[Popliteal venous aneurysm and recurrent pulmonary embolism. A case report].

Primary popliteal vein aneurysms are rare, in contrast with veinous dilatation secondary to trauma or complicating an arterio-veinous fistula. The authors report the case of recurrent pulmonary embolism in a 46 year old man with a popliteal vein aneurysm. This veinous malformation usually presents with pulmonary embolism due to migration of blood clot from the thrombosed aneurysmal sack.

[Spontaneous and isolated dissection of the external iliac artery. Presentation of a case].

Primary dissecting aneurysms of peripheral arteries without involvement of the aorta are rare. The present report deals with a case of dissecting aneurysm of the external iliac artery in a 39-old man treated by resection and prosthetic graft. Although the exact cause of the dissection was not apparent, it seems likely that it was related to disorder of connective tissue because of the presence of a pectus excavatum, a deep palate and an increased hydroxyproline urinary excretion.

[Emergency vascular access in patients with renal failure. Apropos of 32 implantations of permcath].

Central venous catheters allow for the most rapid hemodialysis procedure with sparing of peripheral blood vessels. 32 flexible, double-lumen "permcath" catheters were implanted to 27 patients over a period spanning 42 months (February 86-August 89). Catheter placement was definitive in 2 cases while another 30 provided previsory intravenous access for plasmapheresis (25 cases), acute renal insufficiency (7 cases), and chronic renal failure (17 cases).

[Radiation-induced thrombosis of the carotid artery and lingual necrosis. Report of a case treated by cervical peridural nerve block].

A case of lingual necrosis in a patient irradiated 3 years earlier for a tonsillar tumor is presented. Imputability to a post-radiology bilateral external carotid thrombosis is evoked, where the diagnosis of tumoral recurrence and Horton's disease have been ruled out. Cervical peridural nerve block allowed successful treatment of this lesion.

[Study of the late results of reimplantation of heart valve prostheses based on 15-year experience].

Authors studied two groups of patients, in which a cardiac valvular prosthesis was reimplanted within 15 years. Data of patients reoperated on (group A) were used to estimate indications, surgical methods, postoperative course and late results. Data of patients which underwent surgery and then requiring reoperation (group B) were used to evaluate the percentage of reoperation falling to 1 patient/1 year according to a primary implanted valvular prosthesis: 42 patients were divided into two groups.

Aorto-coronary artery saphenous vein bypass surgery. A ten-year follow-up.

The 10-year follow-up of consecutive series of 126 patients who underwent coronary bypass surgery from January 1970 through December 1972 without associated procedures is reported. There were 112 men and 14 women with a mean age of 50.3 +/- 8.

[Reoperations in valve surgery. Apropos of 194 cases].

Between 1970 and 1985, 194 patients underwent one or several reoperations after conservative valvular surgery (Group A) or valvular replacement surgery (Group B). Group A: comprised 141 patients with a previous history of closed heart mitral commissurotomy (114 cases), open heart mitral commissurotomy (20 cases), mitral valvuloplasty (5 cases) or aortic commissurotomy (2 cases) reoperated after an average period of 153 +/- 44 months. At reoperation, prosthetic valve replacement of the previously operated valve was systematic and another valvular procedure was also performed in 66 cases.

[Isolated aortic valve replacement in an advanced stage of cardiac failure. Results and prognostic study apropos of 71 cases].

Between January 1970 and December 1982, seventy-one patients in functional Stage IV of the NYHA classification underwent isolated aortic valve replacement for aortic incompetence (27 cases), aortic stenosis (18 cases) or mixed aortic valve disease (26 cases). Three haemodynamic criteria were chosen: left ventricular ejection fraction less than 40% (average 34 +/- 2%); arteriovenous difference greater than 6 volumes per 100 ml (average 6.7 +/- 0.

[Tracheal diverticuli: apropos of a case: malformation etiopathogenesis?].

A case of 3 contiguous diverticula of the right posterior wall of the upper trachea is reported. The earlier literature on this subject and the different classifications described are studied. Congenital genesis of the tracheal diverticula is suggested by their localisation and histologic bronchial elements, and by embryogenesis and anomalies of the trachea.

