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Biomedical subjects

T Richard

Publications and source records attributed to T Richard.

29 records · Page 2Linked to original sources
PubMed1986

Exclusion-bypass for aneurysms of the descending thoracic and thoracoabdominal aorta.

From October 1973 to April 1985, 81 patients with aneurysms of the descending thoracic or thoracoabdominal aorta underwent surgery. Eight (10%) of these patients were treated by exclusion-bypass. The aneurysm was located in the descending aorta alone in five cases, and in the descending thoracic and thoracoabdominal aorta in three cases. In all cases, the proximal anastomosis of the bypass was performed on the ascending aorta. The site of the distal anastomosis was the supraceliac aorta in two cases, the infrarenal aorta in three cases and the iliac arteries in three other cases. Exclusion was bipolar, at each end of the aneurysm, in six cases, and unipolar, ie. proximal interruption only, in two cases. Two patients died during the first postoperative month, one of rupture of the distal portion of the aortic arch, the second, after onset of secondary paraplegia. There were no other spinal, cardiac or cerebral complications. One patient died three months postoperatively of intercurrent pulmonary infection. The five other surviving patients whose mean follow-up period is 48.1 +/- 25 months, are alive and enjoying good health. Resection and grafting as advocated by Crawford, is the usual treatment proposed for aneurysms of the descending thoracic and thoracoabdominal aorta. Exclusion-bypass may however be preferred in the following cases: elderly patients with compromised respiratory status, aneurysms of the descending thoracic aorta, either voluminous, of infectious origin or associated with aneurysm of the infrarenal abdominal aorta.

Adult↗
PubMed1984

[Injuries to abdominal vessels after surgery of disk herniation].

Four cases of major vascular injury after disc surgery have been treated by the authors. In two instances the symptoms were those of an intra peritoneal haemorrhage after injury to the aorta or to the common iliac artery. These two cases were treated by resection-anastomosis of the vessel. In the two other cases, a fistula developed between the common iliac artery and the inferior vena cava or between the common iliac artery and the common iliac vein. Both lesions were also repaired two days and 10 days after disc surgery. A review of the literature has shown that these lesions are more frequent after surgery at L4-L5 level than at L5-S1 level. They are more frequent after repeated operation. They should be looked for when a fall in blood pressure is noted at the end of the surgical procedure. The published mortality is about 80 p. 100 in vessel division and 10 p. 100 after arterio venus fistula. The earlier the diagnosis is made, the higher is the proportion of healing.

Adult↗
PubMed1984

[Persistent sciatic artery. Apropos of a case, review of the literature ].

A case is reported of bilateral persisting sciatic arteries: complete on the right side but incomplete on the left, revealed by the onset of a distal embolism on the right side treated by exclusion and a right femoropopliteal shunt operation. The observation of this further case in France led to a review of the literature which demonstrated the rarity of this congenital anomaly, which usually however represents the only vascular axis to the lower limb, and the frequency of aneurysmal transformations with subsequent complications that are best treated by ligature combined with a femoropopliteal shunt.

Adult↗
PubMed1983

[Aortocoronary bypass with 10 years' follow-up. Apropos of 183 cases].

Between 1970 and 1972, 183 patients were admitted to the CMC Foch (Pr D. Guilmet) for saphenous vein aorto-coronary bypass surgery. Ten years later a questionnaire was sent to the patient and his cardiologist and the two replies were analysed. Before surgery, all patients had invalidating angina: 12 p. 100 had unstable angina, 61 p. 100 had previous myocardial infarction. Preoperative coronary angiography showed triple vessel disease in 64,5 p. 100, double vessel disease in 18,6 p. 100 and single vessel disease in 14,2 p. 100. There hundred and thirty two grafts were performed (average 1,8 per patient); 42 endarteriectomies were also carried out, 35 on the right coronary artery. Complete revascularisation was achieved in 95 cases (52 p. 100). The incidence of perioperative infarction was 17,5 p. 100 and operative mortality was 7,6 p. 100. Thirty two patients (19 p. 100) died during the 10 year study period; 11 deaths were of cardiovascular origin. The 10 year actuarial survival rate was 66 p. 100. Half the patients are asymptomatic and nearly two thirds take no anti-anginal therapy. The patency of the grafts was chacked in about half the cases and was found to be 72,8 p. 100 at one year. From the professional point of view, two thirds of patients returned to full time working one year after surgery. The degree of activity at 10 years is only known in 87 cases; half these patients are working and a quarter have retired normally. This study shows that: --coronary bypass surgery has excellent long-term effects on symptoms; --the incidence of infarction and survival are comparable to other reported studies; --patients with triple or double vessel disease may have lived longer after surgery than had they been treated medically.

Adult↗
PubMed1982

[Calcifying obstructive disease of the descending thoracic aorta].

The authors present the first surgically treated case of calcifying obstructive disease of the descending thoracic aorta. The diagnosis was based upon the coexistence of an aortic isthmus coarctation syndrome together with massive calcifications seen by chest X-ray. The aetiology remains uncertain but the authors tend in favour of an atheromatous aetiology. Cure was obtained by simple surgical treatment.

Aorta, Thoracic↗
PubMed1981

[Surgical treatment of thoracic and thoraco-abdominal aneurysms involving the Adamkiewicz's artery. Usefulness of deep hypothermia (author's transl)].

The authors present a new surgical technique for the treatment of thoracic and thoraco-abdominal aneurysms involving the artery of the lumbar enlargement (Adamkiewicz's artery) at its point of origin. In two patients the aortic segment giving birth to the artery was accurately located by angiography and re-impaired under deep hypothermia and extracorporeal circulation.

Adult↗
PubMed1980

[Value of surgical approach to the vertebral artery in its extra-cranial segment. A case of aneurysm of the vertebral artery in C3 (author's transl)].

Long considered dangerous, surgical treatment of lesions of the vertebral artery in its extra-cranial course, may be viewed in parallel with angiographic techniques. Approach to the vertebral artery in its different segments, pre-operative arteriographic assessment, are discussed, and operative indications only mentioned. An aneurysm of the vertebral artery in C2-C3 was treated by exclusion and restoration of continuity by a sub-clavian vertebral vein graft in C1-C2.

Aneurysm↗