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Biomedical subjects

B Amahzoune

Publications and source records attributed to B Amahzoune.

8 recordsLinked to original sources
PubMed2003

[Tranexamic acid versus aprotinin for the prevention of bleeding during mitral valve surgery ].

PURPOSE: This retrospective stady has for objective to compare the effect of Tranexamic Acid (TA) to the low dose of aprotinin (AP) in primary mitral valve surgery in terms of blood loss and transfusion requirements. METHODS: Are included in the study operated patients of a valvulopathy mitral isolated. Two groups of 50 patients are collected. The tranexamic acid group has received 30 mg kg-1 the acid tranexamic and the aprotinin group has received a low regimen as 500,000 UIK of aprotinin. Blood loss by the chest drains are assessed to different times during first 24 hours post cardiopulmonary bypass. In the same way, we have measured the platelet and fibrinogen count. Blood products were administered according to a classic protocol. RESULTS: The two groups are comparable clinic and echocardiographic parameters what authorizes us an appariement acceptable. Various cardiopulmonary bypass times are almost similar. We noticed a tendency to excessive blood loss processed by low regimen aprotinin and a significant rate difference of platelet and the fibrinogen level. But no complication has been recorded in the two groups. CONCLUSIONS: This study demonstrates relatively different effect of the two fibrinolytics inhibitors in primary mitral valve surgery. As for the superiority of one of the two produces, it needs a confirmation by a randomised and controlled clinical trial.

Adult↗
PubMed2002

[Arterial manifestations of Behcet's disease. A report of five operated cases].

Vascular involvement in Behcet's disease is common, especially in deep vein thrombosis. Aneurysmal or occlusive arterial disease is, however, rare. The authors report five cases of vascular Behcet's disease reviewed over a period of 4 years (1996-1999). All these patients were men and the mean age was 38 years. The arterial disease was the presenting symptom of Behcet's disease in 3 cases. The other patients had been followed up for Behcet's disease for 4 years. The average time of onset of arterial disease was 7.2 years with respect to the presenting symptom, the range being 2 to 20 years. In all, seven arteries were involved, two patients having two arterial sites at the same time. The femoral artery was involved in 3 cases. The iliac artery was involved twice. One patient had a coronary thrombosis and the last case was of a pseudoaneurysm of the infra-renal abdominal aorta which ruptured into the retroperitoneal space. Six lesions were aneurysmal. All patients underwent surgery. The histological analysis of the resected lesions showed non-specific panvasculitis. The postoperative period was marked by short and medium term complications: four prosthetic thromboses and two anastomotic pseudo-aneurysms which required several surgical procedures and which led to two deaths. These results and a review of the literature underline the need to search for Behcet's disease in all cases of aneurysmal or occlusive arterial disease in young patients, especially those born in the Mediterranean regions. Surgical treatment should not be delayed. In these inflammatory conditions with pronounced perivascular involvement, the surgery is difficult and postoperative complications are common, especially anastomotic disunion. Medical treatment has no surgical implication, but does not prevent progression of the disease.

Adult↗
PubMed2001

[Ruptures of the posterior wall of the left ventricle after mitral valve replacement: surgical repair and prevention].

We report two cases of type III rupture of the left ventricle posterior wall, situated midway between the mitral annulus and the posterior papillary muscle and occurring in immediate continuations of a mitral valvular replacement. The first case has occurred at the moment of the canulas removal in a 28 years old patient operated for mitral stenosis. The tear was repaired with horizontal mattress sutures through felt strips on the external surface of the heart. The immediate post operative course was marked by bleeding recurrence and cardiac failure which has led to death. In the second case, a 68 years old man was operated for degenerative mitral insufficiency. The rupture has occurred just before closing the chest. The repair was realized successfully by using an intra-ventricular patch. The chordae tendinae removal constitutes a factor predisposing to the left ventricle posterior wall rupture. The repair has to use an intra-ventricular patch. The prevention is based on the preservation of the continuity between the mitral annulus and papillary muscles by preserving the sub-valvular apparatus or by using synthetic chordae.

Adult↗
PubMed2001

[Invasive thymoma extending into the superior vena cava and the right atrium: a case report and review of the literature].

If the neoplastic extension with the higher vena cava can be observed during the evolution of the invasive thymomes, the tumoral extension in the right auricle, remains on the other hand an exception. We report an invasive case of thymome to higher intracellar extension, right intraatrial and pleuropulmonary revealed by a syndrome undermines higher and a left pleurisy. The transthoracic echocardiography supplemented by the echocardiography transoesophageal pose the cardiac diagnosis of tumor, and it is the thoracic tomodensitometry which highlights a tumoral process mediastinal of malignant pace invading the left inominal venous trunk, the higher vena cava and extending in the right auricle. The diagnosis of certainty is carried by the endobronchial biopsy and the puncture tomodensitometric biopsy under control of the mediastinal mass after anatomopathological examination. Under chemotherapy, the evolution over 18 months is marked by the absence of cardiovascular complications in spite of the non regression of the tumoral mass. This observation stresses the importance of the realization of the echocardiography especially transoesophageal in front of all invasive thymome and the reliability of the puncture biopsy scanoguided like diagnoses technique not very invasive in the forms not extirpables. The forecast of this affection depends on the effectiveness of the processing. The surgery when it is possible, remains the principal therapeutic measurement which really proved reliable.

Aged↗
PubMed2001

Influence of technique of coronary artery implantation on long-term results in composite aortic root replacement.

BACKGROUND: Long-term results after composite graft aortic root replacement may depend on the insertion technique. The aim of this study is to assess the influence of the technique of coronary artery implantation on long-term results in composite aortic root replacement. METHODS: One hundred fifty consecutive patients (mean age, 55 years; 119 men) with different disorders of the ascending aorta who underwent aortic root replacement with a composite graft prosthesis between January 1985 and December 1999 were retrospectively studied. Thirteen patients had previously undergone cardiovascular surgery. The open button technique was performed in 65 patients (43.3%, group 1) and the inclusion technique in 85 patients (56.7%, group 2). Mean follow-up was 70.5 months. Surgery was elective in 110 procedures (73%). RESULTS: Global actuarial survival was 76.1% +/- 4.3% for group 1 and 73.7% +/- 3.9% for group 2 at 10 years (p = 0.22). Freedom from reoperation excluding early deaths was 81% +/- 3% for group 1 and 86% +/- 2.2% for group 2 at 10 years (p = 0.62). Group 2 demonstrated a statistically significantly higher occurrence of pseudoaneurysm formation versus group 1 (p = 0.04). CONCLUSIONS: Composite graft aortic root replacement is a safe and effective therapy for proximal aortic aneurysm and dissection, resulting in good early and long-term results irrespective of the anastomotic technique. However, the open button technique seems to avoid late false aneurysm formation at the anastomotic sites.

Adolescent↗
PubMed1998

[Neurologic complications after surgery for subrenal abdominal aorta. Report of a case of Behcet's syndrome].

Medullary ischemia is an uncommon and serious complication of subrenal aortic surgery. It generally occurs after surgery for ruptured aneurysms and second operations on the aorta. We report the case of a 29-year-old patient who had Behçet's disease with multiple arterial complications. The patient underwent emergency surgery for ruptured aneurysm of the abdominal aorta. An aorto-aortic prosthetic graft was implanted. The postoperative period was complicated by paraplegia and thrombosis of the prosthetic graft with dissection of the iliac arteries. The patient was reoperated and an aorto-bifemoral bypass was installed. After two years, the patient has recovered part of his neurological deficiency. The pathogenesis of this complication is well known, but prevention remains a challenge.

Adult↗