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Biomedical subjects

F Laborde

Publications and source records attributed to F Laborde.

123 records · Page 7Linked to original sources
PubMed1980

[Myocardial infarction in an infant without coronary artery birth anomalies].

The anomalous origin of the left coronary artery is almost the only cause of neonatal myocardial infarction. Other rare causes have been proposed when haemodynamic studies have shown a normal coronary tree. An 18 months old child, born prematurely at the 6th month of pregnancy (in a moribund condition), presented with a postero lateral myocardial infarction and congestive cardiac failure resistant to drug therapy. Angiography showed anormal coronary tree, massive mitral incompetence and a left ventricular aneurysm. The mechanical complications of the infarct were treated surgically with a good result, 2 years postoperatively. The possible aetiologies of the infarction are discussed: embolism, thrombosis, blood disorder, infection, and cardiorespiratory failure at birth in a premature baby. This case shows that the complications of myocardial infarction in childhood may be treated surgically without coronary revascularisation when the coronary arteries are normal. The exact cause of the infarction remain uncertain.

Coronary Vessel Anomalies↗
PubMed1980

[Obstruction of the abdominal aorta and cyanotic heart disease in a 1 year old child (author's transl)].

In a 1 year old child, cyanotic congenital heart disease was complicated by a severe obstruction of the abdominal aorta between the renal arteries and the bifurcation. The surgical treatment consisted of relief of the obstruction in the aorta and a Blalock-Taussig shunt. The general progress was good but there was a ischemia of the left leg for which amputation of the forefoot was required.

Aorta, Abdominal↗
PubMed1979

[Prevention of post-operative infection in heart surgery with extracorporeal circulation (apropos of 295 cases)].

From April 1977 to November 1978, 295 patients were operated on using artificial circulation. 31 p. 100 of these developed a post-operative infectious complication, 7.3 p. 100 being of a serious nature (3.3 p. 100 suffered from mediastinitis, and 4 p. 100 from septicaemia). The organisms responsible are, in the case of the mediastinal infections the staphylococcus Citreus, and Gram negative bacilli in the case of the septicaemias. A retrospective analysis shows that there are two successive periods and that in the course of the second there is a decrease in the occurence of all of the infections and particularly in the cases of mediastinitis. This improvment would seem on superficial analysis to correspond with a change in the preventive antibiotic treatment, the cephradine--gentamicin combination having replaced penicillin G. However, the statistical study shows that other factors were altered between the two periods (type of antiseptic, duration of treatments, time of postoperative intubation) and that these equally contributed to the fall in the incidence of infection. In the light of this study, it would seem that if prophylactic antibiotic treatment essentially directed against staphylococci has a place in cardiac surgery with artificial circulation, it can only be regarded as one of several preventive factors. The statistical data gathered so far is not sufficient to prove the efficacy of this treatment.

Adolescent↗
PubMedDate not supplied

In vivo evaluation of a retrievable vena cava filter--the Dibie-Musset filter: experimental results.

PURPOSE: To evaluate, in an animal model, the efficacy and safety of a 7 Fr percutaneous vena cava filter for temporary or permanent use. METHODS: The Dibie-Musset (DM) filter is a wire preformed into a double-spiral shape with a spring effect. The experiment was performed in 15 adult sheep and consisted of the insertion of 45 filters, clot trapping tests, and filter retrieval. Follow-up in all sheep consisted of radiologic (abdominal radiograph, inferior vena cavogram, abdominal computed tomography), macroscopic, and microscopic examinations between days 8 and 386 after filter placement. RESULTS: Of the 45 filters implanted in 15 sheep, 29 were retrieved between day 0 and day 15. Filtration efficiency was 100% for clots 4 x 4 x 20 mm. No long-term (1 year) side-effects were detectable. Microscopic examination of the vein wall showed only a dense intimal fibrosis without signs of acute inflammation at 1 year. CONCLUSION: These results support the efficiency and safety of the DM filter in an animal model.

Animals↗
PubMedDate not supplied

Feasibility, safety, cost-effectiveness and 1 year follow-up of coronary stenting without predilation: a matched comparison with the standard approach.

