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Biomedical subjects

B Lancelin

Publications and source records attributed to B Lancelin.

54 records · Page 3Linked to original sources
PubMed1977

[Arrhythmias following closure of atrial septal defects. Apropos of 300 cases].

In a series of 300 cases whose atrial septal defects were closed (268 with ostium secundum, 27 with ostium primum, and 5 cases with both), arrhythmias were found in 60%. These were usually slow supraventricular arrhythmias caused by substitution (51%), and less commonly rapid supraventricular arrhythmias (27%), extra-systoles (16%), disorders of atrio-ventricular conduction of second and third degree and disorders of the auricle (6%). Conduction disorders were significantly more common (p less than 0.001) after closure of ostium primum (37%) than after closure of an ostium secundum (4.5%). Arrhythmias are most common during the first week (56%), and are usually of the slow type, and during the three succeeding weeks are markedly less frequent (31%) with a higher proportion (p less than 0.001) of the rapid type. No one anatomical type of ASD was complicated with arrhythmia more than the others. The slow type of arrhythmias occurred in the high ASDs, and the fast type especially amongst elderly patients. Longterm follow-up showed arrhythmias in 28% of patients with an ostium secundum defect. The factors influencing arrhythmias were age, cardiac enlargement, and the mean pulmonary arterial pressure. Arrhythmias were just as common in cases with a small shunt.

Adolescent↗
PubMed1977

[Valve replacement in case of a partial atrioventricular canal. A propos of 17 cases].

In 17 patients with a partial form of atrioventricular canal, at least one valve was replaced. The mitral valve was the most commonly affected (16 cases), sometimes in association with the tricuspid valve (5 cases) or the aortic valve (1 case); the tricuspid valve alone was replaced in one case. 7 cases were ranked as operative deaths, and the longer term mortality was of 4 cases. The factors leading to this high mortality figure are discussed. The future treatment policy for this condition is discussed.

Adolescent↗
PubMed1977

[Value of the exercise test after aortocoronary bypass].

The 100 patients who underwent an exercise test and a follow-up coronary arteriogram at a mean interval of 10.1 months after an aorto-coronary bypass had suffered preoperatively from incapacitating angina 50%), a threatened infarction syndrome (35%), or Prinzmetal's angina (15%). The majority had a single bypass graft (72%), but 28% had two or three grafts. The exercise test was positive 39 times, negative 51 times, and indeterminate in 10. Correlation with the clinical picture shows that 27% of the patients in functional category I had a positive exercise test. Correlation with coronary arteriography shows that a positive test is reliable evidence for a defect or occlusion of the graft. On the other hand, a negative exercise test is a less reliable indicator of a good result. No instances of positive exercise tests were found when there was complete alleviation of the coronary condition.

Adult↗
PubMed1977

[Non-invasive study of the patency of aortocoronary bypass with pulsed Doppler technic. Preliminary studies].

The pulsed Doppler effect is a non-invasive investigation technique based on the fact that the blood cells moving in a vessel on which ultrasound is incident cause a rebound of different frequency, according to their rate. This technique allows us to measure flow in a "measuring volume", whose size and depth are regulable. It is also possible to collect the signal from one or several aorto-coronary grafts, and to distinguish these from the sorrounding vasculature by their diastolic perfusion. This preliminary study (11 cases) is an attempt to formulate strict procedural criteria by comparison with follow-up arteriography of the grafts. The ease of performance of this investigation should, eventually, make it unnecessary to have to carry out repeated arteriography.

Blood Flow Velocity↗
PubMed1977

[Simultaneous measurement of cardiac output by indium 113 m detected externally and by dye dilution of indocyanine green].

The cardiac output of 11 patients was measured by a method of dilution of a short-life radio-isotope, and compared with measurements obtained simultaneously by a dye dilution technique. After sudden intravenous injection of siderophilin (transferrin) labelled by Indium 113 m, the precoridal radioactivity was measured by a single panel detector probe. In 9 patients these measurements were carried out twice with a 15 minute interval. The correlation coefficient between the two methods was 0.884 for 20 measurements, and 0.939 for the first 11 measurements. The reproducibility of these measurements was comparable for the two techniques. The radio-isotope method of measuring cardiac output, which can be carried out at the bedside, is a simple, reliable and reproducible technique.

Cardiac Output↗
PubMed1976

[Enlarged heart caused by massive subepicardial lipomatosis with idiopathic dilatation of the right cavities].

The case is reported of a man of 48 with known longstanding gross cardiomegaly which was completely asymptomatic. Angiocardiography and coronary arteriography showed dilatation of the right side of the heart, and especially of the auricle. In addition, the ventricle was separated from the diphragm by a transparent non-fluid area. At operation, gross dilatation of the right atrium was confirmed, but no causative lesion could be found; there was also marked lipomatosis which involved particularly the area beneath the right ventricle. It is difficult to classify this most unusual case as either a classical dilatation of the right atrium, idiopathic or secondary, or as a cardiac lipoma or lipomatosis.

