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Biomedical subjects

U Hvass

Publications and source records attributed to U Hvass.

At least 73 records · Page 4Linked to original sources
PubMed1987

[The autologous pericardial tube-flap. A new technic for restoring the continuity between the right ventricle and the pulmonary artery].

Re-establishing continuity between the right ventricle and the division of the pulmonary trunk may prove difficult in surgical correction of transposition of the great vessels. Although prosthetic tubes, which had many drawbacks, have been replaced by direct anastomoses, partial reconstruction of the pulmonary arterial wall is still often necessary. The materials commonly used are segments of gore-tex, stored pericardium and fresh or glutaraldehyde-treated pericardium. However, retractions may develop in these reconstructions resulting in pulmonary stenosis. These complications have revived the debate on the best technique for re-establishing continuity, and it is mandatory to use a growing tissue to keep pace with the child's development. We report here an original technique used in an infant. Previous studies have shown that the autologous pericardial flap, transformed here into a tube, retains its potential for growth.

Blood Vessel Prosthesis↗
PubMed1987

[Reconstruction of pulmonary artery branches with pedicled flaps from the autologous pericardium].

A new reconstruction technique using pedicled flaps from autologous pericardium was applied in a case of long hypoplastic segments of the two branches of the pulmonary artery in a 6-year old child. The pericardial sac was incised vertically on the midline, and two rotating flaps, one on the left, the other on the right, were created to bring the pericardium in front of the corresponding arterial branches. Each branch was split open all along its hypoplastic segment which was then widened to normal diameter, using the pericardial flap for reconstruction. Control echocardiography, performed one year later, showed that the excellent post-operative results persisted. This is of particular interest as it is well known that all other materials previously utilized to reconstruct the pulmonary artery do not grow or even shrink, resulting in progressive stenosis.

Child↗
PubMed1987

[Hydatid cyst of the right heart and post-embolic pulmonary hypertension].

A 22-year old man with hydatid cyst of the right ventricle presented, for about 10 years, with clinical signs of post-embolic pulmonary hypertension. Despite tumoral resection, the patient died post-operatively of his pulmonary hypertension. Post-mortem examination showed a hydatid cyst on the main pulmonary artery and fixed post-embolic pulmonary hypertension, but we were unable to determine whether we were dealing with old migrated cysts or blood clot emboli developed in contact with the cardiac tumour.

Adult↗
PubMed1986

[Repair of rheumatic mitral lesions by transfer of a segment of the posterior valve with its chordae onto the anterior valve].

Since 1981, 100 patients have undergone mitral valve repair alone or in association with aortic or tricuspid valve surgery. The basic technique used was that described by Carpentier. However, in 13 of these patients, the repair was performed by a technical innovation consisting in transferring a one to two centimetres segment of the posterior leaflet with its chordae to the anterior leaflet. The lesions in which this particular technique was required were extensive chordal rupture of the anterior leaflet (5 cases), localised retraction of the surface of the anterior leaflet (2 cases), and perforation near the valve free edge due to endocarditis (1 case). The valvular disease was due to rheumatic fever in all cases. None of the patients had active endocarditis. The age of the patients varied from 4 to 60 years. Eight patients were under 15 years of age. Postoperative echocardiography and pulsed Doppler studies showed results comparable to the other patients who had undergone mitral valve repair although the valvular lesions were more severe in this particular group of patients. Only one patient had a poor operative result and had to be reoperated.

Adolescent↗
PubMed1986

[Mitral stenosis with notable or important subvalvular changes. Complete open commissurotomies supported by chorda transfer].

