PubMed Health⌕ Search

Biomedical subjects

G Dussaillant

Publications and source records attributed to G Dussaillant.

13 recordsLinked to original sources
PubMed2001

[Acute myocardial infarction caused by total occlusion of the left main coronary artery treated with percutaneous endoluminal revascularization. Clinical case].

We report a 43 years old female who developed an intense precordial pain and arterial hypotension. The patient was admitted to the emergency room in cardiogenic shock. An emergency angiography revealed a total occlusion of the left main coronary artery. An endoluminal coronary angioplasty with the placement of two stents was performed and coronary reperfusion TIMI III was achieved. The patient had a good evolution and one month later, a surgical revascularization was done, to avoid new occlusions. She was discharged in good conditions and in functional capacity I.

Adult↗
PubMed2001

[Comparative study of coronary angioplasty in diabetic patients. Immediate clinical and angiographic results and clinical evolution in the first year of follow up].

BACKGROUND: The success of revascularization procedures for coronary artery disease could be lower in diabetic patients. AIM: To report the results of coronary angioplasty in diabetic and non diabetic patients. PATIENTS AND METHODS: All angioplasty procedures performed between 1996 and 1999 were recorded. Demographic data, procedure details, hospital outcome and evolution at one year of follow up were analyzed. RESULTS: During the study period, 358 patients were treated; of these, 79 were diabetics. Despite the greater severity of coronary lesions among diabetic patients the clinical success of the procedure was 92.4% in diabetics and 91.8% in non diabetics. Hospital mortality was 1.3% in diabetics and 0.7% in non diabetics. Major complications occurred in 3.8% of diabetics and 3.2% in non diabetics. One year survival was 95.9% for diabetics and 98% in non diabetics. There were five late cardiac deaths among non diabetics and 3 among diabetics during the year of follow up. The frequency of new revascularization procedures was 4.3% in diabetics and 8.3% in non diabetics. Event-free survival was 95.6% in diabetics and 89.2% in non diabetics. CONCLUSIONS: Results of angioplasty were similar in diabetic and non diabetic patients in terms of hospital outcome and late follow-up.

Adult↗
PubMed2000

[Secondary ionizing radiation generated by digital and analog coronary cineangiographic equipment: influence of external systems of radiologic protection].

BACKGROUND: Exposure to ionizing radiation is a known hazard of radiological procedures. AIM: To compare the emission of secondary ionizing radiation from two coronary angiographic equipment, one with digital and the other with analog image generation. To evaluate the effectiveness of external radiological protection devices. MATERIAL AND METHODS: Environmental and fluoroscopy generated radiation in the cephalic region of the patient was measured during diagnostic coronary angiographies. Ionizing radiation generated in anterior left oblique projection (ALO) and in anterior right oblique projection (ARO) were measured with and without leaded protections. In 19 patients (group 1), a digital equipment was used and in 21 (group 2), an analog equipment. RESULTS: Header radiation for groups 1 and 2 was 1194 +/- 337 and 364 +/- 222 microGray/h respectively (p < 0.001). During fluoroscopy and with leaded protection generated radiation for groups 1 and 2 was 612 +/- 947 and 70 +/- 61 microGray/h respectively (p < 0.001). For ALO projection, generated radiation for groups 1 and 2 was 105 +/- 47 and 71 +/- 192 microGray/h respectively (p < 0.001). During filming the radiation for ALO projection for groups 1 and 2 was 7252 +/- 9569 and 1671 +/- 2038 microGray/h respectively (p = 0.03). Out of the protection zone, registered radiation during fluoroscopy for groups 1 and 2 was 2800 +/- 1741 and 1318 +/- 954 microGray/h respectively (p < 0.001); during filming, the figures were 15,500 +/- 5840 and 18,961 +/- 10,599 microGray/h respectively (NS). CONCLUSIONS: Digital radiological equipment has a lower level of ionizing radiation emission than the analog equipment.

Adult↗
PubMed1999

[Angioplasty in acute myocardial infarction. Early and late results].

