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M J Maître

Publications and source records attributed to M J Maître.

6 recordsLinked to original sources
PubMed2000

[Balloon pulmonary valvuloplasty in the neonatal period. The clinical and echocardiographic effects].

AIM: To analyze the efficacy of balloon pulmonary valvuloplasty (BPV) as the elective treatment for neonatal critical pulmonary valvar stenosis (PVS). MATERIALS AND METHODS: The results of clinical and echocardiographic features before and after the BPV were reviewed in 29 neonates (18+/-12 days of life). Different hemodynamic and 2-D color Doppler echocardiographic were evaluated. The BPV result was classified as favourable if no other balloon or surgical therapy was required to normalise pulmonary flow and achieve a sustained right ventricle-pulmonary artery (RV-PA) Doppler gradient below 40 mmHg. It was considered unfavourable if the neonate died, needed surgery or redilation and/or the RV-PA Doppler gradient was > or =40 mm Hg. The study developed in three phases: pre BPV immediate post BPV until the hospital discharge (14+/-11 days), and in the mid-term follow-up of between 8 and 96 months (51+/-31 months). RESULTS: Mortality was not registered with BPV. The RV/left ventricular systolic pressure decreased from 1.4+/-0.3 to 0.8+/-0.3 (p<0.01) as a consequence of the dilation, and the the systemic oxygen saturation increased from 85 +/-12 to 92+/-6% (p<0.01). The RV-PA Doppler gradient diminished from 86+/-18 to 28+/-16 mm Hg immediately after BPV (p<0.01) and was registered at 13+/-6 mm Hg in the follow-up (n = 24). The RV-PA junction Z value grew from -1.25+/-0.9 before valvuloplasty to -0.51 +/-0.7 at the final echocardiogram (p<0.01). No changes in the tricuspid diameter were detected between both periods of time. Five neonates obtained unsatisfactory results: 4 in the immediate post BPV (systemic-pulmonary artery shunt 2, transannular patch 2), and 1 in the mid-term follow-up (valvectomy + transannular patch). The actuarial curve reflects that 82,7% of the patients were free form reinterventions at 8 years. CONCLUSIONS: BPV is safe and effective to relief PVS in the neonate. The balloon promotes advantageous changes in both, pulmonary annulus and the right ventricle. In addition, the RV-PA Doppler gradient observations in the follow-up, support the expectation that the BPV is a "curative" therapy.

Catheterization↗
PubMed1989

[Atrioventricular septal defect with associated tetralogy of Fallot. Clinico-morphological aspects and surgical considerations].

In this work the clinical features, diagnostic methods, surgical procedures and postoperative follow-up are reviewed in 19 cases of atrioventricular septal defect with associated tetralogy of Fallot. The clinical situation was always related to the degree of pulmonary ischemia, that pointed out the urgency and need for a palliative surgical procedure before corrective surgery. There was no data in the ECG for the differential diagnosis of isolated forms of atrioventricular septal defect. In 50% of the cases the cardio-thoracic index was increased by right atrial enlargement. The diagnosis of the malformation was made in every case by means of 2D echocardiography. In 16 cases palliative surgery was done (aortic-pulmonary shunts), with one death (6.2%) due to facts unrelated to the technique. Of the 6 cases with corrective surgery (5 cases with previous shunts), one needed a mitral valve replacement (St Jude prosthesis). There was no mortality in this group and the functional status in the long-term follow-up was: 3 cases were in the functional class I and 3 cases in class II. The overall mortality for all surgical procedures carried out was 4.3%. In conclusion, we consider the use of the corrective surgery adequate to the clinical stability of the patients with atrioventricular septal defect with associated Fallot's tetralogy.

Child, Preschool↗
PubMed1989

[Surgery of congenital cardiopathies without previous catheterization. Preoperative evaluation and surgical indication using bidimensional echocardiography and Doppler].

With the non-invasive devices available nowadays, many congenital heart diseases may be diagnosed with a definition comparable and even perhaps superior to catheterization and angiography. According to this issue, from January 1983 to December 1987, 239 children underwent operations for palliation or correction of different cardiopathies based on an echo-Doppler assessment without prior catheterization. Preoperative echo-Doppler diagnoses had an adequate correlation with the surgical findings in 234 cases (97.9 percent), so there was no correlation in 5 cases. In general, we consider that echo-Doppler provides a complete and definitive diagnosis in most cases, thus eliminating the need for further invasive procedures, although we still have to rely on catheterization to obtain the necessary information or reassurance in some cases. Progressive increase of reliance in echo-Doppler techniques by the surgeon and self confidence of the cardiologist in his accurate state of the art will considerably increase the performance of cardiac operations without prior catheterization in the future. At present, this is our current policy, as day after day, we are increasing the diagnoses in which we consider unnecessary the catheterization to indicate surgery.

Adolescent↗
PubMed1980

Brucella endocarditis on double valvular prosthesis.

The case is reported of a 48-year-old man suffering from Brucella endocarditis on a double prosthesis. The successful medical and surgical treatment is described. So far as the authors know, this is the first report of Brucella endocarditis from a heart valve prosthesis.

Brucellosis↗