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J Beissel

Publications and source records attributed to J Beissel.

13 recordsLinked to original sources

[Treatment of massive arterial thrombosis caused by thrombocytopenia induced by heparin with local thrombolysis].

The authors report the case of a patient treated by subcutaneous injection of calcium heparin after deep vein thrombosis with floating thrombus and pulmonary embolism. She was readmitted to hospital after 16 days' treatment because of a massive aorto-iliac thrombosis due to heparin-induced thrombocytopenia (platelet count = 29.000). This thrombosis was treated by local injection of Urokinase (total dose = 7.425.000 U) over 93 hours without any major complications. The aorto-iliac circulation was completely restored to normal after treatment. Thrombotic complications secondary to immuno-allergic heparin-induced thrombocytopenia are relatively common because of the widespread use of heparin. From the therapeutic point of view, it is imperative to stop the heparin, which makes surgery very difficult, and the platelet-fibrin composition of these thrombi suggests that local thrombolysis with Urokinase is the treatment of choice in this syndrome.

Aorta, Abdominal

[Xipamide].

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Adult

[An attempt to estimate the value of myocardial contractility in left ventricular aneurysms].

Using monoplanar angiography at 30 degrees, the authors have attempted to quantify the effectiveness of the non-aneurysmal myocardium in 50 patients (17 of them having undergone surgery) with an aneurysm of the left ventricle. Having fixed the position of two points during systole and diastole, they first delimit the aneurysmal zone and/or neighbouring dyskinetic zones in relation to the zones which are still 'healthy'. By a method of integration based on the formula of the three levels, they first measure the global volume of the left ventricle and its ejection fraction, and gain an idea of the size of the aneurysm. They then evaluate the ejection fraction and the volumes of each of the other zones. They have shown that the prognosis depends upon the ejection fraction and the end-diastolic volume of the ventricle which is presumed to be healthy, these measurements being corrected according to the size, expressed as an ejection volume, of the adjacent dyskinetic zone, which can be assessed by an index (volume of the dyskinetic zone as a proportion of the total 'healthy' and dyskinetic zones, in turn expressed as a ratio of the ejection fraction). The application of this work is to be found in seeking a limit of operability for extensive left ventricular aneurysms with cardiac failure.

Heart Aneurysm

[Comparative study of different methods of evaluation of left ventricular volume by monoplane angiocardiography].

The authors compare 5 methods of evaluating left ventricular volume and the ejection fraction by monoplanar angiocardiography in the 30 degrees right oblique incidence: the method of Green (1 and 2), Snow and Dodge, and by trapezoidal integration which was used as a reference. The have calculated the regression ordinates and the correlation coefficients for various systolic and diastolic volumes as well as for various ejection fractions. For these latter, Dodge's quadratic equation can also be used. Provided there is no gross distorsion of ventricular contolr, there is fairly good correlation, but there is a marked discrepancy for large volumes or small ejection fractions (less than 0.40). When more elaborate methods are not available, it seems reasonable to use a single method to calculate these parameters, but it is essential to have recourse to other techniques when there are gross changes in the left ventricle.

Angiocardiography

[Exercise test after myocardial infarct. Correlations with data of coronary angiography and ventriculography].

The authors have studied the exercise test carried out at least three months (3-6 months: 52 cases; greater than 6 months: 48 cases) after myocardial infarction in the anterior position (50 cases), in the "inferior" position (42 cases), and of a diffuse type (8 cases), in patients who were taking no treatment which might interfere with interpretation of the test. For the anterior infarctions there was a good correlation between ST elevation (J max greater than or equal to 1 mm, or better than the sun of the J greater than or equal to 2 mm) and the presence of severe involvement of the left ventricle. A depressed ST segment beyond the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 36 p. 100 of cases. In inferior infarctions, the correlation between ST elevation and left ventricular involvement is also specific but less sensitive. ST depression outside the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 66 p. 100 of cases; it is then lateral, but may extend as far as V2. They also indicate a mirror image, especially when the depressed area slopes upwards, and is localised in V2-V3. The other changes which were found have no practical application.

Adult

[Emergency surgical treatment of septal perforations in the acute phase of myocardial infarct. Apropos of 2 cases operated on successfully in the 48th hour and 5th day after development after the necrosis].

The authors report two personal cases of septal perforation during the acute phase of myocardial infarction which under medical treatment would have been rapidly fatal, and which were treated successfully by surgery on the second and fifth days respectively after the infarction, i.e. very early. After briefly recalling the main diagnostic and etiological factors of this serious complication, and the spontaneous prognosis which is usually catastrophic, they emphasise that in presence of poorly controlled heart failure and cardiogenic shock, uncontrollable by intensive medical treatment, only early surgical repair during the first few hours or days of the course of the coronary accident will permit one in certain cases to avoid a fatal issue as proved by their two cases and a review of recent publications. They emphasis the place of circulatory assistance by intraaortic balloon in the preparation of patients for operation and the methods of mycardial revascularisatin during the operation.

Aged

[Familial forms of the mid-end systolic click and murmur syndrome with deviations of left ventricular kinetics].

The aetiology and pathogenesis of the "mid/end-diastolic click and murmur" syndrome, with prolapse of the mitral valves, is obscure in most cases. However, the fact that some cases have had a familial distribution is evidence in favour of a dysgenetic origin. Seven new cases of this type are reported. The authors suggest in this paper that the incidence of the familial form of the syndrome is greater than the literature seems to suggest, and that the syndrome is likely to be due to a malformation. They also emphasise the important part which echocardiography plays in its diagnosis and investigation. Finally, the finding on cine-angiocardiography of specific abnormalities of left ventricular function similar to those found in other studies is indicative of a primary myocardial disorder, associated with subsequent structural alterations of the valvular mechanism.

Adolescent