References of "Defraigne, Jean-Olivier"
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See detailEffects of cold and warm ischemia on the mitochondrial oxidative phosphorylation of swine lung.
Willet, Katty; Detry, Olivier ULg; Lambermont, Bernard ULg et al

in Transplantation (2000), 69(4), 582-588

BACKGROUND: The aim of the study was to investigate the consequence of warm and cold ischemia on lung mitochondria in order to define bioenergetic limits within lung could be suitable for pulmonary ... [more ▼]

BACKGROUND: The aim of the study was to investigate the consequence of warm and cold ischemia on lung mitochondria in order to define bioenergetic limits within lung could be suitable for pulmonary transplantation. METHODS: Twenty-two pigs underwent lung harvesting after lung flush with Euro-Collins solution. Mitochondria were isolated from fresh lungs, from lungs submitted to 24 or 48 hr of cold ischemia, to 30 or 45 min of warm ischemia, and to 30 min of warm ischemia followed by 24 or 48 hr of cold ischemia. Mitochondrial oxidative phosphorylation parameters were determined in isolated mitochondria by in vitro measurement of oxygen consumption. RESULTS: Relative to controls, mitochondria submitted to cold ischemia showed an alteration in the oxidoreductase activities of the respiratory chain but no membrane permeability alteration. After 48 hr of cold ischemia, there was a decrease in the yield of the oxidative phosphorylation. Thirty minutes of warm ischemia did not alter the mitochondrial respiratory parameters. However, lung submitted to 45 min of warm ischemia showed mitochondrial damage as a decrease in the oxidative phosphorylation efficiency and ADP availability but no change in the oxidoreductase activities. Relative to cold ischemia alone, 30 min of warm ischemia preceding cold ischemia promoted no significant change in the respiratory parameters. CONCLUSIONS: On bioenergetic basis, lung submitted to warm ischemia could be suitable for transplantation if the warm ischemia duration does not exceed 30 min. This could be a major concern in lung procurement from non-heart beating donors. [less ▲]

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See detailEvaluation des concentrations plasmatiques en anti-oxydants, anticorps contre les LDL oxydees et homocysteine dans un echantillon de la population liegeoise
Pincemail, Joël ULg; Siquet, Jean ULg; Chapelle, Jean-Paul ULg et al

in Annales de Biologie Clinique (2000), 58(2, Mar-Apr), 177-85

A large number of epidemiological and clinical studies suggest that oxidative stress plays an important role in the development of cardiovascular diseases. In this way, following reference values in ... [more ▼]

A large number of epidemiological and clinical studies suggest that oxidative stress plays an important role in the development of cardiovascular diseases. In this way, following reference values in plasmatic antioxidants have been determined in a group of 123 blood donors (94 males, 29 females; age: 21-64 years) living in the surroundings of Liege, Belgium: vitamin A (1.5-3.62 mmol/l), vitamin C (3.68-75.21 mmol/l), vitamin E (16.98-46.46 mmol/l), ratio vitamin E/cholesterol (3.92-8.32 mmol/mmol), selenium (0.66-1.26 mmol/l), sulphydryl proteins (216-556 mmol/l), uric acid (174-477 mmol/l), superoxide dismutase (542-852 IU/g hemoglobine), glutathion peroxidase (39.55-91.83 IU/g hemoglobine). Only a few number of subjects were found with values corresponding to high risk of deficiency in antioxidants although low values in vitamin C (< 11.35 mmol/l) and in selenium (< 0.75 mmol/l) were respectively observed in 5.69 and 10.5% of our subjects. Autoantibodies against oxidized LDL, as marker of oxidative stress, and homocysteine, as a risk factor of atherosclerosis involved in the development of oxidative stress, have also been investigated. Approximatively 40% of the population presented values higher than the superior limit mean value (20.3% > 650 IU/l in autoantibodies and 19.5% > 15.2 mmol/l in homocysteine) that are, however, not correlated with age or low levels in antioxidants. The effect of smoking (25% of the population) contributed to significantly decrease vitamin C, selenium and glutathion peroxidase concentrations by 31.9 and 13% when compared to nonsmokers. Intake of 1 to 4 fruits per day resulted in a significant increase of 56.9% in vitamin C when compared to nonconsumers (26.8% of the population). In contrast, homocysteine concentrations were significantly decreased by 21.4% in fruits consumers. Thank to the development of methods allowing the routine dosage of all these parameters, general practitioners can now easily establish the oxidative stress status of their patients and, as fonction of getting patterns, detect populations at risk of developing cardiovascular diseases. [less ▲]