BACKGROUND: We evaluated the feasibility, safety, procedural cost-effectiveness, radiation dose and time and 1-year target vessel revascularization rate of direct unprotected mounted stenting without previous balloon dilatation (DS) in native coronary artery lesions. METHODS: DS was attempted in 119 patients; 39 had a recent myocardial infarction, 62 had unstable angina, and 18 had stable angina. The clinical follow-up was obtained at 14+/-5 months (range 6 to 24 months). These results were compared with those for a consecutive group of 160 patients matched for type and length of lesions and who had a stent only if the post-balloon residual stenosis was >30%. RESULTS: The feasibility of DS was 112/119 (94%). The number of inflations, the length of the stent/length of the lesion ratio, the time and the dose of radiation were dramatically lower in the DS group (P<0.001). DS conferred a slight reduction in procedure-related cost [$820+/-157 for DS vs. 894+/-427 for standard dilatation (SD) per patient]. The 1-year target vessel revascularization rate was similar in both groups [nine (8%) for DS vs. 17 (11%) patients for SD, ns]. CONCLUSIONS: DS is feasible and safe in selected coronary lesions. This method provides a low rate of repeat revascularization and reduces the time and the dose of radiation compared with the standard approach.

Aged↗
PubMedDate not supplied

Successful surgical treatment of mitral valve stenosis in a dog.

OBJECTIVE: To report the successful surgical management (open mitral commissurotomy, OMC) of mitral stenosis (MS), incorporating heart-beating cardiopulmonary bypass (CPB), in a 1-year-old dog. STUDY DESIGN: Clinical case. ANIMALS: One-year-old Cairn Terrier with MS. MATERIALS AND METHODS: Diagnosis of MS was confirmed by means of 2-dimensional, continuous-wave and color-flow Doppler echocardiography. Surgery was performed through a left intercostal thoracotomy. CPB was initiated and the heart was kept beating. The fused commissures of the mitral valve were incised to free the cusps of the valve. RESULTS: Left intercostal thoracotomy allowed easy observation of the mitral orifice during heart-beating OMC. Persistent bleeding from the atriotomy site required a second surgical procedure after which the dog had an uneventful recovery. Echocardiography at 2 weeks and 1 year postoperatively indicated substantial improvement in left ventricular filling (pressure half-time=187 ms before surgery, 105 ms [2 weeks] and 110 ms [1 year] after surgery). Enlargement of the left atrium resolved; however, moderate mitral valve regurgitation was still present. CONCLUSIONS: MS can be successfully treated by OMC, facilitated by use of CPB. Substantial improvement in cardiac function was evident by ultrasound and Doppler examination postoperatively. CLINICAL RELEVANCE: OMC under heart-beating CPB should be considered for the treatment of MS in the dog.

Animals↗
PubMedDate not supplied

[Total abnormal pulmonary venous return. Preoperative stabilization by extracorporeal veno-venous circulation].

BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is a rare congenital cardiac disease. When this includes pulmonary artery hypertension, the infant is severely ill. Survival beyond infancy is rare without surgical correction. CASE REPORT: A girl in whom hydramnios and a short femur were discovered by ultrasonography at the 25th week of gestation was admitted to the intensive care unit a few hours after birth because of respiratory distress. Blood PaO2 was 37 mmHg, PaCO2, 36 mmHg, and pH 7.25. She had tachycardia (190/min) and circulatory insufficiency. Echocardiography showed right ventricular overload, a right-to-left shunt through a patent ductus arteriosus and foramen ovale and tricuspid insufficiency. This refractory hypoxemia was not corrected by conventional respiratory support, high-frequency oscillation plus dobutamine and dopamine followed by noradrenaline infusion. Because of further deterioration, the baby was given extracorporeal lung support; this rapidly improved the respiratory and hemodynamic conditions. Persistent pulmonary artery hypertension led to a second investigation that showed TAPVR She underwent emergency surgery. CONCLUSION: Extracorporeal lung support can stabilize a precarious state in a case of severe congenital cardiac disease, so allowing surgical treatment under satisfactory conditions.

Emergencies↗