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Biomedical subjects

R Boussaada

Publications and source records attributed to R Boussaada.

7 recordsLinked to original sources
PubMed2005

[Surgical repair of atrial septal defect in 1011 consecutive patients].

The immediate postoperative complications of 1011 consecutive patients undergoing surgical repair of atrial septal defects between 1980 and 1998 at Marie Lannelongue Hospital were analysedwith the ultimate objective of comparing their incidence with that of percutaneous closure. Five patients died (0.49%) of low cardiac output (N=3), pulmonary oedema (N=1) or pulmonary hypertension (N=1). A total of 356 patients (35.2%) had 448 postoperative complications. There were 77% minor and 23% major complications. The minor complications included arrhythmias and conduction defects (N=130), respiratory complications (N=90) and pericardial effusions (N=64). The main major complications were cardiac failure (N=27), cardiac tamponade (N=13), neurological complications (N=8) and reoperation (N=28). Of the survivors, 95.6% of patients were discharged from hospital with no residual problem and 41 (4.4%) had sequellae: arrhythmias (N=29, including one pacemaker implantation), neurological complications (N=4), acquired mitral regurgitation (N=2), phrenic nerve paralysis (N=1) and minimal residual shunt (N=10). Factors correlated with surgical morbidity were age, the severity of pulmonary hypertension, the type of atrial septal defect (less morbidity with ostium secundum defects), the presence of associated malformations, the surgical approach (less morbidity with the right postero-lateral thoracic approach). This study demonstrated the incompressible risk of open heart cardiac surgery. It will form a basis for a comparative study of the two modern methods of treating atrial septal defect: surgical and percutaneous closure.

Adolescent↗
PubMed2001

[Percutaneous mitral commissurotomy: how can it be made simpler and more efficacious?].

The authors report the results of a simplified method of percutaneous mitral dilatation from 936 procedures. This method introduced in our service since 1997 consists in progressively increasing diameters inflation of Inoué balloon, using echographic control and without any arterial procedure. Our population consists on 683 women (73%) and 253 men with a mean age 34 +/- 15 years (extremely 9 and 80 years) with subgroups composed of 26 pregnant women, 32 children less than 17 years, 59 restenosis after closed heart mitral commissurotomy, 14 restenosis after open heart mitral commissurotomy, 74 restenosis after percutaneous mitral commissurotomy, 5 tricuspid and mitral dilatation, 2 coronary and mitral dilatation (with stenting), 2 patients with a history of surgical mitral valvuloplasty for pure mitral regurgitation. The mitral area passed from 1 +/- 0.2 cm2 to 2.1 +/- 0.1 cm2. A surgical mitral regurgitation was observed in 3 cases. The time of fluoroscopy was 6.4 +/- 3.3 min. The hole time procedure was 19 +/- 9 min. The delay of hospitalisation was one day in 97% of patients. The decreased cost was about 20%. The patient comfort and the large diffusion of this method predicts a good future of this simplified technique.

Adolescent↗
PubMed2001

[Cardiac hydatid cyst (report of 8 cases)].

Hydatic cardiac cyst (HCC) is a rare anomaly, characterized by wide spectrum of clinical presentations. Its diagnosis took large benefit from echocardiography progress. We aimed in this study to analyse epidemiologic aspect of HCC, as well as its diagnostic data, with special emphasize on echocardiography. Observations of 8 patients, admitted between 1991 and 2000 has been reviewed. Age average was 30 years (13 to 59). Main symptoms consisted of chest pain (62.5%) and dyspnea (35%). Chest X-Rays showed cardiac silhouette anomaly in 4 cases. Electrocardiogram showed sub-epicardical ischemia in 5 patients. HCC diagnosis was established by transthoracic echocardiography in all cases. It was located inside a cardiac chambers (n = 5), the interventricular septum (n = 2), and the pericardium (n = 1). HCC relation with adjacent cardiac structures was well defined by transoesophageal echocardiography performed in 7 cases. All patients underwent surgery with good immediate results. All patients were events free, with a mean follow-up of 25 months.

Adolescent↗
PubMed2001

[Severe pulmonary hypertension in ostium secundum atrial septal defect].

Between 1969 and 1999, 149 patients underwent cardiac catheterization for ostium secundum atrial septal defect, in hemodynamics department. Age average was 21.5 +/- 16 years (2-67). Systolic pulmonary arterial pressure average was 35 +/- 15.6 mm Hg (15-140). The atrial septal defect was closed in 108 patients (by surgery in 107 cases, and by interventional catheterization in one case). Mean follow-up was 8 +/- 7 years (1-20). Overall mortality rate was 2.7%. Severe pulmonary hypertension (systolic pressure > or = to 50 mm Hg) was seen in 13.4% of cases. It was present at all ages, but more frequent above 20 years. Obstructive pulmonary vascular disease was noticed in 2% of patients. Clinical and haemodynamic data analysis showed that, severe pulmonary hypertension is a frequent, and unpredictible complication of secundum atrial septal defect; it might occur at any age and worsen considerably the cardiac disease prognosis. Because of atrial septal defect hemodynamic profile, and current rise of percutaneous closure technics, invasive investigation should be more and more routinely performed, in order to define the best therapeutic option. Early and systematic closure of secundum atrial septal defects, should prevent, or at least minimize pulmonary vascular lesions.

Adolescent↗
PubMed2000

[Evolution after 5 years of percutaneous pulmonary valvulotomy: report of 47 cases].

47 patients aged from 2 to 59 years affected by valvular congenital or mixed pulmonary stenosis including three fallot trilogies and one patient with right congestive cardiac failure are treated by percutaneous pulmonary valvulotomy between october 1986 and december 1990. All patients have been controlled with a mean follow-up of 6.5 +/- 1.1 years. The total gradient rate between pulmonary artery and right ventricule decrease from 112 +/- 55 mm Hg to 20 +/- 8 mm Hg on the last control with disappearance of infundibular inflammation and inter auricular shunt in all the concerned cases. We observe the regression of right cardiac failure symptoms with disappearance of tricuspid insufficiency in the cases of advanced pulmonary stenosis with right ventricular dysfunction. Percutaneous pulmonary valvulotomy by its simplicity and harmlessness, its long term efficiency is a good method of treatment of pure valvular or mixed pulmonary stenosis.

Adolescent↗
PubMed2000

[Percutaneous mitral commissurotomy: simplified new method].

We report a new simplified method of mitral dilatation done on 146 patients. This technique use the Inoue balloon with progressive diameters under ultrasonographic control, avoiding the arterial part of the dilatation. The population include 9 pregnant women, 13 children, 13 with restenosis and closed heart and 12 restenosis after dilatation. Mean age is 32 +/- 16 years (9 to 72) and sex ratio 3.7 (114 F/32 M). Three groups are individualized according to histopathologic exam of mitral structure, group I (26%) concern good indication and III (32%) bad indication for this technique, group II (42%) contain intermediate indications. Commissurotomy increase the mean mitral square for 0.2 to 1.9 +/- 0.1 cm_. We observe 3 cases of chirurgical mitral insufficiency needing remplacement recruited for 2 patients from the group III. Mean fluoroscopic exposition time is 5.2 +/- 3.3 mn and procedure duration 18 +/- 11 mn. Hospitalisation duration is one day for 95% of the patients. This method remaining simple, efficient and safe permit a gain in time of 70% with a good comfort for patient and a return to work on the 4th day.

Adolescent↗