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See detailCrossover Iliofemoral Bypass Grafting for Treatment of Unilateral Iliac Atherosclerotic Disease
Defraigne, Jean-Olivier ULg; Vazquez, C.; Limet, Raymond ULg

in Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery and International Society For Cardiovascular Surgery, North American Chapter (1999), 30(4), 693-700

PURPOSE: In patients with unilateral iliac disease, a less invasive procedure than aortobifemoral bypass grafting may be desirable, especially in poor-risk patients or when sexual dysfunction is feared ... [more ▼]

PURPOSE: In patients with unilateral iliac disease, a less invasive procedure than aortobifemoral bypass grafting may be desirable, especially in poor-risk patients or when sexual dysfunction is feared. In these cases, femorofemoral (FF) bypass grafting is often proposed. Compared with FF bypass grafting, iliofemoral (IF) bypass grafting avoids bilateral exposure of the groins, which may reduce the risk of infection. When the primitive iliac artery is occluded from its origin or heavily calcified, one may use the contralateral artery as inflow, after a small retroperitoneal exposure, to perform a crossover iliofemoral (CIF) bypass grafting procedure, through the Retzius space. Our 10-year experience with CIF bypass grafting in a select group of patients was studied. METHODS: Between 1986 and 1996, 36 patients underwent CIF bypass grafting for symptomatic unilateral iliac occlusion or stenosis. All patients were examined by means of Doppler ultrasound scanning and underwent bilateral multiplane angiography. Patients were considered for this procedure when the ipsilateral common iliac artery was occluded from its origin or was diffusely and heavily calcified. The decision to perform a CIF bypass grafting procedure was made when no significant disease of the contralateral common iliac artery was seen, and patients who had features of contralateral iliac disease were excluded. The main outcomes were perioperative mortality and morbidity, long-term primary and secondary patency rates, and limb salvage rate. RESULTS: The study included 31 men and five women, with a mean age of 58.8 years. Indications for bypass grafting were disabling claudication (26 of 36 patients, 72%) and limb-threatening ischemia (10 of 26 patients, 28%). Twelve procedures were performed simultaneously: endarterectomy of the recipient common femoral artery (n = 3), femoropopliteal bypass grafting (n = 4, 11.1%), profundoplasty (n = 4, 11%), and right internal carotid endarterectomy (n = 1). New postoperative erectile dysfunction did not develop in any of the patients. The survival rate was 97.3% at 1 year and 68.5% at 5 years. The primary and secondary patency rates were 94% and 100%, respectively, at 1 year and 76.7% and 95%, respectively, at 5 years. The limb salvage rate was 100% at 1 year and 87% at 3 years. CONCLUSION: The operative mortality associated with CIF is low. The long-term primary and secondary patency rates are satisfactory, and they are lower than those reported for aortobifemoral bypass grafting. This procedure does not preclude a later performance of an aortobifemoral bypass grafting procedure. CIF bypass grafting is not only suitable for poor-risk patients with a limited life expectancy who have the appropriate arterial anatomy, but also may be warranted for young patients in whom erectile dysfunction is feared. [less ▲]

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See detailAlphacalcidol in Prevention of Glucocorticoid-Induced Osteoporosis
Reginster, Jean-Yves ULg; de Froidmont, C.; Lecart, M. P. et al

in Calcified Tissue International (1999), 65(4), 328-31

One of the major drawbacks of glucocorticoids long-term therapy is the occurrence of a severe osteoporosis characterized by fractures occurring at different sites, mainly at the level of trabecular bone ... [more ▼]

One of the major drawbacks of glucocorticoids long-term therapy is the occurrence of a severe osteoporosis characterized by fractures occurring at different sites, mainly at the level of trabecular bone. One of the major determinants of glucocorticoid-induced osteoporosis is a decrease in the intestinal absorption of calcium (Ca) leading to a secondary hyperparathyroidism. D-hormones have been shown to significantly improve Ca absorption in the gut and subsequently to decrease parathyroid hormone circulating levels, hence normalizing bone turnover. In a recent study evaluating 145 patients suffering from diseases requiring long-term treatment with high doses of corticosteroids, we have demonstrated a significant benefit of alphacalcidol (1 microg/day) over placebo in terms of changes in bone mineral density of the lumbar spine. These results are in accordance with studies showing better prevention of bone loss and vertebral fractures in cardiac transplant patients treated with alphacalcidol than those treated with etidronate. There is now a convergent body of evidence to suggest that alphacalcidol is a reasonable, safe, and effective option for the prevention of glucocorticoid-induced osteoporosis, provided that serum Ca is monitored on a regular basis. [less ▲]

