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Biomedical subjects

J Mathey

Publications and source records attributed to J Mathey.

At least 37 records · Page 2Linked to original sources

[Anantomical aspects and surgical treatment of pulmonary stenoses and atresias with intact interventricular septum in the newborn and the infant under 6 months].

The series presented consists of 25 babies (18 of which were neonates), seen between 1972 and 1974. The anatomical and angiographic study revealed 5 anatomical types, according to whether the pulmonary orifice was patent or atretic, and according to the size of cavity of the right ventricle, which may be normal or reduced (perhaps almost totally). The diagnostic clinical features and findings on angiography are recalled. The operative procedure in all 25 cases was pulmonary valvotomy carried out with a brief normothermic period of cirulatory arrest. The technique is described briefly. The results, which vary widely with the anatomical type, were as follows: out of the 25 operated cases there were 12 deaths during or immediately after surgery. The figures are none-the-less encouraging, given the grave natural history of this condition in the baby. The best results were seen in cases in which there was a right ventricular cavity of normal or at least acceptable size. The maximum postoperative follow-up period was 3 years. Most of these children have a persistant pulmonary stenosis and hypertrophic right ventricle, and require a second operation in early infancy.

Follow-Up Studies

[Atheromatous stenosis of the left coronary trunk. 28 surgical cases].

22 patients with atheromatous narrowing of the left coronary trunk underwent surgery between 1969 and 1974. Most of these patients had severe and incapacitating angina pectoris. The clinical features are readily explained by the size of the diffuse anatomical lesions, which are to be found on the left coronary trunk as well as on the three coronary vessels themselves. This series has not confirmed the serious risk of surgery in such cases, as there were no operative deaths. Secondary mortality was low (9%), and the 20 survivors (average length of follow-up: 26 months) were mostly (18/20) in an excellent condition functionally. These facts have lead us to advise surgery whenever possible.

Adult

[Primary bacterial aneurysm of the aorta. 4 cases].

The causal agent was a Salmonella in three cases and a Pseudomonas Aeruginosa in one case. In these four patients there was no evidence of endocardities and the causal germ was verified by the bacteriological cultures of the anevrysmal lesions and/or by the blood cultures. In one patient full recovery was obtained by surgical repair after complete bacteriologic cure.

Aged

Postperfusion stenosis of the common left coronary artery.

Late stenosis is a rare but potentially lethal complication of coronary perfusion. In 3 patients, anginal pain appeared 2 to 6 months after aortic valve surgery. Coronary angiography was performed because of rapid evolution of symptoms. Severe stenosis of the common left coronary artery was shown in all 3 cases. Immediate aorto-coronary bypass was undertaken with good results. Graft patency was demonstrated in 2 cases, 6 and 7 months after the operations.

Adult

[Congenital cardiopathies appearing during the neonatal period. The view points of the cardiologist, the hemodynamics specialist, the surgeon, and the anesthetist].

The best chances of survival for a new-born depend on the following factors: the possibility of clinical and haemodynamic diagnosis of the malformation, adequate reanimation and surgery. All this must be carried out as early as possible. Although catheterization is very risky it should be complete and as fast as possible, under monitoring of ventilation and haemodynamies. Reanimation is very important before, during and after surgery; it should be more preventive than curative. Very often, surgery is only palliative at this age. Taking into account progress in surgical techniques, the authors report their experience in anaesthesia and ressuscitation of 100 patients under 10 days old. They were all operated on in Laennec in Professor MATHEY's department but only some of them were catheterized there.

Anesthesia, General

[Palliative surgery of transposition of great vessels associated with pulmonary stenosis].

Palliative treatment for transposition of the great vessels with pulmonary stenosis (combined or not with ventricular septal defect) was studied in relation with 24 patients operated upon at Laennec's Hospital in Professor Mathey's section between January 70 and January 74. Three therapeutic attitudes are possible according to whether or not an atrial septal defect is created (Blalock-Hanlon's operation) in combination with the systemic-pulmonary artery anastomosis, and according to whether the operations are performed in one or many steps. It seems that for the badly-tolerated forms of the new-born, combination of both operations seems to be the best attitude, the curative treatment being impossible at this age.

Blood Pressure

[Mid-term fate of Beall's prosthesis in the mitral or mitro-tricuspid position. Apropos of 100 cases].

Aiming at investigation, a Beall's valve was implanted in mitral or in mitral-tricuspid positions only on 100 patients, between November 1969 and February 1972. The details of the initial valve lesions, the clinical condition of the patients, and the modalities of prosthetic replacement are described. The causes of death within the first month were analysed. None could be related with the prosthesis itself. At distance, 17 patients were lost of sight, 18 died and 51 were studied from 12-42 months after operation. It results from this investigation: -- that 84% of the patients reexamined were improved. Most of them were included in a better functional class; -- that the incidence of thrombo-embolic accidents amounted to 12% for the whole group of patients, a percentage similar to that observed with other types of prostheses; -- that in contraat, haemolysis is an obvious disadvantage of Beall's prosthesis (20 of 51 cases); -- that abnormal wears in two valves resulted in valve dysfunction compelled to re-operation. These latter two incidents have lead to abandoning this type of prosthesis.

Adolescent

[Post-cannulation stenosis of the left coronary artery trunk. 5 operated cases].

The authors report five cases of stenosis of the trunk of the left coronary artery following cannulation of the coronary artery, and discuss the types of lesion, and whether they exist as an entity. The morbidity of these lesions, and the threat of sudden death which they pose, indicates an aggressive treatment plan: - definite angina occurring 2 to 6 months after aortic surgery (under coronary artery perfusion) is an indication for urgent coronary arteriography; - this investigation must be followed by a revascularization procedure within a few days if it shows a tight stenosis of the coronary trunk. The constant finding of a good vascular bed distally would seem to presage good long-term results.

Adult