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Biomedical subjects

P Vermeersch

Publications and source records attributed to P Vermeersch.

14 recordsLinked to original sources

Delayed post-traumatic tamponade together with rupture of the tricuspid valve in a 15 year old boy.

With the increase in the number of high speed motor vehicle accidents, blunt, non-penetrating trauma to the heart has become an important health problem. An unusual case is reported of a 15 year old boy urgently referred with cardiac tamponade and a new systolic murmur four months after a car accident. The problems of the diagnosis and possible causes of late cardiac tamponade and tricuspid regurgitation following this type of accident are discussed.

Accidents, Traffic↗

L-arginine administration reduces neointima formation after stent injury in rats by a nitric oxide-mediated mechanism.

The clinical outcome of vascular stenting is limited by in-stent stenosis. Increased nitric oxide (NO)/cGMP signaling by L-arginine (L-Arg) supplementation, the substrate for NO synthase (NOS), or NOS gene transfer may reduce in-stent neointima formation. After stenting, vascular cell proliferation in rat carotid arteries, as measured by 5'-bromodeoxyuridine (5'-BrdU) incorporation, indicated 15+/-8%, 28+/-5%, and 33+/-7% 5'-BrdU-positive vascular cells at 4, 7, and 14 days, respectively. Reporter beta-galactosidase gene transfer efficacy was evidenced by 30% beta-galactosidase-expressing medial smooth muscle cells at 14 days. The intima-to-media ratio (I/M) progressively increased to 2.32+/-0.24 at 14 days. To target in-stent neointima formation, animals were infected with adenoviral vectors (4x10(10) plaque-forming units per mL) expressing NOS2 (AdNOS2) or no transgene (AdRR5), or they received daily doses of L-Arg (500 mg. kg(-1). (d-1) IP). The neointima at 14 days was smaller in L-Arg-treated than in untreated rats (I/M 1.25+/-0.35 vs 2.32+/-0.24, P<0.05, n=7 each) or in AdRR5- and AdNOS2-infected rats (I/M 2.57+/-0.43, n=7 and 1.82+/-0.75, n=8, respectively; P<0.05 for both). The effect of L-Arg was abolished by simultaneous administration of N(G)-nitro L-arginine methyl ester, an NOS inhibitor (2.03+/-0.39, P<0.05, vs L-Arg). Inflammation was markedly less in L-Arg- and AdNOS2-treated than in AdRR5-infected rats. Supplemental L-Arg reduces neointima formation after stenting by way of an NOS-dependent mechanism and may be a valuable strategy to target in-stent stenosis.

Adenoviridae↗

Saphenous vein graft disease treated with the Wiktor Hepamed stent: procedural outcome, in-hospital complications and six-month angiographic follow-up.

OBJECTIVES: To evaluate the effectiveness of electively placed heparin-coated stents in the treatment of coronary saphenous vein bypass grafts with de novo lesions less than 15 mm in diameter in a prospective study with all eligible consecutive patients presenting to Middelheim Hospital, Antwerp, Belgium between September 1997 and August 1998. PATIENTS AND METHODS: Fifty patients with 53 lesions were studied. Anginal class, risk factors, quantitative coronary angiographic measurements pre- and postprocedure, procedural outcome, in-hospital events, clinical status on discharge, and six-month clinical and angiographic follow-up (in 48 patients) were recorded. All patients received acetylsalicylic acid and ticlopidine, unless known intolerance was present. RESULTS: On average, 1.1 stents/patient were placed in very old saphenous vein grafts (11. 7+/-3.9 years). Procedural success was 98%. Only two non-Q wave myocardial infarctions (MIs) occurred, with no Q-wave MIs and no deaths during hospital stay. Length of hospital stay was short (2. 4+/-1.7 days), and 96% of patients were free of angina on discharge. At six-months' follow-up, two patients had died, one of whom died of a noncardiac cause. One patient suffered a non-Q wave MI. At six months, 86% of patients were free from angina. Minimal luminal diameter decreased from 1.14 mm before to 3.33 mm after stenting and to 2.52 mm at six months. Restenosis was present in 22% of patients (21.6% of lesions). CONCLUSIONS: In a selected population with coronary saphenous vein bypass graft disease, Wiktor heparin-coated stents can be delivered with an excellent periprocedural outcome. Six-month outcome appears favourable with a low recurrence of angina (18%) and a low rate of angiographic restenosis (21.6%).

Aged↗

Usefulness of low-dose dobutamine stress echocardiography in predicting recovery of poor left ventricular function in atrial fibrillation dilated cardiomyopathy.

Assessment of contractile reserve was performed in 16 patients with dilated cardiomyopathy and chronic atrial fibrillation. In this prospective study, low-dose dobutamine echocardiography could predict recovery of left ventricular dysfunction and could identify tachycardiomyopathy before restoration of sinus rhythm.

Acute Disease↗

Intralobar pulmonary sequestration supplied by the right coronary artery.

Bronchopulmonary sequestrations are malformations that are often congenital; they consist of isolated nonfunctioning lung segments having no communication with functional tracheobronchial elements of the surrounding lung. They are supplied by single or multiple branches from the distal thoracic or proximal abdominal aorta, or from the celiac, splenic, intercostal, subclavian, or pulmonary artery. Due to the absence of ventilation, the lung tissue can become chronically infected. We describe an intralobar pulmonary sequestration with arterial supply from the right coronary artery.

Angioplasty, Balloon, Coronary↗

Elective Wiktor GX stenting for symptomatic stenosis in old aortocoronary saphenous vein bypass grafts: the Antwerp experience.

PURPOSE: We compared initial outcome, peri-procedural complications and long-term clinical follow-up of elective Wiktor GX stent implantation in severely narrowed vein grafts to a historic register of elective angioplasties in saphenous vein grafts in the same center. METHODS: Eighty-one consecutive patients with angina and a history of coronary artery bypass grafting (CABG), all received elective angioplasty (PTCA) of the diseased graft; we described them as group P. The next 38 consecutive patients were treated with elective angioplasty and Wiktor Stent implantation, followed by one month ticlopidine; they were called group S. CONCLUSION: This retrospective study suggests that elective Wiktor stenting in old saphenous vein graft stenosis, in combination with one month ticlopidine, leads to: 1) a better angiographic result, with reduction of peri-procedural complications; and 2) a lower incidence of recurrent angina, need for invasive or surgical re-intervention, myocardial infarction and death during follow-up.

Aged↗

Calcified papillary fibroelastoma of the tricuspid valve.

Papillary fibroelastoma (PFE) is an infrequently and often incidentally encountered benign tumour found on the endocardium. We describe the case of a patient with a small, mobile, calcified mass on the tricuspid valve incidentally seen during radioscopy for cardiac catheterization. Echocardiography revealed a rounded, bulky shaped and calcified tumour. At histopathology a PFE with extensive dystrophic calcifications was found. To our knowledge this is the second case report of calcified PFE.

Fibroma↗

Cardiac transplantation in giant cell myocarditis. A case report.

The present report describes a 15-year-old boy who underwent an urgent cardiac transplantation for giant cell myocarditis because of fulminant progressive heart failure, complicated by ventricular tachycardia, unresponsive to classical inotropic medical treatment. The physiopathology and the treatment are discussed.

Adolescent↗