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Biomedical subjects

M Massin

Publications and source records attributed to M Massin.

At least 19 recordsLinked to original sources
PubMed2004

Long term outcome up to 30 years after the Mustard or Senning operation: a nationwide multicentre study in Belgium.

OBJECTIVE: To assess long term outcome of patients who underwent Mustard or Senning repair for transposition of the great arteries up to 30 years earlier. DESIGN: Retrospective review of medical records. SETTING: The six university hospitals in Belgium with paediatric cardiology departments. PATIENTS: 339 patients were reviewed, of whom 124 underwent the Mustard procedure and 215 the Senning procedure. This represents almost the entire population of patients in Belgium with either simple or complex transposition. MAIN OUTCOME MEASURES: Mortality, morbidity, functional abilities, social integration. RESULTS: Overall mortality was 24.2%. Early mortality (< or = 30 days after surgery) accounted for 16.5%, late mortality for 7.7%. Actuarial survival of early survivors at 10, 20, and 30 years after surgery was 91.7%, 88.6%, and 79.3%, respectively. Patients in the Senning cohort had a slightly better survival rate than those in the Mustard cohort (NS). Baffle obstruction occurred more often after Mustard repair (15.3%) than after the Senning procedure (1.4%). Arrhythmia-free survival did not differ between the two cohorts, but was determined by the complexity of the transposition. Survivors of the Senning cohort had better functional status, and tended to engage in more sports activities. CONCLUSIONS: The long term outcome for patients surviving the Mustard or Senning operation was favourable in terms of late mortality, morbidity, functional, and social status. Overall mortality in the Senning cohort did not differ from the Mustard group, but Senning patients had better functional status, greater participation in sports activities, and fewer baffle related problems.

Adolescent↗
PubMed2004

[Paroxysmal tachyarrhythmias in pediatrics].

The purpose of this retrospective study was to investigate the clinical characteristics in pediatric patients with supraventricular or ventricular tachycardia. Sixty-nine pediatric patients were included. Age distribution at first episode of tachyarrythmia, most indicative symptoms and signs, associated conditions and long-term prognosis were determined for the different mechanisms of tachyarrythmia. 78% of the children had supraventricular tachycardia and 22% ventricular tachycardia. At diagnosis, 57% of the children with supraventricular tachycardia were younger than 1 year. The majority of infants were detected during routine investigation without having any complaints whereas the majority of children presented with symptoms. Recurrence was rare in cases diagnosed during infancy, but was usual in cases diagnosed beyond infancy.

Age of Onset↗
PubMed2003

[Catecholaminergic polymorphic ventricular tachycardia in a child: an often unrecognized diagnosis].

UNLABELLED: Catecholaminergic polymorphic ventricular tachycardia is important to be diagnosed as an underlying disease in children with syncope and normal heart, because of its poor prognosis. CASE REPORT: A 3-year-old boy was referred for stress and emotion induced syncope. Primary ventricular arrhythmia, consisting of salvos of bidirectional ventricular tachycardia, was reproducibly induced by physical exertion. The syncopal events and severe arrhythmia disappeared with beta-blocking therapy. CONCLUSION: Despite its rare occurrence, catecholaminergic polymorphic ventricular tachycardia is an important cause of stress and emotion induced syncope and sudden death in children.

Adrenergic beta-Antagonists↗
PubMed2003

[Prevention of bacterial endocarditis].

Because of its severity, it is agreed that infectious endocarditis should be prevented whenever possible. Certain patient populations at risk for endocarditis have been identified. Antibiotic prophylaxis is therefore recommended when these individuals undergo procedures likely to cause bacteremia with organisms that cause endocarditis. In this article we attempt to provide a comprehensive approach to infectious endocarditis prophylaxis based both on the pathophysiology of the disease and on the mechanisms of action of prophylactic drugs. Approaches to the prevention of endocarditis have been recently modified and are reviewed in this paper, especially important issues for the primary care physician.

Antibiotic Prophylaxis↗
PubMed2002

[Preventive cardiology: strategies in children].