BACKGROUND: The usefulness of angioplasty in the first hours of an acute myocardial infarction is widely demonstrated. However, its long term effects are less well known. AIM: To report the effects of coronary angioplasty on early and late outcome of patients with acute myocardial infarction. PATIENTS AND METHODS: A non-randomized, consecutive and retrospective analysis of the hospital and late outcome of 70 patients, aged 35 to 85 years, subjected to coronary angioplasty during an acute myocardial infarction. Patients were followed during 12 to 60 months. RESULTS: Angioplasty was performed 5.3 +/- 5 hours after the initial symptoms. Anterior descendent artery was occluded in 63% of patients with a 99.5% luminal occlusion and TIMI 0-1 anterograde flow. An angiographic success was achieved in 83% of procedures with a residual stenosis of 32.3%. Recurrent ischemia was observed in 6% of patients, that were treated with a new revascularization procedure. Thirteen percent of patients died, all due to cardiogenic shock. Severe ventricular failure and failure of revascularization influenced mortality. During the first year of follow up there was a 3.3% mortality and 3.3% of patients required a new revascularization procedure. Eighty percent of patients were asymptomatic and event-free. CONCLUSION: Angioplasty was a useful therapeutic procedure in this group of patients.

Adult↗
PubMed1998

[Endovascular stent implantation in the treatment of coronary artery disease: angiographic, and immediate and late clinical results].

BACKGROUND: Coronary revascularization allows a better survival and quality of life in high risk patients with coronary artery disease. AIM: To report the experience in stent placement as treatment for obstructive atherosclerotic coronary artery disease. PATIENTS AND METHODS: A prospective analysis of 105 stent placements. A morphological and quantitative analysis of coronary angiograms, using an electronic caliper, was performed. Patients were followed during their hospital stay and after discharge. RESULTS: In four of 112 coronary lesions, it was not possible to liberate the stent and in 108, it was successfully placed (48 in anterior descending, 19 in circumflex, 36 in right coronary arteries and 5 in saphenous aortocoronary by-pass. Lesions with stent implantation were type A in 11%, B1 in 30%, B2 in 44% and C in 15%. Reference diameter was 3.13 +/- 0.58 mm. After placement, luminal diameter increased from 0.95 +/- 0.43 to 2.99 +/- 0.46 mm, with a final stenosis of 7.2 +/- 10.1%. Angiographic success was obtained in 99% and procedure success in 98%. Hospital mortality was 0.98%. After a mean of eight months follow up, 91% of patients is free of major cardiac events. In 17% angina recurred and 5% required a new revascularization. There were no late cardiac deaths, acute stent thrombosis or infarction in relation to the treated lesion. CONCLUSIONS: In these patients, stent placement has had excellent immediate and late results.

Adult↗
PubMed1995

[Vital prognosis in severe acute hepatic failure. Value of the quantitative indexes of evaluation].

The aim of this study was to assess the predictive value for mortality of admission and daily APACHE II score, mortality due to multiple organ failure and the Organ Failure Score in patients with acute hepatic failure. We retrospectively studied 15 such patients admitted to an intensive care unit. Thirteen patients died (87%) and their admission APACHE II score was 22 +/- 7.5 compared to 21 +/- 8.5 in survivors. Daily APACHE II score, mortality due to multiple organ failure and multiple organ failure score had a 100% sensitivity to predict mortality and a 69.2, 76.9 and 76.9% specificity respectively. The predictive accuracies of multiple organ failure and multiple organ failure score were 80% and significantly better than the accuracy of admission APACHE II score (53%). We conclude that these prognostic scores can be useful in the assessment of patients with acute hepatic failure.

APACHE↗
PubMed1994

Amiodarone protection against myocardial injury and fibrosis induced by isoprenaline is abolished by thyroid hormone.

OBJECTIVE: Catecholamines induce myocyte necrosis and myocardial fibrosis. These effects are probably related to beta adrenergic receptor stimulation and to thyroid hormonal status. The aim of the study was to test the hypothesis that amiodarone prevents myocardial damage induced by isoprenaline and that these effects are not observed when thyroid hormone is administered. METHODS: Myocardial injury was assessed in the first experiment. Isoprenaline (1 mg.kg-1 subcutaneously once) was given to two groups of rats which received monoclonal antimyosin. Group 1 (n = 5) was pretreated with amiodarone and group 2 (n = 6) received only isoprenaline. In the second experiment, the effects of amiodarone on isoprenaline induced myocardial fibrosis and of supplementary triiodothyronine (T3) were examined. Group 3 (n = 10) received only isoprenaline for 4 d. Group 4 (n = 10) received amiodarone for 14 d and isoprenaline during 4 d. Group 5 (n = 8) received amiodarone and isoprenaline like group 4, plus T3. Untreated rats served as controls (group 6; n = 10). Collagen volume fraction (CVF) was measured in each heart. RESULTS: No rats pretreated with amiodarone showed antimyosin labelling, while the mean score of rats receiving only isoprenaline was 2.8 (p < 0.05), indicating the presence of significant myocyte injury. In group 3, CVF was significantly higher than in controls, at 7.63(SEM 0.89)% v 1.74(0.07)%, p < 0.001, whereas rats pretreated with amiodarone (group 4) showed significantly less fibrosis [CVF 2.96(0.19)%]. This protective effect was lost when amiodarone and T3 were given together [CVF 7.92(1.8)%, p < 0.005 between groups 4 and 6]. CONCLUSIONS: By preventing isoprenaline induced myocardial injury and fibrosis, amiodarone may have a cardioprotective role. This effect is completely abolished by thyroid hormone.

