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Biomedical subjects

F Deuvaert

Publications and source records attributed to F Deuvaert.

At least 19 recordsLinked to original sources
PubMed1992

Membranous subvalvar pulmonary stenosis in complete transposition; advantage of biplane transoesophageal echocardiography for the diagnosis in a young adult.

A young adult who had previously undergone a Mustard repair for complete transposition developed symptomatic left ventricular outflow tract obstruction. Biplane transoesophageal echocardiography allowed an optimal preoperative assessment. In the longitudinal plane, a discrete calcified membrane was imaged. Consequently, a pulmonary arteriotomy was chosen for the relief of the malformation.

Adult↗
PubMed1990

[Late results of surgical repairs of tetralogy of Fallot].

The late results of 115 children with tetralogy of Fallot born and corrected between 1969 and 1988 are analyzed; the patients were distributed into 3 anatomical groups: normal pulmonary annulus (group A, 49 patients) annular stenosis (group B, 56 patients) and pulmonary atresia (group C, 10 patients). The probability of survival 15 years after correction is 97 p. 100 in cumulated groups A and B and 72 p. 100 in group C (p = 0.005). The probability of reoperation ten years after correction is 4 p. 100 in cumulated groups A and B without a previous shunt, 20 p. 100 in A and B with a previous shunt (p less than 0.05) and 55 p. 100 in group C (p = 0.0004). The proportion of serious cardiac sequellae amounts to 17 p. 100 in group A, 55 p. 100 in group B and 100 p. 100 in group C (p = 0.0005). As a whole, 55 p. 100 of the adolescents operated on for tetralogy of Fallot during infancy present a residual problem of some severity.

Actuarial Analysis↗
PubMed1990

[Localization of the accessory pathway and surgical treatment in Wolf-Parkinson White syndrome].

The accessory bypass tracts are responsible for many episodes of supraventricular arrhythmias in man. The Wolff-Parkinson-White syndrome is the best example. These arrhythmias can be refractory to the medical treatment and are sometimes lethal. Different techniques can be used to destroy these pathways. The surgical dissection is the most widely accepted technique. The accessory pathways are made of working muscle and are neither visible, nor palpable by the surgeon. The electrical properties of these pathways are used to localize them. These techniques are either non-invasive or invasive. The non-invasive techniques consist of the careful analysis of the surface electrocardiogram in sinus rhythm and during tachycardia. The invasive techniques consist of a pre-operative electrophysiological study and intra-operative mapping. The electrophysiological study consists of the introduction of multiples catheters inside the heart through peripheral veins. The intra-operative mapping consists of measurements done on the surface or inside the heart after the chest has been open. After precise localization of the areas of insertion of these abnormal tracts the surgeon proceeds with the dissection, starting either on the epicardial or on the endocardial side of the heart. The surgical results are excellent and there are only few complications. These techniques were used to operate six patients presenting with the Wolff-Parkinson-White syndrome.

Adolescent↗
PubMed1986

Coronary vasospasm after myocardial revascularisation. Treatment by verapamil.

Coronary vasospasm occurring after myocardial revascularisation must be quickly and efficiently treated to avoid the haemodynamic complications that it may cause. Treatment by nitroglycerin intravenously (i.v.) is not always efficient and an alternate possibility of treatment is essential. During the period from March 1982 to August 1983, we observed in our institution three patients with coronary vasospasms occurring after myocardial revascularisation which did not respond to nitroglycerin i.v. and were successfully treated by verapamil. Recurrence of vasospasm was prevented in those cases by verapamil perfused i.v. (dosage: 0.37 to 0.75 microgram/kg/min). The clinical evolution of these 3 cases are described here. Dosages of verapamil used to treat and to prevent the incident are discussed. The limitations of this therapy are briefly reviewed.

Coronary Vasospasm↗
PubMed1984

Normally and abnormally functioning left-sided porcine bioprosthetic valves after long-term implantation in patients: distinct spectra of histologic and histochemical changes.

This morphologic study (X-ray examination of gross specimens, histologic study and histochemical staining) compares two groups of explanted left-sided bioprosthetic valves: group I, 6 valves with normal cusp function and group II, 10 valves with significant dysfunction. Implantation periods ranged from 26 to 79 months. A computerized descriptive statistical method (principal component analysis) is used to analyze the qualitative results. Although qualitatively identical alterations are observed in both groups, the findings in the deep layers of the cusps of severe collagen breakdown, intensive fibrin penetration and various degrees of calcification are restricted to group II. Other findings of interest in both groups include amyloid deposits (four cases) and layering of fusiform host cells on the cusp surface (three cases). The computerized study shows that individuals of one clinical group are morphologically different from those of the other. Mechanical stress may contribute to surface alterations early after implantation, while further collagen breakdown and macrophagic activity result in deep penetration of plasma components and fibrin. Subsequent calcification is likely to be dystrophic rather than metabolic. Colonization of the cuspal surface by endothelial cells after long-term implantation of bioprosthetic valves expresses a new type of relation between host and bioprosthesis.

Adolescent↗
PubMed1984

Fourrier analysis demonstrate EEG slowing after circulatory arrest at 20 degrees C.

