[Cardiovascular complications in chronic atrophic polychondritis. Apropos of an anatomo-clinical case. Review of the literature].

The case of a man, 25 years of age and presenting with chronic atrophic polychondritis (CAP), complicated by a complete atrioventricular block, double mitral valve incompetence and aneurysm of the ascending aorta, offered the possibility of investigating the various clinical manifestations and cardiovascular complications of this common disorder. CAP is a connectivitis of unknown etiology, it corresponds to ubiquitous and recurrent cartilage inflammation, leading to characteristic chondritis of the ears and nose, joint disease and laryngo-trachco-bronchial disorders. Other systemic impact is seen at sites containing high levels of proteoglycans, such as the eye, inner ear and cardiovascular system.

[Results of surgery in 144 cases for aneurysms of the infra-renal abdominal aorta in patients over 75 years of age].

114 patients aged over 75 underwent surgery for aneurysm of the infra-renal abdominal aorta in the University Teaching Hospitals in Nantes and Angers between 1979 and 1988. A retrospective study of these patients was performed to evaluate the immediate and long-term results. The mean age of the patients was 79 (+/- 4) years, the oldest being 94.

[Mechanical obstruction of the duodenum after surgery of the abdominal aorta].

The authors report two cases of duodenal obstruction occurring after insertion of an aorto-iliac prosthesis. This form of mechanical obstruction is much rare than the other forms of post-operative mechanical intestinal obstruction. While the need for surgery is often evident, precise diagnosis before the procedure is seldom obtained.

Retrograde dissections of the aortic arch after exclusion-bypass of the descending thoracic aorta: a report of three cases.

We report three cases of fatal retrograde dissection of the aortic arch after exclusion-bypass with metal clamps according to Carpentier's thromboexclusion method. All three patients were male, aged 59, 66, and 73 years. Initial operative indications were chronic dissections in two cases and atheromatous aneurysm of the descending thoracic aorta in the other.

[Aortico-left ventricular tunnel. Long-term follow-up, therapeutic implications].

Aortico-left ventricular tunnel is a rare entity resulting in a communication between the ascending aorta and the left ventricle, with clinical signs of aortic incompetence. On the basis of two personal cases and a review of the literature including 57 patients, the operative mortality and long-term follow-up of these patients are analysed. 51 patients were operated upon with a mortality rate of 21.

Tuberculous aneurysm of the descending thoracic aorta.

Tuberculous aneurysm of the descending thoracic aorta is a rare entity. To our knowledge the present case is the sixth on record to have been successfully treated surgically. These aneurysms present the usual difficulties of surgical therapy of the thoracic aorta: spinal cord and renal circulatory protection and the choice between distant or in situ revascularization.

[Fibromuscular dysplasia of the arteries of the leg. Apropos of 1 case].

A 40 year old man presented fibromuscular hyperplasia of posterior tibial artery media, a rare lesion, and only exceptionally reported in the calves since a total of 3 cases were found in the literature.

[Gamma-angiography in the diagnosis of akinesia and dyskinesia after myocardial infarction].

A one year prospective double blind trial included all patients with myocardial infarction and clinical, electrocardiographic or radiographic signs of left ventricular aneurysm. All 36 patients underwent ventriculography and radionuclide angiocardiography in the same projections: right anterior oblique, antero-posterior, left anterior oblique and left lateral. The angiographic diagnosis of left ventricular aneurysm was based on the finding of a deformation of the ventricular contour persisting in diastole; 22 patients were classified as having a left ventricular aneurysm and the 14 others had akinesia alone.

[Arterial diseases of the lower limbs in subjects less than 40 years old. Nature and prognosis. Apropos of 41 surgically treated patients].

This study of 41 cases of young patients with obliterative arterial disease treated surgically, with follow-up for 6 and a half years, used the standard classification. Collection of the patients from a department of treatment falsified their true distribution. Atheroma was present in 90% of cases.

[Obstructive calcification of the descending thoracic aorta and suprarenal abdominal aorta. 2 cases].

Two cases of obstructive calcification of the aorta treated by surgery are reported. The disease is extremely rare, notably in the aortic segments involved in these two cases. Its clinical features were similar to those of coarctation.

[Trauma to the axillary artery in shoulder dislocations. Apropos of a case].

The authors have observed one case of injury to the axillary artery complicating anterior dislocation of the shoulder. It produced a marked haematoma of the axilla and ischaemia of the upper limb. At operation, avulsion of a posterior branch was associated with thrombosis of the trunk of the axillary artery.

[Acute renal failure after extracorporeal circulation with aortic counterpulsation in surgically treated patients].

In a series of 604 adults operated on for cardiac surgery with cardiopulmonary bypass (CPB), 21 (3.5%) underwent circulatory assistance by intra-aortic balloon pump (IABP); in 5 of them (24%), acute renal failure (ARF) was observed. ARF occurred in only 26 (4.

[Incidence and prognosis of acute renal failure after cardiac surgery with extracorporeal circulation].

Acute renal failure occurred in 21 patients after 311 cardiac operations with cardiopulmonary bypass in adults (6,75%). It was non oliguric in 20 cases. It is related to per and postoperative hemodynamic depression.

Mitral valve replacement with St Jude Medical prosthesis. Incidence of thromboembolic events in 349 patients.

This study reports incidence of thromboembolic episodes in a series of 349 patients where the St. Jude Medical (SJM) valve was implanted in the mitral position (252 isolated mitral, 91 mitral and aortic, 4 triple valve and 2 mitral and tricuspid valve replacements). The mean follow up was 28 months (range 6 to 57 months) which represents 784 patient-years.

[Heart surgery with extracorporeal circulation in hemodialyzed patients with renal insufficiency].

The authors report 4 valvular replacements under cardiopulmonary bypass in chronic hemodialysis-dependent patients. The peri-operative management was the same in every case. The recent improvements of intensive care medicine amend this protocol.

[Electroencephalographic changes in patients with cardiopathies, subsequently operated under extracorporeal circulation. Significance and outcome. Evaluation of 679 cases].

This study analysed the pre-operative electroencephalographic recordings of 679 patients with heart disease, later undergoing surgery under extra-corporeal circulation. The type and the severity of the abnormalities are listed for each heart disease. These results are compared to those already published in the literature on this subject and are discussed in terms of a number of possible aetiological factors: the age of the patients, data provided by the pre-operative cardio-pulmonary assessment.

[A new case of epidermolysis bullosa dystrophica in a fifteen years old girl operated upon for pulmonary stenosis with a cardiopulmonary bypass (author's transl)].

The authors encountered technical difficulties for the endotracheal intubation but neither laryngeal damage nor serious oropharyngeal lesions occurred after this intubation. The general evolution was favourable without specific trouble (cutaneous or infectious). The risk of intubation was reexamined from the recent literature.