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D Blin

Publications and source records attributed to D Blin.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Primary cardiac sarcoma treated by orthoptic cardiac transplantation. Apropos of a case].

The authors report a new case of cardiac sarcoma treated by cardiac transplantation. This treatment has been proposed for these malignant tumours of poor prognosis when simple excision is impossible, with variable results. This patient is in good general condition 20 months after transplantation. Transplantation is a therapeutic procedure which should be considered in malignant tumours limited to the heart.

Adult↗
PubMed1996

False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management.

OBJECTIVE: This study evaluates retrospectively the clinical presentation, radiographic findings, and angiographic management of false aneurysm of the pulmonary artery resulting from Swan-Ganz catheter placement. MATERIALS AND METHODS: Over a 4-year period, seven false aneurysms of the pulmonary artery were diagnosed in five patients (four women, one man) who were 67-81 years old. All five patients underwent Swan-Ganz catheter placement to monitor cardiac surgery--coronary artery bypass grafting in four and mitral valve replacement in one. All patients were anticoagulated. For five patients, we reviewed the medical records and the results of chest radiography, digital subtraction pulmonary angiography, and pulmonary artery embolization. For two patients, we reviewed the results of CT scanning. RESULTS: Non-life-threatening hemoptysis was noted in all cases and occurred in three patients after the Swan-Ganz catheter had been removed (elapsed time of 1-19 days). Chest radiographs revealed a pulmonary infiltrate in one patient and a pulmonary mass in two patients. The results were unremarkable in the other two patients. CT depicted two false aneurysms of the pulmonary artery as round masses with eccentrically enhanced lumina circumscribed by thrombosis. Pulmonary angiography revealed a single false aneurysm in three patients and two false aneurysms in two patients. All false aneurysms were localized in segmental or subsegmental branches of the right middle pulmonary artery (n = 4) or the right lower pulmonary artery (n = 3). All patients were successfully treated with transcatheter steel-coil embolization. CONCLUSION: Even when the chest radiograph appears unremarkable, patients clinically suspected of developing a false aneurysm of the pulmonary artery after Swan-Ganz catheter placement require enhanced CT or pulmonary angiography to establish the diagnosis. False aneurysms of the pulmonary artery can be treated at the time of pulmonary angiography by steel-coil embolization.

Aged↗
PubMed1995

Type A dissection of the thoracic aorta: use of MR imaging for long-term follow-up.

PURPOSE: To evaluate routine magnetic resonance (MR) imaging for long-term follow-up in patients who undergo surgery for type A aortic dissection. MATERIALS AND METHODS: Ninety-two MR examinations were performed in 36 patients. Standard spin-echo images were obtained with electrocardiographic gating (n = 92) and rapid images with a fast low-angle shot sequence and intravenous administration of gadopentetate dimeglumine (n = 25). All segments of the native thoracic aorta were evaluated. Anastomoses of the prosthesis and periprosthetic hematoma were carefully analyzed. RESULTS: Of 22 complications that occurred in 18 patients, 18 were diagnosed at MR imaging (nine false aneurysms and nine aneurysms distal to the graft). Nine patients underwent reoperation. The findings at MR imaging correlated with those at surgery. CONCLUSION: Routine follow-up with MR imaging should improve long-term survival in patients who survive emergency surgical repair of type A aortic dissection.

Aortic Dissection↗
PubMed1993

Focal myositis: a localized form of polymyositis?

We describe an additional case of focal myositis presenting as a painful pseudotumor of the lower leg. Surgical biopsy showed typical features of myositis; the disease improved spontaneously, without clinical or biological abnormalities. Focal myositis can remain a localized process, but in some cases it can become an authentic polymyositis. These generalized forms are associated early with elevated erythrocyte sedimentation rate and/or muscular enzymes.

Adult↗
PubMed1993

[Evaluation of prognosis and myocardial ischemia using thallium in myocardial tomoscintigraphy].

