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M C Maréchal

Publications and source records attributed to M C Maréchal.

6 recordsLinked to original sources

[Evaluation of the quality of life in adulthood of 158 patients surgically-treated for tetralogy of Fallot].

Open heart correction of tetralogy of Fallot is now carried out in infancy. This operation provides children with the best physical and mental conditions for them to complete their education. Until recently, follow-up had been too short to assess the results of repair during infancy in adults. The object of this study was to evaluate the quality of adult life in the first 158 survivors of this surgery, now aged 19 to 36 years, performed in our department since 1968. Ninety eight per cent of these patients are physically capable of leading a normal life; 24% obtained their "baccalaureate" and hold positions of high professional responsibility; 37% achieved basic education diplomas. Even those who left school without qualifications were usually able to find employment. The number of unemployed is less than that of the same age group in the general population. Thirty per cent are married or live with someone, and twenty five per cent have normal healthy children. The large majority have normal active lives. Thirty per cent play sport regularly as a leisure activity. Notwithstanding, all these patients were operated for severe symptoms. Two thirds had had previous Blalock shunts. Severe and persistent cyanosis is not a sign of anatomic severity of tetralogy of Fallot and does not seem to influence the socio-professional outcome. These results are those of what was considered to be high risk surgery at the time because of the inaccuracy of angiographic diagnosis, the inadequacy of myocardial protection and the chronicity of the anatomo-pathological lesions (average age of operated patients was 8 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Comparative assessment of cardiac and psychologic results of aortocoronary bypass].

Two categories of criteria are used to evaluate the cardiological and psychological results of aortocoronary bypass (ACB): objective criteria, which support the clinician's judgement, and subjective criteria, which contribute to the patient's comfort. Numerous studies have revealed major discrepancies between these two modes of evaluation. A prospective study was undertaken to compare the cardiological and psychological results of ACB at 1 year. The study was based on 24 parameters collected in an ordinary cardiology consultation and from an open discussion between the patient and his (or her) partner and a psychiatrist. In the first phase of the study the results observed in 51 patients were classified as "good" in 40 and "poor" in 11 by the cardiologist, as against "good" in 32 and "poor" in 19 by the psychiatrist. The psychiatrist's assessment differed from that of the cardiologist on 22 patients, being better in 7 and not as good in 15. The second phase of the study has been devised to validate the results obtained in the first phase and to evaluate the contribution of ergonometric test to the cardiological classification of 37 new patients. This study makes it possible to analyze the reasons for the difference in assessment of the cardiological and psychological benefits of ACB, and to develop a method for measuring the impact on these results of new therapeutic measures, such as rehabilitation.

Adult

[Schizophrenia].

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Adolescent

[Study of the long-term psychological consequences of heart valve prostheses].

The present follow-up period of cardiac surgery allows assessment of the long-term consequences of valvular prostheses, the short-term consequences having already been the object of many studies. 50 patients of both sexes, operated on for aortic or mitral valve disease between 1973 and 1974 were interviewed to assess their degree of psychological adaptation with regard to their cardiac status and the principal factors of adaptation. The position of the prosthetic valve (aortic or mitral) seemed to be of little importance and the prognosis depended rather on sex, age at operation, previous personality, intelligence quotient, postoperative psychiatric complications and the interval between diagnosis of the disease and operation.

Adaptation, Psychological