Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Feb 1997
Comparative Study[Dynamic three-dimensional cardiac reconstruction by transesophageal echocardiography. A clinical experience apropos of 100 cases].
Three-Dimensional (3D) echocardiography was performed during routine transesophageal examinations in 100 patients to identify the most promising applications. The approach used was based on the integration of multiple two-dimensional images recorded with a multiplane probe to achieve 3D reconstruction. A series of 90 cardiac cycles was recorded from a fixed position during computer-controlled rotation of the transducer. ⋯ However, the sensitivity of the 3D method was not as good as 2D echocardiography for detecting bacterial vegetations in cases of infective endocarditis. On the other hand, the determination of the precise localization of infectious, degenerative and tumoral lesions and their size were facilitated by 3D reconstruction. The authors conclude that 3D echocardiography is applicable in routine practice and the complementary information provided in certain cardiac diseases should help management of these patients.
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Arch Mal Coeur Vaiss · Nov 1996
[Value of the study of latent atrial vulnerability in unexplained ischemic cerebrovascular accident of young subjects].
This study searched for abnormalities of the atrial electrophysiological substrate in young subjects with unexplained ischaemic cerebrovascular accidents. Thirty-seven patients (18 to 45 years) underwent programmed atrial stimulation at 2 sites in the right atrium after an unexplained ischaemic cerebrovascular accident. Seventeen of them underwent repeat study at 6 months. ⋯ These results confirm the presence of an arrhythmogenic substrate similar to that of patients with paroxysmal atrial fibrillation in over two thirds of cases. Programmed atrial stimulation is a reproducible technique. The relationship between latent atrial vulnerability and abnormalities of the interatrial septum requires confirmation in a series with a larger numbers of patients.
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Arch Mal Coeur Vaiss · Oct 1996
Case Reports[Acute upper limb ischemia in a young adult without cardiac disease. Value of transesophageal echocardiography].
The authors report the case of a 34-year old woman with no previous cardiovascular disease who was admitted to hospital for acute ischaemia of the right arm due to embolism, preceded by two episodes of pain and tingling of the left arm related to subacute ischaemia. After right embolectomy, with no possibility of controlateral disobliteration an effective anticoagulation, no cardiac source of embolism could be found; However, transoesophageal echography showed a large mobile thrombus in the aortic arch implanted just before the origin of the left subclavian artery. The only explanation for embolism to the right arm was a retro-oesophageal subclavian artery which was confirmed by scanner. ⋯ These investigations, however, did not allow visualisation of the aortic thrombus. In view of the risk of recurrent embolism, a thrombectomy was performed without cardiopulmonary bypass, associated with correction of the vascular abnormality with no complications. This case shows that oesophageal echography is a useful investigation in the work up of acute arterial obstruction in young patients with no cardiac disease.
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Arch Mal Coeur Vaiss · Sep 1996
Case Reports[Localised primary lesion of the right pulmonary artery in Takayasu's disease].
Takayasu's disease involves the pulmonary vessels in over 50% of cases. However, primary lesions of the pulmonary arteries are very rare. The authors report the cases of a 34 year-old Caucasian woman presenting with clinical and radiological signs of acute pulmonary embolism, but in whom the pulmonary angiography showed stenotic and occlusive lesions of the right pulmonary artery. MRI provided an accurate diagnosis by showing typical thickening of the pulmonary arterial walls.
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Arch Mal Coeur Vaiss · Jul 1996
Review[Doppler echocardiographic investigation of cardiomyopathies].
There are three types of cardiomyopathy: hypertrophic, dilated and restrictive. The diagnosis and prognosis of these three types may be assessed from Doppler echocardiographic data. In hypertrophic cardiomyopathy, the diagnostic criterion is parietal hypertrophy. ⋯ Restrictive types of cardiomyopathy are more rare, amyloidosis being the commonest cause. Symmetrical wall thickening and a small ventricular chamber are observed. In advanced stages with abnormal systolic function, an E/A mitral ratio > 2 and deceleration time < 150 msec, the outcome is rapidly fatal.