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See detailDevelopment of a new rat model of fulminant hepatic failure
Detry, Olivier ULg; Gaspard, Yves; Defraigne, Jean-Olivier ULg et al

in Acta Gastro-Enterologica Belgica (1999, January), 62(1), 43

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See detailAtteintes physiopathologiques liees a la circulation extracorporelle. Pathogenies et modes de prevention
Defraigne, Jean-Olivier ULg

in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (1999), 154(10-12), 381-91392-5

During heart surgery, several humoral cascades (coagulation, complement, kallicrein-kinin, cytokines, fibrinolysis) and several cell systems (platelets, neutrophils, endothelial cells, ...) are activated ... [more ▼]

During heart surgery, several humoral cascades (coagulation, complement, kallicrein-kinin, cytokines, fibrinolysis) and several cell systems (platelets, neutrophils, endothelial cells, ...) are activated. Numerous contributing factors have been reported: blood contact with foreign surfaces of the extracorporeal circuits, blood-air interface, lung and myocardial ischemia-reperfusion after unclamping, hypothermia, shear stresses, ... A post-perfusion syndrome may develop which include miscellaneous symptoms: coagulation disturbances and bleeding, neurological alterations, inflammatory syndrome, and, in extreme cases, multisystemic organ failure. Even if the present mortality of cardiac surgery is low, several approaches have been proposed to reduce such activations. They are based on changing in the circuit design, or in the composition of the luminal surfaces of the tubing and oxygenator, on improvement of the operative technique, and on modifications of the perfusion technique. Pharmacological agents are also used (anti-inflammatory drugs, corticoids, serine proteases inhibitor (aprotinin, ...). Nevertheless, the development of more biocompatible surfaces seems a promising goal. [less ▲]

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See detailTransplantation combinée du foie et du coeur chez un patient souffrant de thalassémie majeure
Detry, Olivier ULg; Defechereux, Thierry ULg; Honore, Pierre ULg et al

in Médecine & Chirurgie Digestives (1999), 28(3), 109-110

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See detailEffects of Peep on Systemic Venous Capacitance
Lambermont, Bernard ULg; Detry, Olivier ULg; D'Orio, Vincenzo ULg et al

in Archives of Physiology & Biochemistry (1998), 105(4), 373-8

The aim of the present study was to determine effects of positive end expiratory pressure (PEEP) application on peripheral venous capacitance and relate them to concomitant central hemodynamic ... [more ▼]

The aim of the present study was to determine effects of positive end expiratory pressure (PEEP) application on peripheral venous capacitance and relate them to concomitant central hemodynamic disturbances. The venous volume-pressure (V/P) relationships were studied in 6 intact anesthetized pigs to describe the effects of PEEP on systemic venous compliance (computed as the slope of the V/P relationship) and unstressed volume (referred to as the extrapolated volume intercept). Cardiac volumes as well as partitioning of circulating blood volume between central (ITBV) and peripheral (PBV) compartments were assessed by thermo-dye dilution techniques. During a 15 cm H2O PEEP application, venous compliance was reduced by 48%, while unstressed volume was increased by 25% and peripheral blood pooling increased from 63 to 74%. As a result, left heart and right ventricular end diastolic volumes were decreased by 8% and by 44%, respectively. It is concluded that increased venous unstressed volume and reduced compliance depicted the distension of the venous tree secondary to PEEP which acted as an impediment to venous return. As a consequence, cardiac output was reduced because of decreased preload. [less ▲]

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See detailNormothermic preservation of rabbit hearts using a new perfluorocarbon emulsion
De Roover, Arnaud ULg; Deby, G.; Chapelle, Jean-Paul ULg et al

Poster (1998, March 07)

