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Biomedical subjects

J P Binet

Publications and source records attributed to J P Binet.

At least 109 records · Page 6Linked to original sources
PubMed1982

[Two-dimensional echocardiography in subvalvular aortic stenosis. Apropos of 20 cases].

Twenty cases of discrete subvalvular aortic stenosis in children aged from 8 months to 23 years were examined by 2-dimensional echocardiography and cineangiography. Fifteen of these patients subsequently underwent open heart surgery to relieve the obstruction. In 18 cases the obstacle was a fixed stenosis (13 type I, 3 type II and 2 type III) and in two cases, the obstacle was provoked by accessory tissues of the anterior mitral leaflet. The echocardiographic incidences used were the left parasternal long axis, the apical LAO-equivalent, and longitudinal and transverse subcostal views. In type I, fixed subvalvular stenosis, one fine abnormal echo was visualised in the left ventricular outflow tract throughout the cardiac cycle immediately below the aortic valve, best seen on apical views. Twelve of the 13 stenoses of this type were demonstrated by 2D echocardiography. In type II stenosis an abnormal thickened echo was visualised in the left ventricular outflow tract at a distance from the aortic cups. The adherence of this abnormal echo to the anterior mitral leaflet was best demonstrated by apical views. All three cases of this type were demonstrated by echocardiography. Type III stenosis was characterised by widespread narrowing of the subaortic region with irregular borders. Obstruction due to accessory tissues of the anterior mitral leaflet were well demonstrated in left parasternal long axis and apical views. They showed an even rounded mass of echos attached to the anterior aspect of the anterior leaflet prolapsing into the left ventricular outflow tract. Both cases in this series were diagnosed by 2D echocardiography. Therefore, 2D echocardiography with apical and subcostal views is a valuable method for diagnosing subvalvular aortic stenosis and for determining its anatomical type.

Adolescent↗
PubMed1982

["Straddling" tricuspid valve across an isolated ventricular septal defect. Apropos of 4 cases].

Four cases of children from 10 months to 3 years of age with isolated ventricular septal defects and straddling tricuspid valve are reported. Three patients underwent surgery (mean age: 24 months). The lesion was diagnosed during operation in 2 cases. The VSD was a perimembranous defect with extension to the ventricular inlet in 2 cases, and in the other it was entirely muscular. The straddling involved all the septal leaflet of the tricuspid valve in 1 case. In two cases, there was doubling of the segment with one part crossing the VSD. The left ventricular attachment was a type B in 2 patients and type C in 1 patient. The tricuspid ring was normally situated in all patients (no overriding). In 2 patients, the diagnosis was made with the aid of complementary investigations, and, in particular, 2D echocardiography. One of these patients has not yet undergone surgery as the lesion is well tolerated and because of associated mitral regurgitation. In 3 patients, surgery consisted of repairing the ventricular septal defect, leaving the abnormal part of the tricuspid valve in the left ventricle. All patients survived; there were no cases of post-operative atrioventricular block or signs of tricuspid incompetence. With reference to these three cases, the authors review the main anatomical lesions, the diagnostic signs and different methods of treatment of this condition. Straddling tricuspid valve may present as a simple ventricular septal defect. This diagnosis should be considered in all cases of posterior ventricular septal defects.

Angiography↗
PubMed1981

[Coarctation of the thoracic aorta with extensive segmental hypoplasia. A new surgical approach (author's transl)].

The authors describe a new surgical technique used for the repair of coarctations of the aorta with extensive segmental hypoplasia. The technique is divided into four stages: enlargement of part of the hypoplastic segment by arterioplasty, using a flap from the subclavian artery; the extent of possible enlargement is governed by the length of subclavian artery available; resection of the residual hypoplasia and of the coarctation area proper; end-to-end anastomosis of the two aortic segments; revascularization of the arm by direct implantation of the subclavian artery into the left common carotid artery.

Aorta, Thoracic↗
PubMed1981

Recurrent coarctation of the thoracic aorta: subclavian flap arterioplasty with carotid reimplantation of the distal subclavian artery.

Combining a subclavian flap procedure and reimplantation of the distal subclavian artery into the left carotid artery was used in 2 patients with recurrent coarctation of the thoracic aorta. One of the patients was 12 years old and the other, 6 years old. The operation has several advantages. (1) It is very efficient in relieving recurrent gradients. (2) The use of prosthetic material is avoided. (3) Minimal dissection is required. (4) It prevents subsequent subclavian steal syndrome and long-term ischemia of the left upper limb.

Aorta, Thoracic↗
PubMed1981

Evaluation of T cell subsets in myasthenia gravis using anti-T cell monoclonal antibodies.

