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Biomedical subjects

S Ninot

Publications and source records attributed to S Ninot.

At least 19 recordsLinked to original sources
PubMed2000

[Prospective and comparative study of pacemaker implants carried out at the electrophysiology laboratory and the operating room].

INTRODUCTION AND OBJECTIVES: Permanent pacemaker implantation is done by different physicians with either a surgical or clinical training. Our objective was to evaluate if there were significant differences in the implantation parameters and in the complication rate among implantations performed by cardiologists in the electrophysiologic laboratory and cardiological surgeons in the operating room. MATERIAL AND METHODS: We prospectively collected those patients' data who received a first pacemaker implantation by cardiovascular surgeons and electrophysiologists during the year 1998. Data collected included demographic information, indication for pacing, surgical time, complications during procedure, stimulation and sensing thresholds as well as type of pacing. RESULTS: We first-implanted 216 pacemakers in a one year period, 101 by cardiovascular surgeons and 115 by electrophysiologists. 56% were male patients. Average age in the surgery group was 74.2 +/- 9 years and 72.09 +/- 12 in the electrophysiology group (p = NS). Main diagnoses were as follows: complete heart block in 32.9% patients, complete heart block 2. degrees 16.4%, sinus node dysfunction 12.2%, AV node ablation 12.2% and others. The complications rate for surgery group was 4% and 1.7% for electrophysiologists (p = NS). Electrophysiologists placed more bicameral devices. No clinically significant differences were found among other implant parameters. CONCLUSIONS: Pacemaker implant by cardiologists in an electrophysiologists laboratory is a safe procedure that does not have more complications when compared to the same procedure done in the operating room by surgeons. This allows hospital resource optimization and reduction of hospital stay length.

Aged↗
PubMed1994

[Postinfarction ventricular septal defect. Surgical approach by right ventriculotomy in 4 patients].

Ventricular septal defect secondary to myocardial infarction still have high mortality. Early and swift surgical repair is needed to obtain adequate results. Surgical exposure of defect through the infarcted left ventricle wall is the usual technique. Nevertheless right ventricular access to the interventricular septum has given excellent results on 4 of our patients. Our results are analyzed.

Aged↗
PubMed1992

[Traumatic rupture of the tricuspid valve. Its conservative surgical treatment].

Tricuspid insufficiency caused by blunt chest trauma is rare and usually unsuspected clinically, early after trauma. Cross-sectional Echocardiography and Cardiac Catheterization are essential to establish the diagnosis. Therapy applied varies from repair to valvular replacement. We describe an 18-year-old boy with traumatic tricuspid regurgitation treated by reconstruction of the attachments of the anterosuperior leaflet and annuloplasty with a Puig-Massana ring. Six month after surgery he is fully recovered, although persist a moderate degree of tricuspid insufficiency.

Accidents, Traffic↗
PubMed1991

Delayed sternal closure for life-threatening complications in cardiac operations: an update.

Over a 7-year-period, 25 patients had delayed sternal closure after open heart operations out of 34 patients whose sternum was not closed. The indications were extreme cardiac dilatation and uncontrollable mediastinal hemorrhage. This represented a 1.79% incidence in the overall open heart surgical experience at our unit. Sternal closure was performed at a mean of 2.64 days after the initial operation. Eighteen patients (52.9%) left the hospital alive and well, representing a 72% survival rate among patients undergoing delayed sternal closure. No mediastinal or fatal infection developed and only 1 patient had late superficial wound infection after delayed sternal closure. We conclude that delayed sternal closure is an effective method to treat severe complications after cardiac operations.

Adult↗
PubMed1990

AIDS and Salmonella-infected abdominal aortic aneurysm.

The case of a bisexual male patient with acquired immunodeficiency syndrome (AIDS) and an infected abdominal aortic aneurysm requiring surgery is presented. Attention is drawn to the fact that an unpredictable number of operations will be needed in AIDS patients in the next future.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Improvement of renal function in azotaemic hypertensive patients after surgical revascularization.

Between 1974 and 1986, 17 patients (16 men and 1 woman) with renal insufficiency (serum creatinine greater than 1.5 mg/dl, mean 3.75 mg/dl), with a mean age of 51.3 years, underwent surgical renal revascularization. Two of them were on maintenance haemodialysis. All were severely hypertensive in spite of antihypertensive drugs. Atherosclerosis was the cause of renal stenosis in 14 cases and fibromuscular dysplasia in 3. Operative procedures included splenorenal shunt (5), autotransplantation (3), aortorenal bypass (3), hepatorenal bypass (1), bilateral renal endarterectomy (1), renal ostial closure (1) and nephrectomy (3). Mean serum creatinine showed a decrease from 3.76 to 1.65 mg/dl (P less than 0.005). Mean arterial pressure dropped from 161 mmHg to 103 mmHg (P less than 0.001). Systolic and diastolic pressures also showed significant decreases. Two patients died. Four patients required a second operation and the renal function and blood pressure then improved. Renovascular disease must be ruled out in patients with renal insufficiency associated with hypertension, including those patients on haemodialysis. We conclude that renal revascularization surgery is a reliable and efficient form of treatment in selected cases of renal failure of renovascular origin.

