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Biomedical subjects

J C Kahn

Publications and source records attributed to J C Kahn.

54 records · Page 3Linked to original sources

Treatment of post-myocardial infarction angina by intra-aortic ballon pumping and emergency revascularization.

Twenty-one patients with postinfarction angina (2 to 15 days after acute myocardial infarction) unresponsive to medical therapy were treated by intra-aortic balloon pumping (IABP). Anginal pain and electrocardiographic (ECG) ST-segment changes were prevented in all patients. Coronary angiograms were obtained during IABP without complication and confirmed severe coronary artery disease. Of the four nonoperated patients, three had reinfarction and two died of cardiogenic shock. Seventeen patients underwent aorta-coronary bypass grafting, associated with aneurysmectomy in two patients and closure of a ventricular septal defect in one. Sixteen patients survived the operation. All survivors are in clinically improved condition and 14 are pain free from 9 to 28 months postoperatively, but three have mild heart failure.

Adult↗

[Arteriography in a case of single coronary artery with myocardial ischaemia (author's transl)].

Coronary arteriography is the only examination by which the diagnosis of single coronary artery may be made in vivo by demonstrating the presence of an entire coronary system arising from a common trunk. The discovery may be made under two distinct sets of circumstances: 1 degree Coronary ischaemia in a young subject. Arteriography confirms the diagnosis and the customary 2 degrees Coronary ischaemia in an older individual. Arteriography shows atherosclerotic lesions in a single coronary artery. The severity of the condition is related to the proximal character of the stenoses. The most logical therapeutic approach is aorto-coronary bypass if the quality of the distal network as seen at arteriography makes it possible.

Aged↗

Comparative efficacy of short-acting and long-acting quinidine for maintenance of sinus rhythm after electrical conversion of atrial fibrillation.

Forty patients with chronic atrial fibrillation, apparently unrelated to any overt heart disease, were randomly allocated to two groups after restoration of sinus rhythm by direct current shock. The patients in group A were given 4 daily doses of quinidine polygalacturonate, while those in group B were given 2 daily doses of a long-acting quinidine preparation, quinidine arabogalactan sulphate. The percentage of early relapses (within the first month following DC shock) was not significantly different in the two groups: 44-4% in group A and 35% in group B (P greater than 0-50). On the other hand, there were fewer late relapses with long-acting quinidine. After 18 months of treatment, 27-8% of patient in group A remained in sinus rhythm, compared with 61% in group B (P less than 0-05). The average amount of quinidine actually ingested by the patients in group A was smaller than that in group B. However, this could not entirely account for the difference observed in the incidence of relapse since with short-acting quinidine the proportion of patients remaining in sinu rhythm was similar whether the dose was decreased or not. The incidence of gastrointestinal side-effects was the same in the two groups and there were no seriou complications that could be attributed to treatment. It is concluded that long-acting quinidine preparations are more effective than conventional quinidine in preventing late relapses of atrial fibrillation.

Aged↗

[Angiographic study of coronary artery disease patients receiving circulatory assistance by intra-aortic diastolic counter-pulsion (author's transl)].

In patients receiving circulatory assistance by intra-aortic counter-pulsion for myocardial infarction, angiography may be carried out by the retrograde femoral route. It should include left ventriculography makes it possible to assess the number of segments which contract and to draw a correlation between the kinetics of a segment and its vascularisation. Vascular studies should be carried out at the time of maximum effect of the pump, i.e. from the 18th hour onwards. Indications for angiography are as follows: isolated or mechanical cardiogenic shock, early recurrence of infarction, refractory left ventricular failure and persistent arrhythmias. In cardiogenic shock and refractory left ventricular failure, the coronary lesions are diffuse. All our patients died. By contrast, in the group with early recurrence of infarction or persistent arrhythmias surgical treatment is often possible.

Arrhythmias, Cardiac↗