Biomedical subjects

G Jarolin

Publications and source records attributed to G Jarolin.

3 recordsLinked to original sources

PubMed1994

[Post-infarction rupture of the heart into the pericardium. Surgical treatment combining synthetic patch and biological fibrin glue].

A 66-year old man was hospitalized with chest pain and acute ischaemia of the lower limbs highly suggestive of dissection of the aorta. Computed tomography and aortography however showed pericardic effusion and thrombosis situated in the iliac bifurcation of the aorta. During the emergency operation, acute tamponade required sub-xyphoid drainage. The haemodynamic situation was reestablished and the operation continued but within minutes a cataclysmal haemorrhage occurred through the drainage tube due to ischaemic rupture of the lateral wall of the heart into the pericardium. Extra-corporal circulation was installed immediately and a large polytetrafluoroethylene patch was sutured to the epicardium, distally from the necrosed area, in healthy tissue. A biological fibrin glue was injected under the patch. The operation was terminated with an axillo-bifemoral bypass. The postoperative period was satisfactory and the patient was discharged. At the six months examination, the patient was in NYHA class II and the echography showed moderate left ventricular dysfunction with grade II mitral regurgitation and a false aneurysm facing the area of necrosis. This technique allowed us to patch the rupture without excessive tension on the sutures in the fragile tissue which would have increased the risk of secondary rupture. In addition, the large patch avoided excessive reduction in volume of the left ventricular cavity and saved the mitral chordae which would have been destroyed by direct suture. This method can be an effective salvage technique for heart rupture during the acute phase of myocardial infarction and offers the possibility of a second look in case of a secondary false aneurysm.

Aged↗

PubMed1992

[Surgical lung biopsy].

Open lung biopsy enables a diagnosis to be made in cases of diffuse infiltrative pulmonary disease. It was developed to aid the diagnosis of opportunistic infectious disease observed in virus infections in immune deficiency states and during transplants. Open lung biopsy involves the partial resection of the lung parenchyma. The availability of the mechanical stapler has resolved the problem of parenchymal air leaks when suturing lung tissue. Open lung biopsy should be carried out when endoscopic techniques have failed to achieve a diagnosis, including bronchoalveolar lavage and transbronchial biopsy. The place of open biopsy continues to develop. It is becoming less important when other techniques have become available for certain diagnoses such as Pneumocystis carinii, histiocytosis X, alveolar proteinosis and the rejection of lung transplants.... It should be carried out early when a particular diagnosis might change the management of a patient.

Biopsy↗

PubMed1989

[Technic for implanting biventricular external assistance devices. Pending cardiac transplantation].

The extensive development of orthotopic heart transplantation results in a relative shortage of grafts. When cardiac grafts are unavailable, some patients at the end-stage of decompensated heart failure may benefit from a biventricular external circulatory assistance device as a "bridge" to transplantation. We describe a reproducible technique for the implantation of such external devices, based on the systematic use of extracorporeal circulation. This technique was tested in 8 patients. Its main advantage is that it prevents thromboembolic complications which are a constant threat when the devices are used for a prolonged period.

Adult↗