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Biomedical subjects

F Herreman

Publications and source records attributed to F Herreman.

At least 19 recordsLinked to original sources
PubMed1986

[Valvular cardiopathies due to nonpenetrating injury. Apropos of a surgical case of aortic insufficiency].

One case of traumatic aortic valve regurgitation operated upon is reported, and published cases of cardiac valve regurgitation caused by non-penetrating traumas are reviewed. This study demonstrates the relatively high frequency of traumatic heart diseases and among these, valve lesions. The dynamic disturbance occurs suddenly in a heart that is usually healthy and therefore without adaptation mechanism. This explains why such lesions are poorly tolerated and accounts for some peculiarities of semiology and haemodynamics. Plastic surgery seems to be successful in mitral valve lesions, whereas lesions of the aortic valve are such that valve replacement is required. The same applies to the tricuspid valve. The medico-legal aspects of the subject are mentioned.

Accidents, Traffic↗
PubMed1984

[Aortic valve replacement by bioprosthesis with enlargement of the aortic ring].

Small diameter aortic valve bioprostheses are associated with resting ventriculo-aortic pressure gradients of 10 to 35 mmHg. In order to avoid this factor favouring degradation of left ventricular function and early deterioration of the bioprosthesis, we enlarged the aortic ring when the diameter was less than 23 mm in patients considered unsuitable for long-term anticoagulation. The surgical technique involved incising the annulus from the postero-lateral commissure to the anterior mitral leaflet and implanting a Dacron patch lined with pericardium. Nine patients aged from 10 to 70 years (average 22 years) underwent aortic valve replacement with a Carpentier-Edwards bioprosthesis associated with enlargement of the aortic ring, between June 1979 and December 1981. The mean follow-up period is now 18 months (range 9 to 39 months). One patient has been lost to follow-up. Before surgery, 6 patients were in Stage III and 3 patients in Stage IV of the NYHA classification. There were 4 patients with pure aortic regurgitation with valve prolapse, 1 patient with aortic regurgitation due to endocarditis, and 4 patients with mixed aortic valve disease. The underlying disease was rheumatic in 6 cases, congenital in 2 cases and infective endocarditis in 1 case. The mean diameter of the aortic ring before enlargement was 19 mm. After the procedure, it increased to 23,8 mm, so enabling the implantation of no 23 and no 25 bioprostheses. Three patients had associated mitral regurgitation, 3 patients had mixed mitral valve disease, 1 patient had a membranous VSD with infundibular stenosis, and 1 patient had subvalvular aortic stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

[Aneurysms in Takayasu disease].

Takayashu's inflammatory panarteritis essentially results in stenotic lesions of the supra aortic axes and the collateral vessels of the abdominal aorta. Fusiform, segmental post-stenotic dilatation is commonly observed. Three particular types of aneurysms are described, each illustrated by a case report: --aneurysm of the ascending aorta causing severe aortic regurgitation by dilatation of the aortic ring: the diagnosis of Takayashu's disease was made in a young West Indian female on the evidence of associated aortic lesions and calcification of the descending thoracic aorta. The patient underwent replacement of the ascending aorta and aortic valve replacement. This form is very rare, although mild aortic regurgitation in Takayashu's disease has been reported in about ten cases by different workers; --large saccular aortic aneurysm. This lesion of the descending thoracic aorta with parietal calcification and without intrasaccular thrombosis was associated with a long, irregular stenosis of the paroxismal segment of the aorta, giving rise to signs of coarctation, and with multiple stenoses of the supra-aortic axes in a 31 year old Algerian. Surgical cure was realised by occluding the orifice in order to avoid replacing the aorta at the origin of the main medullary arteries. An ascending aorta-abdominal aorta bypass was performed at the same time, together with correction of the stenoses of the supra-aortic vessels. A few similar cases of large succular aneurysms of the thoracic or abdominal aorta or of the large collateral vessels have previously been described; --pseudo-aneurysm due to arterial rupture and formation of a large hematoma. A 20 year old Algerian presented with a polylobulated saccular aneurysm of the superficial femoral artery in the femoral triangle. Several stenotic lesions typical of Takayashu's disease (including a particularly rare stenosis of the contra lateral superficial femoral artery) were associated. At surgery, the lesion was found to be a pseudo-aneurysm with no true arterial wall on histological examination. The role of an infective endarteritis is discussed and excluded. This type of lesion does not appear to have been previously reported. These three varieties of aneurysm were the presenting signs of Takayashu's disease in the cases reported.