Blood Pressure↗
PubMed1986

Severe fibrous epicarditis after microporous polyurethane (Mitrathane) cardiac patch implantation.

Several materials have been used for pericardial closure after open heart surgery. Mitrathane is a recently introduced material designed for use in the cardiovascular system. A case of severe epicarditis after implantation of a Mitrathane cardiac patch for pericardial closure is presented. This epicardial reaction rendered the exposure of the heart at reoperation extremely difficult. This is a complication not reported to date with this new material. Thus, careful evaluation of Mitrathane is needed before extending its use to larger series.

Adult↗
PubMed1985

Early results with intraoperative transluminal coronary artery balloon dilatation.

We used intraoperative transluminal coronary balloon dilatation, together with coronary artery bypass grafting, to obtain complete myocardial revascularization in extensively diseased coronary arteries. Our patient population consisted of ten males and two females, with a mean age of 58 years. The left anterior descending artery was dilated in five patients, the posterior descending artery was dilated in three, the obtuse marginal artery in two, the left circumflex artery in one, and the right coronary artery in one. Additionally, a mean of 2.81 grafts per patient were placed. Hospital mortality was one patient (8.33%). There was also one case of perioperative myocardial infarction. Postoperative angiography was done in seven patients: five were shown to be improved, one had a vessel that appeared unchanged, and one had an occluded vessel. We found intraoperative transluminal coronary balloon dilatation to be a simple and efficient technique that offers potential improvement in myocardial revascularization.

Journal Article↗
PubMedDate not supplied

[The arterial complications of closed injuries to the shoulder girdle].

After a period of time of 5 years, we made a review of all the patients registered at our Center. Eight cases of closed traumatism at the scapulohumeral belt, with vascular injury associated (0.2% of all closed traumatisms at this level registered in our center during this time) were reported. Six patients presented also an osteoarticular injury associated. Three different vascular injuries were showed: three cases of complete arterial section, two arterial contusions and a partial arterial section. From the two cases without osteoarticular injuries, one of them showed a complete section and the other presented an arterial contusion. Polytraumatic patients showed multiple osteoarticular injuries. We registered one fracture-luxation at the shoulder, 3 diafisaric humeral fractures, one humeral neck fracture, one clavicle fracture, one fracture-luxation at the cervical column and one simple luxation of the shoulder.

Adult↗
PubMedDate not supplied

[Aneurysms of the abdominal aorta in patients on a permanent hemodialysis program].

Surgical approach of an aneurysm at the infrarenal aorta abdominal, in six patients with terminal renal failure and chronic hemodialysis, is presented. They were all men, and the middle age was 62 years. There were two hospital deaths and a latter death. At the moment of this report, the three survival patients are well, after a follow-time of 34.6 months. Treatment of this group of patients, as well as the literature concerning to this subject are reviewed.

Aged↗
PubMedDate not supplied

[Vascular injuries of the lower extremity].

Authors present their experience (32 patients affected by a traumatic femoropopliteal injury) with vascular traumatisms at the lower limb. Causes, treatment and successful results with the new technics and the early clinical management to the patients are commented.

Adolescent↗
PubMedDate not supplied

Complete translocation of the aortic root and coronary bypass grafting with a microporous polyurethane (Mitrathane) composite valved graft in the treatment of recurrent prosthetic valve endocarditis.

The case of a 20-year-old male patient, with a history of addiction to parenteral heroin and recurrent prosthetic valve endocarditis, is presented. In this case the final procedure consisted of a complete translocation of the aortic root and coronary bypass grafting with a composite graft made from a microporous polyurethane (Mitrathane) cardiac patch, a prosthetic valve and two Mitrathane vascular grafts for the coronaries. This is a complex operation, only indicated in cases of extensive destruction of the aortic root due to recurrent endocarditis. To our knowledge, it is the first case of this type performed using Mitrathane.

Adult↗
PubMedDate not supplied

Open heart surgery for thrombosis of a prosthetic mitral valve during pregnancy. Fetal hydrocephalus.

Pregnant women with cardiac valvular prostheses present an important risk factor and the major complications are endocarditis and thromboembolism. Thromboembolism is determined by a hypercoagulation state. Compulsory anticoagulation treatment is an associated risk factor producing maternal and fetal complications. Different open heart surgical cases during pregnancy have been reported and a review of the literature shows favourable maternal prognosis. A 30-year-old woman with a Björk-Shiley mitral prosthesis, during the 6th week of pregnancy presented with thrombosis and embolism due to a change in anticoagulation treatment from acenocumarol to heparin. Open heart surgery was carried out and the patient's course was favourable. A fetal hydrocephaly of unknown etiology was discovered during the 18th week of pregnancy. Open heart surgery during pregnancy and the necessity of thromboembolic prophylaxis, have been analysed and revised.

Adult↗