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J Mulet

Publications and source records attributed to J Mulet.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Traumatic rupture of the tricuspid valve. Its conservative surgical treatment].

Tricuspid insufficiency caused by blunt chest trauma is rare and usually unsuspected clinically, early after trauma. Cross-sectional Echocardiography and Cardiac Catheterization are essential to establish the diagnosis. Therapy applied varies from repair to valvular replacement. We describe an 18-year-old boy with traumatic tricuspid regurgitation treated by reconstruction of the attachments of the anterosuperior leaflet and annuloplasty with a Puig-Massana ring. Six month after surgery he is fully recovered, although persist a moderate degree of tricuspid insufficiency.

Accidents, Traffic↗
PubMed1991

Delayed sternal closure for life-threatening complications in cardiac operations: an update.

Over a 7-year-period, 25 patients had delayed sternal closure after open heart operations out of 34 patients whose sternum was not closed. The indications were extreme cardiac dilatation and uncontrollable mediastinal hemorrhage. This represented a 1.79% incidence in the overall open heart surgical experience at our unit. Sternal closure was performed at a mean of 2.64 days after the initial operation. Eighteen patients (52.9%) left the hospital alive and well, representing a 72% survival rate among patients undergoing delayed sternal closure. No mediastinal or fatal infection developed and only 1 patient had late superficial wound infection after delayed sternal closure. We conclude that delayed sternal closure is an effective method to treat severe complications after cardiac operations.

Adult↗
PubMed1991

Adverse reactions to vancomycin prophylaxis in cardiac surgery.

Several adverse effects of vancomycin have been reported. The aim of this study was to assess the incidence of adverse responses to antibiotic prophylaxis with vancomycin in cardiac surgical patients. Prospectively, 116 consecutive patients (106 adults and 10 children) undergoing cardiac surgical procedures in this institution from January to June 1990 were studied. After the anesthetic induction, vancomycin, 1 g in adults and 10 mg/kg in children, was intravenously administered over 30 minutes. The infusion rate was slowed if any adverse effect was observed. As a control group, 10 similar patients were evaluated during the same period of 30 minutes after anesthetic induction but prior to vancomycin administration and surgical stimulation. Thirty-one patients (26.72%) developed an adverse effect, mainly hypotension (29 patients, 25%), which was considered severe in 15 patients (12.93%). Seven patients (6.03%) developed a maculopapular erythema that was associated with hypotension (Red-Man's syndrome) in 5 patients and with bronchospasm in 1 patient. The incidence of adverse reactions in children (20%) was similar to the overall incidence. Only 1 patient in the control group (10%) developed hypotension during the period studied. The incidence of adverse reactions was not related to age, body weight, vancomycin dose administered per kilogram body weight, type of surgical procedure, or associated disease. Mean duration of the infusion was similar in patients with and without adverse responses (34.60 +/- 12.41 minutes and 37.38 +/- 14.55 minutes, respectively). It is concluded that perioperative prophylaxis with vancomycin in cardiac surgery produces a high and unpredictable risk of significant hypotension.

Adult↗
PubMed1991

Diethylstilbestrol-induced müllerian abnormalities, septate uterus, genital tuberculosis and twin pregnancy with term delivery after in-vitro fertilization.

We report a case of a twin pregnancy at term obtained after five multiple embryo transfers in a patient who presented diethylstilbestrol (DES)-associated cervical and uterine structural abnormalities, a septate uterus and bilateral tuberculous salpingitis. The suitability of in-vitro fertilization/embryo transfer in DES-exposed women is discussed.

Adult↗
PubMed1990

Amrinone in perioperative low cardiac output syndrome.

Amrinone has been shown to have a beneficial effect on left ventricular function in low output syndrome (LOS), but its use after open-heart surgery has not been extensively revised. We studied 10 patients with LOS post-cardiopulmonary bypass (CPB), who failed to respond to conventional treatment (vasoactive drugs plus intraaortic balloon pump) and were treated with amrinone, 0.75 mg.kg-1 followed by a continuous infusion of 5 to 10 micrograms.kg-1-min-1. One patient failed to respond to the treatment and subsequently died, but in the other nine patients blood pressure and cardiac index increased, left filling pressure decreased and they were successfully weaned from the CBP and survived. These results suggest that amrinone, either alone or combined with other inotropic drugs and mechanical support, is a valuable drug in the management of LOS after CPB.

Aged↗
PubMed1990

AIDS and Salmonella-infected abdominal aortic aneurysm.

The case of a bisexual male patient with acquired immunodeficiency syndrome (AIDS) and an infected abdominal aortic aneurysm requiring surgery is presented. Attention is drawn to the fact that an unpredictable number of operations will be needed in AIDS patients in the next future.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Infective endocarditis caused by coagulase-negative staphylococci: a review of 19 cases].

