References of "Defraigne, Jean-Olivier"
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See detailOstéite sternale et médiastinite après chirurgie de pontage aorto-coronaire
DETROZ, B.; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Annales de Chirurgie (1991), 45(2), 128-35

Between 1980 and 1987, 31 cases of osteitis (n = 9) and/or mediastinitis (n = 22) were observed after 2,801 consecutive aorto-coronary bypasses (1.1%). Three types of treatment were used: 1) sternal ... [more ▼]

Between 1980 and 1987, 31 cases of osteitis (n = 9) and/or mediastinitis (n = 22) were observed after 2,801 consecutive aorto-coronary bypasses (1.1%). Three types of treatment were used: 1) sternal debridement with osteosynthesis and continuous mediastinal irrigation (n = 25); 2) sternal and mediastinal debridement with open drainage without osteosynthesis (n = 2); 3) incision and debridement of sternal abscesses (n = 4). The overall mortality was 26% (8/31), i.e. 11% (1/9) for isolated osteitis and 32% (7/22) for mediastinitis. Four factors were statistically associated with infection: reoperation for hemorrhage (19.4%, p less than 0.001); preoperative diabetes (25%, p less than 0.001), postoperative low cardiac output (55%, p less than 0.001), postoperative respiratory insufficiency (45%, p less than 0.001). [less ▲]

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See detailIndications actuelles de la greffe hétérotopique en transplantation cardiaque
RADERMECKER, Marc ULg; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Revue Médicale de Liège (1990), 45(12), 614-9

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See detailCardiac Transplantation Beyond 55 Years of Age
Defraigne, Jean-Olivier ULg; Demoulin, J. C.; Beaujean, M. A. et al

in Transplant International (1990), 3(2), 59-61

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of ... [more ▼]

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of the cases. The immunosuppressive regimen consisted of cyclosporin A, corticoids, and azathioprine. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of corticoids or monoclonal antibodies (OKT3). The operative mortality was 10% (n = 2). The 1-year survival rate was 70%. The 1-year incidence of infection and/or rejection episodes was 1 and 1.53 episodes/patient, respectively. One patient was successfully retransplanted after 9 months because of intractable rejection. Age beyond 55 years is no longer a contraindication to cardiac transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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See detailTumeurs cardiaques primitives: myxomes de l'oreillette gauche
RADERMECKER, Marc ULg; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Revue Médicale de Liège (1990), 45(3), 99-104

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See detailLe remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos de 13 cas opérés à la phase aigue de l'infarctus
Defraigne, Jean-Olivier ULg; LAVIGNE, Jean-Paul ULg; Remy, D. et al

in Archives des Maladies du Coeur et des Vaisseaux (1990), 83(3), 377-82

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the ... [more ▼]

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the posterior papillary muscle in 12 cases. The average left ventricular ejection fraction was 47 +/- 9 per cent (range 34 to 63%). Pulmonary capillary pressures ranged from 76 to 41 mmHg (average 35 mmHg). Eleven patients presented with acute pulmonary oedema and 7 had cardiogenic shock. Coronary arteriography showed triple vessel disease in 3 cases, double vessel disease in 7 cases and single vessel disease in 3 cases. Surgery was carried out on average 2.7 days after the rupture and 10 days after the initial infarct. In addition to mitral valve replacement (N = 13), 11 patients underwent a myocardial revascularisation procedure. The operative mortality was 15 per cent (N = 2). Papillary muscle rupture in the acute phase of myocardial infarction causes cardiac failure which is related more to the mechanical abnormality than to an alteration of left ventricular function. Considering the operative mortality and the natural history of PMR treated medically, the authors recommend early surgery as the only management which can improve the precarious haemodynamic status of patients with this complication. [less ▲]

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See detailIntérêts et limites du bypass de l'ileon distal dans le traitement de l'hypercholestérolémie
Defraigne, Jean-Olivier ULg; Pirenne, J.; Swinnen, J. C. et al

in Journal de Chirurgie (1990), 127(2), 76-82

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2 ... [more ▼]

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2), presenting with hyperlipidemia (II B: n = 7; IIA: n = 1). None of the patients had diabetes, 2 had mild hypertension, and all were cigarette smokers. Hypolipidemic drugs were discontinued prior to PIB. Following bypass surgery, patients received vitamin B12 injections twice monthly. Total plasma cholesterol (TPC) and total plasma triglycerides (TPT) were assayed at 3 months and 1 year after surgery. The mean follow-up period was 84 months. Mean TPC level was significantly lower (3.96 +/- 0.57 preoperatively vs 2.19 +/- 0.79 (p less than 0.001) and 2.54 +/- 0.76 (p less than 0.01) 3 months and 1 year postsurgery, respectively. Mean TPT level was significantly lower 3 months after the intervention (4.85 +/- 2.37 vs 2.33 +/- 0.62, p. less than 0.02), but not after one year. Similar trends were observed throughout the follow-up period. One of the ACB patients died of drowing, while three others had recurring angina pectoris symptoms. Coronary angiography showed that, despite low TPC levels, coronary artery disease had extended either to other vessels not included in the former bypass, or beyond the anastomoses. Patients with a history of stroke were asymptomatic. PIB is effective in normalizing TPC. Nonetheless, this isolated procedure is insufficient to prevent the evolution of multifactorial atherosclerosis. [less ▲]