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See detailMalignancy transplantation with heart graft
Detry, Olivier ULg; Hans, Marie-France ULg; Defraigne, Jean-Olivier ULg et al

in Journal of Heart & Lung Transplantation (1998), 17(3), 331-332

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See detailComparative Effects of University of Wisconsin and Euro-Collins Solutions on Pulmonary Mitochondrial Function after Ischemia and Reperfusion
Detry, Olivier ULg; Willet, K.; Lambermont, Bernard ULg et al

in Transplantation (1998), 65(2), 161-6

BACKGROUND: The aim of this study was to compare the effects of Euro-Collins and University of Wisconsin solutions on pulmonary mitochondrial function after cold ischemia and subsequent warm reperfusion ... [more ▼]

BACKGROUND: The aim of this study was to compare the effects of Euro-Collins and University of Wisconsin solutions on pulmonary mitochondrial function after cold ischemia and subsequent warm reperfusion. METHODS: Seventeen pigs underwent lung harvesting after classical lung flush with either University of Wisconsin or Euro-Collins solutions. The mitochondria were isolated from fresh swine lungs, from swine lungs subjected to 24 hr of cold ischemia, and from swine lungs subjected to 24 hr of ischemia followed by 30 min of subsequent ex vivo reperfusion at 37 degrees C with Krebs-Henseleit buffer solution and air ventilation. Mitochondrial oxidative phosphorylation parameters were determined in isolated mitochondria by in vitro measurement of oxygen consumption rates. During reperfusion, the lung function was assessed by the pulmonary aerodynamic parameters and the pulmonary vascular resistance. RESULTS: Relative to controls, mitochondria submitted to cold ischemia showed an alteration in the oxidoreductase activities of the respiratory chain. However, the yield of oxidative phosphorylation was conserved. After reperfusion, pulmonary mitochondria underwent a significant worsening in the oxidoreductase activities of the respiratory chain, and a decrease in the respiratory control and the efficiency of oxidative phosphorylation. Meanwhile, the reperfused lungs showed evidence of early dysfunction, assessed by the aerodynamic parameters and pulmonary vascular resistance. In this model, there was no advantage of University of Wisconsin solution over Euro-Collins solution. CONCLUSIONS: The mild mitochondrial alterations after cold ischemia were not sufficient to explain the limited tolerance of lung to ischemia. After reperfusion, the mitochondrial damage was more severe and could be involved in the posttransplant lung dysfunction. [less ▲]

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See detailDe l'etude des alterations biochimiques du muscle squelettique ischémie et reperfuse à la reperfusion contrôlée des membres chez des patients en ischemie aigue severe
Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Revue Médicale de Liège (1998), 53(2), 91-7

The reperfusion of a limb which has been submitted to a severe and prolonged period of ischemia may be followed by dramatic local and systemic complications. The results of several experimental studies ... [more ▼]

The reperfusion of a limb which has been submitted to a severe and prolonged period of ischemia may be followed by dramatic local and systemic complications. The results of several experimental studies have given insights on the biochemical and physiopathological alterations occurring in the ischemic and reperfused skeletal muscle. Therefore the technique of the controlled limb reperfusion has been developed. we present the results obtained in two patients with this technique. Two patients were admitted for a limb-threatening ischemia consecutive to embolism. After removal of the thrombi with a Fogarty's catheter and before reperfusion with the normal blood, a controlled limb reperfusion was performed by mixing the systemic blood with a crystalloid solution in order to obtain a hyperosmolar, hypocalcemic, alcalotic and substrate-enriched (aspartate and glutamate) reperfusate. This reperfusate was infused during 30 min with a roller pump into the deep and superficial femoral arteries. The delivery conditions (temperature, flow and reinjection pressure) were closely monitored. In both cases, no post-operative complication was observed and the pedal pulses were restored after the operation. Complete recovery of the motor and sensitive functions were observed and the patient were discharged at the 10th post-operative day. [less ▲]

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See detailL'assistance cardiaque par muscle strie squelettique transforme: la cardiomyoplastie
RADERMECKER, Marc ULg; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Revue Médicale de Liège (1998), 53(2), 88-90

The biomechanical potential of transformed skeletal muscle used for cardiocirculatory assistance is the keystone of this surgical concept. This underscores the necessity to modulate type II to type I ... [more ▼]

