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Biomedical subjects

C Stankowiak

Publications and source records attributed to C Stankowiak.

At least 19 recordsLinked to original sources
PubMed2000

Enteroviruses can persist with or without active viral replication in cardiac tissue of patients with end-stage ischemic or dilated cardiomyopathy.

To investigate enterovirus replication versus persistence in end-stage cardiac diseases, endomyocardial biopsies from explanted hearts of 70 patients with idiopathic dilated cardiomyopathy (IDCM), 64 patients with chronic coronary disease (CCD), and 45 donors of healthy hearts (controls) were examined by reverse transcriptase-polymerase chain reaction for genomic and antigenomic enterovirus RNA and by VP1 antigen immunohistochemistry. Enterovirus genome was detected in 25 of 70 patients with IDCM and in 21 of 64 patients with CCDs (35.7 vs. 32.8%, respectively; P=.12). Of the 46 patients positive for genomic RNA, only 3 exhibited antigenomic RNA and VP1 antigen that demonstrated active viral replication, whereas 43 had latent infection characterized by the absence of antigenomic RNA associated with or not with VP1 antigen expression. No viral component was detected in control subjects. The findings demonstrate that a small percentage of patients with end-stage chronic cardiac diseases had active enterovirus replication in their myocardium.

Adult↗
PubMed1998

Aortic root replacement with a pulmonary autograft in young adults: medium-term results in 70 patients.

BACKGROUND: Pulmonary autograft aortic valve replacement has been introduced in our institution in selected adult patients in light of the known disadvantages and limitations of conventional prosthetic valves. METHODS: We prospectively evaluated the use of the pulmonary autograft in a series of 70 young adults (31.2+/-8.7 years, range 16 to 49 years) operated on from March 1992 to April 1997 with aortic root replacement only. RESULTS: There were no in-hospital deaths and two noncardiac-related late deaths during follow-up of up to 62 months (mean 33 months). Thromboembolic complications were not observed. One patient required reoperation for infective endocarditis 4.3 years after surgery. Discharge echo-Doppler studies showed normal autograft and allograft valve function. Serial echo-Doppler studies showed no significant progression of aortic insufficiency and no dilatation of the autograft. A severe stenosis of the pulmonary allograft developed in 1 patient. CONCLUSION: Aortic root replacement with a pulmonary autograft, although more complex than conventional prosthetic valve replacement, is a safe, effective, and reproducible procedure in properly selected adult patients. Long-term results remain to be evaluated.

Adolescent↗
PubMed1998

Coil embolization of a gluteal false aneurysm in a patient with Marfan syndrome.

Gluteal aneurysms, whether true or false, are exceptional. They represent less than 1% of all aneurysms and develop within the superior or inferior gluteal arteries, being branches of the internal iliac artery. We report here the case of a 35-year-old patient with Marfan syndrome in whom annuloaortic ectasia and Barlow's disease with mitral valve insufficiency successively developed followed by a gluteal false aneurysm, which led us to investigate the etiologic mechanism of the patient's conditions. The gluteal aneurysm was successfully treated by selective embolization, which would appear to be the elective therapeutic approach for these lesions.

Adult↗
PubMed1996

Relationship between CMV and graft rejection after heart transplantation.

This study, which included 153 heart transplant patients, was designed to determine whether the cytomegalovirus (CMV) status of both donor and recipient may influence graft rejection. The follow-up was 1 year and they all received the same triple-drug immunosuppressive regimen with induction (antilymphocyte serum). There was no difference in the total rejection rate, but an increase in repeated rejection rate was shown in transplant recipients with hearts from CMV seropositive donors (P < 0.05). These data strongly suggest the impact of CMV in enhancement but not in induction of rejection. To prevent iterative rejection in the CMV seropositive donor group, antiviral therapy could be proposed during enhancement of antirejection therapy.

Cytomegalovirus Infections↗
PubMed1995

Total aortic root replacement with pulmonary autografts: short term results in 45 consecutive patients.

