Archives des maladies du coeur et des vaisseaux
-
Between July, 1967 and December, 1987, 71 children and adolescents (43 boys, 28 girls) aged from 9 days to 20 years (mean 7.8 years) underwent pacemaker implantation. In 91 p. 100 of the cases this treatment was performed for complete atrioventricular block (CAVB). Surgical CAVB was the reason for 59 p. 100 of implantations (correction of tetralogy of Fallot and, more recently, of complex cardiopathies), the second main reason (16.9 p. 100) being nonsurgical CAVB associated with heart disease; the children in this group were young (mean age 4.2 years), and the prognosis mainly depended on the heart disease. ⋯ Breakage of the wire was the main complication. Rises in threshold are the major drawback of epicardial pacing, as they require reoperation when the energy delivered cannot be effectively programmed. Endocardial pacing, preferably with a dual-chamber instrument, seems to be the best method, being the least aggressive, with minimal complications in short and very long term; it is justified as first-line treatment of permanent or predominant CAVB.(ABSTRACT TRUNCATED AT 400 WORDS)
-
Arch Mal Coeur Vaiss · Nov 1987
Case Reports[Value of magnetic resonance imaging in a lipoma of the left ventricle].
A patient with benign left ventricular lipoma was explored pre- and post-operatively with echocardiography, computerized tomography (CT) and magnetic resonance imaging (MRI). With MRI spin-echo sequences the lipoma emitted a bright signal similar to that of normal fatty tissue on the two echoes of the sequence (28 ms and 65 ms). ⋯ After surgery, MRI displayed the remains of a septal lipomatous lesion. This case underlines the usefulness of MRI for the evaluation of cardiac tumours, and particularly lipomas.
-
Fibrinolysis is a physiological process which aims at dissolving intravascular thrombi and is mediated by activation of plasminogen to plasmin. Streptokinase (SK) and urokinase (UK) are non-specific plasminogen activators. They have proved effective as thrombolytic agents, but their use is limited by the risk of haemorrhages due to systemic fibrinogenolysis. ⋯ So far, the most extensively studied of these complexes is BRL 26921 (anisoylated plasminogen streptokinase activator complex, or APSAC) which is administered by bolus intravenous injection. It is more thrombolytic than SK but produces systemic fibrinogenolysis to an equivalent degree. Injected intravenously (by infusion or bolus) during the first hours of a coronary infarction these three new thrombolytic agents have proved effective in promoting coronary reperfusion, with an early coronary patency rate of 70-75%.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Arch Mal Coeur Vaiss · May 1987
Case Reports[Traumatic tricuspid insufficiency. Apropos of a case treated by conservative surgery].
Traumatic tricuspid insufficiency is a rare condition which raises the problem of when and how should its surgical correction be performed. Its diagnosis has been considerably facilitated by echocardiography. ⋯ Optimal correction was obtained by conservative surgery. The excellent results observed at short and medium term suggest that surgical indications should be extended.
-
Arch Mal Coeur Vaiss · Apr 1986
Case Reports[Tricuspid endocarditis with right-left shunt in the atrium].
A case of tricuspid regurgitation due to endocarditis causing a right-to-left shunt through a patent foramen ovale is reported. Tricuspid valve endocarditis occurred after septic abortion and caused valvular regurgitation with dyspnea and cyanosis. ⋯ The physiopathology of these right-to-left shunts is the same as that already described during traumatic tricuspid regurgitation: reopening of the foramen ovale by the right atrial dilatation and ventricularisation of right atrial pressures. The presence of a shunt is an indication for surgery.