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Biomedical subjects

M Sabatier

Publications and source records attributed to M Sabatier.

48 records · Page 3Linked to original sources
PubMed1984

[Emergency surgical revascularization in establishing myocardial infarctions. Treatment of subtotal coronary occlusions].

The introduction of intracoronary thrombolysis as a treatment for myocardial infarction has led to an increase in the number of very early coronary angiographies carried out in the acute phase of myocardial infarction. These investigations can be performed without excessive risk. In some cases, severe stenosis with significant distal circulatory impairment without evidence of thrombosis is found. In these very early investigations, these findings may represent a "pre-thrombolic" lesion in an evolving myocardial infarction. Six cases of very severe pre-thrombolitic stenosis of the LAD were observed in a series of 67 coronary angiographies performed in the early stages of myocardial infarction. These six cases were selected on strict clinical, ECG and angiographic criteria. One patient was hospitalised with cardiogenic shock. The six patients underwent emergency coronary bypass surgery: average time from admission to coronary angiography was 55 minutes; average time from coronary angiography to surgery was 3 hours. These 6 pre-thrombolic lesions of the LAD were also associated with lesions of the left circumflex and right coronary arteries. There were no operative complications but two patients had stormy immediate postoperative periods. There was no hospital mortality. All patients were reinvestigated at 1 month and all grafts were shown to be patent. The left ventricular ejection fractions improved in 3 cases, remained unchanged in 2 cases, and deteriorated in 1 case (the patient with cardiogenic shock). These results suggest that emergency coronary bypass surgery is a rational treatment of pre-thrombolic coronary stenosis observed at early coronary angiography in patients with evolving myocardial infarction in order to preserve as much myocardial muscle as possible.

Aged↗
PubMed1982

Aneurysms complicating coarctation of the aorta: anatomic aspects and evolution. Report of six successful surgical cases.

Six cases of coarctation of the aorta with aneurysms are reported. The 6 patients have been successfully operated with resection of the aneurysm and replacement of the aorta by a Dacron graft. The different anatomic characteristics are described. The authors emphasize the frequency of other aneurysms upstream of the coarctation, the risk of rupture (2 cases out of 6) and the technical difficulty of the operative procedure in comparison with a common coarctation. Aneurysm formation is a rare but severe sequel of coarctation in the adult and underlines the importance of surgical treatment of this lesion in childhood.

Adult↗
PubMed1982

[Monodimensional echographic study of echogenic masses in the left ventricular outflow tract in aortic valve insufficiencies. Apropos 5 cases].

The presence of a mass in the left ventricular outflow tract is often a sign of severe pathology. The authors report 4 cases illustrating this echocardiographic diagnosis. In bacterial or mycotic endocarditis these masses suggest either aortic valve vegetations or prolapse of an aortic cusp. Two causes may be observed in patients with aortic bioprostheses: paravalvular leak with rocking of the sewing ring and destruction of the bioprosthetic cusps. In the 4 cases presented hemodynamic and angiographic investigations were contra indicated because of the risk of embolism of bacterial vegetations. Echocardiography gave precise diagnosis of the causal disease process and led to early surgical cure. Correlations between the anatomical and echocardiographic appearances are described and discussed.

Aortic Valve Insufficiency↗
PubMed1981

Delayed pulmonary thrombectomy via a peripheral approach in the treatment of pulmonary embolism and sequelae.

Delayed unilateral pulmonary embolectomy via the peripheral approach has been performed in 12 patients suffering from chronic pulmonary vascular obstruction after a single or repeated embolisms. Arterial hypoxemia and pulmonary hypertension were present in all cases. Embolectomy was performed several months or years after the initial event. There were 2 early and one late death. The surviving patients are doing well clinically and show definite hemodynamic and angiographic improvement.

Adult↗
PubMed1981

[Preliminary study on the resumption of work after aorto-coronary bypass].

A questionnaire was sent 8 months to 3 years after aorto-coronary bypass to 98 patients who, before surgery, had had to abandon their professional activities because of ischaemic heart disease to assess the numbers who had returned to work: thirty six patients (37%) had not returned to work for medical or personal reasons; only one patient had been refused by his employee; sixty two patients (63%) had returned to work, 81% full-time and 19% with a different job. Only 19% had to stop working secondarily for medical reasons. The criteria thought initially to influence the chances of resumption of professional activity were analysed: factors not influencing the return to work were: type of work before operation (judged by the physical activity involved and the statute of salaried or independent worker), the severity of surgery (number of grafts and associated resection of aneurysm), a subjective assessment of physical condition after surgery (91% or patients not returning to work admitted to feeling well); uncontrollable factors influencing the return to work were: age of patient (average 51,7 years for those returning to work, compared to 55,1 years for the others), previous history of myocardial infarction (2,5 times more common in those not returning to work); finally, controllable factors influencing return to work were: the duration of unemployment before surgery (3,3 months for those returning full-time, compared to 16,4 months for those not returning to work); the period between surgery and resumption of activity which averaged 5 months and should not exceed 6 months. Three factors seemed to be particularly important: apart from the shortest possible period of unemployment before surgery, early physical reeducation after surgery based on chest physiotherapy and readaptation to physical activity and a psychological preparation for the return to work which should be started even before surgery.

Age Factors↗
PubMedDate not supplied

Endoventricular patch reconstruction in large ischemic wall-motion abnormalities.

Endoventricular patch plasty (EVPP) has been used since 1984 to rebuild the left ventricle. The global experience of our group includes more than 835 cases. Large wall-motion abnormalities were detected by the center line method when > 60% of the circumference of the left ventricle was asynergic. In this series, 269 patients had an ejection fraction < 30%. Surgery for repair of large wall-motion abnormalities was conducted on the arrested heart with insertion within the left ventricle of a patch rebuilding the contractile area while leaving a residual volume between 50 and 70 cc/m2 of body surface. The global results of the technique of EVPP are analyzed on the last 700 operated patients. Three series of patients with large wall-motion abnormalities were examined. We conclude that this technique is appropriate in advanced stages of ischemic disease as an alternative to cardiac transplant. At an operative risk of approximately 12%, improvement is obtained in 80% of cases.

Blood Vessel Prosthesis Implantation↗