The importance of preventive cardiology in youth has been established by several critical observations: there is evidence that the atherogenic process begins in childhood, and that the degree of atherogenesis is related to measurable risk factors present during childhood. The literature indicated that long-range prevention of atheroselerosis and its sequelae by control of those risk factors should begin in childhood. This article reviews the established risk factors, the identification of high-risk individuals, public health strategies for the promotion of health in the French Community of Belgium and treatment of high-risk individuals.

Arteriosclerosis↗
PubMed2002

[Observations and reflections on the management of pediatric emergencies in Belgium].

Similar to the findings of other nations, inappropriate utilization of the pediatric emergency departments is a major problem in Belgium. The majority of patients come with non-urgent complaints. Maximum rush is seen in the evening when the outpatient clinic is closed. It results in a waste of resources, stress among the emergency room staff and an increase in waiting time for patients requiring attention. It appears important to adapt to this new situation by improving the organisation of the pediatric emergency departments (triage, human resources, equipment), but also by finding alternative solutions such as health education of families and greater availability of primary care providers. This article describes the present situation and evaluates strategies that could be applied in Belgium.

Ambulatory Care↗
PubMed2001

Impaired autonomic control of the heart by SOX10 mutation.

The autonomic nervous system plays an important role in the generation of complex heart rate dynamics that enable an organism to adapt to stress. Little is known about genes influencing the development of this autonomic control of the heart. We suggest the SOX10 gene to be a candidate for this process.

Adolescent↗
PubMed2001

[Chronic heart failure in children: recent contributions of physiopathology and therapeutic implications].

The treatment of chronic heart failure has made remarkable progress over the past ten years. Recent advances in our understanding of the pathophysiologic mechanisms involved in heart failure syndrome have led to changes in our approach to the treatment of children. The goals of the therapy have shifted from purely hemodynamic manipulation to a combination of hemodynamic and neurohumoral modulation. As for adults, three therapeutic classes have recently emerged: conversion enzyme inhibitors, spironolactone and beta-blockers. Pediatricians know that a child is not a small adult and we have to think about heart failure on the basis of etiology, the age of the patient, and circulatory physiology and maturation.

Adrenergic beta-Antagonists↗
PubMed2001

[Children in sports].

A sedentary lifestyle has been linked to the development of cardiovascular disease, diabetes mellitus and obesity. Although these conditions are predominantly found in adults, they are lifelong processes with their origins in childhood. Therefore promotion of physical activity is important in pediatrics. Although some children may be too sedentary, others are participating in training programs and competitive sports that are inappropriate for age. Guidelines for sports participation must be based on a careful consideration of the child's physical fitness, developmental requirements and limitations.

Adolescent↗
PubMed2001

[Exercise in children with chronic disease].

Regular physical exercise is gaining acceptance as a prescription for the prevention, management and rehabilitation of diseases occurring in the pediatric and adolescent age group. Exercise is generally used to increase the physical capabilities of these young patients, but, at times, it can directly influence the evolution of the condition. However, in children with chronic diseases, enhanced physical activity can also be deleterious. A well structured exercise program should be implemented. This paper will focus on the role of exercise in different diseases including cardiovascular, pulmonary, neuromuscular disease, diabetes and obesity.

Adolescent↗
PubMed2001

[Shone's syndrome: report of four cases and review of the literature].

The observation of four clinical cases of Shone's complex, two of them presenting first with predominant coarctation of the aorta, prompted us to review the pertinent literature. Patients with multiobstructive lesions of the left heart, including Shone's complex, represent a surgical challenge where the adequate management of mitral valve anomalies, subaortic stenosis, and coarctation constitutes the key prognostic factor for satisfactory mid-term outcome.

Aortic Coarctation↗
PubMed2000

[Early diagnosis of coarctation of the aorta in children: a challenge].

Coarctation of the aorta presents with characteristic and distinctive physical findings. Because delayed detection of severe forms may be fatal and late detection of classic forms is associated with premature cardiovascular disease in adult life, early detection and treatment is important. However, in our survey a few patients in whom aortic coarctation was ultimately diagnosed had the correct diagnosis made by the referring physician. Our survey suggests that an incomplete physical examination explains the diagnostic failure. This survey reaffirms the need for palpation of pulses and proper measurement of blood pressure in all infants and children to facilitate early recognition of coarctation.

