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Biomedical subjects

J F Conso

Publications and source records attributed to J F Conso.

At least 19 recordsLinked to original sources
PubMed1995

[Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

Angioplasty, Balloon↗
PubMed1984

[Cardiac stimulation in children. A multicenter study of 241 patients].

This study analyses the results of cardiac pacing in 241 children operated between 1965 and March 1982 in 9 french cardiac centres. The ages at primary implantation were: less than 5 years, 32.8 p. 100, 6 to 10 years, 33.6 p. 100 and 11 to 16.5 years, 33.6 p. 100. Atrioventricular block was congenital in 40.7 p. 100 of cases (98 children) and postoperative in 56.4 p. 100 (136 children) with 67 cases, after repair of isolated ventricular septal defect and 18 after repair of an endocardial cushion defect. The symptoms preceding pacing were syncope (67 cases), bradycardia (92 cases) and cardiac failure (33 cases). The electrocardiographic indications were third degree block in 66.8 p. 100 of cases. The pulse generators were usually implanted in the abdominal wall (71.8 p. 100). The power sources in service (August 1982) were lithium (74 p. 100) and isotopic batteries (26 p. 100). Myocardial electrodes were used in 93.4 p. 100 of cases; 82.2 p. 100 were made by Medtronic. Early problems included: infection (10 cases), displacement of endocavitary electrodes (3 cases), elevated thresholds (2 cases). The late problems encountered were due to fracture of the pacing electrodes (19 cases) and elevated thresholds (50 cases). Two hundred and seven children are alive and well. A total of 341 pulse generators were implanted, 90 p. 100 being VVI mode. In August 1982, 56.6 p. 100 were programmable or multiprogrammable. Despite the technical problems involved, the myocardial approach is still used with good results, especially in young children and babies. The endocavitary approach is an alternative after 5 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Secondary closure of the sternum in open-heart surgery. 50 cases].

In intrathoracic cardiac and vascular surgery, immediate repair of median sternotomy sometimes results in rapid haemodynamic failure. We therefore chose delayed sternal closure in 50 patients with complex heart disease. Three cases of infection were recorded. This safe and easy procedure presents the advantage of being life-saving for more than one third of the patients.

Adolescent↗
PubMed1983

Perirenal space implantation of permanent cardiac pacemakers in infants and small children.

Permanent pacemakers were implanted in 40 children aged one day to 17 years. A new technique, necessitating thoracotomy and lumbotomy, is described briefly. Indications were surgical block in 22 (55%) and congenital block in 18 (45%) patients. Five of 40 (12.5%) died. Reoperation was required 4 times: for electrode problems (3), and wound problem (one). No late infection or wire fractures were noted. The time paced ranged from 7 days to 37 months. All of these patients received lithium units.

Adolescent↗
PubMed1983

[Pacemakers in infants and young children. Comparative study of pleural and lumbar modes of implantation].

The authors report their experience of 62 implantations of pacemakers in babies and small children by two different methods. The pleural cavity was chosen as the site of implantation in 22 patients aged 8 months to 10 years, weighing 4,2 to 26 kg, with a maximum follow-up period of 7 years. Reoperation was required in 11 cases: 6 replacements of mercury batteries, 5 electrode dysfunctions, 1 electrical leak syndrome and 1 septic complication. In the other 40 patients aged 24 hours to 17 years, weighing 2,2 to 37 kg, with a maximum follow-up period of 5 years, the pacemaker was implanted in the lumbar region. Reoperation was required in 4 cases; 1 pacemaker replacement for infection and 3 electrode faults with pacemaker replacement. It is 5 years since the authors abandoned the pleural cavity in favour of the lumbar area as the site of implantation in babies and small children. Programmable pacemakers with lithium power sources are preferred for their many well known advantages. The use of the pulse generators and the progressive improvement in the electromechanical properties of the pacing electrodes which have become more and more reliable, have made reoperation a rare occurrence. In addition, replacement of implanted material only requires a small lobotomy in the great majority of cases. Recurrent thoracotomies, difficult for the surgeon and dangerous to the patient, are thereby avoided.

Adolescent↗
PubMed1982

[Pacemakers in infants and young children. A new implantation technique (author's transl)].

Long-term stimulation of the heart in young children often raises technical problems, most of which are associated with the site of implantation of the pacemaker. For this reason, a new technique of implantation was devised with the following main stages: (1) the child is made to rest on its right side, with slight posterior declivity; (2) a pacemaker electrode is implanted on the left ventricle through a short left thoracic incision in the 5th intercostal space; (3) the pacemaker itself is implanted through a short lumbar incision into the space between the posterior peritoneum and the left renal fossa; it is attached to the costal grid. None of the complications usually reported (infection of the pacemaker cavity, displacement or exteriorization of the instrument) was observed in this series of 25 young patients.

Child, Preschool↗
PubMed1980

[One stage repair of VSD in infants (author's transl)].

Concerning their experience between February 1973 and May 1979 about 258 infants less than 12 Kg operated up for large VSD, the authors studies the 27 deaths. Their is not statistical difference between patients under 6 Kg of weight (128 cases, 15 deaths) and patients over 6 Kg of weight (130 cases, 11 deaths). The procedure is performed under hypothermia and circulatory arrest under 5 Kg and moderate hypothermia with cardioplegic myocardial protection in other cases. The causes of deaths have been: --either post-op. complications (post-operative bleeding, catheter complication, mediastinitis), --or pre-operative error (Swiss cheese VSD, single ventricle). The indications for pulmonary artery banding remain multiples VSD, and VSD associated with other visceral malformations.

Body Weight↗
PubMed1978

Ductus arteriosus sling: report of a newly recognised anomaly and its surgical correction.

Surgical exploration of a 7-week-old infant with a diagnosis of 'pulmonary artery sling' (left pulmonary artery arising from the right) revealed the true nature of the abnormality to be persistence of the ductus arteriosus which connected the right pulmonary artery to the aortic isthmus. This malformation has not been described previously. It has the same symptomatology as 'pulmonary artery sling' and it may be treated by surgical ligation and division. We suggest the term 'ductus arteriosus sling' to describe this rare congenital anomaly.

Aorta, Thoracic↗
PubMed1978

[Cor triatriatum associated with a ventricular septal defect in infancy. 2 cases treated surgically].

Although rare, the diagnosis of cor triatriatum in its classical form is usually made pre-operatively. The association with a large ventricular septal defect, as in the two cases reported here, masks the clinical and haemodynamic signs. In one case it was the echocardiogram and cineangiography which led to pre-operative diagnosis. The surgical correction of the two lesions was done successfully in one stage. In our second case, lack of recognition of the cor triatriatum led to the death of the patient in a low output state, following closure of the ventricular septal defect.

Cineangiography↗