Adult↗
PubMed1979

[Value and limitations of sequential technetium 99m angiocardiography in the detection, localization and quantification of left-right intracardiac shunts apropos of 110 cases].

A comparative study of the diagnosis of intracardiac left-to-right shunts by isotope radiography on the one hand and oxymetry, abnormal catheter trajectory and angiocardiography on the other, was performed on a series of 110 patients, comprising 12 normals, 46 valvulopathies or cardiomyopathies without shunts, 23 ASDs, 22 VSDs, and 7 other shunts. Intravenous injection of Technetium 99 m with scintigraphic imagery and interpretation of time-activity curves detected even small left-to-right shunts and appeared to be more sensitive than oxumetry. The estimation of the size of the shunt correlated well with oxymetry for VSDs but not for ASDs. The localisation of the shunt was more difficult. The atrial level of the defect was detected in some but not the majority of cases. The isotopic technique appeared unreliable in the presence of severe haemodynamic disturbances. The isotopic method is a quick means of detecting left-to-right shunts without measurable risk, particularly useful in the investigation of children and young adults thought to have left-to-right shunts.

Adolescent↗
PubMed1978

[Severe tricuspid insufficiency and primary carcinoid tumor of the ovary. Long term success after valve replacement. Apropos of a case].

The case is reported of carcinoid heart disease in a lady of 70 with intractable congestive cardiac failure 5 years after the removal of a primary carcinoid tumour of the ovary. The special features of primary carcinoid tumours of the ovary are recalled, with emphasis on their rarity and of the absence of liver metastases. The various features of carcinoid syndrome are recalled in the light of current knowledge of the pathogenesis. A review of the literature on cardiac involvement in primary carcinoid tumours of the ovary, amounting to 10 cases, is included. The possibility of surgical cure of the heart lesions in carcinoid tumour by a prosthetic tricuspid valve are discussed, in the light of the 6 reported cases and the present one. Our report is the first one of replacement of the valve after removal of a primary ovarien carcinoid tumour, and the excellent result has been maintained after three years.

Aged↗
PubMed1977

[Interventricular communication, aneurysm of the membranous septum and acquired atrioventricular block].

Over a ten year period of a man 40 had a progressively increasing atrioventricular conduction defect, resulting from a ventricular septal defect with eventual cardlac failure due to persistant bradycardia. Intracavitary recordings showed the block to be situated distally, below the bundle of His. Cineaarteriography, and subsequent operation, showed an aneurysm of the membranous septum lying above a fibrous-edged ventricular septal defect. The aetiology of the block is discussed in the light of these defects; Haemodynamic trauma to the conduction pathways exposed in the inferior edge of the septal defect seems to be the most likely cause.

Adult↗
PubMed1977

[Hypoplasia of the right ventricle with inter-atrial communication and without any other abnormality. Apropos of a case treated surgically by closure of the inter-atrial communication].

A case is reported of hypoplasie of the right ventricle with a wide atrial septal defect in a child of 10. The presence of cyanosis with right atrial and left ventricular preponderance led us to suspect tricuspid atresia, but this was excluded by catheterisation and angiocardiography. There was definitely and atrial septal defect with a two-directional shunt, but the tricuspid valve could be negotiated, and the right-sided opacity provided the essential diagnostic criterion, namely hypoplasia of the sinus portion of the right ventricle with a normal infundibulum. 17 other published cases of hypoplasia of the right ventricle with atrial septal defect are reviewed. The current indications for surgery are discussed in the light of the nature of the disordered physiology. Simple closure of the atrial septal defect, which was carried out successfully in 3 cases, appears to be of great value in the larger child, when there is a wide defect.