The clinical, microbiological and echocardiographical features as well as the response to therapy of 19 cases of infective endocarditis (IE) caused by coagulase-negative staphylococci (CNS) are reported. Six patients had native valve IE, 11 had prosthetic valve endocarditis and 2 were associated with catheters in right cardiac chambers. In the group of native valve IE, 11 patients were heroin abusers and 4 had previous valvular disease. IE was left sided in 3 cases, mixed in 2 and right sided in 1. All CNS were methicillin-sensitive. The echocardiogram detected vegetations in 5 of the 6 cases. One patient required surgery and another died. In the group of prosthetic valve IE, 5 patients had early endocarditis and 6 had late endocarditis. A bioprosthesis was involved in 5 cases, a mechanical prosthesis in another 5, and an annuloplasty annulus in one. The involved prosthesis was aortic in 5 cases and mitral in 6. The echocardiogram detected vegetations in 3 cases (27%) and prosthetic dysfunction in 4. One patient had a relapse, 8 (73%) required valve replacement and 3 died. Although the greatest incidence of IE caused by CNS is found among patients with prosthetic valves, it can also be seen in patients with underlying valvular heart disease, drug abusers and patients with indwelling catheters in right cardiac chambers.

Adult↗
PubMed1989

Human in vitro fertilization in couples with unexplained infertility and a poor postcoital test.

The results of in vitro fertilization (IVF) with the husband's semen were compared in 3 groups of fully investigated infertile couples. In those with tubal infertility (n = 43) 194 out of 273 (71.1%) oocytes were fertilized, at least 1 oocyte being fertilized in 42 of the 43 couples (97%). In couples with unexplained infertility and a 'good' postcoital test (PCT) (n = 9), 39 out of 64 (61.5%) oocytes were fertilized in 8 of the 9 (88%) couples. In couples with unexplained infertility and a 'poor positive' PCT despite normal semen analysis, 16 out of 44 (36.3%) oocytes were fertilized in 5 of the 6 (83%) couples. These results show a good correlation between in vivo sperm penetration of cervical mucus and human IVF in couples with unexplained infertility.

Female↗
PubMed1988

Improvement of renal function in azotaemic hypertensive patients after surgical revascularization.

Between 1974 and 1986, 17 patients (16 men and 1 woman) with renal insufficiency (serum creatinine greater than 1.5 mg/dl, mean 3.75 mg/dl), with a mean age of 51.3 years, underwent surgical renal revascularization. Two of them were on maintenance haemodialysis. All were severely hypertensive in spite of antihypertensive drugs. Atherosclerosis was the cause of renal stenosis in 14 cases and fibromuscular dysplasia in 3. Operative procedures included splenorenal shunt (5), autotransplantation (3), aortorenal bypass (3), hepatorenal bypass (1), bilateral renal endarterectomy (1), renal ostial closure (1) and nephrectomy (3). Mean serum creatinine showed a decrease from 3.76 to 1.65 mg/dl (P less than 0.005). Mean arterial pressure dropped from 161 mmHg to 103 mmHg (P less than 0.001). Systolic and diastolic pressures also showed significant decreases. Two patients died. Four patients required a second operation and the renal function and blood pressure then improved. Renovascular disease must be ruled out in patients with renal insufficiency associated with hypertension, including those patients on haemodialysis. We conclude that renal revascularization surgery is a reliable and efficient form of treatment in selected cases of renal failure of renovascular origin.

Blood Pressure↗
PubMed1988

Iatrogenic arteriovenous fistula in infancy.

Iatrogenic arteriovenous fistulas (AVF) in infancy are rare and are usually located at the level of femoral and antecubital vessels. They are generally secondary to multiple diagnostic or therapeutic arterial or venous punctures. The diagnosis is usually easy to make on clinical grounds; however, invasive procedures such as digital subtraction angiography (DSA) can be used to locate the fistula. These iatrogenic AVF may present as direct vascular communications or pseudoaneurysms originating in the venous wall. Surgical treatment is the therapy of choice. The case of an infant with an iatrogenic AVF of the femoral vessels is presented.

Arteriovenous Fistula↗
PubMed1986

Extracranial internal carotid artery aneurysms.

Two cases of extracranial internal carotid artery aneurysms are presented. In each case the cranial end of the aneurysm was in contact with the base of the skull. Ligation of the internal carotid artery was performed in the first case. Temporary occlusion of the distal internal carotid artery by means of a Fogarty catheter allowed resection with end-to-end anastomosis in the second case.

Aneurysm↗
PubMed1985

Aneurysm of the gastroduodenal artery. Surgical treatment in an asymptomatic case.

Aneurysms of the gastroduodenal artery are very rare. We present the case of a 51-year-old female with an asymptomatic gastroduodenal artery aneurysm which was discovered by means of arteriography. The patient was surgically treated by proximal and distal ligation of the gastroduodenal artery and partial resection of the aneurysm. Preoperative and postoperative arteriograms are shown. Seven months after the operation the patient remains asymptomatic. We comment on and review other cases in the English language literature.

Aneurysm↗
PubMed1985

Early results with intraoperative transluminal coronary artery balloon dilatation.

We used intraoperative transluminal coronary balloon dilatation, together with coronary artery bypass grafting, to obtain complete myocardial revascularization in extensively diseased coronary arteries. Our patient population consisted of ten males and two females, with a mean age of 58 years. The left anterior descending artery was dilated in five patients, the posterior descending artery was dilated in three, the obtuse marginal artery in two, the left circumflex artery in one, and the right coronary artery in one. Additionally, a mean of 2.81 grafts per patient were placed. Hospital mortality was one patient (8.33%). There was also one case of perioperative myocardial infarction. Postoperative angiography was done in seven patients: five were shown to be improved, one had a vessel that appeared unchanged, and one had an occluded vessel. We found intraoperative transluminal coronary balloon dilatation to be a simple and efficient technique that offers potential improvement in myocardial revascularization.

Journal Article↗