so-called "arterial" ventricular tachycardias; -- a follow-up period of supervision of more than two years, which excludes certain primary cardiomyopathies whose presenting feature is a series of attacks of ventricular tachycardia. They then attempt to classify the ventricular tchycardias into four types, according to their clinical features and the electrocardiographic tracings at rest and on exercise, and to predict the prognosis. The most frequently encountered and benign type was the classical ventricular tachycardia of Bouveret.

Adolescent↗
PubMed1975

[Paroxysmal tachycardia due to a latent Wolff-Parkinson-White syndrome].

The authors studied 35 cases of Bouveret type paroxysmal tachycardia with normal baseline ECB, without any signs of Wolff-Parkinson-White syndrome. In more than half the patients, it seems that it may be stated that the paroxysmal tachycardia is related not to a reciprocal intranodal rhythm, as is said classically, but to a reciprocal rhythm using in the anterograde direction the normal pathways and in a retrograde direction a direct atrio-ventricular bundle in which only retrograde conduction is possible. This explains the absence of any patent preexcitation pattern on tracings in sinus rhythm. The authors particularly stress the value of a sign recorded at the onset of an attack of tachycardia: transient slowing of the rate of the tachycardia when functional bundle branch block is present can only be explained by the existence of a latent preexcitation bundle on the side of the "slowing bundle branch block".

Bundle-Branch Block↗
PubMed1975

[Left ventricular perforation after insertion of a mitral prosthesis. 6 cases].

The external ruptures of the left ventricule occuring in the first twelve postoperative hours and demonstrated by a disastrous haemorrhage or cardiac failure, the other traumatics accidents could be delayed and be observed during the first month, or even later. Essentially two mechanisms are implicated: -- Direct traumatism by a ball valve on the ventricular septrum. -- Sub-annular splitting in connection with the excision of a piece of calcareous valve. Two lines of approch can be offered to avoid these accidents: -- Choose a disc valve when the surgeon finds a small left ventricle below a stenosed and calcified mitral valve. -- Care in the decalcification of the mitral ring and the valvular resection, leaving in case of need a small calcified cuff for safety. The analysis of these findings clarify the main causes of left ventricular rupture after mitral replacement, rare complications, but ones which are very real.

Adult↗
PubMed1975

[Myocardial infarction in diabetics (author's transl)].

In 160 patients admitted during the first 8 days following myocardial infarction during the period November 1st 1974 - March 15th 1975, the prevalence of diabetes was 17%. Among 655 patients treated for a month in a convalescence centre following the acute phase of myocardial infarction during the period January 1st 1974 - March 15th 1975, the prevalence of diabetes was 17.5%. Mortality rate during the first 8 post infarction days was 28% in diabetics and 13% in non-diabetic patients in the coronary care Unit; over the subsequent month, the mortality rate was 7.7% in diabetics and 3.7% in non-diabetics while at the convalescence Centre. The higher mortality rate from myocardial infarction in diabetics could not be contributed to a greater severity or more wide spread nature of the coronary artery disease as evidenced by the results of coronary cineangiography performed in diabetic and non-diabetic patients with severe ischaemic heart disease. In the cases in which an aorto-coronary by-pass was performed, there was no apparent difference in the response of diabetics compared to non-diabetic subjects. Despite progress in intensive treatment of myocardial infarction, mortality rate of this disease in diabetics remain very high. Reduction of the incidence of ischaemic heart disease in diabetics requires early identification and reversal of all of the many risk factors for arterial disease.

Aged↗
PubMed1975

[Hemodynamic study of dopamine used in chronic heart failures and in cardiogenic shock as a complication of acute myocardial infarct].

The object of this study is to examine the properties of dopamine at the hemodynamic and renal level in 16 patients with decompensated chronic cardiopathies or very serious cardiogenic shock due to myocardial infarction. The results show an increase in the cardiac index in 75 p. 100 of the cases with a favourable diminution of the arterio-venous difference in O2 and of the pulmonary arterial resistances. The most noticeable and the most constant effect is the recovery and increase of the diuresis. Positive chronotropic and bathmotropic effects were observed which necessitated the limitation of prescription of dopamine in those subjects showing signs of disturbances in ventricular excitability.

Angina Pectoris↗
PubMed1975

[Continuous electrocardiographic recording. Clinical, diagnostic and therapeutic value].

The interest of permanent electrocardiographic recording in ambulatory patients is not restricted to the demonstration of the cardiogenic origin of some functional disturbances. This method provides the proof of the often non fiable character of anamnesis for the diagnosis of arrhythmias. It shows the close relationship between "minor" (extra-systoles) and "major" (tachycardias) arrhythmias, and consequently the prognostic value of the former in relation with the latter. Continuous ECG follow-up affords in the assessment of anti-arrhythmic drugs efficiency a higher safety than that provided by the conventional simple clinical follow-up.

Anti-Arrhythmia Agents↗
PubMed1975

[Septal perforation of myocardial infarct. Progress and limitation of current treatment. Apropos of 28 recent cases].

The emergency treatment of septal perforation in a myocardial infarction was markedly improved by pre-operative preparation of the patient by an intra-aortic balloon. If one excludes 7 cases in which the favourable immediate course made possible a delayed operation, 21 cases, severe from the start, were observed in the last two years: 8 patients, were thought to be operable with 6 successes. The type of the patient, the age, the associated diseases, the gravity and extension of the local lesions explain that this complication nevertheless still remains very often beyond the present possibilities of the medical-surgical treatment.

Aged↗
PubMed1975

[Paroxysmal junctional tachycardia. Determination of the inferior point of junction of the reentry circuit. Dissociation of the intra-nodal reciprocal rhythms].

Stimulation of the bundle of His and of the uppermost portion of the interventricular septum gives us an opportunity to make a precise study of capture phenomena in patients with paroxysmal nodal tachycardia. According to whether the capture is correctly timed, delayed, or unusually premature, the inferior junction point of the reentry circuit can be located precisely by reference to the H wave and the onset of the R wave. Out of a series of 65 patients, only 30 of whom had a true WPW syndrome, it was shown that 43 cases had a bundle of Kent which ensured retrograde conduction during the tachycardia, and was therefore the seat of a unidirectional block in 13 cases. In 22 cases (33.8%) the diagnosis of WPW syndrome was excluded, but the reentry circuit was nevertheless not of nodal origin. The inferior junction point of the circuit was effectively situated between H and R in 12 cases, and at H in 5. In only 5 cases (7.8%) might there have been a reciprocal intra-nodal rhythm, which should not necessarily be taken as proof of its existence. The validity of the classical criteria in localising the reentry circuit is discussed.

Atrioventricular Node↗