Amiodarone↗
PubMed1994

[Multiple organ failure syndrome in fulminant hepatic failure].

BACKGROUND: in fulminant hepatic failure, different organs systems become involved and a multiple systems organic failure may ensure. AIM: to perform a retrospective analysis of patients with fulminant hepatic failure admitted to UC Hospital Intensive Care Unit. PATIENTS AND METHODS: the charts of fourteen patients (8 male) were analyzed. Multiple systems organic failure was defined as the presence of 2 or more organic dysfunctions. The evolution and mortality of these patients was analyzed. RESULTS: patient's ages ranged from 30 to 74 years. The etiology of hepatic failure was B hepatitis in 4, non A non B hepatitis in 5, acute fatty liver of pregnancy in 3 and use of halothane and HIN in 2. ICU stay ranged from 1 to 44 days and 2 patients survived (one with drug induced liver failure and one with acute fatty live of pregnancy). Mean prothrombin time was 19 +/- 9.5%, total bilirrubin was 24 +/- 8.9 mg/dl and 12 patients reached grade IV encephalopathy. Mean admission APACHE II score was 21.5 +/- 6. Twelve patients developed multiple systems organic failure, that appeared 1.5 days after or was already present at ICU admission; it lasted a mean of 2.5 days and all these 12 patients died. Neurologic involvement occurred in 13 patients, renal in 10, cardiovascular in 9, respiratory in 5 and hematological involvement in 1. CONCLUSIONS: multiple systems organic failure is frequent in fulminant hepatic failure and is associated with a high mortality.

Adult↗
PubMed1994

[Primary coronary angioplasty as early reperfusion treatment of acute myocardial infarction].

Between March 1990 and July 1993, 21 patients with an evolving acute myocardial infarction were treated with coronary angioplasty after 2-9 hours of chest pain (mean 3.9). Thirteen had a clinically and electrocardiographically large infarction, including 3 in cardiogenic shock. The dilated arteries were the left anterior descending in 14, the left circumflex in 4 and right coronary artery in 3 patients. With angioplasty successful reperfusion of the infarct area was obtained in 18 patients (86%). The procedure was well tolerated by most patients and the in-hospital mortality rate was 5%.

Aged↗
PubMed1993

[Hemodynamic effects of dobutamine in critical patients: discrepancies between parameters of tissue oxygenation and lactic acid].

A retrospective study on the effects of dobutamine on hemodynamic parameters of tissue oxygenation and lactic acid levels was performed in 35 patients. The use of the drug in a mean dose of 5.0 +/- 2.1 ug/kg/min was associated with a significant increase in cardiac index, oxygen transport and consumption and decrease in arterial lactic acid levels. A separate analysis of patients with or without basal hyperlactacidemia and those with favorable (decrease) or unfavorable (no change or increase) lactic acid response to the drug, was performed. This analysis disclosed important disagreements between changes in hemodynamic parameters of oxygen consumption and transport and arterial lactic acid levels, as indexes of tissue perfusion. It is concluded that is advisable to monitor together hemodynamics, oxygen transport and consumption and arterial lactic acid in patients with severe cardiorespiratory disturbances or shock.

Adult↗
PubMed1989

[Blood cell count in a reference chilean population].

Since the 1930's peripheral blood cell counts are among the most common clinical tests contributing to diagnosis of a wide variety of diseases. The original Schilling formula, based on findings in a European population at the beginning of this century are still used as reference in our country. We therefore report the values found in a population of both sexes without manifest disease and qualifying to be blood donors. Means, 5 and 95 percentiles for 212 males and 43 females obtained with the use of a Technicon H6000 are reported.

Adult↗