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See detailCarotid-Subclavian Bypass with or without Carotid Endarterectomy
Defraigne, Jean-Olivier ULg; Remy, D.; CREEMERS, Etienne ULg et al

in Acta Chirurgica Belgica (1990), 90(5), 248-54

From 1981 to 1987, 29 patients (14 women and 15 men, with a mean age of 56 +/- 15 years) underwent a carotid-subclavian bypass for occlusive lesion of the subclavian artery (or of the left common carotid ... [more ▼]

From 1981 to 1987, 29 patients (14 women and 15 men, with a mean age of 56 +/- 15 years) underwent a carotid-subclavian bypass for occlusive lesion of the subclavian artery (or of the left common carotid artery). The symptomatology included vertebrobasilar insufficiency, arm ischemic symptoms, or combination of both symptoms. Twelve patients (42%) have had a previous transient ischemic attack, or a cerebrovascular accident. There were 22 stenoses or occlusions of the left subclavian artery, and 6 of the right subclavian artery. On arteriography, 9 patients had significant associated lesions on the internal carotid artery, either homolateral (n = 7), or heterolateral, or bilateral. Carotid to subclavian bypasses were performed either with autogenous saphenous vein (n = 15), or with prosthetic graft (n = 14). In 5 cases, a carotid endarterectomy was done simultaneously to the bypass. Operative mortality was 3.4% (1/29). Early patency (less than 1 month) was 97% and late patency 89%, with a mean follow-up of 40 +/- 24 months. The patency rates were not significantly different whether a prosthesis or a vein was used for the bypass. All patients were improved and complete relief of symptoms was achieved in 92%. No patient experienced symptoms of carotid steal after the bypass. We concluded that carotid-subclavian bypass is a safe and efficient method for revascularization of the subclavian artery of of the left common carotid artery in selected cases. [less ▲]

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See detailChirurgie coronarienne et carotidienne en simultané: à propos de 73 cas
VAN DAMME, Hendrik ULg; CREEMERS, Etienne ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1990), 90(4), 185-96

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms ... [more ▼]

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms, angiographic carotid lesions and operative outcome of these 73 patients are compared with the aspects of 3544 coronary bypass patients (Group II) and 1001 carotid endarterectomized patients (Group III) during the same period. The angina in Group I is more severe, with 22% belonging to NYHA class IV and 26% having a stenosis of the left main coronary artery, vs 14% and 13% in Group II. Seventy percent of the carotid lesions in Group I are asymptomatic vs 33% in Group III. Group I patients had more problems in the perioperative period, with 16.4% needing prolonged high-doses analeptics and 5.4% intraaortic counterpulsation balloon. Operative mortality is higher (7%) in Group I compared with Group II (2.3%) and Group III (1.7%). These results permit to define a population of polyvascular patients with concomitant coronary and carotid disease, characterized by a more diffuse atherosclerosis and a higher operative risk. Operative morbidity and mortality after combined myocardial and cerebral revascularization remains nevertheless inferior to the cumulated surgical risk of the sequential procedures (74 patients with coexistant coronary and carotid lesions operated in two sessions before 1986). [less ▲]

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See detailCombined One Stage Cardiac and Pulmonary Surgery by Median Sternotomy
Adant, J. P.; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Acta Chirurgica Belgica (1990), 90(4), 197-202

From 1985 to 1989, 6 patients underwent a pulmonary surgical procedure simultaneously with a cardiac operation. All patients were male with a mean age of 60 +/- 8 years. The cardiac procedures included: 1 ... [more ▼]