Aortic Coarctation↗
PubMed1999

Cardiac anomalies associated with congenital absence of the portal vein.

The authors discovered congenital absence of the portal vein, with visceral venous return to the right atrium, in a 5-year-old girl with aortic valvar stenosis. Interestingly, of the 19 patients, it was discovered that 11 reported with portal venous agenesis also had cardiac defects. We have, therefore, investigated the hypothesis that the congenital absence of the portal vein and the associated cardiac malformations may result from a similar embryologic insult, and that cardiac development may be affected by the systemic diversion of portal venous flow.

Child↗
PubMed1999

[Interventional catheterization in pediatric cardiology].

During the last decades there has been an enormous increase in the use of transcatheter techniques to improve or correct congenital heart lesions. Balloon valvuloplasty and angioplasty, closure of heart defects, foreign body retrieval and ablation of conduction bundles are now available to the pediatric cardiologist. The variety of lesions so treated continues to expand and equipment continues to improve. However therapeutic catheterization techniques should only replace conventional surgery as the initial procedure of choice in lesions for which the results of these interventions are either similar to or better than those reported for the alternative surgical treatment. The purpose of this paper is to present the current state-of-the-art of this exciting new discipline.

Cardiac Catheterization↗
PubMed1999

[Congenital abnormalities of the vessels of the base of the heart: "ring" and "sling" vascular abnormalities. Case report].

We present a case of double aortic arch corrected by surgical interruption and full mobilization of the trachea and the esophagus. The vascular malformations of the supraaortic trunks, which form more or less complete vascular rings encircling the esophagus and the trachea, are reviewed. The different presentations of double aortic arch, aberrant subclavian arteries, and abnormal development of the pulmonary arteries are discussed.

Aorta, Thoracic↗
PubMed1998

Results of the Bruce treadmill test in children after arterial switch operation for simple transposition of the great arteries.

Children who underwent arterial switch operation for simple transposition of the great arteries in the neonatal period are now reaching an age when exercise testing becomes feasible. This study was conducted to assess exercise tolerance and electrocardiographic response to exercise stress in 50 asymptomatic children, aged 4 to 9 years, using the Bruce walking treadmill protocol to voluntary exhaustion. Heart rate and blood pressure response to exercise stress, endurance time, and electrocardiographic changes were analyzed and compared with those of age-matched normal children. Forty-seven patients had normal exercise capacity and parameters. One patient, whose coronary angiogram showed occlusion of the left main coronary artery, developed electrocardiographic signs of myocardial ischemia during exercise. In 1 patient with a single right coronary artery ostium and in another, who underwent a neonatal internal mammary bypass graft for obstruction of the right coronary artery, the resting electrocardiogram showed ventricular premature complexes and exercise stress-induced salvos of ventricular tachycardia. We conclude that most of the children who underwent the neonatal arterial switch operation for simple transposition of the great arteries have a normal exercise capacity. Exercise testing appears to be useful in detecting ischemic damage or exercise-induced arrhythmias possibly secondary to reduced coronary flow reserve.

Age Factors↗
PubMed1998

Clinical and haemodynamic correlates of heart rate variability in children with congenital heart disease.

UNLABELLED: Heart rate variability (HRV) represents a noninvasive parameter for studying the autonomic control of the heart. Cardiac patients have a complex autonomic disturbance. The relation of HRV to this abnormality in children with congenital heart disease (CHD) has not yet been examined. The present study examined HRV indices from 24 h Holter recordings in 258 children with an operated or non-operated CHD, to determine their differences as an indicator of the severity of heart disease. The latter was defined clinically as New York Heart Association (NYHA) functional classes I to IV and haemodynamically by invasive parameters. Five time-domain measures (SDNN, SDNNi, SDANNi, rMSSD and pNN50) and three frequency-domain measures (LF, HF and balance LF/HF) were compared with normal ranges. HRV was reduced in children with CHD, except in patients of NYHA class I. The level of reduction depended on the NYHA functional class. None of the measures was significantly related to haemodynamic data. CONCLUSION: Heart rate variability is reduced in children with Congenital heart disease depending on the functional limitation but not on haemodynamic disturbances. Heart rate variability indices are sensitive markers of the clinical state.

Adolescent↗