Functional T cell subsets have been evaluated in the peripheral blood of patients with myasthenia gravis using monoclonal anti-T cell antibodies and a suppressor cell assay based on the suppression of the mixed-lymphocyte reaction by concanavalin A-activated lymphocytes. A significant decline of suppressor cells was found in a large proportion of patients, both by direct count using the anti-suppressor-cytotoxic T cell antibody (OKT8) and by the suppressor assay. Patients also showed an increase in immature T cells defined by their simultaneous reaction with the anti-helper cell (OKT4) and anti-suppressor cell (OKT8) antibody. Thymectomy tended to enhance the deficit in suppressor cells, and to induce the disappearance of double-labelled cells.

Adolescent↗
PubMed1981

[Heart with criss-cross ventricles associated with an obstruction of the ejection pathway of the left ventricle and a mitral anomaly].

A case of criss-cross heart with situs inversus associated with subvalvular aortic stenosis and mitral regurgitation in a 9 year old boy is reported. Surgical correction of the valvular abnormalities gave an excellent clinical and haemodynamic result. A review of the literature shows that this abnormality of rotation of the ventricles coexists with a concordant atrioventricular connection in 70 % cases; the ventriculoarterial connection is only discordant in 12 % cases. The right ventricle is always situated above the left ventricle. The most common associated lesions are usually accessible to surgery; ventricular septal defect (98 % cases); stenosis or atresia of the pulmonary artery (70% cases). However, right ventricular hypoplasia is also common (65 % cases). Six patients underwent surgical correction of the associated lesions with 4 successes and 2 deaths. Surgery is possible in these complex cardiac malformations with good results providing a precise preoperative anatomical diagnosis is made.

Aortic Stenosis, Subvalvular↗
PubMed1981

[Diagnosis and localization of ventricular septal defects by two-dimensional echocardiography. 50 cases].

A series of 50 children aged between 1 month and 15 years old, with ventricular septal defects (VSD) were investigated by two-dimensional sector scanning and cineangiography. Fifty other children of the same age group with congenital heart disease without VSD were also investigated by two-dimensional echocardiography and angiography. No VSDs were diagnosed by echocardiography in children with angiographically intact inter ventricular septa. In the group with VSD, two-dimensional echo localised with precision: --36 membranous VSDs (36/36) --5 infundibular VSDs (5/6) --2 isolated muscular VSDs (2/2) --I atrioventricular canal type VAD (I/I) --3 multiple VSDs (3/5). The subcostal view was the most useful for visualising the VSD in 49 out of 50 cases. The parasternal views only showed the VSD in 23 cases, and the apical views only in II cases. The dimensions of the left heart chambers and the movement of the interatrial septum gave an indication of the volume of the left-to-right shunt. Dilatation of the left heart chambers and bowing of the interatrial septum into the right atrium in systole were observed in all cases where QP/QS greater than 2, except when there was an associated atrial septal defect. Two-dimensional echo also detected associated lesions: pulmonary stenosis (9/9), prolapse of an aortic valve cusp (4/5), atrial septal defect (2/2), stradling of the tricuspid valve (I/2). Two-dimensional echocardiographic short axis subcostal views are reliable in the detection and localisation of VSD. Nevertheless, trabecular and apical VSDs are particularly difficult to visualise and the use of pulsed Doppler coupled with two-dimensional echocardiography should enhance the sensitivity in diagnosing this type of VSD.

Adolescent↗
PubMed1981

[Diagnosis of a complete atrioventricular canal with infundibular pulmonary stenosis and left superior vena cava by 2-dimensional contrast echocardiography. Apropos of a surgically treated case].

The case of an eight year old child with complete atrioventricular canal, pulmonary infundibular stenosis and persistent left superior vena cava draining into the coronary sinus is reported. Two-dimensional echocardiography with injection of contrast in a left arm vein gave a precise and complete diagnosis of the malformations before catheterisation and angiography. The complete atrioventricular canal was demonstrated by apical four-chamber views. The pulmonary infundibular stenosis was visualised by a short axis subcostal view. Contrast echocardiography in the apical four-chamber view showed a right-to-left shunt at atrial level at the site of the ostium primum and a right-to-left shunt at ventricular level just below the hemivalve. The left superior vena cava was detected by a short axis suprasternal view which visualised its vertical trajectory as far as the coronary sinus. The lesions were confirmed at surgery, and a complete repair was performed.

Atrioventricular Node↗
PubMed1980

[Complete correction of the tetralogy of Fallot without right ventriculotomy].

The authors present an improved technique for operative treatment of tetralogy of Fallot. Developed by Edmund's technique it complets and improves it in several ways making it suitable for nearly all forms of tetralogy of Fallot. The transatrial approach is intended by it's author to only selected cases of the malformation, namely with large pulmonary arteries a correct pulmonary annulus and moderate infundibular hypertrophy. The combined approach which we propose (transatrial and transpulmonary) gives us very good post-operative and short term results.

Heart Ventricles↗