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Biomedical subjects

Y Logeais

Publications and source records attributed to Y Logeais.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Surgery of calcified aortic stenosis in patients aged 70 and over. Immediate results. Apropos of a series of 229 cases].

229 patients aged 70 or over with aortic stenosis (AS) underwent surgery between January 1972 and July 1983 (21.8% of 814 cases of AS operated on during the same period). The Björk Shiley prosthesis was used at the beginning of the series (115 cases, 50.2%), until bioprostheses became the treatment of choice in this age group. Overall operative mortality in the series was 10.9% (25/229). Analysis shows a very marked reduction in recent years: from 15.6% between 1972 and 1977, to 5.8% in 1982-3. Improvement can be attributed in part to the technical progress in myocardial protection. Patient age is a very significant factor in the prognosis. Progress in surgery, together with that in anaesthetics and intensive care, justifies operation in these elderly and incapacitated patients whose general and neurological condition is well preserved.

Age Factors↗
PubMed1983

[Recurrent ejection of aortic valve prostheses. Apropos of 22 case reports].

Twenty two cases of recurrent perivalvular leaks in aortic valve prostheses were reviewed in a multicentre cooperative study. From 1963 to 1978, 22 patients, mean age 39 years, underwent aortic valve replacement; 18 patients had aortic regurgitation, 6 due to infective endocarditis, and 4 patients had calcific aortic stenosis. Eight Starr-Edwards, 6 Smeloff-Cutter, 2 Braunwald-Cutter, 3 Björk, 1 Lillehei-Kaster and 2 bioprostheses were inserted. All 22 patients had to be reoperated for perivalvular leaks due to active or previous infective endocarditis in 7 cases. The prostheses implanted (3 reinsertions, 19 valve replacements) were 10 Starr-Edwards, 4 Smeloff-Cutter, 5 Björk, 1 Lillehei-Kaster, 1 Magovern and 1 bioprosthesis. All 22 patients had further perivalvular leaks, 6 caused by infective endocarditis, and 15 patients underwent a third operation. The prostheses implanted this time (2 reinsertions, 13 valve replacements) were 4 Starr-Edwards, 3 Smeloff-Cutter, 7 Björk and 1 bioprosthesis. Four patients had a third perivalvular leak, and 2 patients a fourth perivalvular leak. The first and second episodes of perivalvular leak were detected early in over half the cases. They were associated with cardiac failure, angina and hemolysis in 20 to 45% of cases. The average period between the first and second operations, and the 2nd and 3rd operations were 15 months and 9 months respectively. Overall, 11 patients died (50%), 4 due to cardiac failure and 3 of sudden death; 3 patients have been lost to follow-up (14%), and there are 8 survivors (36%) with a mean follow-up period of 5 years. However, the mortality rate when the cause of perivalvular leak was infective, was 82%, and only 18% when the cause was mechanical. The factors which favour recurrent perivalvular leaks are infection (30% of cases) and technical difficulties related to the poor quality of the aortic ring (calcification, dystrophy or dilatation). The prevention of this complication depends on careful peroperative technique, the use of certain surgical bypass techniques, a constant battle against infection, and regular examination of operated patients.

Adult↗
PubMed1982

[Immunological changes following heart surgery under extracorporeal circulation (author's transl)].

Post-operative immunological changes were studied in 40 patients undergoing heart surgery. Tty-five patients were operated upon under extracorporeal circulation (ECC), and 15 without ECC. Immunological investigations were performed before, immediately after the operation and again 7 days later. The post-operative changes recorded were early decrease in IgG and IgM followed by a rise in IgM, transient lymphocytopenia affecting mainly T lymphocytes and delayed increase in complement (CH50, C2, C3). These changes were comparable in both groups of patients and therefore seemed to relate to the operation itself rather than to the ECC. It may be concluded that ECC does not appear to increase the risk of post-operative infection by depressing immune defence mechanisms.

Adolescent↗
PubMed1982

[Surgery of aneurysms of the abdominal aorta. Clinical study and surgical results. Apropos of a series of 54 cases].