From March 1992 through March 1995 we have performed 45 Ross procedures for total aortic root replacement in our institution. There were 32 males and 13 females with a mean age of 31 years (range: 3-49 years). Indications for surgery were: aortic stenosis (n = 20), aortic regurgitation (n = 16), native valve endocarditis (n = 6), replacement of prosthetic valve (n = 3). Of these 45 patients 13 (28%) had at least one prior repair. Additional procedures were Dacron graft extension of the autograft (n = 7), enlargement of aortic annulus (n = 3), mitral valve repair (n = 2), CABG (n = 1), closure of VSD (n = 1). The mean cross-clamp time was 132 minutes (76-187 minutes) and the mean bypass time 156 minutes (106-240 minutes). There were two postoperative cardiac deaths, not valve-related, and five non-lethal postoperative complications: right ventricular failure (n = 1), low cardiac output (n = 1), sternal re-entry for bleeding (n = 3). The follow up is complete (1.5-37 months) for the 43 survivors. There was one non-cardiac late death (acute fulminating hepatitis) in an eight years old boy eight months post-operatively. Discharge echo-Doppler studies showed normal autograft and homograft valve function except in one patient who had a grade two aortic regurgitation. Serial echo-Doppler studies showed no significant progression of aortic regurgitation, no significant pulmonary gradients, no dilatation of the autografts during the follow up. It is suggested in conclusion that aortic root replacement with a pulmonary autograft is a safe procedure in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Surgical treatment of leiomyosarcoma of the left atrium Report of a case and review of the literature].

The authors report a case of left atrial leiomyosarcoma presenting with systemic disturbances and retinal emboli diagnosed by echocardiography and surgery in a 59 year old woman. Surgical ablation was completed by a course of chemotherapy. Histopathological examination confirmed the diagnosis of sarcoma; although the patient remained generally well, severe mitral regurgitation appeared 21 months after surgery. Transoesophageal echocardiography revealed an abnormal, hyper-mobile, intra-atrial echo suggesting a ruptured chordae tendinae and the mitral valves appeared very thickened and retracted. The patient was reoperated and the mitral valve replaced with a bioprosthesis. After a total follow-up of 29 months, the patients is still alive and asymptomatic. The authors underline the importance of echocardiography in the diagnosis of intra-cardiac tumours in general and, in particular, of intra-cardiac sarcomas.

Echocardiography, Transesophageal↗
PubMed1991

[Leiomyosarcoma of the superior vena cava. Case report].

Leiomyosarcoma of the blood vessels is a rare malignant tumor, and its localization in the superior vena cava is exceptional. We had the opportunity to study such a case and we compared our clinical, histological and ultrastructural results with those of 5 other reported cases.

Aged↗
PubMed1989

[Durability of the Carpentier-Edwards porcine bioprosthesis in aortic or mitral positions. 10 years' results on 458 surgically treated cases].

458 patients with a Carpentier-Edwards porcine bioprosthesis (aortic (Ao): 169, mitral (Mi): 289) operated between January 1975 and December 1981, were studied during the first trimester of 1987. Forty seven patients underwent an associated operation. The total follow-up was 3,001 patient-years with a maximum follow-up of 11.4 years and a mean follow-up of 6.5 years. Only 5.6% of patients were lost to follow-up. The patients were aged between 20 and 80 years. The actuarial 9-year survival rate was 69.2 +/- 6.3% for aortic prostheses and 79.6 +/- 3.9% for mitral prostheses. The principal cause of valve failure, appearing with a considerable frequency after 5 years, was primary tissue degeneration which alone represented 67.8% of the causes of valve failure. The rate of absence of valve failure, for all causes combined, was 77.8 +/- 5.9% for the aortic position and 74.9 +/- 4.9% for the mitral position. The actuarial rate of absence of primary tissue degeneration at 9 years was 79.7 +/- 4.1% for aortic prostheses and 75.2 +/- 4.4% for mitral prostheses. The frequency of tissue degeneration decreased with increasing age, representing 2.9%, 1.9% and 1.5% patient-years respectively for the age-groups: 20 to 39 years, 40 to 59 years and 60 to 80 years. However, this difference was not statistically significant. Tissue degeneration was the principal cause for reoperation (n = 59) with an operative mortality of 7.8%.

Actuarial Analysis↗
PubMed1987

[Popliteal venous aneurysm. Apropos of 3 cases].

The popliteal venous aneurysm is a rare cause of recurrent phlebitis and pulmonary embolus. In reference to 3 personal cases, their etiology, their role in the occurrence of phlebitis, the place of phlebography and vascular sonotomography respectively, are discussed. The treatment is essentially surgical.

Adult↗
PubMed1984

Experience with 813 aortic or mitral valve replacements with the Carpentier-Edwards bioprosthesis: Five year results.