Thallium scintigraphy holds a unique position amongst the methods available for evaluating the prognosis of coronary patients: it enables quantification of underperfused myocardium and evaluates already constituted ventricular damage (irreversible necrosis) and areas at risk of future coronary events (viable but ischemic myocardium). In a series of 1,926 patients who underwent exercise stress or dipyridamole Thallium myocardial scintigraphy for angina pectoris and followed up fort an average of 34 months, the following features were observed: the long-term prognosis in patients with normal myocardial scintigraphy (715 patients) was identical to that of a normal population of the same age (0.11% cardiovascular deaths per year) whereas the cardiovascular mortality was 15 times higher in cases with a pathological scintigraphy: finally, the long-term prognosis (cardiovascular deaths, infarcts or secondary revascularisation) was directly related to the severity of the initial lack of Thallium uptake. This method was used to assess the prognosis and evaluate the myocardial ischaemia in 75 patients who underwent complete surgical revascularisation fort ischaemia, 50 of whom had previous myocardial infarction: all patients had at least one arterial bypass graft: 39% of the myocardium was underperfused before revascularisation; this procedure reduced by 80% (p < 0.0001) the zones of reversible underperfusion but also zones of irreversible underperfusion by 17% (p = 0.04). The results were particularly impressive in patients who underwent revascularisation with an arterial pedicle (left and right internal mammary, gastroepiploic alone or in association) as 91% of the ischemic territories recovered on average 13 days after revascularisation.(ABSTRACT TRUNCATED AT 250 WORDS)

Dipyridamole↗
PubMed1993

Pulmonary function tests predict outcome after cardiac surgery.

The aim of this study was to examine the value of systematic preoperative pulmonary function tests (PFTs) in order to reliably predict prolonged stay in I.C.U., prolonged mechanical ventilation and mortality in elective cardiac surgical patients. 149 consecutive adult patients (valvular replacement or coronary bypass graft) were studied retrospectively. We examined the preoperative respiratory data: vital capacity (VC), first second forced expired volume (FEV1), PaCO2 and PO2. Length of stay in I.C.U. (LICU), duration of mechanical ventilation (DMV), incidence of reintubation and survival rate were used as indices of respiratory morbidity. The results of the present study clearly indicate that patients with impaired airway flow rates had a prolonged postoperative recovery following cardiac surgery. Mortality, ICV and DMV increased when FEV1 was less than 1.5 L, VC was less than 2.5 L, or PaO2 was less than 8.5 kPa. Reintubation was associated with impaired flow rates. Pulmonary function tests appeared effective in predicting postoperative complications and the need for prolonged ventilatory support.

Cardiac Surgical Procedures↗
PubMed1992

Double-lung transplantation using donor lungs with a right tracheal bronchus.

A 58-year-old man underwent sequential bilateral lung transplantation. On the donor heart-lung block, it was discovered that the right apical segment was supplied by a tracheal bronchus. After the separate implantation of both lungs, a right apical segmentectomy was performed and the postoperative course was uneventful. The management of this problem is discussed.

Bronchi↗
PubMed1992

[Ectatic tumoral thrombosis of the superior vena cava revealing thyroid cancer].

Microscopic angio-invasion by carcinoma of the thyroid is known. Extension into the great veins is much more uncommon. Most of the cases which have been previously described were discovered on post-mortem examination. We report the case of a 55 year-old woman who was found to have an asymptomatic small cervical goiter 6 years ago; during the last 12 months she developed superior vena cave (SVC) syndrome radiological investigation (angiography, CT scan) and surgical exploration showed a carcinoma of the thyroid with intraluminal extension of the tumor leading to thrombosis and ectasia of the SVC. Surgery was performed with resection of the whole thyroid, the SVC and the innominate veins. A double prosthetic venous by pass was then inserted between the innominate veins and right atrium. Five years after resection, the patient has no recurrence or metastasis and no clinical symptom of SVC syndrome. To our knowledge, this is only the third reported case successfully treated by surgery.

Angiography↗
PubMed1992

[Diffuse bronchomalacia after double lung transplantation. Thoughts apropos of a case].

