Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Jan 1989
Case Reports[Right ventricular assistance by intrapulmonary counterpulsation].
Right ventricular failure is relatively frequent and constitutes one of the causes of post-operative heart failure. Few drugs are available to treat right ventricular failure. We present a simple and effective means of mechanical support available in all cardiovascular units: counterpulsation in the pulmonary artery. Our experience and a review of the literature have enabled us to determine the indications for this method to support a failing heart.
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Arch Mal Coeur Vaiss · Sep 1988
Clinical Trial Controlled Clinical Trial[Dose-response relation of intravenous enoximone in congestive cardiac insufficiency].
Enoximone (MDL 17043) is a new generation inotropic drug which acts by inhibiting phosphodiesterase and is endowed with both inotropic and vasodilator properties. The purpose of this study, which involved 23 patients aged from 18 to 75 years in NYHA class III or IV and with evidence of severe haemodynamic disturbances (cardiac index below 2.5 1/mn/m2, pulmonary wedge pressure above 15 mmHg), was to evaluate the acute haemodynamic responses to doses of enoximone that ranged from 0.25 to 2.50 mg/kg administered by bolus intravenous injection. Heart failure was either of ischaemic origin (6 cases) or idiopathic (10 cases) or due to various causes (7 cases). ⋯ Cardiac index and pulmonary wedge pressure were significantly improved in both groups (P less than 0.005): cardiac index +39 p. 100 in group A, +55 p. 100 in group B; pulmonary wedge pressure -36 p. 100 in group A, -48 p. 100 in group B; systemic vascular resistance -46 p. 100 in group B. Heart rate and arterial pressure were not significantly altered. The duration of response was 1 to 3 hours in group A patients and 4 to 8 hours in group B patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arch Mal Coeur Vaiss · Aug 1988
[Aortic media necrosis in Marfan's disease in young adults. Apropos of 5 surgically treated cases, with 3 survivals].
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. ⋯ 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.
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Arch Mal Coeur Vaiss · Aug 1988
Case Reports[The electrocardiogram and hypothermia. Apropos of a case].
Hypothermia induces characteristic electrocardiographic changes (Osborn wave). They have been observed in the animal and in man, both in accidental hypothermia and in hypothermia induced during cardiac surgery. ⋯ This case report is accompanied by a brief review of the literature. The recognition of these clinical signs should enable the diagnosis of hypothermia to be made at an early stage and appropriate treatment instituted, as this is a condition which is generally associated with a high mortality rate.