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Biomedical subjects

J Fouchard

Publications and source records attributed to J Fouchard.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Conservative surgery of the mitral valve. Pre- and post-operative hemodynamic and angiographic study of 20 cases].

Twenty patients with pure or prevalent mitral regurgitation, undergone mitral valve conservative surgery according to the Carpenter-technique from 1975 to 1979, have been studied. There are 19 women and 1 man, mean age of 25 years (range 11 to 65); 18 had a rheumatic fever; 2 had a mitral valve prolapse due to a degeneration of collagen within the central core of the cordae tendineae, which was the primarily responsible for cordae rupture in 1 case. The clinical and hemodynamic features were severe in a 50 per cent of cases (8 patients in N.Y.H.A. functional class III; 3 in class IV); there was pure mitral regurgitation in 12, combined mitral stenosis and regurgitation in 8; tricuspidalic regurgitation which needed annuloplasty in 5 patients. All the patients have been studied by hemodynamic and angiocardiographic study before and an average of 14 months after surgical treatment. Surgical conservative technique of mitral valve is described; the results are analyzed. All the patients are in N.Y.H.A. functional class I, 14 months after surgical valve therapy. In three cases, a systolic 3/6 murmur which was present immediately after surgical treatment and that not increased in time, remains. EKG left overload is still present in 2 cases; Heart-Chest ratio decreases in all the patients (range 0,61 to 0,51). Atrial fibrillation is present in 6 patients. Hemodynamic findings show: Pulmonary Systolic Pressure (PSP) decreases (45 +/- 4 to 27 +/- 1); Mean Pulmonary Capillary Wedge (PCW) pressure decreases (19 +/- 1 to 11 +/- 1); Total Peripheral Resistance (TRP) (2023 +/- 112 to 1595 +/- 70 dynes sec cm--5), Total Pulmonary Resistances (TPR) (742 +/- 89 to 351 +/- 36), Pulmonary Arterial Resistances (PArtR) (344 +/- 51 to 133 +/- 18 dynes sec cm--5), and Left Ventricle Diastolic Pressure (LVEDP) (12 +/- 1 to 8 +/- 1 mmHg) normalize. The Ejection Fraction (EF) decreases at the most operative control after surgery in 11 patients (56 +/- 3 to 50 +/- 1). Angiographic study shows no regurgitation in 4 patients, a least regurgitation in 13 cases and there is a 2/4 regurgitation in 3 cases only. The AA. have got to an excellent result in 17 patients; a 2/4 degree angiographic regurgitation persist in 3 cases, although a clear clinical improvement. The AA. consider of great utility this surgical valvular management according to a critical review of the efficacy and stability of the results.

Adolescent↗
PubMed1980

[Valvular insufficiency in Lobstein's disease. A review of the literature apropos of a patient operated on for aortic insufficiency].

Lobstein's disease, a hereditary disorder of connective tissue, may rarely be accompanied by aortic or mitral regurgitation due to valvular dystrophy. The case reported is that of a patient with severe aortic incompetence with dilatation of the ascending aorta, complicated by angina pectoris and left ventricular failure; the patient also had Lobstein's disease with numerous spontaneous fractures, transverse lines of ossification, blue sclera skeletal deformities, and a positive family history of blue sclera. At surgery, valvular dystrophy was confirmed and corrected by aortic valve replacement. The patient's brother died recently with the same pathological association of Lobstein's disease and aortic incompetence. 28 cases of valvular disease and Lobstein's disease have been reported 12 with pathological evidence (at operation) on the purely dystrophic origin of the valvular regurgitation, and 2 with histological diagnoses alone in two newly born children. Aortic incompetence with dilatation of the ascending aorta is commoner than mitral incompetence. The macroscopical and histological appearances are similar to Marfan's syndrome and account for the operative risk of valvular replacement and for the incidence of postoperative haemorrhage. The rarity of valvular dysfunction in Lobstein disease contrasts with its relatively common occurrence in Marfan's syndrome.

Adult↗
PubMed1979

[Arterial thrombosis caused by electric injury].

A thrombosis of the axillary artery was discovered in a 36 year old man, four days after electrocution. It was treated successfully by venous bypass. The case was then compared with five similar cases in the literature. The damaged arteries were situated in the area crossed by the electric current. The artery was normal above and below the thrombosis. The thrombosis was accompanied by parietal lesions. The development of the collateral circulation explains the absence of signs of acute ischemia. The pathogenic medico-legal and therapeutic aspects of these thromboses by electrocution are then discussed.

Adult↗
PubMed1977

[Interventricular communication, aneurysm of the membranous septum and acquired atrioventricular block].

Over a ten year period of a man 40 had a progressively increasing atrioventricular conduction defect, resulting from a ventricular septal defect with eventual cardlac failure due to persistant bradycardia. Intracavitary recordings showed the block to be situated distally, below the bundle of His. Cineaarteriography, and subsequent operation, showed an aneurysm of the membranous septum lying above a fibrous-edged ventricular septal defect. The aetiology of the block is discussed in the light of these defects; Haemodynamic trauma to the conduction pathways exposed in the inferior edge of the septal defect seems to be the most likely cause.

Adult↗
PubMed1975

[Treatment of Laubry-Pezzi syndrome apropos of a case in a 7-year-old child].

Report of one case of a Laubry and Pezzi syndrome. In spite of the already severe aortic incompetence at the age of 4 years, operation was postponed. Three years later, at the first signs of bad tolerance of the aortic incompetence the operation was undertaken including: -- closure of the ventricular septal defect by a patch, and correction of aortic incompetence by a metallic-ball Starr's prosthesis n 9. After an observation period of 18 months, the result of operation is satisfactory, in spite of signs of haemolysis. Comparison with the data from the literature led to the following conclusions: 1) in a patient with ventricular septal defect the demonstration of a diastolic murmur indicates closure of the septal defect. 2) When the aortic incompetence is a severe one, it should be corrected urgently, whatever the age of the child, if badly tolerated. In the very young child, if it is well tolerated, the operation might be postponed in view of the difficulties of plastic operations and the hazards of prostheses in such patients. 3) A moderate aortic incompetence constitutes the most difficult indication; a conservative operation seems to be preferable to a valve replacement by a prosthesis, a homograft or a heterograft. The results obtained by some techniques of valvular plasty after observation periods amounting to 12 years are considerable.

Aortic Valve Insufficiency↗