The biomechanical potential of transformed skeletal muscle used for cardiocirculatory assistance is the keystone of this surgical concept. This underscores the necessity to modulate type II to type I transformation to premise the muscle bulk, shortening velocity, and, therefore, power. It is only if an efficient autologous engine is available that optimal surgical configuration (i.e. aortomyoplasty) will provide active cardiocirculatory support. [less ▲]

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See detailComparison between Three- and Four-Element Windkessel Models to Characterize Vascular Properties of Pulmonary Circulation
Lambermont, Bernard ULg; Gérard, Paul ULg; Detry, Olivier ULg et al

in Archives of Physiology & Biochemistry (1997), 105(7), 625-32

In 11 anaesthetised pigs the accuracy of the three-element (WK3) and the four-element (WK4) Windkessel models to describe hemodynamic properties of the pulmonary circulation was compared during six ... [more ▼]

In 11 anaesthetised pigs the accuracy of the three-element (WK3) and the four-element (WK4) Windkessel models to describe hemodynamic properties of the pulmonary circulation was compared during six different experimental conditions increasing pulmonary arterial pressure: increase in left atrial pressure, increase in alveolar pressure, increase in pulmonary blood flow, endotoxin shock, mechanical obstruction of left pulmonary artery or histamine infusion. Our results showed that WK4 fitted better the data than did WK3 because values of 1-R2 decreased from 6 percent (WK3) to 1.4 percent (WK4) when WK4 was used (P < 0.0005). 1-R2 was an adequate marker of the accuracy of the linear regression used to solve equations of both models. Compliance values estimated by WK4 were decreased by 5% comparatively to WK3 (P = 0.008). However, this difference can be considered as not physiologically relevant. Values of characteristic resistance corresponding to R1 + (L/R2C) in WK4 and to R1 in WK3 were not different (P = 0.22). The relative changes in R1, R2, and C observed due to the different experimental conditions were comparable regardless of the model. In conclusion, the conversion of WK3 in WK4 by adding an inductance, whose physiological meaning is not clear, resulted in an increased statistical accuracy of the model, but did not seem to have relevant influence on parameters or their evolution during experimental conditions. [less ▲]

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See detailCarotid Chemodectomas. Experience with Nine Cases with Reference to Preoperative Embolization and Malignancy
Defraigne, Jean-Olivier ULg; Sakalihasan, Natzi ULg; Antoine, Paul ULg et al

in Acta Chirurgica Belgica (1997), 97(5), 220-8

The medical records of nine patients (five female and four male, mean age 58 +/- 5 years) presenting with a carotid chemodectoma between 1983 and 1995 were reviewed. In two cases (22%) the diagnostic was ... [more ▼]

The medical records of nine patients (five female and four male, mean age 58 +/- 5 years) presenting with a carotid chemodectoma between 1983 and 1995 were reviewed. In two cases (22%) the diagnostic was not suspected at the time of initial presentation. The most common complaint was a swelling in the anterolateral region of the neck. One patient (11%) presented with a preoperative peripheral nerves deficits (vagus and hypoglossal palsies and Horner's syndrome). Two tumours were embolized preoperatively with polyvinyl alcohol particles. Complete surgical excision was possible in each patient and the plane of resection was adventitial. In three cases, early ligation of the external carotid artery facilitated the resection. In two patients, the vagus nerve was sacrificed because of tumour involvement. No operative mortality was observed and no vascular complication occurred. In addition to the patient with preoperative neurologic symptoms, three patients developed peripheral nerve deficits (vagus and hypoglossal nerves) postoperatively. Two of these deficits were transient. These peripheral neurologic complications were observed with the largest tumour sizes. Two cases were malignant (lymph nodes and bony metastases). These two patients received postoperative radiotherapy. The mean follow-up period 63 +/- 19 months. No patient developed local recurrence during the follow-up. Two patients died during the follow-up, one for condition unrelated to their disease and the second from metastatic dissemination. In conclusion, carotid chemodectomas may be safely resected. The best way to minimize the rate of complications is to operate them at an early stage of evolution. [less ▲]

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See detailConsequences of Cold and Warm Ischemia on Pulmonary Mitochondrial Respiratory Function
Detry, Olivier ULg; Willet, K.; Lambermont, Bernard ULg et al

in Transplantation Proceedings (1997), 29(5), 2338-9

IN RECENT years, pulmonary transplantation has become the treatment of choice for several end-stage lung diseases, but remains limited by the scarcity of suitable donors and the lack of reliable prolonged ... [more ▼]

