ABSTRACT
The mechanism of rheumatic aortic regurgitation is retraction of the three cusps leading to lack of coaptation. The authors describe a technique of aortic valve repair by extension of the cusps using autologous pericardium, undertaken in 52 patients (mean age 21 +/- 5 years) and report the short and medium term results. There were no operative deaths or reoperation for technical failure. The postoperative echocardiographic examinations showed absent or minimal aortic regurgitation in 45 patients (87%) and moderate regurgitation in 7 patients (13%). The echocardiographic results at 2 years were stable: no patient was reoperated for deterioration of the valvuloplasty. This technique is reproducible and reliable is selected patients.
Subject(s)
Aortic Valve Insufficiency/surgery , Pericardium/transplantation , Rheumatic Heart Disease/surgery , Adolescent , Adult , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/physiopathology , Cardiac Surgical Procedures/methods , Child , Humans , Middle Aged , Reproducibility of Results , Rheumatic Heart Disease/diagnostic imaging , Rheumatic Heart Disease/physiopathology , Transplantation, Autologous , Treatment Outcome , UltrasonographySubject(s)
Academies and Institutes , Cardiac Surgical Procedures , International Cooperation , Clinical Protocols , France , Humans , VietnamSubject(s)
Cardiac Surgical Procedures/adverse effects , Mediastinitis/surgery , Surgical Wound Infection/surgery , Anesthesia, General/methods , Follow-Up Studies , Humans , Mediastinitis/microbiology , Mediastinitis/prevention & control , Prognosis , Suppuration/surgery , Therapeutic Irrigation/methodsABSTRACT
A case of recurrent coronary artery spasm after coronary revascularization under cardiopulmonary bypass is related. The spasm, which occurred under nitroglycerin perfusion, was suspected on the ECG tracing and confirmed during immediate reoperation. It was successfully treated with bepridil, a calcium-channel blocking agent. The use of such agents after cardiac surgery is discussed.
Subject(s)
Calcium Channel Blockers/therapeutic use , Coronary Artery Bypass/adverse effects , Coronary Vasospasm/drug therapy , Pyrrolidines/therapeutic use , Bepridil , Coronary Vasospasm/etiology , Electrocardiography , Extracorporeal Circulation , Humans , Male , Middle AgedABSTRACT
Nitroglycerin in aqueous solution has been used as hypotensive agent during a caesarean section, in a patient who presented an arterial hypertension not controled by administration of four antihypertensive agents (acebutolol, clonidine, dihydralazine, alpha-methyl-dopa). Nitroglycerin continuous infusion started two hours before caesarean section at the dose of one milligramme over one hour and stopped several hours after.
