Outcomes after surgical treatment for type A acute aortic dissection in octogenarians: a multicenter study.

Background: Management of octogenarian patients with acute type A acute aortic dissection is controversial. This study analyzed the surgical outcomes to identify patients who should undergo operations.

Methods: Beginning January 2000, we established a registry including all octogenarian patients operated on for type A acute aortic dissection.

Ventricular patch endocarditis caused by Propionibacterium acnes: advantages of gallium scanning.

Propionibacterium acnes is a weakly pathogenic commensal of the skin. When isolated from blood cultures it is often considered a contaminant. However, P.

Retroesophageal subclavian artery aneurysm arising from Kommerell's diverticulum.

This report describes a novel technique used for management of retroesophageal subclavian artery aneurysm arising from Kommerell's diverticulum. The procedure consists of endoaortic exclusion of the aneurysmal neck, using a prosthetic patch after sternotomy during circulatory arrest, and antegrade cold blood cerebroplegia. The advantages of this technique are avoidance of hemorrhagic complications during clamping of the aneurysmal neck, limiting of the extent of dissection of the aortic arch, and elimination of the risk of inadvertent left recurrent nerve paralysis.

[Technical problems during coronary revascularization in case of massive calcified aorta].

A massively calcified ascending aorta which may make aortic clamping impossible, is a major obstacle to coronary revascularisation surgery. The aim of this study was to demonstrate that by the use of certain technical modifications, these patients can be treated even in multivessel disease. In the author's experience, two patients with this condition underwent complete revascularisation with a good surgical result controlled by angiography.

[Postoperative acute aortic dissection. Apropos of two cases].

Aortic dissection after cardiac surgery is a rare complication. The prognosis is often poor: 33-78% of mortality. The study of two cases out of 2100 patients operated upon during the last three years, and the review of the literature, allows to recall the mechanism, the anatomic origin and the different surgical techniques.

Spontaneous dissecting aneurysm of the common iliac artery.

A 52-year-old man sought medical advice for sudden onset of intermittent claudication of the left lower limb after 50 meters walking. Aortography documented a dissecting aneurysm limited to the left common iliac artery. After resection, a prosthetic graft was inserted.

[Protection and reperfusion of the myocardium by cardioplegia with blood enriched in aspartate and glutamate. Technique and initial results. Report of 60 cases].

From 1st November 1987 to 30th September 1988, 27 patients with recent myocardial infarction and 33 patients at high risk of postoperative circulatory failure were operated according to the same protocol. In each case, myocardial protection, at the time of aortic clamping, consisted of an intra-coronary injection of a cardioplegic solution of blood enriched with aspartate and glutamate, administered in 3 phases (normothermic induction, hypothermic induction, normothermic reperfusion) according to the protocol described by Buckberg et al. The operative mortality was 11.

[Intra-aortic balloon counterpulsation. Percutaneous insertion at surgical units. Apropos of 170 cases].

From 1st January 1985 to 31st December 1987, an intra-aortic balloon counterpulsation device (IABCP) was inserted in 170 patients: 166 balloons were inserted percutaneously and 4 surgically after failure of the percutaneous route. The indications for insertion of IABCP are classified into 3 categories. Category 1 (N = 28) consists of non-operated patients, category 2 (N = 60) consists of patients in whom IABCP balloons were inserted by necessity before, during of after a surgical operation under cardiopulmonary bypass (CPB) and category 1 (N = 82) consists of patients in whom the IABCP balloons were inserted prophylactically prior to an operation under CPB in patients at high risk.

[Coronary endarterectomy associated with by-pass. A series of 111 patients controlled angiographically].

Out of 2 638 patients undergoing coronary bypass surgery at the Arnault Tzanck Centre from 1973 to September 1984, 305 (12%) also required coronary endarterectomy. One hundred and eleven of these patients had control angiographies at the Centre and were the object of this study. Endarterectomy was carried out on a totally occluded artery in 38% of cases and was performed out of necessity in the other cases.

[Congenital tracheal stenosis associated with aberrant left pulmonary artery. Apropos of a severe form with neonatal disclosure].

The case report is presented of a newborn infant afflicted with extensive congenital tracheal stenosis associated with anomalous left pulmonary artery, proving rapidly fatal. The possibility of tracheal anomaly must be envisaged in the face of any neonatal respiratory distress unexplained by pulmonary parenchymatous pathology. Diagnosis of this complex malformation relies on endoscopy and oesophagogram and tracheo-bronchogram contrasts.

[Transluminal coronary angioplasty. Experience apropos of 155 procedures].

The authors report their experience of transluminal coronary angioplasty (TCA) from February 1980 to November 1983. 140 patients underwent TCA and 155 procedures were performed. The mean age was 55 years (range 33 to 74 years).

[Emergency surgical revascularization in establishing myocardial infarctions. Treatment of subtotal coronary occlusions].

The introduction of intracoronary thrombolysis as a treatment for myocardial infarction has led to an increase in the number of very early coronary angiographies carried out in the acute phase of myocardial infarction. These investigations can be performed without excessive risk. In some cases, severe stenosis with significant distal circulatory impairment without evidence of thrombosis is found.

[Effect of open heart surgery on intellectual efficiency. Prospective study apropos of 40 cases].

Neurological accidents following open heart surgery have become exceptionaly rare because of technical advances. However, some minor intellectual problems are quite common (loss of memory, lack of concentration..

Aneurysms complicating coarctation of the aorta: anatomic aspects and evolution. Report of six successful surgical cases.

Six cases of coarctation of the aorta with aneurysms are reported. The 6 patients have been successfully operated with resection of the aneurysm and replacement of the aorta by a Dacron graft. The different anatomic characteristics are described.

Delayed pulmonary thrombectomy via a peripheral approach in the treatment of pulmonary embolism and sequelae.

Delayed unilateral pulmonary embolectomy via the peripheral approach has been performed in 12 patients suffering from chronic pulmonary vascular obstruction after a single or repeated embolisms. Arterial hypoxemia and pulmonary hypertension were present in all cases. Embolectomy was performed several months or years after the initial event.