Transplantation combinée du foie et du coeur chez un patient souffrant de thalassémie majeure
Detry, Olivier ; Defechereux, Thierry ; Honore, Pierre et al
in Médecine & Chirurgie Digestives (1999), 28(3), 109-110Detailed reference viewed: 46 (4 ULg)
Artérite et coronarite post-radiques: a propos d'un cas
; Sakalihasan, Natzi ; Bonnet, Pierre et al
in Journal de Cardiologie [= JDC] = Tijdschrift voor Cardiologie [= TVC] (1999), 11(3), 33-37Detailed reference viewed: 58 (0 ULg)
Routine ultrasound screening for abdominal aortic aneurysm among 65- and 75-year-old men in a city of 200,000 inhabitants.
; SAKALIHASAN, Natzi ; et al
in Annals of Vascular Surgery (1998), 12(6), 544-9
Unruptured abdominal aortic aneurysm (AAA) is seldom recognized. Thus it is difficult to know whether the incidence of AAA in the general population is high enough to warrant routine screening at least in ... [more ▼]
Unruptured abdominal aortic aneurysm (AAA) is seldom recognized. Thus it is difficult to know whether the incidence of AAA in the general population is high enough to warrant routine screening at least in men after a certain age. Ultrasound screening studies to evaluate the incidence of AAA have been carried out in several English-speaking and Scandinavian countries. The purpose of this report is to describe the results of a study carried out in Belgium. All 65- and 75-year-old men living in the city of Liege, Belgium, were given the opportunity to undergo a free ultrasound examination. Only 41% of the target population was examined. AAA defined as abdominal aortic diameter of >30 mm was observed in 28 subjects (incidence: 3.8%). Mean abdominal aortic diameter was 34.7 mm. A diameter >29 mm was observed in 33 subjects (incidence 4.5%). Mean abdominal aortic diameter was 30.4 mm. On the basis of epidemiological data collected, a high-risk population for AAA was identified. Arterial hypertension (p < 0.05), previous coronary artery surgery (p < 0.05), and smoking (p < 0.06) were more common in subjects with than without AAA. The overall cost of screening was $18.175. The cost per AAA diagnosed was $551.00. [less ▲]Detailed reference viewed: 9 (3 ULg)
Abdominal aortic aneurysms in octogenarians.
VAN DAMME, Hendrik ; SAKALIHASAN, Natzi ; et al
in Acta Chirurgica Belgica (1998), 98(2), 76-84
The decision on whether to operate or not abdominal aortic aneurysms (AAA) in elderly depends on the relative risk of the operation versus the natural course of the unoperated AAA. From January 1984 to ... [more ▼]
The decision on whether to operate or not abdominal aortic aneurysms (AAA) in elderly depends on the relative risk of the operation versus the natural course of the unoperated AAA. From January 1984 to December 996, 138 patients, aged 80 years and older, were referred to our department for an aneurysm of 40 mm or more (transverse diameter) of the infrarenal abdominal aorta (95 asymptomatic, 15 painful, and 28 ruptured AAA). For 58 patients with asymptomatic AAA, operation was denied at referral because of transverse diameter less than 50 mm (n = 21), patient refusal (n = 10) or unacceptable operative risk or poor general condition (n = 27). Thirty-four of these observed AAA were ultimately operated after a mean delay of 41 months because of aneurysm enlargement (n = 15), aneurysm tenderness (n = 6) or rupture (n = 13). Overall, 52 patients had immediate (n = 37) or delayed (n = 15) elective repair of their AAA, with an in-hospital mortality of 5.7%. Urgent operation was done for 21 patients with a painful AAA. Six patients died at hospital (28% mortality rate). Emergent surgery was applied to 41 patients with ruptured AAA (including 13 AAA who ruptured during surveillance). The operative mortality in this subgroup attained 68%. Follow-up for the 77 survivors and the 24 non-operative patients averaged 43 months. The 5-year survival (operative mortality included) is 47% for electively operated patients, 30% for urgently and 20% for emergently operated patients. For comparison, the 5-year survival of an age and sex matched Belgian population is 63%. For the 24 medically followed AAA, the 5-year survival was 33%. In six cases, the cause of death was rupture of the AAA. Of the 58 patients for whom operation was initially not considered, 19 (33%) presented AAA rupture (13 operated in emergency and 6 who never came to surgery). The operative outcome of AAA repair in octogenarians is less favourable than in the younger age group (3.6% mortality after elective repair, 44% after operation for AAA rupture, according to our institution data). The authors conclude that AAA surgery should not be denied to octogenarians on the basis of advanced age alone. They recommend a straightforward surgery for otherwise healthy octogenarians with AAA of 50 mm diameter, surveillance up to 60 mm for high-risk patients and no surgery for unfit, bedridden or demented patients. [less ▲]Detailed reference viewed: 19 (3 ULg)
Pathogenesis of abdominal aortic aneurysm (AAA) formation.