From 1985 to 1989, 6 patients underwent a pulmonary surgical procedure simultaneously with a cardiac operation. All patients were male with a mean age of 60 +/- 8 years. The cardiac procedures included: 1 aortic and 1 mitral valve replacement, 3 coronary artery bypass grafts and 1 closure of an atrial septal defect. Four patients had primary pulmonary nodules: 2 bronchogenic carcinomas and 2 benign hamartomas. They presented with cardiac symptoms, and lung nodules were incidentally found on preoperative Chest X-Rays. The 2 last patients had pulmonary metastases of colonic neoplasms previously resected, respectively 3 and 6 years before. After completion of the cardiac procedures, during the rewarming of the patient, the pulmonary resection was performed on a deflated lung, via the median sternotomy. Pulmonary procedures included: right upper segmentectomy (n = 1), left pneumonectomy (n = 1), left interior lobectomy (n = 1), right middle lobectomy (n = 1), left upper wedge resection (n = 1), and right upper lobe wedge resection (n = 1). All patients were extubated on day one. One patient died from rythm disturbances on day 13. All other patients are alive with a mean survival of 30 months. The authors conclude that combined surgery is feasible in selected cases. Sternal approach is not a limitation to pulmonary resection. [less ▲]

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See detailRenal Autotransplantation: A Kidney-Saving Procedure
VAN DAMME, Hendrik ULg; Defraigne, Jean-Olivier ULg; CREEMERS, Etienne ULg et al

in Acta Chirurgica Belgica (1990), 90(2), 54-8

The authors report their recent experience with renal autotransplantation (3 cases). In one case it concerned a complex aneurysm of the renal artery involving secondary arterial renal branches, and ... [more ▼]

The authors report their recent experience with renal autotransplantation (3 cases). In one case it concerned a complex aneurysm of the renal artery involving secondary arterial renal branches, and associated with hydronephrosis (case 1); another patient presented a high ureteral injury unsuccessfully repaired by previous surgery (case 2), and the third patient had diffuse fibrodysplasia of intrahilar arterial branches (case 3). The procedures were technically successful and gave good functional results. They describe the technique of kidney refrigeration, extracorporeal vessel repair and ureteral preservation or reimplantation. Indications and technical advantages of this organ-saving reconstructive approach are discussed. [less ▲]

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See detailValvular and Coronary Surgery in Renal Transplant Patients
Defraigne, Jean-Olivier ULg; Meurisse, Michel ULg; Limet, Raymond ULg

in Journal of Cardiovascular Surgery (The) (1990), 31(5), 581-3

The Authors report aortic valvular replacement (AVR) and coronary artery bypass graft surgery (CABG) successfully performed in two renal transplant patients. The postoperative blood urea and creatinine ... [more ▼]

The Authors report aortic valvular replacement (AVR) and coronary artery bypass graft surgery (CABG) successfully performed in two renal transplant patients. The postoperative blood urea and creatinine levels were comparable to the preoperative values. The first patient underwent isolated AVR. The second patient had an initial AVR combined with CABG followed two years later by a further AVR for prosthetic dysfunction. For many reasons, coronary artery (CAD) and valvular diseases are not uncommon in renal transplant patients. Cardiac surgery is feasible without impairment of the renal function provided some precautions are taken, ie good mean perfusion pressure during cardiopulmonary bypass (CPB), adequate volume replacement, and selected use of mannitol and dopamine. [less ▲]

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See detailChirurgie aortique en présence d'une cholelithiase. Faut-il pratiquer simultanément la cholecystectomie?
Innocenti, C.; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Journal de Chirurgie (1989), 126(3), 159-62

From 1984 to 1987, a cholecystectomy for biliary lithiasis was carried out at the same time as aortic vascular surgery in 21 patients. Seventy six percent of patients presented an abdominal aortic ... [more ▼]

From 1984 to 1987, a cholecystectomy for biliary lithiasis was carried out at the same time as aortic vascular surgery in 21 patients. Seventy six percent of patients presented an abdominal aortic aneurysm and 24% occlusive atherosclerosis. Thirty eight percent had previously presented symptoms related to biliary lithiasis. Biliary surgery was conducted after closure of the retroperitoneum. The gall bladder region was drained separately. The technique did not increase operative morbidity or mortality. Combined cholecystectomy and vascular surgery depends on two arguments. Firstly, patients with stones present a higher risk of post-operative cholecystitis. Secondly, a significant percentage of non-cholecystectomized patients will present with biliary symptomatology in the months following vascular surgery. [less ▲]

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See detailLe chirurgien face aux polyendocrinopathies familiales: attitudes pratiques. Deuxieme partie: La polyendocrinopathie familiale type 2.
Meurisse, Michel ULg; Gérard, J; Plumacker, A. et al

in Revue medicale de Liege (1989), 44(23), 724-30

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See detailLe chirurgien face aux polyendocrinopathies familiales: attitudes pratiques. Premiere partie: La polyendocrinopathie familiale type 1.
Meurisse, Michel ULg; Gérard, J; Plumacker, A. et al

in Revue medicale de Liege (1989), 44(23), 717-23

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See detailSurgical Management of Left Heart Endocarditis
Defraigne, Jean-Olivier ULg; Dalem, A. M.; Demoulin, J.-C. et al

in Acta Chirurgica Belgica (1989), 89(5), 247-52

Between 1981 and 1987, 29 patients (20 men and 9 women, mean age 46 +/- 15) underwent a valvular replacement for endocarditis (19 aortic and 10 mitral). There were 25 native and 4 prosthetic valves. In 85 ... [more ▼]

