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Biomedical subjects

M Redonnet

Publications and source records attributed to M Redonnet.

68 records · Page 4Linked to original sources
PubMed1982

Follow-up of surgically treated patients with massive pulmonary embolism--with reference to 12 operated patients.

Since 1978, 17 patients have undergone surgery for massive pulmonary embolism in our department. Twelve patients survived and have been followed up for between 2 and 31 months postoperatively (mean 16 months). Reassessment of these patients included exercise tolerance test, pulmonary function test, perfusion scan, right heart catheterization and coagulation screening. Two survivors present major sequelae, namely vascular pruning and definite signs of pulmonary hypertension. The other 10 patients have minimal or no residual vascular occlusion, but show a high incidence of minor abnormalities: slight rise in pulmonary arterial pressure during exercise (3 cases), small angiographic and scintigraphic defects (5 cases), arterial hypoxemia (5 cases) and disturbances of pulmonary function (10 cases). Systemic venous problems were found to be frequent and to be a handicap in 5 cases, and an abnormal pattern of response to exercise was observed in 4 patients. These disturbances may be related to ligation of the vena cava. Various derangements of coagulation were found in all but one of the patients.

Adolescent↗
PubMed1982

[Reno-caval thrombosis complicated by massive pulmonary embolism. Diagnostic and therapeutic problems].

The authors report on a case of thrombosis of vena cava and renal vein associated with a nephrotic syndrome and complicated by a massive pulmonary embolism. Under emergency conditions, it was impossible to diagnose preoperatively a renal tumor, which is the most common cause of renal and vena caval obstruction or a thrombosis of the vena cava. Surgical treatment was carried out only because there were no arteriographic signs of renal neoplasm, and because thrombolytic treatment was contra indicated in a patient with greatly reduced vital capacity. Embolectomy was performed under cardiopulmonary by pass. The patient made a good recovery. Results of routine cardiac and pulmonary tests were normal after two months. Embolectomy must always be associated with as interruption of the vena cava, whose different forms are discussed. Partial interruptions using a De Weese clamp seems to be better tolerated than ligation.

Diagnosis, Differential↗
PubMed1981

Tuberculous aortic insufficiency. Report of a case with successful surgical treatment.

A case of endocardial tuberculoma of the left atrium in a 20-year-old woman is presented. Ulceration of the tuberculoma at the aortic anulus led to disruption of the aortic valvular attachment and induced severe aortic insufficiency. Replacement of the aortic valve and administration of antituberculous medication permitted an uneventful recovery. This is probably the first case of tuberculous aortic insufficiency diagnosed in a living patient and surgically treated with the use of extracorporeal bypass.

Adult↗
PubMed1978

[Analysis of factors which can influence results of aortocoronary bypass surgery].

The various factors influencing the result of treatment have been studied in a series of 100 consecutive patients undergoing aorto-coronary bypass graft surgery. There were three operative deaths and twelve cases of post-operative infarction. Longterm, 85% of them were three year survivors, clinical improvement being maintained in 84% of them. Post-operative tests showed that 70% of patients have no pain on the maximal exercise test, but 48% had ischaemic depression of the ST segment. From among the 47 patients who had follow-up arteriography, 78% of the grafts were patent, but no improvement of the contractility of the left ventricle could be demonstrated (pre-operative ejection fraction 47 +/- 3%, post-operative 49+/- 3%). The pre-operative clinical features rarely give any indication of the prognosis. The same is true in the present series of the condition of the left ventricle, bearing in mind the fact that patients with grossly impaired ventricular contractility (ejection fraction below 30%) were routinely excluded from surgery. It is essentially the state of the coronary arterial network, as assessed by a score made up from the degree and number of stenoses, the quality of the distal bed, and the anatomical distribution, which will pick out those patients more at risk both from the surgery and from post-operative death and in whom the longterm result is likely to be disappointing with no improvement in function, with obstruction of the grafts, or with secondary death.

Adult↗
PubMedDate not supplied

[Cardiac troponin I and CK-MB mass after cardiac surgery with cardiopulmonary bypass].

Cardiac troponin I (cTnI) assay is used in the diagnosis of myocardial infarction after cardiac surgery. Variations in the cut-off value have been reported even with the same assay method. The aim of this work is to investigate the release profile of cTnI and CK-MB mass after cardiac surgery and to determine the cut-off value of cTnI and CK-MB mass allowing the diagnosis of perioperative myocardial infarction. In patients without postoperative cardiac complication, the cTnI peak was observed 24 hours after surgery both in coronary artery bypass grafting and in valve replacement. Moreover, the amount of cTnI released within the three hours after surgery is 2.5 fold higher in valve replacement than in coronary artery bypass grafting. The CK-MB peak was observed 3 hours after surgery in the two surgical procedures. In these patients, cTnI and CK-MB concentrations increased with the cross clamp time duration. In patients with postoperative myocardial infarction, the cTnI and CK-MB peaks were observed 24 hours after surgery. Diagnosis of perioperative myocardial infarction can be performed with a sensitivity of 100% at 24 hours with cut-off values of 32 and 7 microg/L for CK-MB and cTnI, respectively, both with Stratus (Dade Behring) and Immulite (DPC) analysers.

Adult↗
PubMedDate not supplied

Aortic valve replacement with Smeloff-Cutter prosthesis: 1 to 8 year follow-up.

Two hundred patients had an aortic valve replacement with the Smeloff-Cutter prosthesis between 1972 and 1980. One hundred and seventy six patients had aortic valve replacement alone (mortality 2.8%) and 24 patients had additional procedures. The overall mortality was 6.5%. One hundred and eighty seven patients have been followed up for from 4 months to 8 years (mean 33 months). The 14 patients who died later are analysed; half of these deaths were prosthesis related. There has been no instance of structural failure, ball variance or massive thrombosis in this series. All but 4 of the survivors showed functional improvement. We consider the Smeloff-Cutter valve a good choice for aortic valve replacement.

Adolescent↗