[Results of venous aortocoronary bypass with a minimum follow-up of more than 10 years].

The results of saphenous vein coronary bypass alone were assessed in 126 patients operated between 1970 and 1972 with a postoperative follow-up period of 10 to 12 years. Spontaneous or unstable angina was observed in 72% and incapacitating effort angina in 27.7%.

[Associated coronary and carotid atheroma. Implications and current role of indications for double surgery].

Coronary insufficiency is responsible for part of the peri-operative mortality of carotid surgery and it is by far the principal long term cause of death. Conversely, cerebral vascular accidents due to extra-cranial carotid stenosis compromise the results of myocardial revascularisation operations less than coronary insufficiency itself. Patients who require double surgery can be recognised on the basis of the clinical findings.

[The cloverleaf skull. Anatomical presentation of a case].

We report the case of a still-born baby girl who had a rare craniostenosis known as the "clover leaf skull syndrome". The 125 previously reported cases were reviewed allowing us to better define the principal features of this condition.

[Congenital anomalies of the origin and/or distribution of coronary arteries originating from the aorta. Angiographic study of 39 cases].

39 cases of congenital anomalies in the origin and/or in the distribution of the coronary arteries arisen from the aorta, without associated cardiac abnormality, seen in the course of 6 525 selective coronary arteriographies in adults, are reported and integrated into a general classification of coronary arteries abnormalities. The clinical correlation of these anomalies is specified. The authors emphasize the importance of their diagnosis in the surgery of valve replacement or of myocardial revascularization.

[Prevention of gas microemboli during cardiac surgery. Numerical control of cardiac cavity purging by an ultrasonic detector].

Despite all precautions taken by cardiac surgeons to eliminate air remaining in the cardiac cavities and pulmonary veins at the end of cardiopulmonary bypass, many micro bubbles probably remain and pass into the systemic circulation with a risk of deteriorations of cerebral or myocardial function. Over the last four years we have used ultrasound to try to prevent the risk of preoperative gas microemboli: the machine is equipped with a detector (a quartz oscillator coupled to a piezoelectric transducer emitting a continuous beam of ultrasound at a frequency of 5 Mhz) which allows the following variables to be determined: the time interval from the onset of detection, the total quantity of bubbles (arbitrary units) in the examined regions, the quantity of bubbles detected over a given time interval which can be adjusted from 15 to 120 seconds. The passage of bubbles is also indicated by light and sound alarms.

[Impending carotid and coronary artery obstruction. Operative procedure and monitoring].

A 70 year old woman was admitted to the intensive care unit for unstable angina with haemodynamic repercussions which led to a right hemiparesis because of a left carotid stenosis. The worsening neurological deficit required an immediate endarterectomy. Cardiovascular monitoring, particularly during anaesthetic induction and carotid clamping, included a Swan-Ganz catheter which provided continuous control of myocardial damage.

[Pryce's type I intralobar pulmonary sequestration. Apropos of an anatomo-surgical case].

A case of intralobar pulmonary sequestration revealed by hemoptysis is reported. A left lower lobectomy was performed. Anatomical investigations of the lobe showed a normal lung supplied by an aberrant artery arising from the aorta.

Ilio-femoral and femoro-femoral crossover grafting. Analysis of an 11-year experience.

Experience with 131 crossover arterial bypass grafts for lower limb revascularization has been reviewed. Ninety-nine grafts were placed as a primary procedure for unilateral iliac artery occlusive (97) or aneurysmal (2) disease. In contrast 32 grafts were placed as a secondary procedure following the failure of a previous unilateral or bilateral conventional aorto-iliac reconstruction.

[Infectious aneurysm of the abdominal aorta and Salmonella septicemia. Favorable development over 2 years of a case treated by resection and axillobifemoral bypass].

A 57 years old man had a two months history of chills and fever with abdominal pain. Blood cultures were positive for Salmonella ohio. He suddenly became hypotensive with oedema of lower limbs.

[Galactorrhoea and thoracic surgery (author's transl)].

The authors report 4 cases where galactorrhoea complicated thoracotomy. It was only possible to find 21 cases altogether in the literature where this complication followed thoracic surgery. Galactorrhoea started in the week following surgery.