813 patients underwent aortic (AVR) or mitral valve replacement using the Carpentier-Edwards bioprosthesis from 1976 to 1983. Operative mortality was 5.49% for AVR and 4.59% for MVR. Late mortality and complications were classified using criteria described by the Stanford Group. Actuarial survival at 5 years was 87.9% +/- 2.7% for AVR and 91.1% +/- 1.4% in MVR. Thromboembolism occurred at low rates of 0.48% pt yr for AVR and 0.90% pt yr for MVR. 98.2% +/- 0.90% of AVR and 96.9% +/- 1.3% of MVR pts were free from thromboembolism at 5 years. The low incidence of thromboembolism during the early postoperative period played a role in the low rates observed in the complete study. There was no valve thrombosis. Anticoagulation with warfarin was used in 35% AVR and 75% MVR with rates of bleeding complications of 1.20% pt yr and 1.10% pt yr. Overall valve failure rate was 2.04% pt yr at 5 years for AVR and 1.55% pt yr for MVR. Rates of reoperation for tissue failure remained low (0.24% pt yr for AVR and 0.32% pt yr for MVR). The advantage of a low rate of thromboembolism was not outweighed by the specific problems of bioprosthesis at 5 years.

Actuarial Analysis↗
PubMed1984

[Posttraumatic infarction with a surgically treated floating thrombus of the left ventricle. Apropos of a case].

Forty-two days after severe thoracic trauma which had led to thrombosis of the left renal artery and to nephrectomy, a 22 year old patient developed anterior wall infarction. Echocardiography and coronary and left ventricular angiography showed distal occlusion of the left anterior descending artery and the presence of a large, mobile thrombus at the left ventricular apex. The thrombus was removed surgically without any complications but a small thrombus adherent to the ventricular scar was observed postoperatively. After a discussion on the different possible physiopathological mechanisms, the authors conclude that the patient probably suffered primary myocardial contusion which led to secondary occlusion of the LAD artery, late myocardial infarction and extension of the initial intraventricular thrombus. This case illustrates the value of two-dimensional echocardiography in the detection and follow-up of ventricular thrombosis.

Adult↗
PubMed1982

[Surgical treatment of Prinzmetal variant angina. Coronary artery by pass and plexectomy (author's transl)].

Aorto-coronary by pass, widely accepted in the treatment of patients with coronary artery disease is still controversial in the treatment of Prinzmetal variant angina. Recurrence of attacks, occlusion of grafts and post-operative infarction were frequent by described and seem to be related with the persistence of coronary spasm. Authors propose the association of myocardial revascularization and coronary denervation by resection of periaortic plexi. Results of 50 surgical plexectomies associated with coronary by pass appear far better than by pass alone (mortality 4%, myocardial necrosis 4%, persistence of attacks 4%).

Adult↗
PubMed1982

[Surgical treatment of Prinzmetal's angina pectoris by plexectomy associated with aortocoronary bypass. Apropos of 56 cases].

The results of coronary bypass surgery are generally not as good in Prinzmetal angina as in classical angina pectoris. The percentage of myocardial infarction, recurrent angina and death is much higher. One reason for these failures could be the persistence of coronary spasm. In order to prevent this, denervation of the pre-supra and retro aortic nerve plexuses was carried out in 56 patients (54 male, 2 female) with Prinzmetal angina and operable coronary arterial lesions. Forty patients had documented coronary spasm mainly of the left anterior descending (20 cases) or the right coronary artery (13 cases). Surgery consisted of cardiac denervation associated with direct myocardial revascularisation by implantation of I (37 cases), 2 (13 cases) or 3 (6 cases) aorto coronary bypass grafts. Two deaths were observed in the perioperative period (one low output syndrome and one severe arrhythmia) and one myocardial infarction in the postoperative period. Of the 54 survivors, 49 are asymptomatic and 2 have recurrent spontaneous angina. Exercise electrocardiography in 44 patients was negative in 40 cases. Continuous electrocardiographic recordings (Holter method) in 33 patients was negative for ischemia and of 25 bypass grafts controlled, 24 were patent. Seventy five methylergometrine provocation tests were performed: only 2 were positive, both in patients with recurrent attacks. Therefore, with respect to the total numbers of recurrent angina (2), post operative infarction (I), peri and post operative deaths (3), the percentage of poor results was only 10,7 p. 100, almost three times lower than in previously reported series. In conclusion, we can say that the association of cardiac denervation with coronary bypass surgery significantly improves the percentage of good results (89,3 p. 100 of patients presenting with Prinzmetal angina).

Adult↗