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Biomedical subjects

M de Leval

Publications and source records attributed to M de Leval.

At least 91 records · Page 5Linked to original sources
PubMed1979

Surgical treatment of ventricular septal defect in infancy. Primary repair versus banding of pulmonary artery and later repair.

Results of primary closure of ventricular septal defects are compared with those of two-stage repair, with banding of the pulmonary artery followed by debanding and closure. Apart from the high incidence of unsatisfactory results after banding and a significant morbidity with the two-stage approach, the mortality for primary repair (2.4%) is considerably lower than that achieved with the staged repair (19.3%). Primary repair of ventricular septal defect is advocated for infants resistant to maximal medical treatment. A more flexible policy is adopted for patients with multiple ventricular septal defects and those with associated anomalies.

Child↗
PubMed1978

Reoperation for complictions after inflow correction of transposition of the great arteries: technical considerations.

A right anterolateral thoracotomy through the fifth or sixth intercostal space is described as an easier approach for reoperations after the Mustard procedure for transportation of the great arteries. Advantages of this approach compared with repeated sternotomy include easier cannulation of the superior and inferior vena cava; less extensive dissection of adhesions, resulting in decreased postoperative bleeding; reduced risk of injury to the coronary asteries and the right phrenic nerve; and improved exposure of intracardiac pathways and the tricuspid valve.

Humans↗
PubMed1978

Tracheal compression by the aortic arch following right pneumonectomy in infancy.

Uneventful pneumonectomy was carrried out in a 10-month-old infant for hypoplastic right lung associated with esophageal origin of the right main bronchus. Eight months after operation, symptoms of tracheal compression began. This compression was due to the aortic arch, which was stretched across the lower trachea following the displacement of the heart to the posterior right chest after pneumonectomy. Successful relief of the airway obstruction was achieved by inserting a 20 mm woven Dacron graft between the ascending and the descending aorta, with division of the aortic arch between the left carotid and the left subclavian arteries. An aortogram performed two years after operation confirmed good patency of the graft and normal flow through the descending aorta. The child remains well two years after operation but continues to have mild residual tracheomalacia and limited exercise tolerance, compatible with the presence of only one lung.

Airway Obstruction↗
PubMed1978

A guideline to the management of patent ductus arteriosus in infants and children.

Experience with multiple ligation of the patent ductus arteriosus (PDA) at the Hospital for Sick Children, Great Ormond Street, London, is presented. One hundred and sixty-one consecutive cases between January 1971 and December 1974 have been reviewed. Fifty-four children (33%) were less than one year of age. In the majority of cases the diagnosis was made on clinical grounds. Cardiac catheterization and angiography were carried out when associated intracardiac lesions were suspected. The overall mortality was 2.5%. All the deaths occurred in infants less than six months of age who had associated cardiac lesions. There were no deaths in patients who had an uncomplicated PDA or who were more than one year of age. Multiple ligation of the PDA is a simple and safe operation. The risk of operative treatment is affected more by the presence of associated cardiac lesions and the age of the patient than by the surgical technique employed.

Cardiac Catheterization↗
PubMed1978

Treatment of patients with transposition of great arteries and pulmonary vascular obstructive disease.

Twenty-two patients with transposition of the great arteries with or without ventricular septal defect and one with double outlet right ventricle, d-malposition, and severe pulmonary vascular obstructive disease were treated surgically. All were cyanosed and had very limited exercise tolerance. Preoperatively, systemic arterial oxygen saturation (SaO2) varied from 45 to 79% (mean 65), haemoglobin was 13 to 23 g/dl (mean 19). Pulmonary arteriolar resistance was 6.4 to 35 units m2 (mean 17). In the patients with a ventricular septal defect the Mustard operation was done without closure of the ventricular septal defect, and in the 3 patients with intact ventricular septum the Mustard operation was combined with creation of a ventricular septal defect. All patients survived the operation and improved. Postoperative SaO2 ranged from 75 to 96% (mean 89) and haemoglobin from 10.6 to 17.8 g/dl (mean 14.0). This improvement was significant (P less than 0.05). Five patients have had a postoperative cardiac catheterisation. The pulmonary arteriolar resistance remains high in all. Postoperative follow-up varies from 4 to 40 months (mean 14 months). So far there have been no late deaths and all patients remain improved.

Adolescent↗
PubMed1975

Total correction of type I truncus arteriosus in a 6-month-old infant.

A successful correction of type I truncus arteriosus using a 12 mm 'dacron' conduit containing a porcine aortic valve (Hancock) between the right ventricle and the pulmonary artery in a 6-month-old infant is reported. The rationale for the treatment of truncus arteriosus in infancy is discussed.

Aortic Valve↗