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Biomedical subjects

J P Binet

Publications and source records attributed to J P Binet.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Assessment of the branches of the pulmonary artery by 2-dimensional echocardiography].

Sixty three cases of Fallot's tetralogy aged from 1 month to 30 years old, were studied by 2D echocardiography to evaluate the diameter of the pulmonary arteries and to detect stenosis of the main pulmonary arteries. The right pulmonary artery was visualised clearly enough to be measured in all 63 cases whereas the left pulmonary artery could only be adequately recorded in 58/63 cases. The junction of the two pulmonary arteries was confirmed by 2D echo in 61/63 cases; in two cases, the left pulmonary artery was not connected (2/63), confirmed at angiography and surgery. Six stenoses of the pulmonary arteries, confirmed surgically (6/7), were detected by 2D echo but there were also 3 false positive results. The pulmonary arteries were measured from suprasternal views; the values obtained ranged from 3 to 15 mm. There was a good correlation with the angiographic measurements (R = 0.81 for the right pulmonary, and R = 0.82 for the left pulmonary arteries). Good correlations were also observed between the peroperative and 2D echo measurements (R = 0.84 for the right pulmonary; R = 0.77 for the left pulmonary artery). 2D echocardiography is a non-invasive reliable technique for visualising the pulmonary arteries and their origin, for measuring the calibre of these vessels and for detecting severe proximal pulmonary artery stenosis.

Adolescent↗
PubMed1983

[Use of PTFE (Gore-Tex) in pulmonary systemic anastomoses. Apropos of 50 cases].

Between 1977 and 1981 palliative anastomosis procedures between the subclavian and pulmonary arteries using a PTFE (Gore-Tex) prosthesis for anatomical reasons (short subclavian artery or trajectory incompatible with a Blalock-Taussig anastomosis) were carried out in 50 patients from 1 day to 24 years of age with cyanotic congenital heart disease. Two groups of patients were identified: ten patients in which the PTFE prosthesis was used as an "extension" to the subclavian artery, and 40 patients in which the PTFE was interposed between the respected subclavian and pulmonary arteries. There were three deaths (6 p. 100) at 1,7 and 15 days after surgery (mean mortality 5,7 and 12,3 p. 100). There were no major complications in the survivors. Two prostheses became occluded, one of which was reanastomosed to the ascending aorta. The follow-up ranges from 6 months to 5,5 years. The angiographic investigations performed before complete repair demonstrated the patency and good function of these anastomoses.

Adolescent↗
PubMed1983

[Double isthmic coarctation of the aorta: "tandem" coarctation].

A second case of double coarctation of the thoracic aorta is reported, the first having been observed at the Marie-Lannelongue Surgical Center in an older child. This case was a 3 months infant in which the missed pre- and postoperative diagnosis led to reoperation after control catheter and angiographic studies. These investigations were carried out one month after the first operation because of persistent severe cardiac failure. Surgical cure in two stages consisted in a Waldhausen plastic enlargement procedure and a Crafoord-type resection anastomosis, ensuring the best chances for a good result.

Aortic Coarctation↗
PubMed1983

[Congenital aneurysm of Valsalva's sinus rupturing into the left ventricle. Apropos of a case in a 3-year-old child].

The authors present the case of a 3 year old child with cardiac failure of recent onset, arterial hyperpulsatility and a systolo-diastolic murmur. Aortic angiographic showed an aneurysm of the sinus of Valsalva and valvular aortic regurgitation. At surgery the aneurysm was found to have ruptured into the left ventricle. The fistula was closed. The postoperative course has been satisfactory with a 20 month follow-up period, despite some residual aortic regurgitation. This is the first published pediatric case of a congenital sinus of Valsalva aneurysm rupturing into the left ventricle. The case is discussed and compared with 6 other cases in the literature concerning adults.

Aortic Rupture↗
PubMed1983

[2-dimensional contrast echocardiographic diagnosis of associated atrioventricular canal and cor triatriatum].

2D echocardiography provided the diagnosis of partial atrioventricular canal associated with cor triatriatum in a 4 year old child. The apical four chamber view showed an ostium primum and the presence of an abnormal transverse echo in the left atrium, dividing it into ventral and dorsal chambers. Contrast echocardiography in the four chamber apical view showed an atrial right to left shunt and only opacification of the ventral chamber of the left atrium at the mitral orifice. On the other hand, the dorsal chamber which received the pulmonary veins could not be opacified by contrast. The contrast injection allowed the diagnosis to be confirmed by demonstrating the division of the left atrium into two chambers.

Child, Preschool↗
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↗
PubMed1983

Tricuspid atresia. Results of treatment in 115 children.

We present our experience in the management of tricuspid atresia in 115 children. The anatomic data are categorized as follows: type I, 83.5%, type II, 16.5%. Type IB is the most frequent, representing 63.5% of all the cases. Each patient was operated upon one to four times. The age at first operation ranged from 10 days to 20 years. The first operation was a shunt in 94 children, a Fontan operation in four, and banding of the pulmonary artery in 17. Hospital mortality for the first operation was 12.2%, significantly higher in children under 6 months and in those having Waterston shunts. Potts and Blalock-Taussig operations give low long-term mortality; although few (six) have been done, Potts shunts also seem to give good long-term palliation in this series. The Glenn anastomosis is a good operation when performed after a systemic-pulmonary arterial shunt. The Fontan operation was performed in 24 children (hospital mortality 16.6%). There have been no late deaths after the third month postoperatively. Mean follow-up for this operation is only 2 years, but 88% of the survivors lead a normal life, two thirds of them receiving no treatment. There has been one reoperation for stenosis of a Dacron conduit with a good result. Late arrhythmias are well tolerated. In conclusion, the Fontan procedure is a good operation, but palliative procedures still allow good long-term survival.

Actuarial Analysis↗
PubMed1982

[Diaphragmatic paralysis and eventration].

Paralysis of the diaphragm normally heals in a matter of weeks, provided that it does not result from permanent damage to the phrenic nerve. The most frequent cause is traumatic, a consequence of birth or a postoperative complication, especially after cardiovascular surgery. The vital prognosis may involve respiratory insufficiency and consequent ventilation problems. But the situation has greatly changed as a result of the technical progress made in respiratory reanimation. When the necessary time is available, the indications of surgical plication are becoming rarer. Diaphragmatic eventration, on the other hand, involves rarefaction or the complete disappearance of the muscle fibres of the diaphragm. Over two thirds of such cases require surgical treatment. The eventration may result from an acquired affection leading to permanent destruction of the phrenic nerve. But it may also be associated with malformations, and in that event the prognosis is definitely severe.

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↗
PubMed1982

[Aberrant subclavian artery in infants. Division and reimplantation into the common carotid artery through cervicotomy (author's transl)].

In infants, merely dividing an aberrant subclavian artery (ROSCA) through left-thoracotomy may result in severe cerebral circulatory disorders by vertebrobasilar arterial steal. The authors report on 3 cases where reimplantation of the ROSCA into the common carotid artery reproduced a normal brachiocephalic arterial trunk and resulted in normal revascularization. In 2 of these 3 cases, the ROSCA was approached through a right cervical incision, divided in the mediastinum, behind the oesophagus, and reimplanted by latero-lateral anastomosis into the right carotid artery. In the third case the same approach was preceded by left thoracotomy for easier division of the ROSCA close to the aorta. The three operations were uneventful and no complication occurred, except for transient and mild left hemiparesis without sequelae in one patient.

Aorta, Thoracic↗