[Chronic constrictive pericarditis in African children: report of a case].

The chronic constrictive pericarditis is a rare affection, with multiple etiologies and concerning especially the adult. We report a case of chronic constrictive pericarditis in an African child in whom no etiology was found. A review of the literature raises the characteristics of chronic constrictive pericarditis for a better therapeutic management.

[Extracorporeal circulation: an extraordinary tool that is not just for cardiac surgeons].

Extracorporeal circulation (ECC) is not only used for open heart surgery. There are also other surgical and medical applications. ECC can be used for encephalic arteries surgery to induce hypothermia and maximally protect the brain.

Influence of patient-prosthesis mismatch on long-term results after aortic valve replacement with a stented bioprosthesis.

Background And Aims Of The Study: The study aim was to compare long-term results of bioprostheses implanted in the aortic position, with and without patient-prosthesis mismatch (defined as effective orifice area (EOA)/body surface area (BSA) < or =0.85 cm2/m2).

Methods: Between 1986 and 1990, 90 consecutive patients (mean age 72.

Clinical outcome after repair of acute type A dissection in patients over 70 years-old.

Background: Despite current aging of patients proposed for cardiac surgery, published results of type A dissection repair in the elderly are sparse and controversial though an increased operative risk when compared to younger patients is well-documented. Whether any patient of an advanced aged suffering from acute dissection of the proximal aorta should be referred for surgery deserves specific clinical studies.

Objective: To define factors of poor outcome after repair of type A dissection in the elderly by focusing on both early and late results.

[Impact of psychiatric disturbances on the outcome of coronary bypass surgery].

The influence of anxiety and depression on the development and prognosis of coronary disease seems to be well established but there are few studies of the effects of these disturbances on the postoperative outcome of coronary surgery. The object of this review of the literature was to present recent data on this subject and to suggest therapeutic strategies for patients referred for coronary bypass surgery to improve their quality of life and even cardiovascular prognosis.

Simple surgical technique to prevent direct secondary aortoenteric fistulas.

To prevent direct secondary aortoenteric fistulas, a devastating complication of abdominal aortic surgery, we describe here a rapid, very easy to perform and no cost operating technique. A part about 4 cm long of the vascular prosthesis was cut to obtain a partial tailored ring which was passed through the prosthesis. After the anastomosis was realized, the tailored ring was hitched up to totally cover proximal anastomosis and prevent direct contact between aorto-prosthetic anastomosis and the bowel.

[Results of coronary artery surgery in octogenarians].

Over an 11 year period from January 1990 to December 2000, 3282 patients underwent isolated or combined surgical myocardial revascularisation. In this group, 42 were aged 80 or over (maximum 87 years), 1.3% of the total patient population.

Aspergillus flavus mitral valve endocarditis after lung abscess.

A 16-year-old male with bone marrow failure due to chemotherapy for recurrent acute lymphoblastic leukemia developed an abscess in the lower lobe of the left lung draining through a bronchogastric fistula, as well as mitral valve endocarditis with large vegetations. After a course of antifungal therapy, the left lobe was removed and the fistula closed. The mitral valve was then replaced, after a failed attempt at valve repair, by a mechanical, double-leaflet prosthesis.

Postoperative exercise tolerance after aortic valve replacement by small-size prosthesis: functional consequence of small-size aortic prosthesis.

Objectives: The objective of this study was to determine whether a small-size valve prosthesis contributes to exercise intolerance, as assessed by VO2 measurement during an exhaustive cycle ergometer exercise.

Background: The determinants of exercise capacity after mechanical aortic replacement are not well known. The selection of small valve sizes has, however, been described as an independent predictor of exercise intolerance as assessed by exercise duration.

Vertebral artery surgery with cardiopulmonary bypass and deep hypothermia.

Deep hypothermia was proposed to prevent neuronal ischemia and stroke during surgical procedures on arteries that supply the brain, especially with extended occlusive lesions on both internal carotid arteries. The interest of this therapeutic option is still under discussion, even in the case of combined cardiac and cerebrovascular surgery. We report the case of a 53-year-old male who was admitted to our institution for symptomatic vertebrobasilar insufficiency.