Limet, Raymond ; Richelle, Betty ; VERLOES, Alain et al
in Acta Chirurgica Belgica (1998), 98(5), 195-8Detailed reference viewed: 21 (5 ULg)
Advantages of Inferior Vena Caval Flow Preservation in Combined Transplantation of the Liver and Heart
Detry, Olivier ; Honore, Pierre ; Meurisse, Michel et al
in Transplant International (1997), 10(2), 150-1
Only a few cases of combined liver and heart transplantation have been reported in the literature, and no standard surgical procedure has yet been established. We report the successful transplantation of ... [more ▼]
Only a few cases of combined liver and heart transplantation have been reported in the literature, and no standard surgical procedure has yet been established. We report the successful transplantation of both liver and heart in a 28-year-old patient suffering from homozygous beta-thalassemia. We used Belghiti's technique of inferior vena caval flow preservation for liver transplantation, which avoids inferior vena cava occlusion by a side-to-side caval anastomosis. Applied to combined liver and heart transplantation, preservation of caval flow during liver transplantation may allow early discontinuation of cardiopulmonary bypass and, thus, minimize the general consequences of prolonged bypass. [less ▲]Detailed reference viewed: 63 (21 ULg)
A propos d'un cas de rupture myocardique dans un traumatisme thoracique ferme.
; SAKALIHASAN, Natzi ; Limet, Raymond
in Revue Médicale de Liège (1997), 52(2), 105-9Detailed reference viewed: 6 (2 ULg)
Uretero-arterial fistula: two observations.
VAN DAMME, Hendrik ; KEPPENNE, Véronique ; SAKALIHASAN, Natzi et al
in Acta Chirurgica Belgica (1997), 97(3), 133-6
Two cases of life-threatening haematuria, secondary to an uretero-arterial fistula, are reported. Both cases present predisposing causative factors. One patient had a combination of previous aorto ... [more ▼]
Two cases of life-threatening haematuria, secondary to an uretero-arterial fistula, are reported. Both cases present predisposing causative factors. One patient had a combination of previous aorto-bifemoral bypass grafting, an iliac artery aneurysm (retrogradely perfused), and an indwelling ureteral stent for ureteral compression. The other patient had previous aortoiliac surgery and obstructive uropathy with chronic urinary tract infection. Preoperative diagnosis of uretero-arterial fistula was made in only one patient. He was successfully operated (exclusion of the iliac aneurysm). In the other patient, nephrectomy was attempted to control reno-ureteral bleeding of unknown origin. Fatal recidive of brisk haematuria occurred some days later. Factors contributing to the development of uretero-arterial fistula, their diagnosis and optimal treatment are discussed. [less ▲]Detailed reference viewed: 17 (1 ULg)
Mecanisme de croissance et de rupture des anevrysmes de l'aorte abdominale.
