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Biomedical subjects

A Martín-Trenor

Publications and source records attributed to A Martín-Trenor.

6 recordsLinked to original sources

Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis.

A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.

Aortic Aneurysm, Thoracic↗

Coronary angioplasty and stenting following heart transplantation with older donors. Is this a rational approach?

The shortage of ideal donor hearts has led to an extension of the classical donor criteria of age. Higher incidence of focal coronary artery disease has been found in this older donor population requiring conventional angioplasty therapy. The authors present two patients with early coronary angiogram post transplantation, requiring angioplasty and stent in the lesions found.

Adult↗

[Postoperative evaluation of Carpentier's mitral rings].

38 patients with Carpentier's ring inserted in the mitral position at surgery, are studied. The grade of the pre and postoperatory mitral murmur is correlated and compared with the radiographic size of the heart and left auricle as well as the pre and postoperatory angiocardiographic study. Only 3 (7'8%) of the 38 patients presented significant elevation of the pulmonary artery sistolic pressure together with important angiographic regurgitation. These three patients had to be operated on again, 60'52% did not present murmurs on these were grade I murmurs, while 76'32% did not present mitral reguritation. Only 8 of 14 patients with grade II sistole murmur in the postoperative period had grade II regurgitation. This no correlation was observed between the intensity of the murmur and the grade of angiocardiographic mitral regurgitation. We conclude that Carpentier's ring restores the mitral valve function to normal in the majority of cases and the angiocardiographic results are favorable.

Adolescent↗

[Large false aortic aneurysm after 30 years of a coarctation repair].

We report a case of a large false aortic aneurysm that had developed in a 43-year-old man who had had coarctation repair 30 years previously. The coarctation repair had been done by inserting an end-to-end Dacron tubular graft which was sutured with silk. The re-operation was successfully performed under deep hypothermic arrest and it was noted that there was complete separation of the graft from both ends and no sutures were visualised. The deep hypothermic technique has considerably improved the ease and safety of this operation. We attribute this complication to the reabsorption of the silk sutures. Patients after coarctectomy with graft material should have regular chest X-rays for life in order to detect false aneurysms.

Adult↗

[Angiocardiographic and clinical development of Carpentier's mitral rings].

Carpentier's ring was inserted in the mitral annulus of 79 patients suffering from mitral valve disease. 49 other patients also underwent surgery on other cardiac valves and are not considered in the present study. The mean follow up time was 19.5 months. The total hospital and late mortality in the isolated ring series was 3.8%. Clinical and hemodynamic improvement was evident postoperatively. The preoperative functional class (NYHA) of the patients was: I, 11.39%; II, 45.5%; III, 34.1%; IV, 8.86% respectively. The postoperative class was: I, 86.8%; II, 7.9%; III, 3.9%; and IV, 1.3% respectively. Postoperative hemodynamic and angiocardiographic evaluation was done in 27 patients. Mean pulmonary artery pressure fell from 49.8 +/- 2.4 mm. Hg to 38 +/- 2 mm. Hg. Mitral regurgitation present preoperatively in 66.6% of cases was present in residual form in only 18.5%. Atrial enlargement was moderate in 42.1% and severe in 57.9% before operation, and 80.3 moderate and 19.7 severe after operation. Tromboembolic accidents occurred in 2 patients (2.2%) both with severe atrial enlargement and atrial fibrillation pre and postoperatively. We conclude that Carpentier's ring is a valid alternative in the surgery of mitral valve disease.

Adolescent↗