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Biomedical subjects

F Laborde

Publications and source records attributed to F Laborde.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Aortic valve replacement in infectious destruction of the aortic annulus. A new technic].

The results of aortic valve replacement in the acute phase of valvular endocarditis are dependent upon the degree of destruction by sepsis of the left ventricle-aorta junction. The stability of the prosthesis installed is conditioned by the extent of the lesion. Numerous techniques have been described to maintain the prosthesis firmly in place. In the technique reported here, the prosthesis is implanted in the usual position, but the sutures are tied outside the heart. Depending on the site of the lesion, this is done by opening the left atrium or the infundibulum of the right ventricle, and by passing the stitches through the aortic wall. This quick and simple technique ensures good stability of the prosthesis.

Aortic Valve↗
PubMed1985

[Antenatal cardiac surgery. Creation of an experimental model of pulmonary stenosis in the fetus and repair in utero].

An experimental model of pulmonary stenosis was created in ewes, fetus and repaired before birth by making use of the materno-foetal circulation. Eighteen ewes fetus underwent pulmonary artery banding at an average of 87 +/- 8 days' gestation (normal 135-145 days). All were reoperated before term at 132 +/- 6 days' gestation. They were divided into two groups : group I (7 fetus) was used to evaluate the experimental model of pulmonary stenosis by measuring right ventricular pressures (80 +/- 16 mmHg compared to 58 +/- 10 mmHg in control models), and the increase in right ventricular mass (2.8 +/- 0.5 X 10(-3) g vs 1.9 +/- 0.2 X 10(-3) g), left ventricular mass (2.2 +/- 0.3 X 10(-3) g vs 1.8 +/- 0.4 X 10(-3) g) and septal mass (1.8 +/- 0.3 X 10(-3) g vs 1.3 +/- 0.2 X 10(-3) g). In group II (11 fetus) the pulmonary stenosis was repaired by total clamping and patch repair. After repair and during the days just before birth, the ventricular masses decreased (RV = 2 +/- 0.3 X 10(-3) g; LV = 1.8 +/- 0.4 X 10(-3) g; septum = 1.8 +/- 0.3 X 10(-3) g) approaching values of normal control fetus. This experimental model shows that it is possible to correct cardiac lesions in utero by making use of the materno-fetal circulation and that antenatal repair of an arterial obstruction can rapidly reverse the reactional ventricular hypertrophy.

Animals↗
PubMed1985

[Interruption of the aortic arch and malformative cardiac lesions requiring repair under extracorporeal circulation. Apropos of 3 cases].

Interruption of the aortic arch is practically always associated with intracardiac malformations of variable complexity, at the least, a ventricular septal defect. Surgery is usually performed in two stages: aortic repair and pulmonary artery banding after intravenous prostaglandin administration. The second stage comprises debanding and repair of the intracardiac lesions under cardiopulmonary bypass. However, in some cases, interruption of the aortic arch is associated with intracardiac lesions which necessitate correction under cardiopulmonary bypass from the onset, this was the situation in two of the three cases described by the authors: aorto-pulmonary window, a lesion which can only be corrected under circulatory arrest and deep hypothermia. One of these two children, operated in the neonatal period, did not survive: the other, operated at 6 weeks, had an excellent result. In the third case, the association of tricuspid atresia and a restrictive ventricular septal defect necessitated enlargement of the septal defect and therefore, open heart surgery under circulatory arrest; the results were favourable.

Aorta, Thoracic↗
PubMed1985

[The laser and rhythm disorders].

Of the different types of laser, Nd-YAG radiation (neodymium-yttrium-aluminium-Garnett) is the most suitable for the treatment of arrhythmias. Research in animals has, in fact, made it possible to demonstrate that its properties (high power, creation of a coagulation necrosis without a sectioning effect) may thus be used for the surgical treatment of supra-ventricular tachycardias (Wolff-Parkinson-White syndrome, common flutter, auricular ectopic rhythm) or ventricular tachycardias, the origin of which may or may not be ischemic. Since 1984, it has been possible to treat 25 patients in this way, with good result. In 15 cases, it was a question of curative treatment for a refractory arrhythmia (common flutter: = 1 case, ischemic VT = 12 cases, VT with congenital aneurysm = 1 case). In the other 10 patients the laser was used to prevent an arrhythmia in the course of a CSD (prevention of flutter = 4 cases) or of an aneurysmectomy (6 cases). The excellent results in the short term (the earliest dating back 17 months) lead us to hope that there will be considerable development of the use of the laser in rhythmological surgery.