Limet, Raymond ; SAKALIHASAN, Natzi ;
in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (1997), 152(7-9), 295-302302-3
The relationship between atherosclerosis and abdominal aortic aneurysm development is well known. Atherosclerosis cannot explain the whole mechanism. Genetic characters of mechanisms leading to abdominal ... [more ▼]
The relationship between atherosclerosis and abdominal aortic aneurysm development is well known. Atherosclerosis cannot explain the whole mechanism. Genetic characters of mechanisms leading to abdominal aortic development is obvious from this study and others. Our study evidences an increased metalloproteases activity in aortic wall proportionally to the size of the abdominal aortic aneurysm. A decrease of aortic wall elastin is evidenced proportionally to the AAA size. Extractable collagen is significantly increased in the aortic wall of patients operated on for aortic rupture. [less ▲]Detailed reference viewed: 11 (3 ULg)
Spinal ischaemia after surgery for abdominal infrarenal aortic aneurysm. Diagnosis with nuclear magnetic resonance.
Defraigne, Jean-Olivier ; OTTO, Bernard ; SAKALIHASAN, Natzi et al
in Acta Chirurgica Belgica (1997), 97(5), 250-6
A 76-year-old man underwent surgery for an infrarenal aortic aneurysm reaching 6 cm in maximal transverse diameter. The aorta was crossclamped below the level of the renal arteries. A tube graft was ... [more ▼]
A 76-year-old man underwent surgery for an infrarenal aortic aneurysm reaching 6 cm in maximal transverse diameter. The aorta was crossclamped below the level of the renal arteries. A tube graft was interposed and tend between the infrarenal aorta and the aortic bifurcation. Due to leakage on the suture line two consecutive episodes of crossclamping for a total duration of 40 min. were required. No hypotension was noted during or after the procedure. After operation, the patient complained of difficulties to move both legs and neurologic examination demonstrated paraparesis, with mild sensory deficit. Faecal and urinary incontinences were also noted and urodynamic testing demonstrated sphincterovesical palsy. Nuclear magnetic resonance imaging detected an ischaemic zone in the spinal cord at the level of T11. Faecal incontinence and motor deficit partially resolved but no bladder function recovery was observed. Spinal ischaemia is a rare complication after abdominal aortic surgery. Several risk factors have been suggested which include level and duration of the aortic crossclamping, possible interruption of the spinal cord blood supply via the greater medullary artery (the so-called artery of Adamkiewicz), presence of intra- or postoperative episodes of hypotension, atheromatous embolization, underlying occlusive arteriosclerosis of spinal arteries, and respect or not of the hypogastric circulation. In our case, the duration of the crossclamping and interruption of the blood flow in lumbar arteries probably supplying the distal spinal cord were likely contributive factors. [less ▲]Detailed reference viewed: 22 (1 ULg)
Une masse cervicale de diagnostic souvent errone: le chemodectome carotidien.
Defraigne, Jean-Olivier ; Antoine, Paul ; SAKALIHASAN, Natzi et al
in Revue Médicale de Liège (1997), 52(7), 485-97Detailed reference viewed: 9 (4 ULg)
Transplantation combinée du foie et du coeur chez un patient souffrant de thalassémie majeure
Detry, Olivier ; Defechereux, Thierry ; Honore, Pierre et al
in Revue Médicale de Liège (1997), 52(8), 532-4Detailed reference viewed: 36 (7 ULg)
Decrease of Plasma Vitamin E (Alpha-Tocopherol) Levels in Patients with Abdominal Aortic Aneurysm
Sakalihasan, Natzi ; Pincemail, Joël ; Defraigne, Jean-Olivier et al
in Annals of the New York Academy of Sciences (1996), 800Detailed reference viewed: 40 (13 ULg)
Activated forms of MMP2 and MMP9 in abdominal aortic aneurysms.
