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Biomedical subjects

M Iselin

Publications and source records attributed to M Iselin.

At least 19 recordsLinked to original sources
PubMed1994

[Calcified constrictive pericarditis in an adolescent].

The authors report the case of an adolescent with no previous medical history with calcific pericarditis which rapidly progressed to constriction. The disease was diagnosed several months after an episode of chest pain very suggestive of acute viral pericarditis. Surgery was necessary and resulted in a complete cure of the constrictive pericarditis. The aetiologies of constrictive pericarditis are reviewed; previously, tuberculosis used to be the most common cause but it is being progressively supplanted by other pathologies.

Adolescent↗
PubMed1991

Malignant ventricular tachycardia during propafenone treatment in a child with junctional automatic tachycardia: effectiveness of intravenous molar sodium lactate.

Propafenone may aggravate the preexisting arrhythmia or induce another one. Usually, such proarrhythmic effects occur in patients with spontaneous ventricular arrhythmias and/or coronary heart disease with poor left ventricular function. We report the case of a 5-year-old girl with junctional automatic tachycardia and no structural heart disease, in whom malignant ventricular tachycardia occurring during propafenone treatment could be terminated by molar sodium lactate (MSL) infusion. The serum propafenone level obtained before MSL infusion was within the therapeutic range. Two hypothesis could explain the beneficial effects of MSL in our patient: (1) alkalinization facilitates the cell membrane hyperpolarization and thus can decrease the voltage-dependent effect of Class Ic drugs, (2) alkalinization could displace propafenone from its tissue receptor sites by an increase in the nonionized fraction.

Atrioventricular Node↗
PubMed1990

[Late myocardial infarction after closure of coronary artery fistula].

Congenital coronary cardiac fistulae are rare conditions for which surgery is the usual indication. The authors report on the case of one female patient of 28 years with a coronary cardiac fistula responsible for exertional dyspnoea and relapsing pulmonary infections. The diagnosis was suggested by a continuous murmur and was confirmed by Doppler echocardiography and catheterization which showed a dilated, sinuous circumflex artery (2 cm) leading into the right atrium. Surgical closure of the fistula was complicated by an early myocardial infarction and a relapse in the same area with resulting mitral insufficiency. The surgical treatment of coronary cardiac fistulae is widely documented in the literature and recent series demonstrate that good results are usually obtained: however, a late infarction has not been described. The constitution of thrombi in the collateral vessels deriving from the distended vessel probably accounts for the particular evolution noted in this specific case.

Adult↗
PubMed1989

Prenatal diagnosis of left ventricular false tendon.

A case of prenatal diagnosis of left ventricular false tendon is reported. The in utero echographic features of false tendon are described, together with their differential diagnosis. The management of neonates with false tendons is described.

Echocardiography↗
PubMed1989

[Echocardiographic monitoring of the left ventricle in infants and children presenting the primary form of acute cardiac failure].

A retrospective multicenter study was based on influential echocardiograms performed in 34 children, the majority (29/34) being under 2 years of age, and presenting with a primary form of acute congestive heart failure. Four died early. The average duration of serial echocardiographic monitoring was 25 months (9-72 months) in the others. During the acute stage, the left cardiac cavities were extremely dilated and the shortening fraction was reduced to 15 +/- 4%. The 4 decreased children belonged to a group of 17 children who had a shortening fraction less than 13%. From the 8th day significant improvement of the left ventricular function was observed. Recovery was faster during the first 6 months of evolution and became very low after 1 year. The age at onset, the severity of the initial left ventricular changes, and the speed of recovery during the first 15 days were not predictive of the degree of eventual recovery of left ventricular function. At the end of the study 28 of the 30 surviving children had recovered a normal shortening fraction. However 16 of 30 still showed some dilatation, albeit moderate in most cases, of this ventricle. These data show that most children presenting with a primary form of acute congestive heart failure recover satisfactory heart function and that the initial echocardiographic features are not predictive of the subsequent course.

Acute Disease↗
PubMed1986

Nutritional treatment of congenital heart disease.

Twelve of 13 patients with congenital heart disease given continuous enteral nutrition displayed normal growth; cardiac function remained stable or improved in 10 in spite of the water load (146 +/- 22 ml/kg/day). This is safe treatment for malnutrition in congenital heart disease.

Body Height↗
PubMed1985

[A possible application of percutaneous transluminal angioplasty: remodelling of an occluded aortocoronary bypass].