Adult↗
PubMed1983

[Tetralogy of Fallot with congenital absence of a pulmonary artery. Apropos of 4 cases].

Four patients aged between 3 1/2 and 16 years were treated surgically for tetralogy of Fallot associated with congenital absence of the left pulmonary artery. This absence, suspected from the chest X-ray, was confirmed preoperatively by angiography of the right and left cavities, aortography, left pulmonary wedged venography and radionuclide scan and substantiated by intraoperative exploration. Congenital absence differs physiopathologically from acquired destruction of a pulmonary branch. In all four patients, repair was performed exclusively on the right branch, without any attempt to introduce a valve in the pulmonary outflow tract and without regard for normal recommendations concerning acquired branch lesions. The only patient to retain a high right ventricular pressure was the one whose pulmonary ring looked sufficiently large to warrant preservation. In all four cases, the postoperative course was uneventful, and the clinical condition is very satisfactory with a follow up of two to twenty-four months. The conclusion would seem to be that the association of tetralogy of Fallot with congenital absence of the left pulmonary artery ascertained with certainty preoperatively, in no way modifies therapy.

Abnormalities, Multiple↗
PubMed1983

[Rupture of a dissecting aneurysm of the ascending aorta 10 years after therapy of coarctation. Apropos of a case of a 10-year-old girl].

This is a rare but life-threatening association. After surgical repair of a coarctation, delayed aneurysm of the ascending aorta may occur, with dissection in some instances. The case we report exemplifies this possibility. Surgical repair is difficult. Data from the medical literature is consistent with the speculation that the aneurysm is not an acquired lesion above the coarctation but a distinct disease of the aortic wall which runs an independent course but which may be promoted by the arterial hypertension. The course and prognosis are so serious that, in spite of its low prevalence, patients should be screened at regular intervals for this condition by ultrasonography of the ascending aorta.

Aortic Dissection↗
PubMed1983

[Tricuspid surgery and tetralogy of Fallot. Observations apropos of 14 case reports].

14 patients underwent tricuspid surgery after radical surgery of tetralogy of Fallot using cardiopulmonary bypass. This series represents 11.5% of all patients with tetralogy of Fallot who were operated on during the same period (1970-1982). Two different pictures were seen: tricuspid pathology may be coincident with tetralogy of Fallot, with surgical repair being done during the same procedure; it may be discovered later on, resulting from trauma of the tricuspid valves, an overlooked valvular malformation, or a residual or recurrent ventricular septal defect. As tolerance is poor because of postoperative right ventricular insufficiency, tricuspid insufficiency must be promptly diagnosed and cured, either during radical surgery of the tetralogy of Fallot or as soon as it becomes clinically patent in the postoperative course.

Adolescent↗
PubMed1983

[Direct pulmonary embolectomy without extracorporeal circulation. 5 cases].

Five patients underwent pulmonary embolectomy without cardiopulmonary bypass. All had recent embolism completely obstructing the right branch of the artery but usually leaving the left branch open or almost totally free. In all patients fibrinolytic drugs were formally contra-indicated. Thoracotomy was performed through the right lateral approach. The embolus was completely removed; there were no post-operative complications and the results on follow-up are excellent.

Adult↗
PubMed1983

[Pulmonary valvulotomy or valvulectomy with simple clamping of the vena cava in infants and young children].

In infants and young children pulmonary valvulotomy or valvulectomy under simple clamping of the vena cava is the treatment of choice for pulmonary valve stenosis with normal interventricular septum. The technique, performed without cardiopulmonary bypass, is described. In 40 patients operated upon, the peri-operative mortality was 10% and short-term clinical results were satisfactory.

Constriction↗
PubMed1983

[Complete atrioventricular canal associated with a tetralogy of Fallot. Results of surgical treatment. Apropos of 4 cases].

Complete atrioventricular canal with tetralogy of Fallot is a rare occurrence (8%). Diagnosis rests on the association with Down syndrome and on data from EKG, ultrasonography and angiography. The high operative risk explains why radical surgery is done at an older age (9 years) than in the usual form of complete atrioventricular canal without associated anomalies (33 months) and why antecedent surgical palliation with anastomotic procedures is so frequent (68% of the cases reported in the medical literature). The same surgical procedure was done in all patients: closure of the defects with two separate patches lined with pericardium, suture of the mitral cleft and relief of the infundibular and pulmonary obstruction without valvulation.

Abnormalities, Multiple↗