Biomedical subjects
Publications and source records attributed to B Estampes.
A woman had a successful pregnancy with a normal delivery at 33 weeks seven years after a modified Fontan procedure for tricuspid atresia. This pregnancy was associated with aggravation of attacks of junctional tachycardia which became symptomatic and recurrent despite prescription of several antiarrhythmic agents.
An M mode echocardiographic study was performed, of left ventricular dimensions and wall thickness in two series of normal (N1, N2) and pathological (P1, P2) subjects. In the more recent series (N2 = 40, P2 = 17) data acquisition was facilitated by tests deduced from the technique of ultrasound transit time. The parameters compared were based on: 1) the proportionality between fractional shortening and fractional thickening (N1: not significant; N2: p less than 0.001), 2) the relationship between systolic radius and wall thickness (linear correlation, r = 0.95, between N2 and P2). The slope seemed to be related to the initial condition of contraction, the ratio of end diastolic wall thickness/radius (N1: p less than 0.01). There are several ways of normalising myocardial surface of section in adults and children; the normal surface is related to body surface area (r = 0.87; p less than 0.001 between calculated and predicted values for a N2 mean of 9.3 +/- 0.06 cm2/m2). The end diastolic diameters and wall thicknesses correlated with body surface area but the coefficients were not as statistically significant due to physiological variations in chamber filling. The indexed myocardial surface was increased (p less than 0.001) in the pathological series. The introduction of these tests improves the reliability of echocardiographic data. The use of several measurements simultaneously allows normalisation of body surface area and increases the diagnostic efficacy.
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Clinical findings and results of treatment in 17 patients with acute mitral incompetence are described. The lesions were secondary to a recent myocardial necrosis causing severe cardiac failure (shock, or acute left ventricular failure), and the presence of mitral incompetence was confirmed by right catherization (15 cases) and/or left ventricular angiography (13 cases). The anatomical lesions are described in 14 cases: rupture of the posterior mitral papillary muscle in 7 cases, and acute dysfunction of the muscle in 7 other cases. Eight patients were treated by an intra-aortic balloon to assist circulation, and 14 were given vasodilators (phentolamine, trinitrin) associated in 5 cases with positive inotropic drugs. Surgical treatment was given (mitral valve replacement) in 7 cases. The respective effects of vasodilators and circulatory assistance are discussed, as well as the indications for, and results of urgent surgical treatment (6 successes in 7 operations).
A child of 10 was admitted to a cardiology unit with adiastole. The marked degree of dwarfism and anatomical features were characteristic of the so-called 'Mulibrey' dwarfism. Surgical intervention confirmed the constrictive pericarditis which is normally found in this condition. Unfortunately, the adiastole persisted which, taking into account the marked eosinophilia, made an associated endomyocardial fibrosis seem likely. The distinctive features of constrictive pericarditis and of the constrictive type of cardiomyopathy are recalled.
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Treatment by phentolamine was carried out in 30 patients presenting with an acute myocardial infarction complicated by left ventricular failure, 8 of which had cardiogenic shock. The response to treatment was closely related to the level of overload of the left ventricle. Significant improvement in the haemodynamic state was only observed in the most severe cases of cardiac failure, and in these cases was accompanied by only a minimal and insignificant change in mean arterial pressure and heart rate.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.