Malignant ventricular arrhythmias revealing anomalous origin of the left coronary artery from the pulmonary artery in two adults.

We report two cases of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), revealed by malignant ventricular arrhythmias in adult patients. A two coronary system was re-established in both patients, and cryotherapy was performed on one of the patients who, in addition, presented ventricular aneurysm triggering ventricular tachycardia.

Prognostic value of myocardial lactate dehydrogenase subunit ratio in heart transplant recipients.

Background: Allograft coronary artery disease (CAD) is a major long-term complication in heart transplant recipients. Unfortunately, methods for early estimation of the likelihood of development of the disease are not currently available. Lactate dehydrogenase (LDH) is composed of heart and muscle subunits.

[Extracorporeal circulation for warming in severe accidental hypothermia. 3 cases].

Background: Severe accidental hypothermia with central temperature below 28 degrees C can result from prolonged cold exposure and lead to a fatal outcome by spontaneous or provoked ventricular fibrillation.

Case Report: Three patients were referred for central temperature below 24 degrees C. At admission, the patients had major ventricular rythm disorders (two were in a state of circulatory arrest and the third had auricular fibrillation and circulatory collapse).

Large encircling cryoablation without mapping for ventricular tachycardia after anterior myocardial infarction: long-term outcome.

Objective: Map-guided procedures have been the accepted standard for ventricular tachycardia surgery. However, promising results of visually guided resections without mapping have been reported. The goal of this study was to evaluate the efficacy of large encircling cryoablation without mapping for ventricular tachycardia after anterior myocardial infarction.

[Outcome of type I acute aortic dissection operated after 70 years of age. A retrospective study of operated dissection of the aorta in the over 70 years old].

The aim of this study was to assess the perioperative mortality and long-term outcome of Type I dissection of the aorta operated in patients over 70 years age. Of the 87 dissections of the aorta operated between 1988 and 1995, 19 concerned patients aged 71 to 79 (average 74.1 +/- 2.

Long-term results with the Sorin Pericarbon valve in the aortic position: a multicenter study.

Background And Aim Of The Study: A multicenter study was designed to evaluate the Pericarbon pericardial bioprosthesis for up 10 years after implantation in the aortic position.

Methods: Between January 1986 and November 1996, 321 patients (mean age 75.8 +/- 7.

Mycotic aneurysm of the extracranial carotid artery: an uncommon complication of bacterial endocarditis.

This report describes a case involving mycotic aneurysm of the extracranial internal carotid artery occurring as a complication of staphylococcal endocarditis in a patient with systemic lupus erythematosus. Three main points are emphasized: (1) this complication occurred in an immunodepressed patient; (2) surgical treatment consisted of aneurysmorraphy using absorbable suture; (3) the outcome was successful with a follow-up of 24 months.

Preservation of three-dimensional annular movement with the SJM-Seguin mitral annuloplasty ring.

Background And Aims Of The Study: In order to achieve optimal annuloplasty during mitral valve repair, we developed a new device, the SJM-Seguin annuloplasty ring, with the aim of remodeling, correcting dilatation, and preserving physiologic annulus function. This ring has variable flexibility; that is, it is sufficiently rigid in its anterior region to maintain intercommissural distance, yet sufficiently flexible in its posterior region so as not to interfere with left ventricular function and to permit the natural three-dimensional annular mobility.

Methods: Following successful studies in animals, 75 patients were operated on for mitral regurgitation between January 1994 and May 1996.

Advance in mitral valve repair using a device flexible in three dimensions. The St Jude Medical-Séguin annuloplasty ring.

To allow remodeling of the annulus while respecting natural three dimensional annular movements during mitral valve repair, a new annuloplasty ring (St Jude Medical [SJM]-Séguin annuloplasty ring) was developed. This ring has variable flexibility; that is, it is sufficiently rigid on the anterior portion to maintain intercommissural distance, and sufficiently flexible on the posterior portion to respect left ventricular function and natural three dimensional annular mobility. Fifty patients operated on for pure mitral regurgitation between January, 1994 and June, 1995 were studied.