SAKALIHASAN, Natzi ; Delvenne, Philippe ; Richelle, Betty et al
in Journal of Vascular Surgery (1996), 24(1), 127-33
PURPOSE: This consistent observation of a reduction of the elastin concentration in abdominal aortic aneurysms (AAAs) has led us to investigate in AAA specimens two metalloproteinases that display ... [more ▼]
PURPOSE: This consistent observation of a reduction of the elastin concentration in abdominal aortic aneurysms (AAAs) has led us to investigate in AAA specimens two metalloproteinases that display elastase activity, MMP2 (gelatinase A/72kDa) and MMP9 (gelatinase B/92 kDa). METHODS: Samples of full-thickness aortic wall, adherent thrombus, and serum were collected in 10 patients with AAAs. Samples of normal aortic wall and serum were taken from 6 age-matched control patients. Quantitative gelatin-zymography and gelatinolytic soluble assays after acetyl-phenyl mercuric acid activation were performed on serum and tissue extracts, and the results were expressed in units on a comparative wet-weight basis. Histologic analysis was performed in parallel to score the inflammatory infiltrate. RESULTS: The luminal and parietal parts of the thrombus contained, respectively, 20- and 10-fold more gelantinolytic activity than the serum. The predominate form was MMP9. Although the total gelatinolytic activity was in the same range both in AAAs and in normal walls, a significantly higher proportion of MMP9 was found in the aneurysmal aortic walls. Furthermore, a significant proportion of MMP9 was under its processed active form, which was never observed in normal samples. A significantly higher proportion of MMP2 was also present as processed active form in AAA wall. This latter parameter positively correlated with the inflammatory score. CONCLUSIONS: The presence of activated MMP9 and MMP2 might contribute to the degradation of the extracellular matrix proteins that occurs during the development of aneurysms. [less ▲]Detailed reference viewed: 15 (6 ULg)
Une cause parfois meconnue de lesions vasculaires: la maladie de Behcet.
Defraigne, Jean-Olivier ; SAKALIHASAN, Natzi ; Pierard, Gérald et al
in Revue Médicale de Liège (1996), 51(10), 639-46Detailed reference viewed: 8 (1 ULg)
Saphenous vein patch (SVP) is superior to direct closure (DC) for long-term patency of carotid endarterectomy (CEA)
Desiron, Quentin ; Detry, Olivier ; Sakalihasan, Natzi et al
in Cardiovascular Surgery (1995, September), 3(Suppl. 1), 44Detailed reference viewed: 19 (1 ULg)
Involvement of MMP2 and MMP9 in the development of abdominal aortic aneurysms.
SAKALIHASAN, Natzi ; DELVENNE, Philippe ; Nusgens, Betty et al
in Cell Biology International (1995), 19(3), 250-51Detailed reference viewed: 10 (7 ULg)
Aneurysms of the abdominal aorta: familial and genetic aspects in three hundred thirteen pedigrees.
VERLOES, Alain ; SAKALIHASAN, Natzi ; Koulischer, Lucien et al
in Journal of Vascular Surgery (1995), 21(4), 646-55
PURPOSE: Familial clustering of abdominal aortic aneurysm was first noticed in 1977. METHODS: Through questionnaire and phone inquiry, familial data on 324 probands with abdominal aortic aneurysms allowed ... [more ▼]
PURPOSE: Familial clustering of abdominal aortic aneurysm was first noticed in 1977. METHODS: Through questionnaire and phone inquiry, familial data on 324 probands with abdominal aortic aneurysms allowed the establishment of 313 multigenerational pedigrees including 39 with multiple affected patients. RESULTS: There were 276 sporadic cases (264 men, 12 women); 81 cases belonged to multiplex pedigrees (76 men; 5 women). We compared familial and sporadic male cases; the ages at diagnosis were 64.1 +/- 7.9 years and 66.0 +/- 7.3 years (p < 0.05), respectively, the ages at rupture were 65.4 +/- 6.6 years and 75.2 +/- 8.6 years (p < 0.001), and the rupture rate was 32.4% and 8.7% (p < 0.001). Survival curves were computed. Relative risk for male siblings of a male patient was 18. We performed a segregation analysis with the mixed model, the most likely explanation for occurrence of abdominal aortic aneurysm in our families was a single gene effect showing dominant inheritance. The frequency of the morbid allele was 1:250, and its age-related penetrance was not higher than 0.4. CONCLUSION: This analysis indicates the preeminence of genetic factors on multifactorial/environmental effects of the pathogenesis of abdominal aortic aneurysm. [less ▲]Detailed reference viewed: 7 (2 ULg)