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Biomedical subjects

J-G Kretz

Publications and source records attributed to J-G Kretz.

7 recordsLinked to original sources
PubMed2005

[An atypical discipline: surgery in bullfighting. Two case reports].

Many bullfighters had been seriously injured, even sometimes killed during the fight in the bullring (around 300 deaths since the beginning of the 20th century). There is no comparison between bullfight's traumas and civil or war traumas, so only specialized medicine doctors and surgeons can be involved for practising. Surgery of bullfighting is a single speciality. The bullfight's surgeon in safekeeping will operate immediately in the bullfight place's infirmary and will aim at reducing the deep effect of horn injury. In this work, authors point out the bullfight pathology's complexity and its surgical treatment by presenting two original cases.

Animals↗
PubMed2005

[Low molecular weight heparin in patients undergoing vascular surgery].

OBJECTIVES: Despite the fact that there are no approved indications by the French regulatory agency and despite the absence of recommendations, low molecular weight heparins (LMWH) are frequently used in vascular surgery, an area at both high risk of perioperative arterial and venous thrombosis as well as of bleeding. The aim of this study was to investigate medical practice in vascular surgery, using a survey of prescribers of antithrombotic agents. STUDY DESIGN: Survey of physicians from different specialities involved in patient care before, during, and after vascular surgery. PATIENTS AND METHODS: Between March and June 2003, 301 physicians filled a questionnaire providing information about their antithrombotic regimens depending on the type of vascular surgery. These physicians are involved in an important part of vascular surgery activity in France. RESULTS: The survey confirmed the use of LMWH in near 80% of patients scheduled for vascular surgery. The prescribed LMWH is frequently associated with antiplatelets agents. During patient's hospitalization, LMWH prescription is guided by numerous factors, making the prescription protocol rather complex. Major risk factors favoring continued prophylaxis after patient's hospital discharge include surgery with a high risk of thromboembolic events and limited ambulation. Analysis of the data also showed that the surgeon and the referring physician are both implicated in the majority of the postoperative care following patient's discharge, and therefore, in prescribing the antithrombotic drug. CONCLUSION: This survey gives information on practical use of LMWH in the vascular surgery setting. This information could lead to prospective studies of LMWH in situations other than venous thromboembolic disease.

Anticoagulants↗
PubMed2004

[Vascular graft prosthesis].

Performed since the 1950s, vascular grafting has opened modern era of vascular surgery. Autologous venous grafts are of first choice for revascularisation of small arteries. Synthetic grafts are mainly modelled using microporous polytetrafluoroethylene or terephtalate polyethylene. These prosthesis are mainly used for revascularization of medium and large size arteries.

Blood Vessel Prosthesis↗
PubMed2004

Influence of the textile structure on the degradation of explanted aortic endoprostheses.

OBJECTIVES: To investigate mechanisms of textile failure in explanted human aortic endoprostheses. MATERIALS AND METHODS: Endoprostheses (n31) underwent optical and scanning electron microscopy, filament dynamometry, and saturation index measurement. RESULTS: The macroscopic lesions observed in the Stentor and Vanguard devices were holes at the extremities of the stents and slipping of the warp yarns at the level of sutures or of the longitudinal seams. The macroscopic lesions observed in AneurX endoprostheses were holes, slipping of the warp yarns and ruptures of the ligatures. The macroscopic lesions observed in the two Talent endoprostheses were sections of fibers at the level of the suture holes and few areas lesions of wear, with sometimes holes at the contact of the stent extremities. Stentor, Vanguard and AneurX all demonstrated low saturation indexes of the fabric (44-59%) with an important anisotropy. Whereas the Talent endograft demonstrated a high index of saturation (124-131%) with a low anisotropy. We did not demonstrate significant polymer degradation in any of the endoprostheses. CONCLUSIONS: It is essential to take into account the saturation index to optimally choose a woven textile for the construction of an endoprosthesis since this property of the textile may contribute to explain the macroscopic lesions observed. We did not observe significant polymer degradation by filament dynamometry but further studies are needed to confirm these data.

Aortic Aneurysm, Abdominal↗
PubMed2003

Mechanisms of rupture of knitted polyester vascular prostheses: an in vitro analysis of virgin prostheses.

OBJECTIVES: Previous explant retrieval studies have shown ruptures occurring on the remeshing line and the guide line of two types of warp-knitted grafts. The aim of our study was to characterize the mechanisms these ruptures. MATERIALS AND METHODS: We performed an in vitro study of the mechanical and chemical characteristics of virgin prostheses. We studied 2 virgin polyester warp-knitted grafts models: the Cooley Double Velour and the Microvel Double Velour constructed by Meadox (USA), using the following techniques: characterization and de-knitting of the textile structure, circumferential tensile strength, filament dynamometry, critical dissolution time of the filaments and scanning electron microscopy. RESULTS: Both prostheses were constructed in the same way but the texturized yarns of the Cooley graft included twice as many filaments (54) than the Microvel (27). There was more adsorbed tension in the Cooley structure than in the Microvel. The circumferential tensile strength test demonstrated that the Cooley graft always ruptured on the remeshing line and the Microvel graft always ruptured at the interface between the remeshing line and the standard line. Filament dynamometry demonstrated a heterogeneous behavior of the filaments inside the yarns, mainly at the remeshing line of the Cooley graft (27.1 cN/tex +/- 11.5% versus 26.1 cN/tex +/- 2.2% for the guide line and 28 cN/tex +/- 6.7% for the standard knit). Critical dissolution time of the filaments was significantly lower for the Microvel grafts (2.5 sec versus 17.2 sec for the Cooley). CONCLUSIONS: Rupture of knitted polyester prostheses are probably an underestimated phenomenon. They may occur at specific areas of the graft. Further studies are required to determine whether all grafts of this type are at risk.

Blood Vessel Prosthesis↗
PubMed2002

Surgical treatment of a Budd-Chiari syndrome secondary to hepatic inferior vena cava agenesia.

We report the case of a surgically treated congenital Budd-Chiari syndrome related to agenesia of the retrohepatic inferior vena cava. The first symptoms of the disease were noticed in childhood. The increasing symptomatology led to propose, at the age of 30 years, first a percutaneous transluminal angioplasty which failed, because of the impossibility to recanalize the obstructed segment. Then a surgical procedure consisting of the implantation of ePTFE prosthesis between the right atria and the retrohepatic inferior vena cava was performed. The hepatic biopsy showed a centrolobular fibrosis and an old subglissonian infarction. The patient was improved, allowing him to recover a normal life. However, three years later, an angiographic evaluation performed because of a recurrence of a slight abdominal pain, showed a thrombosis of the bypass. An attempt at thrombolysis failed. Since the patient did not present major clinical and biological consequences we only proposed a surveillance and no endovascular procedure because of the fear of a pulmonary emboli. The purpose of this case report is to review the literature and discuss the etiopathology of congenital Budd-Chiari syndrome with regard to the different therapeutic options.

Adult↗