A 40 year old woman suffered from respiratory insufficiency (arterial PaO2 = 47 mmHg) because of a chronic beryllium intoxication. On 6th June 1990, she underwent double lung transplantation with cardio-pulmonary bypass. Each lung was separately implanted via an extra-pericardial approach, and both bronchi were anastomosed at the hilum. On the seventh post operative day, a severe bilateral bronchial ischemia was noticed (black mucosa). Few weeks later, a diffuse bronchomalacia was noticed in the proximal and distal parts of both bronchial trees. To our knowledge, such a bronchial post-ischemic complication has never been reported. The explantation could be several added causes: imperfect preservation of the lung during harvesting, post operative pulmonary oedema, and operative use of an antifibrinolytic agent (aprotinin).

Adult↗
PubMed1992

[Ectatic tumoral thrombosis of the superior vena cava revealing thyroid cancer].

Microscopic angio-invasion by carcinoma of the thyroid is known. Extension into the great veins is much more uncommon. Most of the cases which have been previously described were discovered on post-mortem examination. We report the case of a 55 year-old woman who was found to have an asymptomatic small cervical goiter 6 years ago; during the last 12 months she developed superior vena cave (SVC) syndrome radiological investigation (angiography, CT scan) and surgical exploration showed a carcinoma of the thyroid with intraluminal extension of the tumor leading to thrombosis and ectasia of the SVC. Surgery was performed with resection of the whole thyroid, the SVC and the innominate veins. A double prosthetic venous by pass was then inserted between the innominate veins and right atrium. Five years after resection, the patient has no recurrence or metastatis and no clinical symptom of SVC syndrome. To our knowledge, this is only the third reported case successfully treated by surgery.

Carcinoma↗
PubMed1991

[Surgical treatment of right-sided infective endocarditis].

Between 1980 and 1989, 8 patients (5 men, 3 women; mean age 30 years) were operated upon in our department of right-sided infective endocarditis. Six patients were heroin addicts and among these 3 were HIV positive and 2 had confirmed AIDS. The most frequently encountered microorganisms (6 cases) were staphylococci. It was decided to operate because of persistent infection and haemodynamic deterioration. The infection involved the pulmonary valve in only 1 of the 8 patients. Surgery was performed during the acute phase in 5 patients and was conservative in 6 patients, consisting of excision of the vegetations or valvulectomy combined or not with valvuloplasty. A high mortality rate (3/8 cases) was observed only among patients operated upon in the acute phase. This may be due to the underlying immunodeficiency and poor haemodynamic state of these patients. Among survivors, the long-term results were excellent, with no recurrent endocarditis and no death, and with only one subsequent operation, 4 years after the first one, for residual tricuspic valve regurgitation. This study shows that patients with right-sided infective endocarditis should be operated upon outside the acute phase of the disease and as soon as complications appear, and that surgery should preferably be conservative.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Approaching the posterior wall of the aortic arch. Temporary division of the innominate artery].

Two cases of wound affecting the posterior wall of the aortic arch are reported. One wound occurred during mediastinoscopy, the other was caused by a bullet. During surgery under extracorporeal circulation, the approach and repair of the wounds was greatly facilitated by temporary division of the innominate artery: the ascending and horizontal portions of the aorta could be tilted to the left, giving a very satisfactory access to the posterior wall of the arch. The innominate artery was easily repaired, without neurological complications. The authors insist on the convenience of this technique to approach not only the aortic arch but also various mediastinal organs, such as the tracheal bifurcation, the right branch of the pulmonary artery and the roof of the left atrium.

Adult↗
PubMed1989

[Jet intravenous injection of erythromycin lactobionate. A possible cause of the occurrence of crisis in torsade de pointe].

The authors report one case of torsade de pointe which occurred immediately after fast intravenous injection of a 1-gram dose of erythromycin lactobionate in a female patient who had undergone surgical replacement of the mitral and triscuspid valves 24 hours before. The responsibility of erythromycin was strongly suggested by the clinical data (syncope), electrocardiographic findings (electrocardiogram typical of torsade de pointe, slow rhythm and lengthened QT interval in the basal ECG) and the chronology of the sequence of intravenous injection of the antibiotic and the rhythm disorder. A literature search revealed six similar cases. Its seems that the arrythmogenic property of this drug is related to abnormally elevated serum levels following rapid administration.

Erythromycin↗