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Biomedical subjects

N Poirier

Publications and source records attributed to N Poirier.

12 recordsLinked to original sources
PubMed1992

[The intermittent "warm" blood cardioplegia].

Even today, a plethora of cardioplegic solutions are in clinical use. In the study presented here, sixty-six consecutive coronary bypass procedures received normothermic (37 degrees C) blood cardioplegia (NBC) intermittently. This group of patients was compared to an historical group of 68 patients having received cold crystalloid cardioplegia (CCC), and a second group of 41 patients having received cold blood (10 degrees C) cardioplegia (CBC). The number of patients, as well as their age, sex, functional class, ejection fraction and urgency of intervention were comparable between the three groups. The preoperative use of inotropic drugs was less prevalent in the normothermic blood cardioplegia group (NBC 24% v. CCC 52% and CBC 51%, p < 0.05), as was the use of a pacemaker (NBC 8% v. CCC 52% and CBC 51%, p < 0.02). Finally, the rates of myocardial infarction and mortality were comparable between the three groups. These results suggest that normothermic blood cardioplegia is efficient in reducing the demand in O2, by inducing the electromechanical arrest of the heart and, that intermittent normothermic blood cardioplegia can be safe and effective.

Aged↗
PubMed1991

[Development of organ transplantation in Quebec from 1985 to January 1990].

In Québec, the first organ transplantations have been realized in 1958. Several kidney transplant programs started at that time. Cardiac, liver, pancreas and lungs programs followed and reached a full development in the eighties when Cyclosporin became available. Today, there are 4 university transplant programs in Québec (McGill, Montréal, Laval and Sherbrooke) with a total of 7 kidney, 4 liver, 4 heart, 2 pancreas and 2 lungs centers. More than 2,900 transplantations have been realized. Since 1970, organ procurement and distribution is organized by a central agency called Québec-Transplant (previously Métro-transplantation). Organ donation is done on a voluntary basis as every where in North America. More than 90% of the organs comes from cadaveric donors and more than 90% of the relatives accept organ donation. 50% of the donors have deceased from head trauma and 50% from cerebral hemorrhage. In 1989, multi-organ harvesting has been realized in 64% of the donors. Despite efforts and progresses, the number of patients awaiting an organ transplant is steadily growing and outlast the number of available organs. It is hoped that maximal utilisation of the donors and growing exchanges at a national and international level will help to solve this crucial problem.

Heart Transplantation↗
PubMed1991

Cardiac transplantation: treatment for cardiogenic shock.

Eighty-six patients received orthotopic cardiac transplants at the Royal Victoria Hospital in Montreal between 1985 and 1989. Of these, 16 mortally ill, being sustained in hospital by the intravenous administration of inotropic agents (15 patients [94%]) or intra-aortic balloon counterpulsation (6 [38%]). There was one early death (at 7 days), for a death rate of 6.3% (versus 8.6% for the 70 "elective" transplants). Two others died of delayed infection: one of viral hepatitis at 6 weeks, and one of pneumonia due to Pneumocystis 4 months after transplantation. The other 13 patients are alive and well 12 to 66 months postoperatively. Nine have returned to their preoperative work, three have decreased activity levels but are functioning well, and one is retired.

Adult↗
PubMed1979

Fallibility of the epicardial electrocardiogram in quantitation of myocardial necrosis.

Estimation of infarct size utilising the epicardial electrocardiogram has been the subject of considerable controversy. The present study re-examines this technique in a dog model. It demonstrates that epicardial Q waves and S-T elevation are qualitative markers of local necrosis with different degrees of reliability; neither, however, is quantitatively related in a simple linear fashion to extent of necrosis. Conclusions from previous studies have been influenced both by different mathematical analyses of data and the inclusions of nonhomogenous sites in linear regression models.

Animals↗
PubMed1978

Significance of epicardial Q waves as an acute marker of myocardial necrosis in dogs.

This study examines the significance of epicardial Q waves as a marker of myocardial cell necrosis. Ischaemia was produced in dogs by two methods: coronary artery occlusion sustained for 24 h (Group 1) and occlusion for 1 h followed by reperfusion (Group 2). Q waves did not appear until after 3 h of sustained occlusion, but were present within 40 min of reperfusion. In both groups, Q waves were not transient but persisted for at least 24 h. CPK levels were determined at 24 h in specimens from each lead site. In Group 1, Q sites had 66.6 +/- 5.9% (mean +/- SEM) less CPK than R wave sites (P less than 0.005). In Group 2, Q sites had only 28.2 +/- 4.5% less CPK than R sites. These results suggest that the extent of necrosis was greater at Q sites with sustained occlusion than with reperfusion. A similar relationship existed for the levels of ATP and CP determined at Q and R sites at 24 h. Histological examination by light and electron microscopy confirmed that in both groups, Q sites corresponded to areas of necrosis, while R sites indicated normal myocardium. However, the type of necrosis depended on the pathogenesis. Our results demonstrated that epicardial Q waves were a reliable marker of cell death, but that the morphological picture and extent of cell death depended on the mechanism and manner of injury. These conclusions were tested in a final series (Group 3) in which propranolol was given before and with release of the occlusion (0.5 mg.kg-1 at each time). In 47 sites at risk, in five dogs only two Q waves appeared. In each of these two, cell death was confirmed by evidence of CPK depletion and morphological alteration. In the remaining sites, no CPK depletion occurred. Histological examination revealed only infrequent small islands of subendocardial necrosis. The results confirm the validity of the epicardial electrocardiographic findings and illustrate the role of propranolol in preventing reperfusion necrosis.

Animals↗
PubMed1977

Myocardial infarction after aortocoronary saphenous vein bypass. Vectorcardiographic study.

Vectorcardiograms and scalar electrocardiograms were recorded in 30 patients before and after aortocoronary saphenous vein bypass surgery to determine whether vectorcardiograms are helpful in making the diagnosis of perioperative transmural infarction. The vectorcardiogram indicated inferior infarction in 2 cases and anterior infarction in 1 case when the diagnosis was not apparent on the electrocardiogram. In the solitary case of anterior infarction diagnosed by the electrocardiogram, anterior infarction was already present on the preoperative vectorcardiogram. The study indicates that the recording of vectorcardiograms before and after aortocoronary bypass surgery facilitates the diagnosis of perioperative anterior and inferior infarction and may reveal perioperative infarction about a previously infarcted area.

Adult↗
PubMedDate not supplied

[Catheterization of the sylvian aqueduct. Its present role in the surgical treatment of sylvian aqueduct stenosis of PCF tumors, and of syringomyelia].

Catheterization of the Sylvian aqueduct is an elective technique for the surgical treatment of syringomyelia with Chiari's defect. It completes efficiently the decompression of the defect and makes possible exclusion of the IV th. ventricle and of the ependymal orifice of the syringomyelic cavity. The operative results appear thus more regular and more stable than those obtained with simple decompression. Intubation of the aqueduct has opportune indications in the treatment of tumors of the P.C.F. in the case of incomplete exeresis or when a secondary blockade of the spinal fluid is to be feared. Intubation of the aqueduct constitutes a useful complement for those patients treated during childhood for hydrocephalon with sylviduct stenosis and that evidence lately a poor functioning of the ventricular tube with ventricles exhibiting a reduced volume and hypereacute accidents of intra-cranial hypertension.

Adolescent↗