Biomedical subjects

J B Subayi

Publications and source records attributed to J B Subayi.

21 records · Page 2Linked to original sources

PubMed1988

[Surgical treatment of infectious endocarditis on a native valve. Apropos of 71 cases].

The results of surgery in a series of 71 patients operated upon for infective endocarditis on a native valve are presented. The patients' mean age was 35 years; the initial focus of infection was usually located in the mouth and the most frequent pathogens were staphylococci and streptococci. The aortic valve was most frequently involved. Only 26 patients underwent surgery after 40 days of antibiotic therapy; 34 were operated upon in a semi-emergency and 11 in an acute emergency. Pre-operative systemic embolism was common (20 cases), notably in the brain (17 cases), and 11 patients remained with sequelae. There was good correlation between the anatomical lesions found at surgery and the data obtained from pre-operative echocardiography. The operation was performed on one valve in 40 cases, on two valves in 20 cases and on three valves in 11 cases. Bioprostheses were used more often than mechanical prostheses. Hospital mortality was nil in patient who underwent elective surgery; it was 14.7 p. 100 in those operated upon in a semi-emergency and 27.3 p. 100 in those operated upon in an acute emergency. Nine patients developed late complications, mostly within 6 months of the operation; in particular, prosthesis disinsertion occurred in 4 cases, and progression of a pre-existing left cardiac failure was observed in 2 cases. In their conclusions the authors emphasize the reliability of echocardiography and the need for an early operation in cases with haemodynamic disorders in order to avoid severe myocardial failure and, if possible, systemic embolism and its fearsome sequelae.

Adolescent↗

PubMed1987

[The autologous pericardial tube-flap. A new technic for restoring the continuity between the right ventricle and the pulmonary artery].

Re-establishing continuity between the right ventricle and the division of the pulmonary trunk may prove difficult in surgical correction of transposition of the great vessels. Although prosthetic tubes, which had many drawbacks, have been replaced by direct anastomoses, partial reconstruction of the pulmonary arterial wall is still often necessary. The materials commonly used are segments of gore-tex, stored pericardium and fresh or glutaraldehyde-treated pericardium. However, retractions may develop in these reconstructions resulting in pulmonary stenosis. These complications have revived the debate on the best technique for re-establishing continuity, and it is mandatory to use a growing tissue to keep pace with the child's development. We report here an original technique used in an infant. Previous studies have shown that the autologous pericardial flap, transformed here into a tube, retains its potential for growth.

Blood Vessel Prosthesis↗

PubMed1986

[Mitral stenosis with notable or important subvalvular changes. Complete open commissurotomies supported by chorda transfer].

Since 1983, 40 consecutive patients with mitral stenosis (MS) and significant disease of the subvalvular apparatus underwent open heart mitral commissurotomy (OHMC). The aim of the study was to evaluate the effects of an unrestricted dilatation of the two commissures followed by repair of the subsequent mitral regurgitation. The mitral regurgitation created by this procedure in 24 cases was corrected by transferring 2 to 6 chordae tendinae to the free border of the anterior and/or posterior leaflet in the commissural region. A central regurgitant lesion due to lack of coaptation of the valvular surfaces was treated by annuloplasty with a Carpentier prosthesis in 12 cases. The subvalvular abnormalities were treated by the conventional techniques of fenestration, resection and division of the papillary muscles. Thirty of the 38 survivors had no residual murmur, and 6 had a short low intensity systolic murmur. The 2D echocardiographic study showed no residual stenosis. The residual systolic murmurs were evaluated by pulsed Doppler and corresponded to very localised regurgitation. This extensive operative technique gives very good immediate valvular results which, associated with an adequate subvalvular procedure, are considered to be an important prognostic factor.

Adolescent↗