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Biomedical subjects

M A Radermecker

Publications and source records attributed to M A Radermecker.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Clinical case of the month. Complete replacement of the ascending aorta and aortic arch in a case of chronic aortic dissection].

We report the case of a patient who developed an evolutive chronic aortic dissection after ascending aorta replacement for acute type A aortic dissection. Owing to the development of severe aortic regurgitation, aortic root pseudoaneurysm and aneurysmal dilatation of the arch and descending aorta, reoperation was adviced. Reoperation included Cabrol modification of the Bentall operation and aortic arch replacement with elephant trunk performed under deep hypothermic circulatory arrest. The incidence of late aneurysmal formation in type 1 aortic dissection has been reported to be 30%. Close postoperative follow-up of the aortic diameter is necessary to detect a critical dilatation and to permit elective reoperation.

Aortic Dissection↗
PubMed2001

[Coronary revascularization of the beating heart using complete arterial grafts].

A case of complete arterial revascularization using both mammary arteries and the left radial artery is reported. The operation was done on the beating heart with the adjunct of a Y graft owing to a severely calcified ascending aorta. This observation is the occasion to review the basic principles of beating heart surgery.

Aorta↗
PubMed2001

[Shone's syndrome: report of four cases and review of the literature].

The observation of four clinical cases of Shone's complex, two of them presenting first with predominant coarctation of the aorta, prompted us to review the pertinent literature. Patients with multiobstructive lesions of the left heart, including Shone's complex, represent a surgical challenge where the adequate management of mitral valve anomalies, subaortic stenosis, and coarctation constitutes the key prognostic factor for satisfactory mid-term outcome.

Aortic Coarctation↗
PubMed2001

[Ventricular septal defect and recent myocardial infarction].

Rupture of the interventricular septum is a classical complication of acute myocardial infarction. The diagnosis should be evoked when the patient's hemodynamic condition deteriorates in the presence of a new systolic murmur. A transthoracic or, preferably, transesophageal echocardiography confirms the diagnosis. Early surgical correction constitutes the best treatment. Despite recent progresses, mortality remains high but long term results are encouraging. The risk factors conditioning prognosis, the surgical options and the question of simultaneous coronary bypass will be discussed after a thorough review of the literature.

Coronary Artery Bypass↗
PubMed2000

[Place of the Ross procedure (pulmonary autograft) in aortic valve surgery].

The pulmonary autograft operation consists of an aortic replacement using the autologous pulmonary valve. The pulmonary valve is substituted by a cryopreserved pulmonary homograft. This operation is in fact a delicate double valve replacement whose benefits are linked to the viability of the new aortic substitute. The pulmonary autograft has superb hemodynamic features and very low thrombogenicity. The report of a selected observation offers the occasion of defining the current indications of this operation in aortic valve surgery.

Aortic Valve↗
PubMed2000

[Fundamentals and indications for mitral valve repair surgery].

The concept of mitral valve repair is discussed, emphasizing the basic knowledge on which it relies, and the breakthrough it has produced in modern cardiac surgery. This concept challenges the myth of the artificial prosthesis, showing the superiority of autologous biological structures submitted to plastic repair. The foundations of valvular repair and the techniques that have contributed to its success are reviewed, and the advantages for the patients in terms of quality of life, and preservation of the left ventricular function are discussed.

Bioprosthesis↗
PubMed2000

[Extensions of mitral valve repair techniques: surgery for endocarditis and valvular tumors].

Mitral valve repair has demonstrated its superiority over valve replacement. Mitral valve repair constitutes the optimal therapeutic option in case of degenerative dystrophic, rheumatic, congenital or ischemic mitral valve disease. These surgical techniques can also be successfully and advantageously applied in case of bacterial endocarditis or tumoral valvular disease. We report a case of staphylococcal endocarditis and another case of posterior leaflet fibroelastoma to show the place of conservative mitral surgery in these unusual indications.

Adult↗
PubMed1999

Cardiac involvement in Coffin-Lowry syndrome.

Coffin-Lowry syndrome is an X-linked recessive syndrome of mental retardation, characteristic facies and skeletal anomalies. In one patient with the syndrome, we observed early recurrent episodes of congestive heart failure with intercurrent normalization and the late development of mitral insufficiency due to annular dilation and congenital abnormalities of the valve apparatus. This unusual course of cardiac involvement, the non-adaptation of the left ventricular contractility to the aggravation of the mitral insufficiency and the postoperative persistence of the ventricular dysfunction, underline the possible role of an associated primary myocardial disease. This clinical observation demonstrates clearly that a mitral valve malformation can occur in patients with the syndrome, but also the role of a dilated cardiomyopathy, which can be secondary to the mitral regurgitation, but is more likely a myocardial disorder occurring as part of the syndrome.

