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Biomedical subjects

Y Lecompte

Publications and source records attributed to Y Lecompte.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Aortic valve replacement in infectious destruction of the aortic annulus. A new technic].

The results of aortic valve replacement in the acute phase of valvular endocarditis are dependent upon the degree of destruction by sepsis of the left ventricle-aorta junction. The stability of the prosthesis installed is conditioned by the extent of the lesion. Numerous techniques have been described to maintain the prosthesis firmly in place. In the technique reported here, the prosthesis is implanted in the usual position, but the sutures are tied outside the heart. Depending on the site of the lesion, this is done by opening the left atrium or the infundibulum of the right ventricle, and by passing the stitches through the aortic wall. This quick and simple technique ensures good stability of the prosthesis.

Aortic Valve↗
PubMed1985

[Aortic coarctation with hypoplasia of the arch: description of a new surgical technic].

The aortic coarctation is frequently associated with aortic arch tubular hypoplasia, especially in early infancy. The treatment in one time of both lesions is mandatory in these cases. We propose therefore a new surgical technique: after resection of the isthmic coarctation and appropriate cutting of both ends, the anastomosis is widely extended in the concavity of transverse aortic arch, beyond the hypoplastic region. We discuss the advantages of this technique over the classic end-to-end anastomosis, patch graft and subclavian flap angioplasty.

Aorta, Thoracic↗
PubMed1985

[Interruption of the aortic arch and malformative cardiac lesions requiring repair under extracorporeal circulation. Apropos of 3 cases].

Interruption of the aortic arch is practically always associated with intracardiac malformations of variable complexity, at the least, a ventricular septal defect. Surgery is usually performed in two stages: aortic repair and pulmonary artery banding after intravenous prostaglandin administration. The second stage comprises debanding and repair of the intracardiac lesions under cardiopulmonary bypass. However, in some cases, interruption of the aortic arch is associated with intracardiac lesions which necessitate correction under cardiopulmonary bypass from the onset, this was the situation in two of the three cases described by the authors: aorto-pulmonary window, a lesion which can only be corrected under circulatory arrest and deep hypothermia. One of these two children, operated in the neonatal period, did not survive: the other, operated at 6 weeks, had an excellent result. In the third case, the association of tricuspid atresia and a restrictive ventricular septal defect necessitated enlargement of the septal defect and therefore, open heart surgery under circulatory arrest; the results were favourable.

Aorta, Thoracic↗
PubMed1984

Anatomic correction of transposition of the great arteries associated with ventricular septal defect: midterm results in 50 patients.

From May 1977 to August 1982 50 patients who were 1.5 to 44 months old underwent anatomic correction of transposition of the great arteries (TGA) and closure of ventricular septal defect (VSD) at our institution. Thirty-nine patients underwent preliminary pulmonary arterial banding. Hospital mortality was 32%: four patients died as a result of technical problems, seven as a result of associated lesions, three of pulmonary hypertension, and two of left ventricular failure. Three other patients died after the first postoperative month (one of mediastinitis, one at reoperation for a residual VSD, and one of pulmonary hypertension). All 31 survivors are in excellent clinical condition and are in sinus rhythm after a mean follow-up period of 31 +/- 14 months. Twenty-five patients were reinvestigated by echocardiography (M mode and two-dimensional) and/or catheterization. Parameters of left ventricular contractility were within normal limits, but systolic aortic diameter was larger than normal (p less than .01). Seven patients had stenosis of the right ventricular outflow tract and five of these required reoperation. The two persistent problems with the anatomic correction of TGA associated with VSD are a relatively high operative mortality and secondary right outflow tract stenosis. However, use of this procedure results in better left ventricular function and fewer arrhythmias than does use of atrial repair techniques and also results in the use of the anatomically left ventricle as the systemic ventricle.

Cineangiography↗
PubMed1983

[Tricuspid surgery and tetralogy of Fallot. Observations apropos of 14 case reports].

