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Biomedical subjects

B Baehrel

Publications and source records attributed to B Baehrel.

At least 55 records · Page 3Linked to original sources
PubMed1978

[Distal fixation of the intima after endarterectomy. Technical variation].

Oblique termination in a "bevel" of the distal endartery and its fixation by a circumferential continuous suture which provides a surface which is as stable and regular as possible, after endarterectomy. This may favourise improuved distal flow and influence immediate and late local permeability.

Arteries↗
PubMed1978

[A treatable condition: parietal rupture of the heart during the acute phase of myocardial infarct. Apropos of a further case treated successfully with surgery].

A man aged 62 had an unexpected anterior myocardial infarction, complicated during the thirteenth hour after onset by parietal rupture and consequent acute tamponnade. The diagnosis was confirmed by echocardiography and then by pericardial puncture which allowed enough time for an operation to be undertaken under extra-corporeal circulation. The infarct was resected together with the weakened area of rupture, and the quality of the patient's life has been maintained at an excellent level after one year.

Cardiac Surgical Procedures↗
PubMed1978

[Surgical treatment by valve replacement and aorto-coronary bypass in mitral valve insufficiency caused by chronic dysfunction of the posterior papillary muscle].

Nine patients with cardiac failure which was refractory to medical treatment, and which was caused by chronic malfunction of the posterior papillary muscle, as a result of a myocardial infarction, were studied by cardiac catheterisation and coronary arteriography. The mean pulmonary capillary pressure was 31+/-16 mm of mercury with a nu wave at 51+/-27 mm of mercury. The end diastolic volume was increased (141+/-68 ml/m2) and the ejection fraction lowered (0.40+/-0.13). The left ventricle had overall hypokinesia in 5 patients and akinesia of the inferior wall, representing 21+/-24% of the end diastolic perimeter, in 3 others. All these patients had significant lesions of two or three of the main coronary trunks. At operation lengthening of the posterior papillary muscle and/or the cordae was found. All patients had a replacement mitral valve of the Starr-Edwards type, associated with an aorto-coronary bypass of the anterior descending artery. The operative mortality was zero. At a mean follow-up period of 21 months, there had been no late death, and all the patients were improved.

Aged↗
PubMed1978

[Mitral valve insufficiency due to ballooning. A surgical series of 70 cases].

The authors report 70 cases of mitral regurgitation due to ballooning. For the surgeon this is the most frequent cause of degenerative mitral regurgitation in patients around 60-years-old. The aetiology still remains unknown. There are two opposing theories--the congenital and the acquired. The appearances at operation are characteristic--a localised or diffuse ballooning of one or both cusps with elongation of the chordae attached to the ballooned portion. Two histological features are noted--myxomatous degeneration of the cusp and the absence of any inflammatory process. Ballooning may be asymptomatic and bening for a long time before evolving progressively or suddenly into important mitral regurgitation. The pre-operative diagnosis is aided by left ventricular angiography and echocardiography. Surgical treatment, guided by the findings at operation, usually involves mitral valve replacement or, less frequently, mitral valve repair.

Adult↗
PubMed1978

Anatomic, clinical, and therapeutic features of acute cardiac rupture. Successful surgical management fourteen hours after myocardial infarction.

A 62-year-old man sustained an acute myocardial infarction complicated on the thirteen hour by left ventricular rupture and acute periocardial tamponade. Echocardiography confirmed the suspicion of intrapericardial fluid, and immediate pericardiocentesis improved the hemodynamic state for a period sufficient to permit preparation for operation. Resection of ruptured and necrotic anteroapical left ventricular myocardium with primary reconstruction was successfully accomplished with the aid of temporary extracorporeal circulation. The patient has remained well for 1 year after the operation. Anatomic, clinical, and therapeutic features of acute cardiac rupture are discussed.

Cardiac Tamponade↗
PubMed1978

[Isolated rupture of the pericardium after closed trauma of the thorax (author's transl)].

Rupture of the pericardium after closed trauma of the thorax is rare. There are two main clinical presentations: one of severe thoracic trauma with hemothorax requiring an operation which permits the diagnosis, the other of pain and pericardial signs on auscultation which should attract attention. The treatment requires closure of the pericardial tear as a routine owing to the risk of fatal complications due to dislocation of the heart.

Adult↗
PubMed1977

[Traumatic rupture of the descending aorta. A report of 21 operated cases (author's transl)].

From 1965 to December 1976, 21 traumatic ruptures of the descending thoracic aorta have been operated; the last 13 cases have been managed in 1975 and 1976. The lesions consisted in 15 recent ruptures (R.R.) and 6 chronic aneurysma (C.A.). Associated injuries were the rule and 6 patients underwent exploratory laparotomy prior to thoracotomy. Surgical repair was consistently due by use of an extracorporeal by-pass (20 times), and resulted in 12 end-to-end aortic sutures (11 R.R., 1 C.A.) and in 9 reconstruction by means of a tubular dacron graft (5 C.A., and 4 R.R.). 4 patients died. 16 of the 17 survivals are healthy and active. Paraplegia developed in one patient.

Adult↗
PubMed1977

[Right juxtaposition of the atria. Apropos of one case without associated trunco-conal abnormalities].

A child of 7 had coarctation of the aorta and an atrial septal defect. In the course of surgery to close the septal defect, she was found to have a right-sided juxtaposition of the appendages. This is a very rare abnormality, with no symptoms of its own, but usually associated with severe cardiac malformations especially of the truncus and conus. This case report is most unusual because of the right-sided disposition of the appendages and the absence of any serious associated cardiac lesion.

Aortic Coarctation↗
PubMed1977

[Massive pulmonary embolism Apropos of 26 embolectomies with definitive survival, 10 of them by Trendelenburg's operation].

The authors report 26 pulmonary embolectomies carried out successfully, 10 of them having been Trendelenberg procedures and 16 having been carried out under extracorporeal circulation. The latter method gives better results, and appears to be the procedure of choice. The haemodynamics before operation were always abnormal, and there were 4 cardiac arrests, 11 cases of severe shock, and 6 cases with less severe hypotension. In the other cases, cyanosis, respiratory distress and signs of acute cor pulmonale were the clinical features of the massive embolus. It was possible to carry out arteriography in 14 cases, and this showed extensive pulmonary vascular obstruction in between 70 and 90%. In 4 cases this procedure was followed by an exacerbation, and extremely urgent treatment became neccessary. This examination is important for diagnosis and for assessment of the prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe pulmonary embolus. The essential indications for surgery are moribund patients, those in whom fibrinolysis is contraindicated or unsuccessful, and those with massive obstruction of the pulmonary arterial tree.

Adult↗
PubMedDate not supplied

[Primary iliac arterio-venous fistula from spontaneous rupture of an atheromatous aneurysm (author's transl)].

The case of a patients, with a spontaneous arterio-venous fistula between the right common iliac vessels secondary to an atherosclerotic aneurysm of the artery, is presented. The authors, with the aid of the literature, recall the characteristic physical findings, the clues of the diagnosis and the modalities of the surgical treatment of such lesions. They insist on the importance of an early diagnosis as far as aneurysms are concerned, which allows to treat the lesions before complications arise.

Aged↗