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Biomedical subjects

M Belhaj

Publications and source records attributed to M Belhaj.

At least 19 recordsLinked to original sources
PubMed1992

Cardiac operations during active endocarditis.

Between December 1982 and March 1990, 65 patients with active infective endocarditis underwent cardiac operations. Their mean age was 28.6 years (range 1 to 65 years). The most common infecting organisms were staphylococcus (33.8%), streptococcus (18.5%), and brucella (16.9%); 11 patients (16.9%) had cultures negative for infection. A rheumatic, native valve, most commonly the aortic, was involved in 40 patients, a prosthetic valve (with the mitral most common) in 18 patients, and in seven patients the infection involved a congenitally abnormal valve. Aortic root abscess developed in 21.5% of patients. In 30 patients operation was performed within 3 days of the start of intravenous antibiotic therapy, usually within 3 days of admission (group A); this resulted in fewer preoperative complications and a significantly lower postoperative complication rate than in those 35 patients who underwent operations more than 3 days after starting antibiotic therapy (group B). Preoperative embolic phenomena occurred in eight (12.3%) of the 31 patients who had large, mobile vegetations (2/16 [12.5%] in group A and 6/15 [40%] in group B). Overall there was no reinfection. No postoperative paravalvular leaks developed in group A. Nine patients died in the hospital (13.8%) (four in group A and five in group B); in all patients the infecting organism was staphylococcal or fungal. There was one late death. Early operation should always be considered in active infective endocarditis, especially when a prosthetic valve is involved or the infecting organism is staphylococcal or fungal. The disclosure of moderate to large vegetations by two-dimensional echocardiography is an indication for operation.

Adult↗
PubMed1985

[Adult pulmonary valvular stenosis, major stenosing right ventricular hypertrophy and tricuspid insufficiency. Apropos of 2 cases].

2 cases of severe pulmonary valvular stenosis in two young adults aged 21 and 29 years respectively are presented. Despite the degree of stenosis (4 mm jet), the right ventricular pressures did not exceed systemic pressures because of severe tricuspid regurgitation. This dominated the clinical and anatomical findings, causing aneurysmal dilatation of the right atrium and displacement of the tricuspid valve to the left. The diagnosis of Ebstein's anomaly was raised in one case but excluded by echocardiography and angiocardiography. In spite of the severity of the symptoms and peripheral clinical signs, surgery of the right ventricular outflow tract, tricuspid valvuloplasty and resection of part of the right atrium led to a complete and rapid cure, confirmed by catheterisation one month after operation.

Adult↗
PubMed1984

[Abnormal aortic arches in infants and children (experience with 322 cases)].

It is very rare that the knowledge of the human embryology helps the medical diagnosis and guides the surgical treatment when it is necessary. With the oesophagogramm it is possible to obtain the exact topography of the abnormal vascular ring and to perform live saving operation. Our experience of 322 cases is the most important published up to now.

Aorta, Thoracic↗
PubMed1984

[Abnormal aortic arch in children and infants. Experience in 322 cases].

The authors report on their experience in 322 cases of aortic arch anomalies surgically treated in infants and children. The progress recently achieved through improved diagnosis and resuscitation care have made possible to obtain good results in the great majority of cases.

Abnormalities, Multiple↗
PubMed1983

[Secondary closure of the sternum in open-heart surgery. 50 cases].

In intrathoracic cardiac and vascular surgery, immediate repair of median sternotomy sometimes results in rapid haemodynamic failure. We therefore chose delayed sternal closure in 50 patients with complex heart disease. Three cases of infection were recorded. This safe and easy procedure presents the advantage of being life-saving for more than one third of the patients.

Adolescent↗
PubMed1983

Perirenal space implantation of permanent cardiac pacemakers in infants and small children.

Permanent pacemakers were implanted in 40 children aged one day to 17 years. A new technique, necessitating thoracotomy and lumbotomy, is described briefly. Indications were surgical block in 22 (55%) and congenital block in 18 (45%) patients. Five of 40 (12.5%) died. Reoperation was required 4 times: for electrode problems (3), and wound problem (one). No late infection or wire fractures were noted. The time paced ranged from 7 days to 37 months. All of these patients received lithium units.

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

[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↗
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↗
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↗