54 patients with an abdominal aortic aneurysm were hospitalized between 1969 and 1980 in the Clinic of Cardiovascular and Thoracic Surgery at Rennes (Pr. Y. Logeais): 35 were ruptured aneurysms, 19 non-ruptured. The average age of the patients was 70.6 years. 48% of patients showed signs of atheroma in at least one other site. 24% had arterial hypertension. Arteriography was carried out in 51.5% of the non-ruptured aneurysm cases and in 26% of the ruptured cases. Both ultrasound and tomography are regarded presently as very useful tests. The intervention carried out in 41 patients always involved the insertion of a by-pass graft (aortic only in 7 cases; aorto-biiliac in 19 cases; aorto-bifemoral in 15 cases). Mortality was 7.7% for the non-ruptured aneurysms. 59% for the ruptured aneurysms, the deaths above all being related to the degree of visceral ischaemia. Secondary mortality was comparable for all the aneurysms operated on. More than 80% of patients were surviving 5 years after surgery.

Aged↗
PubMed1980

[Ventricular branches of the circumflex artery of the heart].

Because of the great number of anatomic descriptions, and because of the variability of the nomenclature, the authors realized three studies: anatomical, radiological, and surgical studies of 198 hearts (150 dissections and 148 angiographies). There are 3 groups of collateral branches for the left ventricle: --The lateral branch (existing in 49 per cent of the cases), beginning after a short space with often an intra-myocardial segment, and running obliquely on the pulmonary surface of the left ventricle. --The lateral and inferior branch (existing in 38 per cent of the cases), situated just between the pulmonary and diaphragmatic surface of the ventricle, and perpendicular to the coronary sulcus. --The inferior or posterior branches (existing in 59 per cent of the cases), which are parallel to the inferior (or posterior) interventricular sulcus, on the diaphragmatic surface of the heart.

Coronary Angiography↗
PubMed1979

[Dimensions of the aortic ring. Anatomic and surgical study of 2 series of patients].

Both surgical (236 aortic valve replacements) and anatomical (62 dissections) studies have defined the aortic annulus diameter. Measurements (23.5 mm for women; 26 mm for men) are more considerable than established values. Furthermore, surgical study allows the authors to compare these results to several variables, more especially corporeal surface and stature: the height's increase perhaps explains the large sizes discovered.

Aorta↗
PubMed1979

[Agenesis of the left pericardium. Apropos of 3 anatomo-surgical observations].

After a short review of the history and the frequency of this malformation, the authors report three cases of pericardial defect: two cases of partial defect, and a case of complete absence (these three patients have been operated); these observations allow the authors to insist on the difference between the complete absence (often very well tolerated) and the partial defect, which exposes to left atrial appendage's incarceration (and sometimes sudden death). The classification based on the extension of the lesions is then considered, and the usual aspect of each type is described. The embryologic findings can explain the higher frequency of left pericardial defects.

Adolescent↗
PubMed1978

[Successive bilateral adrenal phaeochromocytoma. One case (author's transl)].

A patient underwent surgery for the first time at the age of ten years for a right-sided adrenal phaeochromocytoma. She underwent a second operation at the age of 27 years, for a contro-lateral localisation. Phaeochromocytomas are rare in the child. They are frequently bilateral, multiple and situated extra-adrenally. They fall within the context of Sipple's syndrome more rarely than in the adult. Treatment of these bilateral forms requires bilateral adrenalectomy in one or two stages, followed by substitute hormone therapy.

Adolescent↗
PubMed1978

[Deep femoral artery. Anatomoradiological study].

After a double study (anatomical--50 dissections--and radiological--100 arteriograms) the following points can be stressed: the femoral tripod is only found in 38 per cent of the cases. One or several nutrient arteries of the thigh originate often separately (62% of cases). Their origine is situated highup in a number of cases (at 3 cm below the inguinal ligament). The collateral network develops from each of the arteries forming a complete "profunda femoris system". Two surgical consequences deserve to be underlined: 1. The approach to all the branches is possible by a transverse incision in the fold of the groin. 2. Surgical revascularisation must concern the whole of the "profunda femoris" network.

Collateral Circulation↗