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Biomedical subjects

A Sarkis

Publications and source records attributed to A Sarkis.

8 recordsLinked to original sources
PubMed1992

Isolated extracardiac unruptured sinus of Valsalva aneurysms.

Reports concerning unruptured, isolated aneurysms of one sinus of Valsalva are rare. These aneurysms usually protrude inside the heart and are very rarely extracardiac. We report 4 cases of isolated, unruptured extracardiac aneurysms of the noncoronary sinus of Valsalva. Clinical symptoms were nonspecific. Operation was performed by patch reconstruction of the dilated aortic sinus without replacement of the ascending aorta. Microscopic examination of the diseased aortic wall revealed absence of medial elastic fibers. Late follow-up in all 4 cases revealed a normal ascending aorta with no dilatation of the aortic root and no aortic regurgitation.

Aortic Aneurysm↗
PubMed1992

[Left coronaro-ventricular fistula after septal myectomy].

The authors report the case of a 17 year old patient operated for valvular aortic stenosis associated with severe hypertrophy of the interventricular septum. The operation consisted of aortic valve replacement and septal myectomy. Color-flow imaging in the postoperative period showed a coronary artery--left ventricular fistula in the region of the septal myectomy. In view of the small size of the fistula on echocardiographic examination and the absence of a codified strategy of management of acquired coronary left ventricular fistula after surgery, a simple Doppler echocardiographic follow-up was proposed in this case.

Adolescent↗
PubMed1991

[Epidural chordoma without bone involvement. A propos of a case in a child. Review of the literature].

The authors report the case of a chordoma developed exclusively in the epidural space at the L1-L2 level in a 6 year old child. The tumor was easily removed in toto. No post-operative radiotherapy was given. The diagnosis of chordoma was based on the histological characteristics of the lesion and the results of immunohistological studies which were both typical of this lesion. This observation is exceptional because of the young age of the patient, the lumbar level of the tumor and, even more, the absence of any bone involvement. The 8 previously published cases of chordoma developed along the craniospinal axis but without bone involvement are reviewed and analysed: all were subdural; 7 were intracranial (6 prepontic, 1 suprasellar): only one was intraspinal. These lesions raise the problem of their diagnosis, of their treatment and of their embryogenesis. They could develop from ectopic notochordal remnants: the "ecchondrosis physaliphura".

Child↗
PubMed1990

[Enoximone in the hemodynamic evaluation before heart transplantation. A new test].

A better selection of patients referred for cardiac transplantation should lead to better surgical results. The presence of severe and irreversible pulmonary hypertension is an important factor and its pretransplantation assessment requires pharmacodynamic testing with vasodilators and dobutamine. The aim of this study of 10 patients in congestive cardiac failure referred for cardiac transplantation was to evaluate enoximone in this indication by comparing it with sodium nitroprussiate (3 micrograms/kg/mn). Intravenous enoximone (total dose of 1.5 mg/kg) increased the cardiac index (+49%; p less than 0.01), slightly reduced the mean systemic blood pressure (-8%; p less than 0.05) whilst inducing a greater reduction in systemic arterial resistances (-36%; p less than 0.01); the fall in mean blood pressure was less than with sodium nitroprussiate (-23%; p less than 0.01). Myocardial oxygen consumption (rate-pressure product) did not increase in contrast to the effect of dobutamine (+21%; p less than 0.01). There was a significant reduction in pulmonary arteriolar resistances (p less than 0.01) with all three drugs but the interpretation of this response and its prognostic significance in patients with a low cardiac output and persistent pulmonary hypertension are discutable even when pulmonary arteriolar resistances are less than 6 Wood units. The value of using an inotropic agent such as Dobutamine or Enoximone is to unmask fixed pulmonary hypertension which may be missed in patients with low cardiac output even with vasodilator drugs, and also to mimic the haemodynamic result of transplantation. In this indication Enoximone may be used like Dobutamine but with the advantage of not increasing myocardial oxygen consumption and being probably less arrhythmogenic.

Adult↗
PubMed1990

[Phosphodiesterase inhibitors].

Phosphodiesterase III inhibitors constitute a new therapeutic group for congestive cardiac failure. They inhibit the degradation of cyclic adenosine monophosphate and increase the intracellular calcium. They have a double inotropic and vasodilator haemodynamics occurs without any increase in the myocardial effect. The improvement in the consumption of oxygen. The beneficial haemodynamic effect seems to last over a medium period of time, but the survival in the long term treatment is not yet known.

Electrophysiology↗