Supraventricular tachycardia associated with nodoventricular and concealed atrioventricular bypass tracts.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
A Proclemer
Publications and source records attributed to A Proclemer.
[Reintervention on valve prosthesis. 13 years' experience].
1584 valve prosthesis implants [1231 mechanical (MP) and 353 biological (BP)] were carried out personally between March 1974 and December 1986. Over the same period, 72 patients, 36 m and 26 f, average age 48, underwent 75 reintervention (RI) on 80 malfunctioning prostheses 41 MP, 39 BP, 41 in mitral position, 28 aortic, 1 tricuspid). The reasons for RI in the MP were: partial detachment (61%), infectious endocarditis (19.5%), mechanical dysfunction (14.7%), thrombosis (2.4%), wear (2.4%) and in the BP: wear (84.6%), infectious endocarditis (12.8%), partial detachment (2.6%). The malfunction was diagnosed before the onset of subjective symptomatology in 30.7% of patients. Operative mortality (OM) was 17.3% related to the functional class (II = 0%; III = 2.7%; IV = 38.7%) and to whether or not the intervention was an emergency or of choice (90.9% and 4.7% respectively). Mortality was higher in patients operated on for infectious endocarditis (38.4%) and in wearers of MP (28.2% vs. 5.7% BP); however this difference is largely attributable to a difference in NYHA class. It is concluded that reintervention on valvular prosthesis may have a very prognosis provided diagnosis of malfunction is quick enough to avoid excessive functional deterioration.
Adolescent↗
Signal-averaged electrocardiography and Doppler echocardiographic study in predicting acute rejection in heart transplantation.
BACKGROUND AND METHODS: In a prospective protocol for noninvasive diagnosis of acute cardiac rejection, 83 routine endomyocardial biopsies, followed each time by the analysis of signal-averaged electrocardiography and by a cardiac Doppler echocardiographic study, were performed in 18 heart transplant recipients. The follow-up time was 5 +/- 3.6 months. To detect noninvasively acute cardiac rejection, we compared biopsy findings with the presence of late potentials at signal-averaged electrocardiography and with two diastolic indexes, pressure half-time, and isovolumic relaxation time obtained from Doppler echocardiographic study. RESULTS: Thirteen acute rejection crises requiring modification of immunosuppression were diagnosed by means of endomyocardial biopsy. This clinically relevant acute cardiac rejection was associated with the presence of late potentials in 69% of cases and with the presence of pressure half-time < or = 55 msec and isovolumic relaxation time < or = 60 msec in 69% and 62% of cases, respectively. Sensitivity and specificity were as follows: for late potentials, 69% and 71%; for pressure half-time < or = 55 msec, 69% and 76%; for isovolumic relaxation time < or = 60 msec, 62% and 83%, respectively. The presence in a single patient of at least one abnormal parameter showed a sensitivity of 100% and a specificity of 60% in detecting important rejection. CONCLUSIONS: These data support the use of combined signal-averaged electrocardiography and Doppler echocardiographic study of the left ventricular diastolic function in the screening of acute cardiac rejection. Such results can suggest when endomyocardial biopsy should be performed, with the reliance that a normal noninvasive study highly excludes the presence of acute cardiac rejection requiring intensified immunosuppression.
Adult↗