The authors report the case of a 53 year old patient who had undergone triple coronary bypass surgery for unstable angina. Recurrence of chest pain 4 months after surgery led to control coronary angiography which showed severe stenosis of the proximal and distal parts of the aorto-right coronary graft. Endoluminal dilatation was performed a few days later but, during angiography, complete occlusion of the graft was observed. This was repermeabilised without difficulty and a "remodelling" of the graft was carried out. The outcome was favourable with the complete regression of symptoms. The following alternatives to surgery are discussed: in cases of thrombosis which usually occur in the month following surgery, fibrinolysis may be attempted with a high success rate but a significant risk of haemo-pericardium: in cases of fibrous proliferation of the intima leading to stenosis or occlusion, endoluminal dilatation seems to be the procedure of choice, but this must always be carried out under surgical cover.

Angioplasty, Balloon↗
PubMed1985

[Cardiac tumors with neonatal disclosure. Apropos of a case with spontaneously favorable development].

The authors report the case of a cardiac tumour documented by 2 D echocardiography, presenting in the newborn with cardiac arrest. The echocardiographic features of multiple nodules disseminated in the ventricular walls suggested a diagnosis of rhabdomyoma. The initial course was complicated by poorly tolerated attacks of tachycardia which were rapidly brought under control with amiodarone. The long term outcome was clinically favourable with a rapid regression of the number and size of the tumours on echocardiography, and a tendency to normalisation of the electrocardiogramme. The possibility of regression, which has already been reported by many investigators, suggests that these cardiac tumours may have a better prognosis than previously thought.

Echocardiography↗
PubMed1984

[A possible alternative in failure of percutaneous intracoronary fibrinolysis: percutaneous endoluminal dilatation].

The authors report three cases of myocardial infarction in which an attempt at intra-coronary fibrinolysis in the acute phase was either transiently effective or totally ineffective. In these three cases, percutaneous endoluminal dilatation was possible allowing restoration of correct coronary flow. The place of percutaneous angioplasty is therefore discussed either immediately after fibrinolysis, when the risk of re-thrombosis appears to be greatest or perhaps in the absence of an attempt at clot lysis, when fibrinolytic treatment is contra-indicated.

Angioplasty, Balloon↗
PubMed1984

[Abnormal origin of the left coronary artery from the pulmonary artery, fortuitously discovered in an adult].

The authors report a case of an anomalous left coronary artery discovered by chance in a totally asymptomatic 39 year old man. Appearances of anterior myocardial infarction were observed on routine preoperative ECG in a man with multiple injuries. Coronary angiography showed an anomalous left coronary artery arising from the main pulmonary artery. Left ventricular function was poor with associated mitral regurgitation. Surgical correction consisted in an end-to-end venous graft between the ostium of the coronary artery detached from the pulmonary artery and the right anterior border of the ascending aorta. Left ventricular function did not improve four months after surgical correction. The irreversibility of the myocardial lesions argues in favour of an early correction of this malformation.

Adult↗
PubMed1984

[Associated septal and intrapericardial rupture of the heart in the acute phase of myocardial infarction. Apropos of a case surgically treated with success].

The authors report the case of a double rupture of the heart (septal and parietal intrapericardial) on the 5th day of primary transmural anterior myocardial infarction in a 73 year old women. The diagnosis of septal rupture was made after cardiac arrest and the findings of a systolic murmur, and by echocardiography. Intrapericardial free wall rupture was diagnosed at surgery. The incidence, predisposing factors, gravity, prognostic factors and different medico-surgical therapeutic approaches to septoparietal complications of acute myocardial infarction are reviewed.

Aged↗
PubMed1984

[Transitory appearance of collateral circulation during coronary spasm].

The authors report the case of a patient with coronary spasm characterised on exercise stress testing by an initial depression of the ST segment followed by ST elevation at the 3rd minute of recovery. Coronary angiography showed an important, transient collateral system arising from the left coronary artery, probably minimising the effects of complete occlusion of a dominant right coronary artery. The authors discuss effort-induced spasm and collateral circulation.

Collateral Circulation↗
PubMed1983

[Pulmonary atresia with major hypoplasia of the pulmonary branches. A radical 2-stage correction].

Pulmonary atresia with ventricular septal defect (VSD) and severe hypoplasia of the pulmonary branches is a serious malformation and reputedly inoperable. The surgical restoration of a pulmonary outflow tract may nevertheless dilate the pulmonary arterial branches in the long term. The probable mechanism of this effect is related to high right ventricular and pulmonary pulse pressures due to the absence of the pulmonary valve. The right to left shunt, initially, reverses after a few weeks so authorizing closure of the VSD. Two patients, an adult and a child, were successfully treated by this technique.

Adult↗