Surgical treatment of acute dissection of the aorta superimposed on pre-existing aneurysm of the ascending aorta. Total replacement of the ascending aorta with reimplantation of the coronary arteries. A report on five cases.

Five cases of acute dissection of the ascending aorta superimposed on a pre-existing aneurysm, including two with propagation of the dissection into the coronary arteries, were treated by total replacement of the ascending aorta utilizing a valve containing tube graft and reimplantation of the coronary arteries. Diverse techniques such as the use of an intermediate tube for reconnecting the coronary arteries, correction of the coronary dissection by reapproximation of the two layers or with bypass grafting, support of the distal aortic suture line with Teflon felt and fistulization of the periprosthetic space to the right atrium, greatly simplified the treatment of these lesions, permitting survival of four out of five patients, who are in excellent health one, four, and seven years respectively after surgery.

[Evolution of myocardial temperature following cardioplegia with and without complementary pericardial cooling. Experimental study].

Myocardial temperatures were measured after cardioplegia during cardiac surgery with and without pericardial cooling by a cold bath. Eight animals (50 kg pigs) were placed on cardiopulmonary bypass using a protocol reproducing clinical operating conditions as closely as possible: myocardial mass, median sternotomy, general hypothermia at 25 degrees. Two injections of cardioplegic solution were administered, one at aortic clamping and the other, 30 minutes later.

[Recurrence of mitral disease after commissurotomy. Criteria influencing operative mortality during reintervention using extracorporeal circulation].

Reoperation for secondary deterioration after mitral commissurotomy is associated with a higher immediate postoperative mortality than other open heart operations. We analysed the factors responsible for this increased mortality. A total of 232 patients reported for clinical deterioration after closed heart mitral commissurotomy were reviewed.

A morphological study on gills of a crab acclimated to fresh water.

The gills of the fully euryhaline Chinese crab Eriocheir sinensis were studied by light and electron microscopy. In these Phyllobranchiates, the gills consist of a double row of lamellae extending laterally from a central shaft. Haemolymph flow pattern inside the gill is described and the existence of a complex secondary vascularization inside the platelets is reported.

[Thermal isolation of the heart by means of a plastic foam pad during surgical cooling of the heart: experimental study].

Maintenance of myocardial cooling during aortic clamping is a problem encountered currently during heart surgery. A plastic foam isolation pad was studied. Eight animals (pigs weighing 50 kg) were placed on extracorporeal circulation, 4 of them constituting the control group (A).

Surgical treatment of ventricular tachycardia guided by ventricular mapping in 23 patients without coronary artery disease.

Twenty-three patients with resistant ventricular tachycardia not related to coronary artery disease underwent surgical treatment guided by ventricular mapping. The patients were grouped according to radiological and anatomical findings. Group 1 (13 patients) had arrhythmogenic right ventricular dysplasia.

[Myxomas of the right atrium. Apropos of 3 cases. Review of the literature].

The authors report 3 cases of right atrial myxoma and review 88 other cases in the literature managed by surgery. The first personal case, in a 74 year old patient, illustrate the dramatic consequences of tumour engagement in the tricuspid orifice, in this instance cardiac arrest during catheterisation justifying emergency surgery. The second case exemplifies the diagnostic value of echocardiography: the correction of an erroneous diagnosis of pericarditis.

[Possibilities and limits of angiographic exploration of the deep femoral artery using posteroanterior projections as described by Dos Santos. Radiological and therapeutic consequences (author's transl)].

The study concerns 36 patients treated by an aortobifemoral shunt operation. The decision to operate followed conventional posteroanterior arteriography using the technique described by Dos Santos. Surgical exploration of 54 deep femoral arteries (DF) was conducted during the approach to the femoral tripod.

[Prophylactic intra-aortic balloon pumping in the surgery of the left main coronary artery].

92 significant stenoses of the left main stem artery (LCA) underwent revascularisation procedures by aorto-coronary venous bypass grafting. Three groups of patients were identified. Group I comprised 11 stenoses of the LCA associated with lesions of at least three other coronary vessels and a subtotal stenosis of the LCA.

["Blue phlebitis" by thrombosis of the inferior vena cava on top of dysplastic stenosis].

A case of dysplastic stenosis of the infra-renal segment of inferior vena cava, with acute thrombosis and ischaemia of the left lower limb, is reported. Emergency thrombectomy, with pre- and post-surgery anticoagulant therapy, resulted in perfect recovery. As a comment on this case, various types of vena cava dysplasia, and possible causes of vena cava thrombosis, are briefly reviewed.

[Removal of human kidneys under "in situ" hypothermia by aortic and caval cannulations. Technique and first clinical results (author's transl)].

After dissection and cannulation of aorta and vena cava, the kidneys are washed out "in situ" with a cooling perfusion, avoiding any possibility of so-called warm ischaemia. The kidneys and their vessels, still attached to aorta and vena cava, are then en bloc removed, which enables a satisfactory preparation of the vessels for subsequent anastomosis to be performed. After an experimental study [6], four kidneys were removed according to this procedure, and transplanted after an average cold-storage time of 23 hours.

[Original removing technique of the kidneys for transplantation. An experimental study (author's transl)].

The depicted procedure minimizes the hazards of aggressive manipulations, and excludes any possibility of so-called "warm ischaemia". The kidneys are flushed out in situ with cool pulsatile perfusion through an aortic cannula. Kidneys, aorta and inferior vena cava are then removed en-bloc without interrupting the perfusion, and preserved in Collins' solution at 4 degrees C.