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Biomedical subjects

C Malmejac

Publications and source records attributed to C Malmejac.

At least 19 recordsLinked to original sources
PubMed1990

[Successful cardiac transplantation after 38 days of circulatory assistance with a heterotopic artificial heart].

The survival of a patient with irreversible cardiac failure on the cardiac transplantation waiting list was assured for 38 days by circulatory assistance with heterotopic Pierce Donachy prosthetic ventricles and followed by successful cardiac transplantation. This method of circulatory assistance is relatively simple to install from the technical point of view and provides a satisfactory haemodynamic result whilst waiting for a compatible donor organ. Several complications, some of them serious, were observed. Some were related to the patient's poor preoperative condition: acute renal failure, disorders of coagulation. These regressed slowly when the patient's haemodynamic status improved. On the other hand, septic problems and local haemorrhage were inherent to this technique. These are the commonest complications reported by other authors. Although the mortality rate during the period of circulatory assistance may appear to be high, this technique remains a valuable method of survival for selected patients and does not affect the chances of success of ulterior cardiac transplantation.

Acute Kidney Injury↗
PubMed1990

[Cardiac hydatidosis. Review of recent literature and report of 15 cases].

In the context of a personal series of fifteen cases of hydatid cyst of the heart, the authors present a computerized review of the last one hundred cases published in the literature. The modern features of the disease are discussed together with its severity (mortality of 23.47% in 98 recent cases). Despite the considerable contribution of ultrasonography, computed tomography and magnetic resonance imaging, a certain number of pejorative criteria appear to persist:delayed diagnosis, diagnostic error, acute pulmonary oedema and incomplete surgical cure.

Adolescent↗
PubMed1989

[Septal rupture repaired in the acute stage of myocardial infarction. Clinical, hemodynamic and angio-coronarography findings in the evaluation of surgical risk].

Between 1977 and 1987, 27 consecutive patients (16 men, 11 women, mean age 66 years, range 54 to 75 years) with ventricular septal rupture complicating acute myocardial infarction underwent surgical repair. The purpose of this retrospective study was to analyse the post-operative mortality factors from clinical, haemodynamic and operative data in all patients and also from coronary angiographic data in 23/27 patients whose haemodynamic status allowed this type of exploration. Seventeen patients (63 p. 100) died during the first post-operative month, 10 survived and were discharged. Factors that influenced the prognosis were: (1) inferiorly-located necrosis associated with a 75 p. 100 mortality rate (9 out of 12 patients), as opposed to 53 p. 100 (8 out of 15 patients) with anterior necrosis; (2) right ventricular dysfunction, observed in 83 p. 100 of patients with inferior necrosis and 53 p. 100 with anterior necrosis, which was responsible for 7 out of 9 deaths in the inferior necrosis subgroup and contributed to 3 out of 8 deaths in the anterior necrosis subgroup; this established a cause-effect relationship between right ventricular function and the overmortality of patients with inferior necrosis; (3) independently of the haemodynamic status, two- and three-vessel lesions (56 p. 100 of all lesions) which had an 84 p. 100 mortality rate as opposed to 40 p. 100 with one-vessel lesions; (4) the presence of a state of shock which was associated with a 78 p. 100 mortality rate as opposed to 55 p. 100 in patients without shock. We conclude that when permitted by the patient's haemodynamic status coronary angiography should be part of the pre-operative evaluation to assess the operative risk and guide the surgical procedure.

Acute Disease↗
PubMed1989

[Giant leiomyoma of the inferior vena cava].

The authors report an uncommon case of giant leiomyoma of the inferior vena cava with intracardiac extension and arising from the external iliac vena. This case report illustrates the diagnostical problems usually encountered with this type of tumour. Indeed, despite ultrasound and transverse CT scan, the diagnosis was only assessed by histopathological analysis following a successful surgical removal of the leiomyoma. Only 7 cases of leiomyoma of the inferior vena cava are already reported in the literature. Relationship with intravenous leiomyomatosis of the uterus is also discussed.

Aged↗
PubMed1988

[Results of cardiac surgery in patients over 70 years of age. Apropos of a retrospective study of 170 patients].