The electroencephalographic (EEG) monitoring in infants and children submitted to cardiac surgery under circulatory arrest (CA) and deep hypothermia (20 degrees C) (DH) is usually performed by display or record without analysis. These data disclose the reappearance of EEG activity but give no qualitative analysis of EEG recovery after CA. The electrical activity of the brain was monitored in these conditions by spectral analysis (fast Fourrier transformation with on-line processing). Spectral analysis of the EEG signal recorded during open heart surgery in nine infants and children operated under DH with, in five cases, CA is presented and discussed. The Fourrier analysis demonstrate in all patients with long CA (more than 30 min.) a spectral abnormality, namely the absence of fast activity (8-24 Hz) at least for the remainder of the operation. This abnormality was not present in operations without CA and was only transient after CA of shorter duration.

Cardiac Surgical Procedures↗
PubMed1983

Late prosthetic valve endocarditis: review of 19 cases and treatment.

Eighteen out of 1606 patients treated by valve replacement between January 1971 to June 1979 were admitted in Brugmann University Hospital for late prosthetic valve endocarditis. Of the 19 episodes (one patient had two distinct episodes four years apart), nine (group I) were treated medically and 10 (group II) by combined medical and surgical therapy. The infective organism was Staphylococcus epidermidis in two-thirds of our cases. Two cases in group I (22.2%) were long-term survivors. In group II, all 10 patients survived reoperation. There were four late deaths; six patients (60%) were still alive 1.8 to 4.4 years later (mean survival three years). Prompt prosthetic valve replacement is recommended in the presence of systemic emboli, evolving murmurs, uncontrolled sepsis or congestive heart failures (especially if the infective organism is a fungus or a staphylococcus), in late prosthetic valve endocarditis.

Endocarditis, Bacterial↗
PubMed1979

Cardiac tamponade with renal failure due to hemangioma of the heart.

In a 18 year-old woman, an isolated benign hemangioma of the right atrium led to cardiac tamponade and acute renal failure. After 8 days of anuria, the tumor was excised and replaced by a pericardial patch. The persistence of severe renal shutdown necessitated further hemodialysis during 22 days postoperatively. The patient was discharged on the 45th day in good hemodynamic and renal condition. Thirteen cases of benign hemangioma of the heart have been reported in the literature: 12 were found at autopsy; only 4 were complicated by hemopericardium but none of these survived.

Acute Kidney Injury↗
PubMedDate not supplied

Left-sided cervical aortic arch.

The authors report a case of cervical aortic arch. Left-sided cervical aortic arch is a very rare congenital anomaly which may or not be associated with clinical symptoms. Diagnosis, suspected on chest X-ray or clinical examination, must be confirmed by angiographic studies. A 17-year-old girl presenting an extensive aneurysm of a left-sided cervical aortic arch was successfully operated with the use of partial extracorporal bypass removing the aneurysm and restoring aortic arch continuity. Histological examination revealed mediacystic necrosis.

Adolescent↗
PubMedDate not supplied

Composite graft replacement of the aortic root and ascending aorta for annuloaortic ectasia.

Eighteen patients with annuloaortic ectasia were surgically treated during a six year period. Cystic media-necrosis was present in 17 patients, five of them presented with Marfan syndrome. All patients received a composite graft with reversed mitral Björk-Shiley or St-Jude prosthesis and reimplantation of the coronary ostia or venous bypass grafts. Combined profound selective hypothermia and hyperkalemic cardioplegia was the preferred myocardial protection technique. There was one early postoperative and two late deaths. The fifteen survivors, with a follow-up between 6 and 72 months did not present conduit related complications and clinical results are excellent; all patients are NYHA class I (11) or II (4).

Adult↗
PubMedDate not supplied

Surgical treatment of echinococcal cyst of the right heart.

We report a rare case of hydatidosis of the right heart. Our young patient had know pulmonary hydatidosis and presented precordial chest pain, increasing dyspnea, cough and hemoptysis. Echocardiography, confirmed by angiocardiography delineated the right ventricular cyst. The operation was performed under extra corporal circulation (ECC), moderate hypothermia with cold cardioplegia. The echinococcal cyst was removed after local instillation of 0.5% silver nitrate solution. The postoperative course was uneventful.

Adult↗
PubMedDate not supplied

Coronary artery fistula: an absolute surgical indication.

Two operated cases and an anatomical, clinical and therapeutic review of primary coronary artery fistula (CAF) are presented. The authors focus attention on the deleterious evolution of untreated CAF and on the higher morbidity and mortality of surgical treatment of CAF in the elderly. They recommend surgery for CAF even asymptomatic.

Adult↗
PubMedDate not supplied

Operative management of penetrating wounds of the chest. Experience with 41 patients on the island of Curaçao.

Of the 157 cases of chest injuries, 41 patients underwent thoracotomy. Thirty-three were male and 7 female with an average age of 27 years. Eighty-three percent had stabwounds and 17 percent gunshotwounds . On admission and on examination only seven thoracotomy patients were in a stable clinical condition. Hypotension and hemo- or pneumothorax were often present. Persisting hemorrhage from chest tubes drainage, cardiac tamponnade , and massive hemothorax were indications for immediate thoracotomy. Only few of the patients with an hemothorax have an hemorrhage from a major systemic vessel. Associated intraabdominal injuries were often found (17%). For exploration of the abdominal lesions a separate explorative laparotomy is indicated. The only patient who died in our series suffered from septicemia after multiple associated intra-abdominal wounds (mortality rate 2.4%). The overall complication rate was 19.7%. The average period of hospitalisation was 15.4 days.

Adult↗