Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Nov 1991
[Hemodynamic effects of milrinone in the treatment of cardiac insufficiency after heart surgery with extracorporeal circulation].
Milrinone is an inotropic agent of the phosphodiesterase inhibitor family. In common with all molecules of this class it has both positive inotropic and vasodilator effects. The haemodynamic effects of 3 dosages of milrinone were studied in 25 patients with low output states after open heart surgery. ⋯ It is associated with a mild vasodilatory effect. Improved myocardial function is observed providing attention is paid to vascular filling. None of the maintenance doses used after the bolus injection was shown to be more effective than the others.
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Arch Mal Coeur Vaiss · Nov 1991
[Thrombosis of atrioventricular prosthesis. Contribution of transesophageal echocardiography].
The aim of this study was to assess the diagnostic value of transesophageal echocardiography for the detection of thrombosis of a mechanical mitral or tricuspid valve prosthesis. Twelve patients (mean age 54 +/- 12 years) out of a series of 39 patients operated between April 1988 and June 1989 for prosthetic valve dysfunction had valve thrombosis at operation (11 mitral and 1 tricuspid valve prosthesis). Transesophageal echocardiography was routinely performed preoperatively in addition to transthoracic Doppler echocardiography to search for an abdominal mass on the prosthetic valves. ⋯ Eleven of the 12 abnormal masses on the prostheses were visualised by transesophageal echocardiography, a sensitivity of 91%. Detection of the masses on the arterial side was possible in all cases (10/10) but 5 of the 6 extensions of the thrombus into the ventricle could not be visualised. The diameter of the transprosthetic jet was less than 12 mm in 7 of the 8 thrombosed valves compared with greater than 15 mm in the 5 normal control prostheses.(ABSTRACT TRUNCATED AT 250 WORDS)
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Clinical indications of vena cava interruption are reviewed. During the last few years pulmonary embolism frequency remained high and many new percutaneous vena caval filters became available. These facts probably explain the increasing use of these filters reaching about 10,000 filters each year in France. ⋯ The only admitted indications of vena cava interruption, in case of proximal venous thrombosis, are contraindications to anticoagulation. In other situations no data allow to recommend a cava filter; indication will be discussed on a case by case basis. Prospective controlled studies are greatly encouraged.