IN RECENT years, pulmonary transplantation has become the treatment of choice for several end-stage lung diseases, but remains limited by the scarcity of suitable donors and the lack of reliable prolonged method of lung preservation.1 Transplantation of lung 6 hours postharvest leads to an increased incidence of primary graft dysfunction, due in part to ischemic damage of pulmonary cell structure and metabolism, and to acute reperfusion injury. However, very little is known about the real mechanisms of pulmonary cell injuries before, during, and after lung transplantation. <br /> <br />During ischemia, the cytosolic and mitochondrial adenine nucleotide content falls,2,3 phospholipids are degraded, membrane permeabilities are increased, and the cytosolic levels of Na+, Ca2+ and phosphate are raised.4 Thus, cold and warm ischemia may induce cell dysfunctions and irreversible injuries responsible for necrosis. As mitochondia are believed to be the site of the determinants of irreversibility,5 the study of permanent oxidative phosphorylation damage after ischemia should be of great interest. <br /> <br />The aim of this present study was to investigate the consequences of warm and cold ischemia on the oxidative phosphorylation of isolated lung mitochondria [less ▲]

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See detailSuccessful Controlled Limb Reperfusion after Severe Prolonged Ischemia
Defraigne, Jean-Olivier ULg; Pincemail, Joël ULg; Laroche, C. et al

in Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery and International Society For Cardiovascular Surgery, North American Chapter (1997), 26(2), 346-50

Controlled limb reperfusion was performed in two patients who were admitted for lower limb-threatening ischemia as a result of embolism. After embolectomy, the inflow blood was drained with a cannula and ... [more ▼]

Controlled limb reperfusion was performed in two patients who were admitted for lower limb-threatening ischemia as a result of embolism. After embolectomy, the inflow blood was drained with a cannula and mixed with a crystalloid solution to obtain an hyperosmolar, hypocalcemic, alkalotic, and substrate-enriched (aspartate, glutamate) reperfusate. This reperfusate was reinjected with a roller pump for 30 minutes through two cannulas inserted in the profunda and superficial femoral arteries. Temperature, intraarterial pressures, and flow were closely controlled. No complications occurred, and complete recovery of motor and sensory functions were observed, with restoration of pedal pulses. [less ▲]

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See detailSuccessful Management of Acute Aortic Dissection in a Heart Transplant Recipient
Defraigne, Jean-Olivier ULg; Demoulin, J. C.; Detry, Olivier ULg et al

in Acta Chirurgica Belgica (1997), 97(3), 141-4

A case of type III aortic dissection which occurred fourteen months after heart transplantation is presented. Medical therapy was instituted to achieve controlled hypotension. The evolution was favorable ... [more ▼]

A case of type III aortic dissection which occurred fourteen months after heart transplantation is presented. Medical therapy was instituted to achieve controlled hypotension. The evolution was favorable and the patient could be discharged after one month. Hypertension and increased ejection fraction after transplantation could have been predisposing factors via an increase of the shear stress in the aorta. [less ▲]

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See detailSequential successful surgical management of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm. Case reports.
Detry, Olivier ULg; Defraigne, Jean-Olivier ULg; Desiron, Quentin ULg et al

in Vascular Surgery (1997), 31

The coexistence of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm is a rare event whose management is controversial. Theoretically, the correction of a significant stenosis ... [more ▼]

The coexistence of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm is a rare event whose management is controversial. Theoretically, the correction of a significant stenosis of the extracranial internal carotid may lead to an increase in the downstream pressure in the intracranial carotid, and may consequently increase the risk of rupture of the ipsilateral aneurysm. Moreover, dramatic increase of blood pressure is not uncommon after carotid endarterectomy, and may promote aneurysmal rupture. Intracranial surgical correction of a hypoperfused aneurysm down to extracranial carotid stenosis should carry an increased risk of inadequate cerebral flow during procedure, and unspecific postoperative stimulation of platelets aggregation and coagulation may complete obstruction of a subtotal carotid stenosis. We report the cases of two patients successfully treated by a two-stage surgical procedure. In a first step, the intracerebral aneurysms were controlled and electively excluded by clipping. In a second step, carotid endarteriectomies were performed some days later without any neurological complications. Postoperative recoveries were uneventful and six months after these surgical procedures, clinical examination of both patients did not reveal any worsening of the preoperative neurological status. [less ▲]

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