Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Apr 1991
Review[Thrombosis of mechanical heart valve prosthesis. Value of transesophageal echocardiography in the study of mitral valve prosthesis].
Forty-three consecutive patients with mechanical valve prostheses underwent transthoracic and transoesophageal echocardiography for suspected thrombolic prosthetic valve dysfunction. The results of these investigations were compared with those of cineradiography and the clinical outcome. The diagnosis of thrombosis was retained in 11 of the 43 patients (10 mitral and 1 aortic valve prostheses). ⋯ The cineradiography gave false negative results in 6 cases. In conclusion, these cases underline the undeniable value of transoesophageal echocardiography in occlusive or non-occlusive thrombosis of a mitral valve prosthesis. This investigation should be undertaken whenever there is the least suspicion of thrombosis of the prosthesis.
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Arch Mal Coeur Vaiss · Mar 1991
Review Case Reports[Association of cor triatriatum and obstruction of abnormal left pulmonary venous drainage. Apropos of a case].
A case of subtotal cor triatriatum associated with a partial anomalous pulmonary venous drainage of the left lung, in a 30 months old boy is reported. Diagnosis was suggested by the presence of pulmonary venous obstruction and pulmonary hypertension. ⋯ The cine-angiography demonstrated the anomalous, obstructive, left pulmonary venous drainage. The pulmonary hypertension has mandatorised an early surgical cure, the result was satisfactory at 16 months.
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Arch Mal Coeur Vaiss · Jan 1991
Review[The role of the endothelium in the regulation of vasomotor activity].
The classical physiological concept of the endothelium was that of a barrier and a surface of exchange. Little importance was attached to its role in the regulation of vascular tone. ⋯ These different factors and their possible roles in vascular pathology are reviewed. The endothelial function or functions are probably abnormal in many pathological situations.
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Thirty out of 287 patients (10.4%) admitted to hospital for infective endocarditis between December 1970 and January 1990 had neurological complications. Twenty-three patients had native valve infectious endocarditis and 7 had prosthetic valve endocarditis. The clinical features were characterized by the frequency of aortic valve involvement (23 out of 30) and other complications, especially cardiac failure (16 cases) and peripheral vascular manifestations (7 cases). ⋯ Four patients underwent neurosurgery: 3 for clipping a mycotic aneurysm and 1 for drainage of an intracerebral haematoma. Poor prognostic factors were: coma, cardiac failure, cardiac valve prosthesis and, above all, the extent and multiplicity of the neurological lesions. The authors propose the following measures to improve the prognosis: early surgery in cases of large and/or mobile vegetations especially when the infecting organism is a staphylococcus and when a systemic embolism has occurred; routine CT scanning and/or digitised cerebral angiography in all patients with infective endocarditis to detect surgically accessible mycotic aneurysms.
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Arch Mal Coeur Vaiss · Nov 1990
Case Reports[Venous thrombosis disclosing Marchiafava-Micheli disease].
It is established practice in patients with thromboembolic disease without the classical predisposing factors to search for general causes and abnormalities of blood clotting. The authors report a case of paroxysmal nocturnal hematuria or the Marchiafava-Micheli syndrome, a rare but classical cause of venous thrombosis. In this patient, the hemopathy presented with venous thrombosis.