Mid and long-term follow-up of 50 pediatric cardiac Chadians operated in France from 2003 to 2012.

Introduction: cardiac valvular diseases (CVDs) are the major cause of cardiovascular morbidity and mortality globally, with predominance of rheumatic heart disease (RHD) in developing countries. Congenital heart defects (CHD) diagnoses are delayed due to socioeconomic factors. This study aims to evaluate the post-operative surgical outcomes of CHD and valvular RHD.

Valvular heart disease in patients with Parkinson's disease treated with pergolide. Course following treatment modifications.

Unlabelled: Valvular heart abnormalities have been reported in patients with Parkinson's disease (PD) treated with pergolide. However, the incidence and severity of these abnormalities vary from study to study and their course after drug withdrawal has not been systematically assessed.

Objectives: To estimate the frequency and severity of valvular heart abnormality and its possible reversibility after drug withdrawal in a case-control study.

[Results of 17 months' surgical experience in the Cardiological Centre of Phnom-Penh (CCPP). The challenge of sanitation in a developing country].

The authors report the preliminary results of the first 17 months' experience at the Cardiological Centre of Phnom-Penh (CCPP), set up by the initiative of the "Chaîne de l'Espoir" organisation. The CCPP has only two operative theatres, 8 intensive care beds and 32 hospital beds. During the 17 months, 1193 patients under 30 years of age were examined.

[Epidemiology and aetiology of cardiac failure in the Somme].

Unlabelled: The epidemiology of cardiac failure (CF) is little known in France. Our work, integrated in the prospective ETICS (epidemiology and therapeutics of cardiac insufficiency in the Somme) study, was aimed at determining the incidence of hospitalisation, the epidemiological profile, the causes of CF, as well as the frequency of cardiac failure with preserved systolic function in the Somme.

Method: Patients hospitalised for a first attack of CF from January 1 to December 31, 2000 in one of the 11 medical establishments in the Somme were included.

[Value and indications of transesophageal echocardiography before cardioversion of atrial fibrillation].

Transoesophageal echocardiography is essential for the diagnosis of left atrial thrombosis and its precursors (dense spontaneous contrast--reduced auricular emptying velocities) and for the diagnosis of complex aortic atheroma. The sensitivity and specificity of transoesophageal echocardiography for the diagnosis of left atrial thrombus are about 100% and about 90% for that of aortic atheroma. The formal indications for transoesophageal echocardiography before cardioversion are: atrial fibrillation complicated by stroke or a recent systemic embolism: atrial fibrillation complicated by mitral valve disease as the thrombo-embolic risk is major in this context: atrial fibrillation with a high thromboembolic risk: a history of stroke, presence of cardiac failure, diabetes, permanent hypertension, a very dilated left atrium (> or = 50 mm): apparently isolated atrial fibrillation for which long term anticoagulant therapy is hoped to be avoided.

Elevated serum lipoprotein(a) level is an independent marker of severity of thoracic aortic atherosclerosis.

Study Objective: Lipoprotein(a) (Lp[a]) level is a risk factor for ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. However, few data are available concerning the relationship between Lp(a) level and severity of thoracic aortic atherosclerosis. We hypothesized in this transesophageal echocardiography (TEE) study that Lp(a) level is a marker of severity of thoracic aortic atherosclerosis.

Plasma homocysteine and severity of thoracic aortic atherosclerosis.

Study Objectives: Plasma homocysteine level is a risk factor for coronary events, stroke, and peripheral atherosclerotic disease. However, few data are available concerning the relationship between homocysteine level and severity of thoracic aortic atherosclerosis. We hypothesized in this multiplane transesophageal echocardiography (TEE) study that homocysteine level is a marker of the presence and severity of thoracic aortic atherosclerosis.

Relation between low-density lipoprotein cholesterol and thoracic aortic atherosclerosis.

This prospective study, which included 320 patients, showed that total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol/high-density lipoprotein cholesterol, and triglycerides correlate with thoracic aortic atherosclerosis. Low-density lipoprotein cholesterol is identified as an independent predictor of thoracic aortic plaque related to the severity of thoracic aortic atherosclerosis.

[Diagnostic value of echocardiography and thoracic spiral CT angiography in the diagnosis of acute pulmonary embolism].

The objective of this study was to define the limits of echocardiography and to evaluate thoracic spiral CT angiography (TSCTA) for the diagnosis of pulmonary embolism (PE). One hundred twelve consecutive patients, hospitalised for suspected PE, were included in this prospective study. All were investigated by pulmonary ventilation-perfusion scintigraphy (Sc) and 50 had a high probability of PE on this examination.

Correlation of thoracic aortic atherosclerotic plaque detected by multiplane transesophageal echocardiography and cardiovascular risk factors.

This study of 416 patients identified age, male gender, smoking, diabetes, hypertension, and hypercholesterolemia as independent predictors of thoracic aortic atherosclerotic plaque. Age, smoking, hypercholesterolemia, hypertension, and diabetes were predictors of the severity and extent of thoracic aortic atherosclerosis.

[Transesophageal echocardiography before electric cardioversion for supraventricular arrhythmia].

Objectives: The aim of this prospective study was to assess the risks of electrical shock cardio-version in the treatment of supraventricular rhythm disorders when administered under effective-dose but short duration anticoagulation in patients with no intracavitary thrombus detectable by transesophageal echocardiography.