Between 1981 and 1987, 29 patients (20 men and 9 women, mean age 46 +/- 15) underwent a valvular replacement for endocarditis (19 aortic and 10 mitral). There were 25 native and 4 prosthetic valves. In 85% of cases, underlying valvular lesions were present. The oropharyngeal and the respiratory tracts were the most common sources of infection. In 81%, the infecting microorganism was gram-positive. In 21% of cases, a gram-negative was detected, always mixed with a gram-positive. One infection was caused by a Candida. Indications for surgery were severe valvular insufficiency or cardiac failure (90%), refractory sepsis (21%), thromboembolic events (11%). In 22%, multiple factors were present. A biologic valve was chosen in 12 cases (40%). Simultaneously with the valvular replacement, 4 ventricular septal perforations were occluded and 3 valvular annulus abscesses debrided. The operative mortality was 10% (3/29). The one-year survival is 96%. Two patients required reoperation at 6 months and 2 years, for partial dehiscence, with good subsequent evolution. The authors concluded that surgical operation is the most suitable treatment for unstable or complicated endocarditis, in case of cardiac failure, iterative thromboembolic events or refractory sepsis. [less ▲]

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See detailDiagnostic précoce du rejet de l'allogreffe pancréatique: intérêt du dosage de l'amylasurie.
Meurisse, Michel ULg; Defraigne, Jean-Olivier ULg; Defechereux, Thierry et al

in Revue Médicale de Liège (1989), XLIV(11), 388-395

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See detailLe prélèvement multiorganes: maillon essentiel d'une chaîne de solidarité
Defraigne, Jean-Olivier ULg; Canivet, Jean-Luc ULg; Bonnet, Pierre ULg et al

in Revue Médicale de Liège (1989), XLIII(4), 138-148

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See detailExperience with a totally implantable catheter in adult patients: a single institution retrospective study of 114 cases.
Defraigne, Jean-Olivier ULg; Closon, Marie-Thérèse ULg; Bruyninx, Luc ULg et al

in European Journal of Surgical Oncology (1989), 15(1), 61-4

One hundred and fourteen consecutive totally implantable catheters were inserted in 114 patients between April 1984 and April 1987. Catheters were inserted under neuroleptanalgesia, through the jugular ... [more ▼]

One hundred and fourteen consecutive totally implantable catheters were inserted in 114 patients between April 1984 and April 1987. Catheters were inserted under neuroleptanalgesia, through the jugular vein in 101 cases or the internal saphenous vein in 13 cases. No problem was encountered during the insertion procedure. Infection occurred in 5.2% of the patients but removal of the device was required in only 2.6%. Occlusion of the catheter occurred in 6.1% of the patients but never during the first 2 months. This complication rate is lower than the one observed with external tunnelled catheters. The comfort of the patient is substantially improved and nursing care is greatly facilitated. [less ▲]

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See detailDerivation of an Algorithm for Optimal Initial Cyclosporine Immunotherapy in Kidney Transplantation
Meurisse, Michel ULg; Albert, Adelin ULg; Defraigne, Jean-Olivier ULg et al

in Transplantation Proceedings (1988), 20(5 Suppl 6), 45-51

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See detailMédianécrose aortique dans la maladie de Marfan chez l'adulte jeune. A propos de 5 cas opérés, avec 3 survies
Defraigne, Jean-Olivier ULg; Grenade, Thierry ULg; CREEMERS, Etienne ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (1988), 81(8), 991-5

Five cases of Marfan's syndrome with cardiovascular lesions are presented. Among these five patients, two with type I aortic dissection, one with true aneurysm of the ascending aorta and one with aortic ... [more ▼]

Five cases of Marfan's syndrome with cardiovascular lesions are presented. Among these five patients, two with type I aortic dissection, one with true aneurysm of the ascending aorta and one with aortic regurgitation underwent composite grafting of the ascending aorta according to the Bentall technique. The fifth patient died preoperatively, due to extensive dissection of the transverse aorta. Marfan's syndrome is transmitted in an autosomal dominant manner. Fifty percent of the patients die at a mean age of 32 years, and 95 p. 100 of the deaths are caused by cardiovascular lesions. These lesions predominantly affect the left cardiac valves (aortic or mitral regurgitation) and the ascending aorta. Except in emergencies, replacement of the ascending aorta by a composite graft must be envisaged in subjects with Marfan's syndrome presenting with aortic regurgitation and dilatation of the aortic root. [less ▲]

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