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Biomedical subjects

Y Leclerc

Publications and source records attributed to Y Leclerc.

61 records · Page 4Linked to original sources
PubMed1985

Comparison between antibiotic irrigation and mobilization of pectoral muscle flaps in treatment of deep sternal infections.

Between January of 1978 and December of 1983, 41 patients developed deep sternal infections with mediastinitis after cardiac operations. Between January of 1978 and December of 1981, 19 of these patients were treated with débridement, primary wound closure, and mediastinal antibiotic irrigation (Group I). Between January of 1982 and December of 1983, 22 patients were treated with débridement, open "clean" packing, and delayed wound closure by the technique of pectoral muscle flap mobilization, which preserves the thoracoacromial pedicles and the pectoral humeral attachments (Group II). The purpose of this study was to compare the results of the treatment of deep sternal infections after cardiac operations with these two techniques. The perioperative hemodynamic, operation, functional, and pathological profiles of both groups of patients were the same. The cosmetic and functional results were the same in both groups as were shoulder girdle and torso mobility. We conclude that either technique is equally effective in the management of patients in whom the serious complication of deep sternal infection with mediastinitis develops after cardiac operation, and we now recommend débridement and pectoral muscle flap closure in one stage.

Anti-Bacterial Agents↗
PubMed1979

[Use of automatic suturing devices in surgery of the digestive tract].

A review of 345 surgical procedures performed on the digestive tract with the use of automatic suturing devices is presented. The morbidity due to hemmorrhage, fistula formation and obstruction as well as the reoperation and mortality rates are discussed and compared with those reported in the literature for the same procedures using standard anastomotic and suturing techniques. This study confirms the safety of these stapling instruments in a wide variety of gastrointestinal procedures in which their use resulted in a considerable saving of operative time.

Digestive System Diseases↗
PubMedDate not supplied

Influence of age on late results of valve replacement with porcine bioprostheses.

From 1976 to 1987, 877 patients, aged 13 to 80 years, underwent valve replacement with a Carpentier-Edwards porcine bioprosthesis--330 aortic, 421 mitral, and 126 multiple replacements. Patients were divided into 4 age groups, according to their age at the time of surgery: group I, less than 45 years (190 patients), group II, 45 to 54 years (203 patients), group III, 55 to 64 years (304), and group IV, 65 to 80 years (180 patients). Follow-up was 97.5 complete, averaged 85 months, and totalled 5624 patient-years. There were 79 early deaths (9%), and 181 late deaths. Overall survival was 80% and 64% at 5 and 10 years. Operative mortality increased significantly with age, and late survival was significantly better for group I. Intrinsic structural deterioration was the most common cause for reoperation and was responsible for 91% of the 143 reoperations. Incidence of intrinsic structural deterioration and of reoperation decreased significantly with increasing age, with respective freedom rates at 10 years of 57 and 54 in group I compared to 93 and 92% in group IV. Freedom from treatment failure (including early deaths, valve-related deaths, and valve-related complications with permanent disability) was similar for all 4 groups ranging from 78 to 85%, without any correlation with age of the patient. At last follow-up, a similar proportion of patients of each group remained asymptomatic, patients in functional class I ranging from 50 to 55%. Thus, age is a major determinant of durability of bioprostheses, but it does not appear to have a significant role in the overall success of valve replacement.

Actuarial Analysis↗
PubMedDate not supplied

Cardiac troponin T and creatine kinase MB isoenzyme as biochemical markers of ischemia after heart preservation and transplantation.

An ischemic preservation period of less than 4 to 6 hours for the donor heart is considered safe in heart transplantation. To determine the severity of myocardial cell damage, we measured serum creatine kinase MB isoenzyme activity, creatine kinase MB isoenzyme mass concentration, and troponin T release in 14 patients during the first 48 hours after heart transplantation. All donors had normal cardiac function at echocardiographic evaluation. The heart was arrested with cold crystalloid cardioplegic solution and preserved in a hypothermic solution. All patients survived the first week after transplantation. Total ischemic time averaged 126 +/- 33 minutes (range 88 to 195 minutes). Maximal creatine kinase MB isoenzyme activity, creatine kinase MB isoenzyme mass concentration, and troponin T serum values after transplantation averaged 130 +/- 44 IU/L, 140 +/- 121 ng/ml, and 3.3 +/- 1.4 ng/ml, respectively. No significant correlation was found between ischemic time and peak levels of creatine kinase MB isoenzyme activity (r = 0.22), creatine kinase MB isoenzyme mass (r = 0.37) and troponin T (r = 0.12). A moderate correlation between ischemic time and the initial slope of time-activity curve of creatine kinase MB isoenzyme mass (r = 0.66, p = 0.01) and of troponin T release (r = 0.55, p = 0.03) was observed. Ischemic time and donor age were significantly related to creatine kinase MB isoenzyme mass (R2 = 0.61) and to troponin T (R2 = 0.47) initial release slopes. In conclusion, during a short period of ischemic preservation, myocardial cell damage appears to be mild and best reflected by the elevation and the time-activity curves of release of cardiac troponin T and creatine kinase MB isoenzyme mass.

Adult↗
PubMedDate not supplied

Asymptomatic heterotopic thyroid tumour in the right ventricular infundibulum.

An asymptomatic thyroid cardiac tumour was discovered in the right ventricular infundibulum of a 63-year-old female investigated for angina. The results of the investigation are presented: coronary angiography, echocardiography, magnetic resonance imaging, resting radioactive 201-thallium scintigraphy, dipyridamole-thallium scintigraphy, nuclear isotopic ventriculography. The tumour was successfully removed at surgery for coronary bypass. Anatomopathological description is also included.

Choristoma↗