Patients And Methods: One hundred nineteen patients, mean age 66 years, with permanent arrhythmia due to atrial fibrillation (n = 102), atrial flutter (n = 16) or atrial tachycardia (n = 1) and taking no long-term anticoagulant therapy were treated by electrical shock cardioversion. The patients were given heparin at an effective dose 72 hours prior to cardioversion.

Comparative value of Doppler echocardiography and cardiac catheterization in the decision to operate on patients with aortic stenosis.

With the use of Doppler echocardiography, severity of valvular stenosis, etiology and type of valve lesions, and left ventricular function can be assessed accurately in patients with aortic stenosis. The purpose of this study was to compare the value of noninvasive clinical and Doppler echocardiographic findings, with cardiac catheterization, in the management decision-making for patients with aortic stenosis. One hundred and seventy consecutive patients with aortic stenosis who underwent cardiac catheterization and Doppler echocardiography were prospectively studied.

Paradoxical embolism following acute pulmonary embolism: diagnosis and outcome.

We report on ten cases of paradoxical embolism that occurred following pulmonary embolism and emphasize the echocardiographic contribution. Two patients had a thrombus trapped in a foramen ovale. An embolectomy was performed on one of those patients and the outcome was post-operative death.

[Malignant cardiac lymphoma. Diagnosis by echocardiography].

The authors report a case of cardiac malignant non-Hodgkin lymphoma. The initial clinical presentation suggested recurrent angina in a patient who had undergone angioplasty of the left anterior descending artery two years previously. Echocardiography showed severe left ventricular dysfunction with apical and septal akinesia and also allowed visualisation of two oval masses in the right ventricle without dilatation of the right heart chambers.

Use of transesophageal echocardiography to predict significant coronary artery disease in aortic stenosis.

Study Objectives: This study was conducted to examine if the use of multiplane transesophageal echocardiography (TEE) could predict the absence or the presence of significant coronary artery disease (CAD) in patients with aortic stenosis.

Design: Prospective study.

Setting: University hospital.

Fibrinogen is an independent marker for thoracic aortic atherosclerosis.

The fibrinogen level is an independent risk factor for coronary events and stroke, but no detailed data are available concerning fibrinogen and atherosclerotic disease of the thoracic aorta. This prospective study using multiplane transesophageal echocardiography examined the relation between atherosclerotic thoracic aortic plaque and fibrinogen level. One-hundred forty-eight patients (65 +/- 11 years) with valvular heart disease underwent multiplane transesophageal echocardiography and coronary angiography.

Multiplane transoesophageal echocardiographic absence of thoracic aortic plaque is a powerful predictor for absence of significant coronary artery disease in valvular patients, even in the elderly. A large prospective study.

Aims: This study was conducted to examine whether detection of atherosclerotic aortic plaque by multiplane transoesophageal echocardiography could predict the absence or presence of significant coronary artery disease in young and elderly valvular patients.

Methods And Results: Clinical and angiographic features and transoesophageal echocardiography findings were prospectively analysed in 278 consecutive valvular patients. In 93 patients with significant coronary artery disease, 85 had thoracic aortic plaque on transoesophageal echocardiography studies.

Multiplane transoesophageal echocardiographic detection of thoracic aortic plaque is a marker for coronary artery disease in women.

Objective: This study was conducted to examine if the multiplane transoesophageal echocardiographic detection of atherosclerotic plaque in the thoracic aorta could predict the absence or the presence and the severity of significant coronary artery disease in women. Its association with coronary disease is attractive and may have great influence on foregoing routine preoperative cardiac catheterization in patients with valvular heart disease but no data are available in women.

Methods: Clinical and angiographic features and transoesophageal echocardiographic findings were prospectively analysed in 111 women.

Familial incidence of late ventricular potentials and electrocardiographic abnormalities in arrhythmogenic right ventricular dysplasia.

Familial forms of arrhythmogenic right ventricular dysplasia (ARVD) have been described. Signal-averaged electrocardiograms (SAECGs) and standard electrocardiograms have been used to detect ARVD. The purpose of this prospective study, for a given family member, was to evaluate the risk of having ARVD or only belonging to an affected family.

[Transesophageal echographic demonstration of ulcerated atheromatous plaques of the thoracic aorta responsible for cholesterol emboli].

The authors present of case of a 61-year-old man suffering from cholesterol emboli, in whom transoesophageal echocardiography revealed complex atheromatous lesions of the thoracic aorta. There is growing emphasis, at the present time, on the concept of triggering factors with the multiplication of endovascular radiological investigations, the more widespread availability of cardiac surgery and the use of anticoagulants and fibrinolytics. The prognosis is poor, treatment is only palliative and preventive measures are therefore essential.

[Non-bacterial thrombosing endocarditis. Apropos of 2 cases].

The diagnosis of nonbacterial thrombosing endocarditis or marasmic endocarditis must be considered in patients presenting with a combination of cancer and systemic embolism. The pathophysiological mechanisms of this entity are unclear and purely hypothetical. However, hypercoagulability appears to play an essential role in the pathogenesis of this endocarditis, which could be the cardiac expression of a coagulopathy involving the entire vascular system.

[Chronic constrictive pericarditis apropos of 3 cases disclosed by refractory cardiac failure].

Chronic constrictive pericarditis is a difficult diagnosis and may present atypically. The authors report three clinical cases and review the diagnostic strategy of constrictive pericarditis. In these three patients, the diagnosis was finally made after one or more years of symptomatic disease and after several diagnostic work ups and ineffective treatments.