Angiocardiography↗
PubMed1976

[Changes in the morphology of the normal left ventricle during the phases of isovolumic contraction and relaxation. Consequences on the calculation of the volume and cardiac output by cineangiocardiographic methods].

It is well known that the left ventricular volume, as measured by the cineangiographic method, decreases during the phase of isometric contraction. What is more, the cardiac index and the ejection fraction measured by this method are definitely larger than those derived from dilution methods. These discrepancies can be explained by movements of the mitral valve during the phases of isometric contraction and relaxation. The systolic ejection volume (SEV) was measured by three different methods: 1. End-diastolic volume (EDV) -end-systolic volume (ESV) ; 2. EDV - pre-filling volume (PFV) ; 3. Pre-ejection volume (PEV) - ESV. It has emerged that the results given by the methods (2) and (3) correspond closely, and differ significantly from those given by method (1); they are also close to those obtained by the dilution method. This difference seems to arise from the fact that the movements of the mitral valve during the phase of isometric relaxation are diametrically opposite to those which occur during isometric contraction; thus, when the values EDV-ESV are used in the calculation of SEV, an overestimate is made because the mitral valve is not to be found in the same position within the ventricular cavity for both values.

Adolescent↗
PubMed1976

[Results of a hemodynamic study of valve diseases surgically treated with prosthesis].

The haemodynamic status after valve replacement surgery and the preoperative haemodynamic parameters have been studied for their predictive value in a series of 217 patients who have had aortic, mitral or mitro-aortic valve replacements; all cases had a preoperative catheterisation, and 132 had a postoperative catheterisation at an average of 15 months postoperative. The following conclusions have been drawn from the study: 1. The operation (which consisted of replacement with a Starr valve with Silastein ball-valve in 8 cases out of 10) resulted in a substantial, and statistically significant, improvement in the minor circulation pressures and in the cardiac index. The ejection fraction also increases in most cases. 2. The increase in the cardiac index is significantly greater in aortic stenosis than in aortic incompetence, and in the aortic group than in the mitral group. 3. Improvement is early, and occurs within the first few weeks, in the aortic group; it occurs more gradually in the mitral group, in whom serial catheterisations show a gradual decrease in the pulmonary arterial and capillary pressure and an increase in the cardiac index which may be progressive until the second postoperative year. 4. Analysis of the mean values of the various parameters as a function of the clinical findings, and of the incidence of failures and early or late deaths from haemodynamic changes, has failed to show that the preoperative haemodynamic picture has a statistically significant predictive value.

Adolescent↗
PubMed1976

[Cineangiocardiographic evaluation of mitral valve lesions. Validity of the method according to 100 angio-surgical correlations].

In order to assess their validity, the findings on left bidirectional cineventriculography have been compared with the operative findings in 100 patients with mitral valve disease. This method of investigation has been shown to be a reliable one for the precise and complete evaluation of mitral valve lesions. The information which it provides about the morphology and kinetics of the valve, the site of any calcification, the state of the suspensory apparatus, and the degree and cause of any mitral incompetence often has a decisive influence on the indications for surgery and the choice of operation.

Adolescent↗
PubMed1976

[Cineangiography in adult mitral valve disease. 41 cases of comparison of anatomical with radiological findings (author's transl)].

During the course of their preoperative assessment, 41 patients with severe mitral valve disease underwent left ventricular cineangiography, AP and lateral at rapid speed (100 images per second). This gave a particularly precise anatomical and physiopathological inventory of the lesions, as was confirmed by preoperative findings. The presence of mitral stenosis was confirmed in all cases and an indication of its degree in the majority.

Adult↗