[Atrial septal defect type ostium secundum at the age of 40 or more. Apropos of 86 cases with hemodynamic exploration].

The authors propose a haemodynamic classification for ASD, taking into account the very frequent drop in systemic blood pressure which is observed in this disease in elderly people. The authors examine the clinical signs and the clinical course in terms of this haemodynamic classification and they stress the mitral abnormalities and the arrhythmias. 56% of patients were followed up for a mean of 6 years for non-operated patients and almost 10 years for operated patients.

Myocardial hypertrophy, rate of change of free wall thickness and directional components of ventricular power in man.

The diastolic (Vd) and systolic volumes, the average free wall diastolic thickness (hd) and left cardiac cavity pressures were determined in 25 subjects using monoplan angiography. Ten subjects presented a normal angiogram (NA), 5 a myocardiopathy with predominant dilatation (MCD), 4 a myocardiopathy with predominant non obstructive hypertrophy (MCH), and 6 a volume overload (VO). All the subjects had a normal coronary-cineangiogram.

[Triple-valve replacements].

34 patients aged between 17 and 62 years underwent triple valve replacement, 14 of whom exclusively with Starr-Edwards prosthesis; 25 patients were operated at Stage III and 4 at Stage IV of the NYHA classification; the operative mortality was 14%, the late mortality 21%. The actuarial survival curve shows 66% survival at 5 years; in all, 21 good results were obtained with a follow-up ranging from 3 months to 11 years (average 41 months). A notable late complication specific to these patients was dysfunction of the tricuspid prosthesis; a gradient across the tricuspid prosthesis was observed in 14 postoperative catheter studies; one of these patients had to be reoperated for thrombosis of a Starr-Edwards tricuspid prosthesis.