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Biomedical subjects

M Cuillière

Publications and source records attributed to M Cuillière.

36 records · Page 2Linked to original sources
PubMed1984

[Socio-professional rehabilitation after transluminal coronary angioplasty].

Between April 1980 and October 1982, 109 patients underwent attempted transluminal coronary angioplasty (TCA) with a primary success rate of 71,6% (78 patients). Two patients died of complications of TCA and another one died suddenly 3 months after TCA. The socio-professional rehabilitation of the 106 survivors was studied by questionnaire to which 98 subjects (81 men, 17 women; average age 50,2 +/- 9,2 years) replied. Seventy seven patients were working before their coronary disease and 73 (62 men, 11 women; average age 46,4 +/- 9,1 years) replied to the questionnaire (95%). This constituted the study group, the socio-professional outcome or which was compared to that of 37 active patients who underwent single aorto-coronary bypass surgery during the same period. After TCA, 53 patients (73% returned to work, 48 as full time workers, after an average convalescent period of 4 months. Professional rehabilitation depended mainly on the initial result of TCA: 85% after primary success; 40% after failure (p less than 0,001); in the latter case, the rate of return to work improved if the patients had surgery (58%) rather than medical therapy (125%). Similarly, the average age of re-employed patients was lower (46,1 +/- 7,9 years, compared to 49,3 +/- 6,8 years, p less than 0,05). Finally, the patients returning to work usually claimed to be in good or very good health (72% compared to 30% p less than 001). After single aorto-coronary bypass, only 14 patients (38%) returned to work, 8 full-time, after an average 7 months' convalescence. The duration off work before surgery was related to the incidence of re-employment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Cost of a coronary transluminal angioplasty compared with a single coronary bypass. Economic effects].

The authors discuss the financial incidence of transluminal coronary angioplasty (TCA) compared to isolated coronary bypass surgery (CBS). The study was limited to 1982 (76 cases of TCA) and compares two groups: successful TCA (17 consecutive cases: group I); isolated CBS (18 cases: group II). The following parameters were studied in each group: average length of hospital study, credits received from the Department of Social Security, hospital expenditure. Hospital expenditure was classified under 6 headings: personnel, material, investigations, drugs, hospital costs and administration costs. The results expressed as the mean per patient were: in group I: hospital stay, 10 days; Social Security reimbursement, 10 813 FF; hospital expenditure, 10 586 FF. In group II: hospital stay, 18 days (including 4 days in the ICU); Social Security reimbursement 46 656 FF; hospital expenditure, 28 955 FF. The hospital costs of personnel were relatively small (especially for TCA). The economies realised by reutilising catheters designed for single usage were significant: the use of guide wires, catheters and balloon catheters falls from 1.64, 1.9 and 0.1 per patient to 0.47, 0.53 and 0.05 respectively, a saving of 5 068 FF per TCA and 385 168 FF per year. Compared to costs in the United States (4 773 and 14 952 dollars) TCA and CBS is much cheaper in France.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1982

[Early detection of myocardial alterations in mitral insufficiency with the angiotensin test].

Left ventricular function was assessed at rest and after increasing systemic arterial resistance by angiotensin in 40 patients with isolated mitral insufficiency. Angiotensin was administered intravenously at a dose of 0,4 micrograms/mn until the systolic blood pressure rose by at least 30 mm Hg. Left ventricular and aortic pressures, cardiac index and left ventriculography in the 30 degree right anterior oblique projection (50 frames per second) were recorded before and during angiotensin infusion. The mean rise in systolic left ventricular pressure was 40 +/- 2,8 mm Hg; the heart rate increased slightly but significantly; left ventricular and diastolic pressure rose from 12,0 +/- 1,0 to 24,0 +/- 1,2 mmHg. The systolic index (Fick's method) was significantly decreased (37 +/- 1,6 ml/m2 to 26 +/- 1,6 ml/m2) though the angiographic systolic index remained unchanged. This is explained by an increase in the regurgitant fraction (51 +/- 2,5% ao 65 +/- 3%). The end diastolic volume index was unchanged; the ejection fraction was significantly decreased. The resting hemodynamic status was only slightly disturbed in 29 patients (mean capillary pressure less than 15 mm Hg, 8,8 +/- 0,52 mmHg). The left ventricular function curves with angiotensin distinguished two groups of patients: Group A (20 patients) with left ventricular dysfunction induced by angiotensin, Group B (9 patients) who maintained the systolic index despite the increase in left ventricular end diastolic pressure. These results suggest that the angiotensin test may be useful for detecting early left ventricular dysfunction in patients with isolated mitral insufficiency and virtually normal resting hemodynamic parameters.

Angiotensin II↗
PubMed1981

[Abnormal vascularisation of the right inferior pulmonary lobe by an aberrant coronary artery. Apropos of 2 uncommon cases].

Pulmonary vascularisation by the coronary vessels does not seem to have been previously described. The authors report 2 cases of vascularisation of the righ lower lobe by an atrial branch of the right coronary or circumflex arteries. Several pathogenic hypotheses are discussed. No definite conclusions can be drawn despite postmortem examination in one case. Pulmonary sequestration would seem to be very probably although there are a few contradictory findings. Acquired inflammatory conditions alone or associated with the congenital malformation cannot be excluded. These anomalies pose difficult therapeutic problems for cardiologists as they are discovered during coronary angiography for angina. The question of a "pulmonary steal" syndrome aggravating the coronary insufficiency possibly requiring both a pulmonary and a cardiac operation may be raised. From the pulmonary point of view, other methods of investigating patients with pulmonary sequestration and haemoptysis of unknown origin could be indicated.

Coronary Vessel Anomalies↗
PubMed1979

[Right ventricular dysplasia; a study in 7 cases].

Seven new cases of right ventricular dysplasia are described, five of which were complicated by ventricular tachycardia. The frontiers of this syndrome are unclear and it is uncertain whether it should be considered as a separate disease entity, or as a minor form of "paper thin" right ventricle or Uhl's disease.

Adult↗
PubMed1975

[Infarction with late disappearance of the Q wave. Apropos of 30 cases].

A selective coronary arteriography was performed in 30 subjects with myocardial infarction, after disappearance of the necrosis wave. The angiographic characteristics of this group when compared with a series of infarctions, unselected by the clinical course, wers: a decreased severity index; a better development of the compensatory circulation; and a lesser frequency of severe disturbances of ventricular dynamics. Disappearance of the Q wave might be explained by a very distal occlusion in 2 cases, by a recanalization in 4 cases and by a very intense development of the collateral circulation in 8 cases. One subject had a normal coronary arteriography.

Angiography↗
PubMed1975

[Pre-infarction syndrome involving the anterior interventricular artery. Therapeutic and diagnostic considerations].

Based on the study of 25 cases, the authors define menace syndrome in the anterior descending artery (ADA) according to three criteria: angina of recent onset and rapid development, a major disorder of repolarisation in the anterior part of the heart, and a tight proximal stenosis of the ADA. Of seven patients who could not undergo surgery, three sustained anterior infarctions, and three died after 30 days. 18 patients underwent surgery to revascularise the myocardium by anastomosis of the internal mammary artery to the ADA; 13 of these were carried out as urgent procedures (an average of 26 hours after coronary arteriography). The functional results were excellent, and all of the internal mammary anastomoses studied at 6 months (9 cases) were patent. This study has shown that menace syndrome of the ADA is a surgical emergency, and that a procedure to anastomose the coronary arteries should be carried out immediately after coronary anteriography.

Adult↗