Since 1983, 40 consecutive patients with mitral stenosis (MS) and significant disease of the subvalvular apparatus underwent open heart mitral commissurotomy (OHMC). The aim of the study was to evaluate the effects of an unrestricted dilatation of the two commissures followed by repair of the subsequent mitral regurgitation. The mitral regurgitation created by this procedure in 24 cases was corrected by transferring 2 to 6 chordae tendinae to the free border of the anterior and/or posterior leaflet in the commissural region. A central regurgitant lesion due to lack of coaptation of the valvular surfaces was treated by annuloplasty with a Carpentier prosthesis in 12 cases. The subvalvular abnormalities were treated by the conventional techniques of fenestration, resection and division of the papillary muscles. Thirty of the 38 survivors had no residual murmur, and 6 had a short low intensity systolic murmur. The 2D echocardiographic study showed no residual stenosis. The residual systolic murmurs were evaluated by pulsed Doppler and corresponded to very localised regurgitation. This extensive operative technique gives very good immediate valvular results which, associated with an adequate subvalvular procedure, are considered to be an important prognostic factor.

Adolescent↗
PubMed1985

[Aortic valve replacement in children by autograft of the pulmonary arterial wall].

Since March 1984 we have been using a new biological valve for aortic valve replacement in children. The valve substitute is an autologous segment of cylinder taken from the pulmonary arterial trunk, leaving untouched the bifurcation and the pulmonary valve. The pulmonary artery wall segment is sutured without stand to the brim of the aortic annulus and upward beyond the aortic commissures to achieve adequate support from the aortic wall. The pulmonary artery itself is reconstructed by direct suture. This procedure has been successfully used in 3 patients aged 7, 10 and 13 years presenting with severe aortic regurgitation due to rheumatic heart disease.

Aortic Valve↗
PubMed1984

[Abnormal aortic arches in infants and children (experience with 322 cases)].

It is very rare that the knowledge of the human embryology helps the medical diagnosis and guides the surgical treatment when it is necessary. With the oesophagogramm it is possible to obtain the exact topography of the abnormal vascular ring and to perform live saving operation. Our experience of 322 cases is the most important published up to now.

Aorta, Thoracic↗
PubMed1984

[Abnormal aortic arch in children and infants. Experience in 322 cases].

The authors report on their experience in 322 cases of aortic arch anomalies surgically treated in infants and children. The progress recently achieved through improved diagnosis and resuscitation care have made possible to obtain good results in the great majority of cases.

Abnormalities, Multiple↗
PubMed1983

[Use of PTFE (Gore-Tex) in pulmonary systemic anastomoses. Apropos of 50 cases].

Between 1977 and 1981 palliative anastomosis procedures between the subclavian and pulmonary arteries using a PTFE (Gore-Tex) prosthesis for anatomical reasons (short subclavian artery or trajectory incompatible with a Blalock-Taussig anastomosis) were carried out in 50 patients from 1 day to 24 years of age with cyanotic congenital heart disease. Two groups of patients were identified: ten patients in which the PTFE prosthesis was used as an "extension" to the subclavian artery, and 40 patients in which the PTFE was interposed between the respected subclavian and pulmonary arteries. There were three deaths (6 p. 100) at 1,7 and 15 days after surgery (mean mortality 5,7 and 12,3 p. 100). There were no major complications in the survivors. Two prostheses became occluded, one of which was reanastomosed to the ascending aorta. The follow-up ranges from 6 months to 5,5 years. The angiographic investigations performed before complete repair demonstrated the patency and good function of these anastomoses.

Adolescent↗
PubMed1982

[Aberrant subclavian artery in infants. Division and reimplantation into the common carotid artery through cervicotomy (author's transl)].

In infants, merely dividing an aberrant subclavian artery (ROSCA) through left-thoracotomy may result in severe cerebral circulatory disorders by vertebrobasilar arterial steal. The authors report on 3 cases where reimplantation of the ROSCA into the common carotid artery reproduced a normal brachiocephalic arterial trunk and resulted in normal revascularization. In 2 of these 3 cases, the ROSCA was approached through a right cervical incision, divided in the mediastinum, behind the oesophagus, and reimplanted by latero-lateral anastomosis into the right carotid artery. In the third case the same approach was preceded by left thoracotomy for easier division of the ROSCA close to the aorta. The three operations were uneventful and no complication occurred, except for transient and mild left hemiparesis without sequelae in one patient.

Aorta, Thoracic↗