14 patients underwent tricuspid surgery after radical surgery of tetralogy of Fallot using cardiopulmonary bypass. This series represents 11.5% of all patients with tetralogy of Fallot who were operated on during the same period (1970-1982). Two different pictures were seen: tricuspid pathology may be coincident with tetralogy of Fallot, with surgical repair being done during the same procedure; it may be discovered later on, resulting from trauma of the tricuspid valves, an overlooked valvular malformation, or a residual or recurrent ventricular septal defect. As tolerance is poor because of postoperative right ventricular insufficiency, tricuspid insufficiency must be promptly diagnosed and cured, either during radical surgery of the tetralogy of Fallot or as soon as it becomes clinically patent in the postoperative course.

Adolescent↗
PubMed1983

[Pulmonary valvulotomy or valvulectomy with simple clamping of the vena cava in infants and young children].

In infants and young children pulmonary valvulotomy or valvulectomy under simple clamping of the vena cava is the treatment of choice for pulmonary valve stenosis with normal interventricular septum. The technique, performed without cardiopulmonary bypass, is described. In 40 patients operated upon, the peri-operative mortality was 10% and short-term clinical results were satisfactory.

Constriction↗
PubMed1983

[Problems posed by preparation of the left ventricle for anatomical correction in simple transposition of the great vessels].

Surgical correction of simple transposition of the great arteries by arterial detransposition can only be considered if the left ventricle is capable of functioning under systemic conditions. This is possible at birth but the operation is too big for it to succeed. After a few weeks the left ventricle may lose this capacity but it can be induced to redevelop if it is given a systolic stress by pulmonary banding. This was attempted initially in 30 children aged from 5 weeks to 3,5 years old (20 aged less than 2 months) but had to be abandoned for the following reasons: 8 immediate failures due to severe hypoxia and acidemia, 7 left ventricular failures, mainly in 3 children operated after 6 months of age; 7 severe hypoxemias, 5 pulmonary arterial lesions due to banding and/or the systemo-pulmonary anastomosis associated in some cases; in all, there were 8 failures out of the 17 anatomical corrections performed to date in 22 survivors of banding. The criteria of left ventricular readaptation after banding were difficult to determine. The final result did not appear to be related to either the duration of banding, the degree of aortic desaturation, the ratio of ventricular pressures, or to the various echocardiographic indices. Only the initial hypoxemia (less than 50 p. 100 saturation) with respect to the risk of banding, and the age at which banding was performed (over 6 months) with respect to the risk of anatomical correction, appeared to be obvious risk factors. This is the reason for a new protocol at present under study to try to maintain left ventricular growth by banding in the first days of life, so to ensure a more harmonious and effective, and also less dangerous preparation for anatomical correction. Six new born children have been "prepared" in this way: three had adequate loose banding and underwent atrial correction. Very good results were obtained in the other three patients who have already undergone detransposition at 2,5 and 3 months with excellent immediate results. We believe that neonatal pulmonary banding (before 5 days) when aortic saturation after atrioseptostomy is over 50 p. 100, provides a real alternative to the classical methods of treating simple transposition of the great arteries (Mustard or Senning). Anatomical correction can then be carried out a few weeks later under good conditions.

Angiocardiography↗
PubMed1982

[Results of the repair of isolated coarctation of the aorta during the 1st 6 months of life, Apropos of 46 cases].

Between 1972 and 1978, forty-six infants under six months of age underwent surgery for isolated coarctation of the aorta. These forty-six patients represent 32% of the total number of infants aged less than six months who had surgery for coarctation of the aorta during the same period. At the time of operation, 41% were aged less than one month and the youngest was five days old. The main cause for surgery was heart failure in infants under one month (14/19) and severe systemic hypertension (150 to 300 mm Hg) in the one to six month age group (18/27). Overall mortality rate in our series was 17%. Six of the eight infants who died were under one month of age. Recoarctation occurred in 31,5% of infants; in eight cases the first surgical procedure had been done before one month of age. A second procedure was necessary in four cases. Early surgical repair of severe coarctation diagnosed during the first six months of life leads to functional improvement and avoids residual hypertension. After repair, the main risk is recoarctation.

Aortic Coarctation↗