PubMed HealthSearch

Biomedical subjects

C De Riberolles

Publications and source records attributed to C De Riberolles.

11 recordsLinked to original sources

[Valvular cyst and atrioventricular canal in a child with trisomy 21].

A child with Down's syndrome with an atrioventricular canal of ostium primum type had also a blood cyst of the mitral valve. Aside more frequent complex heterotopic cysts due to migration anomalies, simple cysts are rare with only 27 cases described in medical literature. They are often symptomatic and are cured by surgical removal. Our hypothesis, in accord with recent embryologic observations, is that simple cysts situated close to the valves and fibrous ring of the heart may result from heteroplastic change of tissue coming from primitive pericardial mesothelium. This primitive mesothelium participates to the formation of the fibrous skeleton of the heart.

Atrioventricular Node

Intracardiac ectopic thyroid.

The case of a patient with an intracardiac ectopic thyroid is reported. A lesion was found in a 25-year-old man and was diagnosed by two-dimensional echocardiography as a right intraventricular tumor. An operation was performed. Histologic and ultrastructural studies showed that the tumor was a thyroid mass. The origin of intracardiac ectopic thyroids is probably to be found in disturbances occurring early in embryogenesis.

Adult

[Heterotopic cardiac allograft in the newborn piglet (author's transl)].

Heterotopic cardiac allografts were performed in unrelated Large White piglets to test (i) if such a technique could be used in young (12 days) and neonates (less than five days); (ii) if tolerance to histocompatibility antigens could be induced by donor-cells injection to piglets that were immunosuppressed with heterologous antilymphocyte serum (ALS). The experimentation included two different series. The first one involved ten allografts done in early weaned (10 days), 12-day-old piglets (mean live weight 3.5 kg). They received or not ALS 2 ml per kg per day by subcutaneous route during five consecutive days after transplantation. In addition, two of the ALS treated piglets received endovenously, on day 7 after transplantation, cryoconservated cells from the spleen of the heart-donor. The second series involved ten allografts performed in suckling piglets just after birth at a mean live weight of 1.4 kg. These animals were first thymectomized at day 0 (6 h to 44 h after birth), and then received ALS (4 ml per kg by intraperitoneal route) on day 1. The heterotopic cardiac allograft was performed on day 2. Out of them, two received endovenously, on day 3, conservated splenic cells from the heart donor. In both series the heterotopic cardiac allograft was done, after right nephrectomy, anastomosing the donor thoracic aorta end to side to the recipient abdominal aorta, and the donor pulmonary artery end to side to the recipient inferior vena cava. From the surgical point of view, it appeared that the heterotopic cardiac allograft was easy to perform, and successful in most cases, in 12-day-old piglets. The same operation in neonates was as easy to perform as in older animals, but most failed to survive due to hemorragic leakage and post operative shock (repetitive anesthesia, insufficient suckling). From the immunological point of view, we failed to obtain any active enhancement of heart allograft with significant prolongation of the survival of the allogenic heart allograft (electro-cardiogram from epicardic electrodes). Rejection usually occurred in 6 to 8 days whatever the treatment (ALS with or without splenic cells from the donor, or nothing).

Animals

Is right bundle branch block aviodable in surgical correction of tetralogy of Fallot?

Right bundle branch block (RBBB) is usually considered almost unaviodable after repair of teralogy of Fallot (TOF). By modifications of the standard technique, its frequency has been decreased to 32% in a series of 1000 consecutive patients. These modifications are: (1) a very short right ventricular incision avoiding the ventriculotomy-induced RBBB pattern; (2) an infundibular resection limited to the septal attachment of the infundibular septum; and (3) closure of the ventricular septal defect with a patch sutured to the very edge of the muscular septum, avoiding injury to the right bundle along the right aspect of the septum. No patient in this series sustained permanent complete atrioventricular heart block. Among patients with RBBB, five had a left anterior hemiblock. Postoperative intraventricular conduction was related to age at operation: The incidence of RBBB was significatively higher in infants. The beneficial effects of a low incidence of postoperative RBBB after repair of TOF are not known.

Adolescent

[Pacemakers in children].

This is a study of pacemakers in 32 children with permanent pacemakers, 7 of them for congenital block, and 25 for post-operative block, representing a total of 69 pacemaker implantations. After a brief survey of the results, there is a discussion of the problems of the indications, relative for the congenital blocks, and absolute for the surgical blocks after a short period of observation. The choice of type of pacemaker rests upon three essential features: minimum inconvenience, a good length of active life, and the facility of an increased rate. Recent technical progress has allowed these features to be combined. The pacemakers currently available are shown on a table. The results are to a large extent determined by extreme care being taken over the implantation; meticulous asepsis, a low threshold on the electrode test, a pacemaker which is "comfortable" in its site, all these are essential if the serious complications are to be avoided, namely infection and pacemaker failure. The best route for the child, as for the adult, is by way of an epigastric approach with an abdominal pocket. In the very small infant, it seems better to implant by left thoracotomy, and to site the pacemaker intrapleurally.

Adolescent