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J M Calbet

Publications and source records attributed to J M Calbet.

17 recordsLinked to original sources
PubMed2003

Acute myocardial infarction with cardiogenic shock: treatment with mechanical circulatory assistance and heart transplantation.

UNLABELLED: The mortality of cardiogenic shock (CS) after an acute myocardial infarction (AMI) still remains high. Thrombolysis, PTCA or CABG, when possible, can improve the results, but when all the treatments fail death is almost certain. OBJECTIVE: We investigate the use of the mechanical circulatory assistance (MCA) and heart transplantation (HT) to improve the adverse results in this irreversible situation. METHODS: Among 11 patients with irreversible CS after an AMI we used a MCA (Abiomed BVS-5000). After improvement and hemodynamic stabilization, we performed heart transplantation in 7 patients of mean age 52 years (35-60) including two women. The MCA was univentricular in 7 patients and biventricular in 4. Mean duration of the MCA was 5 days (1-12). RESULTS: Three patients died during the MCA: two due to cerebrovascular accidents and one multiorgan failure. Weaning was possible in one patient. Among Seven transplanted patients one died due to sepsis. Seven (64%) patients are long-term survivors. CONCLUSION: When all the treatments have failed for CS after an AMI, MCA may be used as a bridge to heart transplantation in a select group of patients where the procedure is not contraindicated. The long-term results of 64% survivors in our experience is satisfactory.

Adult↗
PubMed1998

[Aneurysms of the left ventricle. Surgical treatment].

Left ventricular aneurysm as a complication of myocardial infarction is observed in 10% of patients. In recent years, all surgical teams have observed a significant decrease of this complication. There is no doubt that this is due to the current medical treatment in the acute phase of myocardial infarction. Surgical treatment is considered only when the ventricular aneurysm presents complications such as congestive heart failure, thromboembolism, malignant ventricular arrhythmias or angina. In this review, we comment on the principle surgical procedures reported up to now. The indication of surgery is based on good functional results and long-term survival.

Heart Aneurysm↗
PubMed1996

Surgical treatment of Brucella endocarditis.

Between April 1987 and October 1992, six cases of Brucella endocarditis were operated on in the authors' hospital for valve replacement. They were five men and one woman with a mean(s.d.) age of 52(15) years (range 30-71 years). Three patients were in New York Heart Association (NYHA) class III and three in class IV. Two patients had previous history of rheumatic fever, one was a drug abuser, two had peripheral embolism and one constrictive pericarditis. Most were living in rural areas. Echocardiographic diagnoses were: severe aortic regurgitation in two patients, mixed disease in two and double valve involvement in two. Valve vegetations were demonstrated in two patients, valve calcification in two and annulus abscess in two others. Serological tests were positive in all patients. All patients had valve replacements and three were operated on as emergencies. Surgical findings were: valve vegetations in two patients, cusp perforation in two annulus abscess in two and prosthetic leak in two. Mean(s.d.) cardiopulmonary bypass time was 123(77) min with a mean ischaemic time of 79(43) min. All patients were given specific antibiotic treatment after surgery. There was no intraoperative mortality and the 5-year survival rate was 100%. Early reoperations were needed in three patients, two because of prosthetic leakage causing severe regurgitation and one for tamponade. The results suggests that Brucella endocarditis is rare, but still occurs in Mediterranean areas. Surgical replacement is needed in spite of antibiotic treatment and recurrences with prosthetic leaks are usual.

Adult↗
PubMed1996

Early graft failure after heart transplantation due to coronary artery embolization with myocardial tissue.

Myocardial infarction due to myocardial tissue embolism of the right coronary is a rare cause of early graft failure. We report one case with such a complication, in a 44-year-old man who was transplanted with a graft from a 32-year-old male donor. Prolonged refractory cardiogenic shock developed after orthotopic heart transplantation. A right coronary artery bypass graft was performed and the patient was supported with a biventricular assist device for 69 h. Despite that, no improvement of the graft contractility was observed and the patient could not recover from shock. Pathologic examination showed inferior and septal acute infarction. An embolus of myocardial tissue was completely occluding the first portion of the right coronary artery. The tissue probably came from suture lines of the left atrium.

Adult↗
PubMed1995

Valvuloplasty in traumatic aortic insufficiency due to subtotal tear of the intima.

Aortic regurgitation is one of the usual pathologic findings necessitating valve replacement in cardiac surgery. Several diseases may result in leaflet incompetence. Circumferential intimal tear of the aortic root with prolapse of the aortic valve commissures is a rare cause of aortic incompetence. We report the repair of the aortic wall and valve in 1 patient with such a tear 6 months after an important thoracic trauma. Three months after the aortic valve reconstruction the patient is in good condition and fully asymptomatic.

Aged↗
PubMed1993

Cardiac myxomas: surgical treatment, long-term results and recurrence.

Long-term results of the surgical treatment of cardiac myxomas are not completely understood due to its recurrence. We review our experience in 27 operated cases with a follow-up to 22 years (mean 6.5 years), in order to throw light on results and review the problem of recurrence. One patient had a previous recurrent myxoma. At surgery we resect all the tumors and their attachment bases. We prefer a biatrial approach, ample resection and exploration of all cardiac chambers. Hospital mortality was 3.7% (1 case of associated aortic valve replacement) and late mortality 7%. Long-term results were satisfactory, without recurrences. The postoperative life expectancy of these patients seems similar to that of the normal population, except in cases of recurrence or associated valve replacement. Recurrence is very low (4.7% in 526 cases reported in the literature), except in the case of young patients and recurrent, familial, multiple or complex myxomas. The multigrowth potential of the tumor seems more important than an inadequate surgical resection.

Adult↗