Abnormalities, Multiple↗
PubMed1999

Typical presentation of intramural aortic haemorrhage (IAH) with evidence of intimal tear at MRI and angiography.

A typical appearance of IAH was evidenced by CT and TEE in a 56-year-old hypertensive female suspected of developping classical acute aortic dissection (AAD). Further examination with MRI and aortography showed unequivocally the presence of an intimal tear in the aortic arch. This coexistence of intimal tear has never been evidenced preoperatively in patients with IAH. This observation demonstrates at the outset that IAH is part of the spectrum of AAD.

Aortic Dissection↗
PubMed1999

[Clinical case of the month. Prolapse due to fibro-elastic degeneration. The aging of the mitral valve].

We report the case of a 73-year-old woman who presents an acute mitral regurgitation secondary to fibro-elastic degenerescence. A mitral valvuloplasty is rapidly performed with complete disappearance of valvular insufficiency and the patient leaves the hospital ten days later. Degenerative mitral regurgitation is commonly seen in elderly patients. This constitutes an excellent indication for mitral valvuloplasty, rather than valve replacement. In our experience, mitral valvuloplasty leads to a complete correction of valvular regurgitation without neither stenosis, nor subvalvular obstruction. Left ventricular function is preserved, as subvalvular apparatus is conserved. This approach allows, in the absence of specific indication, anticoagulation withdrawn two to three months later.

Aged↗
PubMed1999

[Medico-surgical management of childhood cardiopathy: results of the Liège experience].

OBJECTIVE: Evaluation of the results obtained in the management of congenital heart diseases in Liège. MATERIAL AND METHODS: We evaluated the results, the mortality and the morbidity of diagnostic and interventional cardiac catheterization, and of the cardiac surgery in the 123 cardiac children who were referred to us during the three first years of operation of our medico-surgical team. RESULTS: 89 children underwent a catheterization, including 12 therapeutic interventions, whereas 68 were operated. In the two domains, the results are completely comparable with those of the established centers. CONCLUSIONS: The widening of the activity of paediatric cardiology and the creation of an activity of pediatric cardiac surgery in Liège appeared important to us for the quality of management of the cardiac children. This goal could be reached only if our results were comparable with those of the literature. The bet seems to be held. The ultimate objective is to contribute by an adequate policy of management to the quality of life and the health of the cardiac children.

Adolescent↗
PubMed1999

[Congenital abnormalities of the vessels of the base of the heart: "ring" and "sling" vascular abnormalities. Case report].

We present a case of double aortic arch corrected by surgical interruption and full mobilization of the trachea and the esophagus. The vascular malformations of the supraaortic trunks, which form more or less complete vascular rings encircling the esophagus and the trachea, are reviewed. The different presentations of double aortic arch, aberrant subclavian arteries, and abnormal development of the pulmonary arteries are discussed.

Aorta, Thoracic↗
PubMed1999

[Treatment of border-line dilatation of the ascending aorta using the Robicsek intervention].

The technique and the results of the external contention of the dilated ascending aorta by the application of an external Dacron graft are reported. This technique, without replacing the usual graft interposition, can efficiently and expeditiously treat borderline dilatation of the ascending aorta, as frequently encountered in aortic valve disease. If the sinotubular junction is not dilated, this technique may stop the aneurysmal evolution of the ascending aorta.

Aorta↗
PubMed1998

[Cardiac assistance using transformed striated skeletal muscle: cardiomyoplasty].

The biomechanical potential of transformed skeletal muscle used for cardiocirculatory assistance is the keystone of this surgical concept. This underscores the necessity to modulate type II to type I transformation to premise the muscle bulk, shortening velocity, and, therefore, power. It is only if an efficient autologous engine is available that optimal surgical configuration (i.e. aortomyoplasty) will provide active cardiocirculatory support.

Aorta↗
PubMed1998

[Surgery of the heart valves: prosthetic replacement versus repair (1)].

The surgical management of valvular heart disease nowadays includes the use of various valvular substitutes and sophisticated reparative surgical techniques. Characteristics and indications of these different surgical options are discussed and the objective criteria that justify the use of a given technique in a given clinical situation are provided.

Aortic Valve↗
PubMed1998

Surgical repair for mitral valve disease.

The concept of mitral valve repair is discussed emphasizing the basic knowledge on which it relies. Analysis of the valve disease, characterization of valvular dysfunction and surgical techniques adapted to the most frequent valvular dysfunctions are discussed and illustrated.

Cardiac Surgical Procedures↗