The ever increasing age of the general population and the frequency of coronary and aortic lesions in patients aged 70 or older make cardiac surgery in the elderly a topic of current interest. In a retrospective study of 170 cases the overall mortality rate was 14 p. 100 (4.7 p. 100 in 1986). During the past two years (1985 and 1986), the mortality rates in patients with coronary disease who underwent elective surgery were 10 p. 100 and 4 p. 100 respectively. Emergency surgery (left coronary trunk and unstable angina excluded) and associated operations on the heart made the prognosis worse with overall mortality rates of 13 p. 100 and 15 p. 100 respectively (9 p. 100 in 1985, 10 p. 100 in 1986). In aortic valve surgery, hospital mortality rates were 28 p. 100 in 1985 and 6 p. 100 in 1986. Post-operative morbidity was high (52 p. 100 of patients) and consisted mostly of respiratory and neurological complications (14.7 p. 100 and 9.4 p. 100 respectively of all patients). Only 4 p. 100 of the patients developed peri-operative myocardial infarction. Functional results were satisfactory in both coronary disease and heart valve disease patients. The survival rate at 4 years was 74.5 +/- 10 p. 100 globally and 87.3 +/- 9 p. 100 in coronary patients operated upon electively. Thus, the considerable advances in surgical techniques and post-operative intensive care achieved during the last few years have significantly improved the results obtained in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Disobstruction of the inferior vena cava under extracorporeal circulation].

An original technique used to remove obstructions of the inferior vena cava under cardiopulmonary bypass is described. This technique is indicated in pulmonary embolectomy or to dispose of a vena cava clot prolapsed into the right cardiac cavities. Through a rigid and blunt thoracic drain introduced via the right atrium, a Fogarthy venous catheter is pushed into the inferior vena cava, thus avoiding the risks of accidental passage into the supra-hepatic or renal veins and blockage in a thebesian valve. The catheter is inflated, then removed together with the drain, thereby freeing the caval lumen. The technique is reliable and reproducible, and it has proved very effective.

Catheterization↗
PubMed1987

[Peculiar indications and results of the use of a blood cell saver apparatus in cardiac surgery].

Results are reported of the use of autotransfusion by means of the blood cell saver in a group of patients at high risk for hemorrhage in Heart Surgery Department. Methods employed are described, and results are discussed: these were encouraging both from the clinical and biological viewpoints. The cost benefits of this procedure are emphasized and technical perspectives outlined with respect to recovery of plasma and platelets.

Adult↗
PubMed1985

[Coronary occlusion immediately following a successful coronary angioplasty. Treatment by repeat angioplasty].

The authors report the case of a 52 year old patient with a significant stenosis of the medial portion of the left anterior descending artery (LAD) with excellent left ventricular function. Transluminal coronary angioplasty (TCA) was indicated following a positive exercise stress test. This was initially performed successfully. Fifteen minutes after the end of the procedure, a total obstruction occurred at the site of dilatation immediately eliciting significant precordial chest pain and massive elevation of the ST segment. Isosorbide dinitrate (ISDN) at a dose of 2 mg was injected into the artery 3 times without success as was an attempt to pass through the obstruction with a guide wire. Another TCA was then attempted without administration of the thrombolytic agent. The dilating catheter passed easily by the obstruction permitting several dilatations which restored rapid coronary artery flow, relieved completely the chest pain, and normalized electrocardiographic abnormalities. This procedure represents a new therapeutic approach to obstruction, an often unpredictable and serious complication of coronary angioplasty in the absence of collateral circulation, thereby preventing the development of a myocardial infarction and an emergency aortocoronary bypass operation.

Acute Disease↗
PubMed1983

[Unstable angina and single vessel stenosis of the anterior interventricular artery. Evaluation of the threatened myocardium. Therapeutic implications].

The authors report a special cases of precise evaluation of threatened myocardium during coronaro-ventriculography. Two elements provided this evaluation: 1) spasm in the tight stenosis of the middle part of the anterior interventricular artery with immediate left ventricular dyskinesia (EF: 37%, EDP/EVD: 1.74; EDV: 98 cc/m2). 2) Complete instantaneous recovery after injection of 2 mg of trinitrine into the left ventricle (EF: 69%, EDP/EVD: 4.33; EDV: 28 cc/m2). This loss, in the order of 50%, in the left ventricular function led us to perform an angioplasty (ACT) with success. A further clinical and angiographic stenosis, three months later, in this 72 years old patient with arteritis, led us to perform an aorto-coronary graft, rather than another ACT.

Aged↗