Angiocardiography↗
PubMed1975

[Transposition of great vessels with pulmonary stenosis and interventricular communication. Anatomic and surgical aspects. Apropos of 10 cases].

10 cases of anomalous position of the great vessels are reported. They include 8 cases of d-transpositions, 1 of 1-transposition and 1 anatomically corrected malposition. These cases have in common the combination of a ventricular septal defect with a pulmonary stenosis. The anatomical study (6 of 10 cases) made it possible to describe the type of the VSD (related to a defect of development and/or alinement of parietal on the septal band) and of the pulmonary pathway stenosis. Blalock's anastomosis has made it possible to obtain an improvement in 6 patients. 4 operations of complete cure were undertaken in d-transpositions: 2 Mustard's operations ending in death. 2 operations according to Rastelli's principles with one death and one good result. The case of anatomically corrected malposition died after an attempt at complete cure, in view of a left ventricular hypoplasia. The indication for the type of complete cure was discussed in relation with the anatomical data.

Blood Pressure↗
PubMed1975

[Left juxtaposition of the atria. Apropos of a case with dextroversion, transposition of great vessels, bilateral conus, interventricular communication and pulmonary atresia].

Report of one case of a woman aged 29 years with a severe cyanotic congenital heart disease complicated by brain abscess. The diagnosis of left juxtaposition of the atria combined with dextroversion, a d-transposition of the large vessels and a vestricular septal defect was done pre-operatively. An attempt at a Rastelli's operation was followed by immediate death. The post-mortem examination confirmed the pre-operative diagnosis and demonstrated besides a double conus and a pulmonary atresia. The juxtaposition of the atria was underlined.

Adult↗
PubMedDate not supplied

Feasibility, safety, cost-effectiveness and 1 year follow-up of coronary stenting without predilation: a matched comparison with the standard approach.

BACKGROUND: We evaluated the feasibility, safety, procedural cost-effectiveness, radiation dose and time and 1-year target vessel revascularization rate of direct unprotected mounted stenting without previous balloon dilatation (DS) in native coronary artery lesions. METHODS: DS was attempted in 119 patients; 39 had a recent myocardial infarction, 62 had unstable angina, and 18 had stable angina. The clinical follow-up was obtained at 14+/-5 months (range 6 to 24 months). These results were compared with those for a consecutive group of 160 patients matched for type and length of lesions and who had a stent only if the post-balloon residual stenosis was >30%. RESULTS: The feasibility of DS was 112/119 (94%). The number of inflations, the length of the stent/length of the lesion ratio, the time and the dose of radiation were dramatically lower in the DS group (P<0.001). DS conferred a slight reduction in procedure-related cost [$820+/-157 for DS vs. 894+/-427 for standard dilatation (SD) per patient]. The 1-year target vessel revascularization rate was similar in both groups [nine (8%) for DS vs. 17 (11%) patients for SD, ns]. CONCLUSIONS: DS is feasible and safe in selected coronary lesions. This method provides a low rate of repeat revascularization and reduces the time and the dose of radiation compared with the standard approach.

Aged↗
PubMedDate not supplied

[Medium-term follow-up after percutaneous aortic valvuloplasty in the elderly. Clinical study apropos of 102 cases].

Percutaneous transluminal balloon aortic valvuloplasty was introduced in 1985 and, owing to its sometimes dramatic short-term results, it has rapidly become a useful procedure in the management of aortic stenosis in elderly subjects. The purpose of this study was to determine its clinical results at medium-term and to identify possible prognostic factors in order to improve the selection of patients suitable for this technique. Between January 1986 and December 1987, 78 patients (30 men, 48 women, aged from 60 to 93 years, mean 80 +/- 6.7 years) totalling 85 procedures were selected among 102 dilatations on the basis of a primary success without complications. Dilatation was performed by a technique similar to that described by Cribier et al. The follow-up period was 10 +/- 5.7 months (range: 1 to 27 months). The aortic valve area increased from 0.47 +/- 0.15 cm2 to 0.77 +/- 0.23 cm2, i.e. from 0.29 +/- 0.09 cm2/m2 to 0.48 +/- 0.13 cm2/m2 as regards the indexed area. The hospital mortality rate was 3.3 p. 100. At the end of the follow-up period 55 p. 100 of the patients were in NYHA class I or II; 29 p. 100 had died, 10 p. 100 had undergone a second dilatation and 13 p. 100 had had aortic valve replacement. This distribution into functional classes and major cardiac events was not significantly different in the subgroup of patients with an aortic valve area greater than 0.9 cm2 or in the subgroup of primary failure. The patients who died for cardiac reasons were older (p less than 0.01), had a lower cardiac output before and after dilatation (p less than 0.001) and a lower ejection fraction after dilatation (p less than 0.05) or even before in case of early death (p less than 0.05). Mortality and morbidity therefore were high at medium-term and unrelated to the haemodynamic effect of dilatation. On the other hand, the left ventricular systolic function was determinant, mainly because it could improve or remain stable when initially altered. These results suggest that only patients for whom aortic valve replacement is truly contra-indicated and who have a limited alteration of left ventricular function should be selected for aortic valvuloplasty.

Aged↗