Archives des maladies du coeur et des vaisseaux
-
Arch Mal Coeur Vaiss · Jan 1986
[Infectious endocarditis surgically-treated in the active phase. Apropos of 46 cases].
The clinical and microbiological characteristics, the surgical indications and procedures, the evolution and the principal prognostic factors were reviewed in 46 cases of infectious endocarditis operated in the active phase. Using this date, the authors try to determine the optimal time for surgery during the acute active phase of infectious endocarditis. The study population comprised 28 men and 18 women aged 7 to 64 years (average age: 30). ⋯ The surgical procedure was technically complex in 6 cases. Operative mortality was high (18 cases, 39%). The main cause of death was low cardiac output (13 cases).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Arch Mal Coeur Vaiss · Nov 1985
[Effects of injectable calcium blockers on cardiac function and relaxation in left ventricular hypertrophy].
Nineteen patients with left ventricular hypertrophy were given intravenous calcium antagonists: 9 patients received intravenous verapamil (VPM IV) and 10 patients diltiazem (DTZ) by intracoronary and then intravenous injection. Systemic and pulmonary resistances, cardiac output, left ventricular and aortic pressures, isometric contractility, isometric relaxation and left ventricular compliance were studied in sinus rhythm, during atrial and then ventricular pacing at 120/min and finally after tachycardia before and after administration of calcium antagonists. Left ventriculography in the 30 degrees RAO projection in sinus rhythm was performed before and after injection of the calcium antagonists to study the variations in the end diastolic volume, mass and mass-volume ratio. ⋯ The improvement in left ventricular ejection was independent of the variation in resistances but was closely related to variations of parameters of relaxation. The effects on volumic compliance and filling velocities were also closely related to variations in relaxation (p less than 0.05 and p less than 0.01). Calcium antagonists protected left ventricular ejection during supraventricular tachycardia and prevented the changes in left ventricular relaxation observed during arrhythmias and after tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Arch Mal Coeur Vaiss · May 1985
Case Reports[Ebstein's disease associated with Fallot's tetralogy. Apropos of a familial case, review of the literature, embryologic and genetic implications].
Ebstein anomaly is a rare congenital cardiac malformation, representing 0.3 p. 100 of all congenital heart disease. The authors report a case of a child with Ebstein anomaly associated with tetralogy of Fallot, whose father had an apparently simple Ebstein anomaly. The association of Ebstein-Fallot is extremely rare with only 5 previously reported cases in the literature. ⋯ A certain number of other cases also demonstrate the association of Ebstein anomaly with another congenital cardiac malformation in the same family, usually a VSD or tetralogy of Fallot. Our familial case raises the question of a possible embryological link between Ebstein anomaly and tetralogy of Fallot. Our experimental embryological studies also suggest the presence of a common denominator between these two conditions.
-
Arch Mal Coeur Vaiss · Apr 1985
[Aortic and mitral valve bioprostheses. Normal and pathological M mode echocardiographic aspects].
The M mode echocardiographic recordings of 52 normal mitral bioprostheses (NMB), 7 pathological mitral bioprostheses (PMB), 30 normal aortic bioprostheses (NAB) and 10 pathological aortic bioprostheses (PAB) were reviewed. In normal bioprostheses a significant correlation was observed between the echocardiographic and the "specified" diameters, the diastolic and systolic slopes and the amplitude of anterior motion of the support. In NMB, the end-systolic diameter of the left ventricular outflow tract depended on the "specified" diameter of the bioprosthesis. ⋯ Systolic excursion of the cusps was reduced in cases of relative stenosis due to an inappropriately small sized bioprosthesis. Thickening of the diastolic cusp echos was observed in cases of degenerative stenosis. Ventricular dilatation and reduced septal and free wall motion were dysfunction.
-
Arch Mal Coeur Vaiss · Oct 1984
Case Reports[Emergency surgical revascularization in establishing myocardial infarctions. Treatment of subtotal coronary occlusions].
The introduction of intracoronary thrombolysis as a treatment for myocardial infarction has led to an increase in the number of very early coronary angiographies carried out in the acute phase of myocardial infarction. These investigations can be performed without excessive risk. In some cases, severe stenosis with significant distal circulatory impairment without evidence of thrombosis is found. ⋯ All patients were reinvestigated at 1 month and all grafts were shown to be patent. The left ventricular ejection fractions improved in 3 cases, remained unchanged in 2 cases, and deteriorated in 1 case (the patient with cardiogenic shock). These results suggest that emergency coronary bypass surgery is a rational treatment of pre-thrombolic coronary stenosis observed at early coronary angiography in patients with evolving myocardial infarction in order to preserve as much myocardial muscle as possible.