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Biomedical subjects

A Perrin

Publications and source records attributed to A Perrin.

At least 109 records · Page 6Linked to original sources
PubMed1976

[Results of isolated aortic valve replacement].

Progress in surgical technique and decreased early and late postoperative risk should lead to a modification in the indications for aortic valve replacement, before irreversible myocardial changes have definitively compromised the result of surgery. One hundred and seventy aortic valve replacements (100 pure or predominant aortic stenoses, 70 cases of aortic insufficiency) were carried out by the same surgeon over a period of 4 years with a minimum follow-up of one year and average of 25.4 months, using à Bjork prosthesis or a homograft. Early postoperative mortality was 5.3%, not differing from that associated with other types of valve replacement (mitral, polyvalvular). It is related more directly to surgical technique than to preoperative prognostic factors. Late mortality was 8.1%. Almost one third of these late deaths were related to the surgical technique or to the model of aortic prosthesis used. Stage IV cardiac failure plays a pejorative role in this late mortality, whilst no prognostic role could be demonstrated with respect to angina, meancardiac surface, Sokolow index, mean pulmonary artery pressure or diastolic pressure in the left ventricule. One year after surgery there was found to be a significantly important decrease in the Sokolow index and a modest decrease in mean radiological cardiac surface area. Beyond one year, no further improvement was seen. The majority of the patients surviving surgery had a good functional result since only 1% of the aortic stenosis patients and 7% of the aortic insufficiency group remained in stage III or IV cardiac failure. 78% of the patients who were working before operation were able to resume their professional activity after an average period of 6.2 months. However only 40% of the patients with stage IV failure who underwent surgery could return to work.

Aortic Valve↗
PubMed1976

[Electrocardiographic and radiographic course after aortic valve replacement].

On a series of 170 aortic valve replacement - 100 aortic stenoses (AS) and 70 aortic regurgitations (AR) - with an early post operative death rate of 5.3% and a late one of 8% (with a minimum follow up of 1 year and an average one of 25.4 months, two electrocardiographic and radiological checks could be done on 123 patients, 12 months on an average after the operation, and again for 116 patients, 21 months after the operation. After a year there was a significant and substantial decrease of the left ventricular hypertrophy (LVH) and a moderate one of the radiological heart area (HA). The decrease of LVH (Sokolow's index and AVL) tended to be more marked for the AS group and that of HA for the AR. At the second check no further significant change of LVH or HA was noted for either group, and the average HA of the patients remained high. The mean post-operative decrease of LVH and HA was all the greater as the pre-operative value was higher; but it was independent of the stage of heart failure and of the pre-operative hemodynamic data. There was no correlation demonstrated between the amplitude of post-operative variations of HA or LVH and the main operative stages (aortic clamping, ventricular fibrillation, coronary infusion). There was no significant difference between the mean values of LVH or HA of the survivors and those of the early post-operative deaths. The mean value of pre-operative HA was higher in the patients who were to die late than in the survivors, but the difference was not statistically significant after 25.4 months. The mean pre-operative values of HA and LVH did not influence the quality of the post-operative functional result.

Aortic Valve Insufficiency↗
PubMed1976

[Thrombosis of the coronary sinus due to right endo-ventricular stimulation].

In a patient with a primary cardiomyopathy, anatomical investigation allowed us to find a total old organised thrombosis of the coronary sinus associated with the presence of a right ventricular stimulator of a pacemaker. A brief review of the literature reveals that cardiac thombosis is a surpising and rare complication of a residual intracavitary pacemaker, even if it is located in the coronary sinus.

Aged↗
PubMed1975

Ankylosing rheumatoid arthritis.

The study concerns the clinical, haematological, serological, radiological and histocompatibility antigenic status of eleven in-patients suffering from long-standing sero-positive rheumatoid arthritis at the Royal Hospital and Home for Incurables in London. The study revealed a striking degree of widespread bony ankylosis affecting the peripheral joints and cervical spine. In large part, this bony ankylosis accounted for the disability but it is considered that the cervical spine ankylosis may protect the spinal cord from damage. The absence of the histocompatability antigen HLA 27 is a useful pointer in the exclusion of Ankylosing Spondylitis. Despite the clinical impression that the disease was inactive, the elevated sedimentation rate (23-66, mean 41 mm) suggests that the rheumatoid process remains active.

Aged↗
PubMed1975

[Biopsy of the pericardium. Diagnostic value in subacute and chronic pericarditis, apropos of 70 cases].

The aetiology of pericarditis is often difficult to assess. To try to clear up this problem, a pericardial biopsy through a left lateral thoracotomy was performed in 70 cases in which the cause could not be established by the usual means (including pericardial paracenthesis in 32 cases). They included either subacute pericarditis, dry or with effusion (biopsy being undertaken as an average 45 days after the clinical onset), or chronic pericarditis with effusion. Tuberculosis was thus demonstrated in 14 cases (8 of which were aged more than 60 years), inaugural pericardial tumours in 8 and suppuration in 3 cases. Microscopical examination gave support to pathogenic hypotheses concerning cholesterol pericarditis (5 cases) and multi-recurrent pericartitides (6 cases). By elimination with a high probability) of tuberculosis and tumours, it demonstrated definitely the diagnosis of post-radiotherapy pericarditis with effusion (4 cases) pericarditis with normal serous membrane (4 cases) and "idiopathic" forms (23 cases of common sclerogenous subacute inflammation). The inocuity of this method, its more accurate results than those obtained by cytological and bacteriological examination of the pericardial fluid obtained by paracenthesis, should induce to consider this procedure more often in the cases of pericarditis when the aetiology remains doubtful; not to mention the benefit derived from surgical drainage which results in a quicker and more complete cure than repeated paracentheses of chronic and subacute pericardial effusions.

Acute Disease↗
PubMed1975

[Giant cell myocarditis. Attempt at interpretation, apropos of 3 cases].

Three cases of giant-cell myocarditis were observed, and 63 comparable cases were published in the literature. On the basis of this material, the significance of this disease was studied, which was considered for long to be of "granulomatous" origin, while it seems to be a peculiar histopathologic type of myocardialgeneration. The cause for this necrosis remains unknown; in spite of as complete as possible investigations in one of the three cases (in which death was preceded for labile recurring lung infiltrates during eleven months) no cause could be demonstrated.

Adult↗