Valve aortique percutanée

in Urgences & Accueil (2010), 11(40), 6-8

Transcatheter aortic valve implantation (TAVI) is increasingly performed and represents a relatively safe alternative treatment for high risk patients denied to surgical aortic valve replacement. TAVI is ... [more ▼]

Transcatheter aortic valve implantation (TAVI) is increasingly performed and represents a relatively safe alternative treatment for high risk patients denied to surgical aortic valve replacement. TAVI is performed at the University Hospital of Liege since July 2008 with the Medtronic CoreValve Revalving® system by femoral or subclavian access. This paper exposed the technique of TAVI and the nursing care required after this procedure. [less ▲]

Do we need a new carotid artery stenting trial?

in Acta Chirurgica Belgica (2010), 110(4), 432-44

Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery ... [more ▼]

Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery stenting (CAS) over carotid artery endarterectomy (CEA). There is at the moment no level-I evidence to support widespread use of endovascular management of carotid artery disease in routine practice. In order to shead some light on the continuing debate on the role of carotid artery stenting, the authors conducted a search in contemporary published literature concerning carotid artery stenting. This extensive literature review reveals a higher peri-procedural stroke-death rate after CAS and a higher cost. Two other events hamper the value of CAS: a higher late restenosis rate and a higher risk of micro-embolisation during the procedure, compared with CEA. The authors conclude that the prevailing overenthusiasm of interventionalists (vascular surgeons, radiologists, cardiologists) for carotid artery stenting is not justified. [less ▲]

Successful Bridge to Transplantation with Pierce Donachy (Thoratec) Ventricular Assist Device

in Acta Chirurgica Belgica (1998), 98(2), 90-4

Biventricular assistance with the Thoratec ventricular assist device was performed in a 48-year-old man waiting heart transplantation since 6 months. Indication for circulatory support was considered ... [more ▼]

Biventricular assistance with the Thoratec ventricular assist device was performed in a 48-year-old man waiting heart transplantation since 6 months. Indication for circulatory support was considered because of the development of progressive irreversible right heart failure with deterioration of the hepatic and renal functions. Orthotopic heart transplantation was performed after 13 days of circulatory support. No complications occurred during the assistance and in the posttransplant period. The patient was discharged on day 21 after transplantation. Five months after transplantation he is well and alive. [less ▲]

La maladie de Buerger: aspects cliniques et pronostiques

in Revue Médicale de Liège (1997), 52(10), 675-82

Successful Tricuspid Valve Replacement and Pulmonary Valvulotomy for Carcinoid Heart Disease

in Acta Chirurgica Belgica (1996), 96(4), 170-6

A case of successful tricuspid valve replacement with a mechanical prosthesis and pulmonary valvulotomy for carcinoid heart disease is reported. The patient was a 61 years old women. The primary tumor was ... [more ▼]

A case of successful tricuspid valve replacement with a mechanical prosthesis and pulmonary valvulotomy for carcinoid heart disease is reported. The patient was a 61 years old women. The primary tumor was in the terminal ileum. Liver metastasis and carcinoid syndrome were present since 8 years. After cardiac surgery, the patient survived 38 months and late death was related to disseminated metastasis. Even in case of metastasis, carcinoid tumor is slow growing. Without cardiac operation for correction of valvular lesions, terminal symptoms and death may often be related to cardiac operation for correction of valvular lesions, terminal symptoms and death may often be related to cardiac failure rather than to tumoral growth. Thus, even in presence of metastasis, cardiac surgery may be mandatory to improve both quality of life and survival. [less ▲]

Mechanical Flow Obstruction after Heart Transplantation Diagnosed by Tee

in Annals of Thoracic Surgery (1994), 58(3), 890-1

We report a case of mechanical flow obstruction after heart transplantation caused by a prominent left atrium suture with a "pursestring" effect. The diagnosis was achieved by transesophageal ... [more ▼]

We report a case of mechanical flow obstruction after heart transplantation caused by a prominent left atrium suture with a "pursestring" effect. The diagnosis was achieved by transesophageal echocardiography. The mean transstenotic gradient was measured at 13 mm Hg. Because of the profound hemodynamic and multisystemic failure, no surgical correction was attempted. The postmortem examination confirmed the stenosis at the level of the left atrium. [less ▲]

In Vivo Free Radical Production after Cross-Clamping and Reperfusion of the Renal Artery in the Rabbit

in Cardiovascular Surgery (1993), 1(4), 343-9

Postischaemic reperfusion injury is often attributed to the generation of oxygenated free radicals which may subsequently promote lipid peroxidation in cell membranes. Electron paramagnetic resonance ... [more ▼]

Postischaemic reperfusion injury is often attributed to the generation of oxygenated free radicals which may subsequently promote lipid peroxidation in cell membranes. Electron paramagnetic resonance spectroscopy in association with the spin trap molecule alpha-phenyl-N-tert-butyl-nitrone allowed direct confirmation of lipid free radical production after renal ischaemia-reperfusion in an in vivo rabbit model. A 60-min period of ischaemia followed by reperfusion caused free radical production twofold greater than after 15 min of ischaemia. Glutathione and alpha-tocopherol have been measured in renal tissue, as indirect markers of lipid peroxidation. After 15 min of ischaemia followed by 10 min of reperfusion, the mean(s.e.m.) glutathione content of the ischaemic kidney was slightly but significantly reduced by 11.9(2.5)% (P < 0.003). The content of alpha-tocopherol was unchanged. However, 10 min of reperfusion following 60 min of ischaemia led to significant decrease in mean(s.e.m.) content of both glutathione (30.4(3.7)%) (2.23(0.2) versus 3.14(0.18) mumol/g wet tissue, P < 0.001) and alpha-tocopherol (46.1(7.8)%) (0.57(0.10) versus 1.09(0.14) micrograms/g wet tissue, P < 0.001) when compared to the control kidney. Under these experimental conditions, desferrioxamine (15 mg/kg administered intravenously before inducing ischaemia), a drug known to limit free radical production, significantly limited the decrease of alpha-tocopherol to 20.8(6.4)% (0.83(0.08) versus 1.05(0.04) micrograms/g wet tissue, P < 0.05), but did not prevent glutathione consumption in the reperfused kidney. [less ▲]

Transplantation cardiaque. Mise à jour à partir de notre expérience

in Revue Médicale de Liège (1991), 46(6), 314-28