Quantification of aortic valve area with ECG-gated multi-detector spiral computed tomography in patients with aortic stenosis and comparison of two image analysis methods.

Thirty-three consecutive patients with aortic stenosis underwent a 16-row spiral CT scan. Aortic valve planimetry was performed using two methods: double-oblique reformation (DO) and 2D-curved multiplanar reconstruction using advanced vessel analysis software (VA). The mean aortic valve area determined by transthoracic echocardiography was 0.

[Dissection of the aorta complicated by aorto-pulmonary fistula].

The authors report the case of chronic dissection of the aorta presenting with congestive cardiac failure. The diagnosis was made for the first time by transoesophageal echocardiography which showed both the dissection of the aorta and its fistulalisation into the pulmonary artery. Aortography confirmed the diagnosis.

Coronary-to-bronchial artery communication: report of two patients successfully treated by embolization.

We report two cases of coronary-to-bronchial artery communication responsible for coronary steal. In both cases the anastomosis originated from the proximal circumflex artery and developed because of bronchiectasis. In both cases closure of the anastomosis was achieved successfully by embolization.

[Drug therapy of ventricular tachycardia].

Despite the introduction of new therapeutic techniques such as radiofrequency ablation and the implantable defibrillator, the classical opposition of monomorphic ventricular tachycardia in apparently normal hearts and that arising from documented cardiac disease remains useful. In the first case, treatment is only symptomatic whereas, in the second, lethal progression to sudden death must be prevented. Generally speaking, in chronic post-infarct situations, betablockers are underused although they have been shown beyond doubt to reduce cardiovascular mortality.

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.

Effect of the direct nitric oxide donors linsidomine and molsidomine on angiographic restenosis after coronary balloon angioplasty. The ACCORD Study. Angioplastic Coronaire Corvasal Diltiazem.

Background: Nitric oxide (NO) donors, in addition to their vasodilator effect, decrease platelet aggregation and inhibit vascular smooth muscle cell proliferation. These actions could have beneficial effects on restenosis after coronary balloon angioplasty.

Methods And Results: In a prospective multicenter, randomized trial, 700 stable coronary patients scheduled for angioplasty received direct NO donors (infusion of linsidomine followed by oral molsidomine) or oral diltiazem.

[Angiography of coronary arteries by nuclear magnetic resonance].

Objectives: Evaluate magnetic resonance imaging of the coronary arteries.

Methods: The study was conducted in 18 healthy volunteers (mean age 26 years, range 22-32). A superconducting magnet operating at 1.

[Pulmonary embolism and thrombus trapped in a patent foramen ovale. Cure by heparin therapy].

The authors report the case of a 84-year old patient admitted to hospital for pulmonary embolism. The diagnosis was made by ventilation and perfusion pulmonary scintigraphy. Transthoracic echocardiography was performed routinely and showed a thrombus wedged across a patient foramen ovale, confirmed at transoesophageal echocardiography.

[Delayed angioplasty of residual coronary stenosis after thrombolysis of myocardial infarction: prognostic factors of left ventricular function].

The aim of this study was to analyse the prognostic factors of long term left ventricular function after successful delayed angioplasty of residual coronary stenosis after thrombolysis for myocardial infarction. The left ventricular function of fifty patients, aged 54 +/- 10 years, who underwent intravenous thrombolysis 2.9 +/- 1.

[Coronary angioplasty and electric alternans of the ST segment].

Alternans of the ST segment is a rare phenomenon during coronary angioplasty. The authors report three cases. It is usually observed in left anterior descending arteries without collateral circulation.

[Left ventricular function and secondary angioplasty after anterior infarction in simple coronary vessel disease].

Arterial patency is a good prognostic factor in terms of survival and left ventricular function after myocardial infarction. The aim of this prospective study was to evaluate the benefit of secondary angioplasty of the infarct-related artery in single vessel, left anterior descending disease, on regional and global left ventricular function. Initial coronary angiography was undertaken at the 7th +/- 2 days after the onset of infarction.

[Spontaneous and isolated dissection of the coronary arteries, apropos of 8 cases with favourable outcome].

Spontaneous coronary artery dissection is rare compared with the high incidence of atheromatous coronary artery disease. Eight new clinical and angiographic cases diagnosed between 1984 and 1990 are reported. The patients were 6 men and 2 women with an average age of 44.

[Delayed angioplasty for residual stenosis following thrombolyzed infarction: arterial permeability and left ventricular function after 6 months].

At medium term, the results of delayed angioplasty (DA) following intravenous thrombolysis (IVT) in terms of arterial permeability but particularly of left ventricular function (LVF) is still poorly understood and is the subject of this prospective study. Over 18 months, 76 patients underwent DA for the residual stenosis on day 8 +/- 5 with complete and partial success rates of 88.2% and 11.

[Free-wall rupture during the acute phase of myocardial infarction. Apropos of 2 cases surgically treated with success].

The authors report two cases of cardiac rupture during acute myocardial infarction successfully treated surgically. In the first case, rupture occurred 7 days after hospital admission for anteroseptal myocardial infarction. The patient developed sudden cardiogenic shock with signs of venous hypertension without left ventricular failure.

[Postoperative iatrogenic left coronaroventricular fistula. Demonstration by color two-dimensional Doppler].

The authors report the case of an asymptomatic 67 year old patient, in whom, 6 years after aortic valve replacement, Doppler color flow mapping showed the presence of a coronary artery--left ventricular fistula. The normality of preoperative coronary angiography suggested that this fistula was created during peroperative left ventricular purging: the implantation of a needle through the right ventricle and interventricular septum. A iatrogenic lesion of a septal branch probably caused the communication between the left anterior descending artery and the left ventricle.

[Myocardial infarction caused by closed thoracic injury: pathogenic and angiocoronarographic aspects. Apropos of 4 cases and review of the literature].

The 4 cases of transmural myocardial infarction by closed chest trauma reported by the authors bring the number of angiographically documented and published cases to 52. This group serves as a basis for a detailed review of coronary and myocardial anatomical lesions and their pathophysiological mechanism is suggested. Long controversial, direct traumatic coronary damage has been confirmed by coronary angiography and is the essential mechanism of transmural infarctions.

[EPIM. Survey of myocardial infarction in Picardie].

The aim of this prospective study carried out in picardy (Aisne, Oise and Somme Departments) between October 1st 1985 and September 30th 1986, was to determine the incidence and outcome of recent myocardial infarction (less than 1 month) hospitalised in the region, to assess the time delay before hospital admission, the mode of management, treatment in the acute phase and at discharge, and the attitudes to exercise stress testing and coronary angiography. All public and private hospitals of the 3 departments who admitted patients with acute myocardial infarction accepted to fill out the questionnaire. A total of 1260 infarcts in patients with an average age of 66.

[Doppler echocardiographic study of hemodynamic changes of double stimulation mode and atrial detection in patients with dual chamber pacemaker. Value of hysteresis of the atrioventricular delay].

This Doppler echocardiographic study of patients with a dual chamber pacemaker was undertaken to assess the changes in mitral and aortic flow induced by passing from the double stimulation to the atrial detection mode. Thirteen patients totally dependent on ventricular pacing were examined and mitral and aortic blood flow recorded by pulsed wave Doppler. The chronology of left atrial contraction as assessed by the Doppler mitral A wave was measured with respect to the ventricular stimulation.

[Iatrogenic coronary stenosis after angioplasty].

Restenosis is the usual mechanism of recurrent myocardial ischaemia in the months following successful percutaneous transluminal coronary angioplasty (PTCA). Control coronary arteriography may occasionally show another cause: the constitution of a new stenosis near the dilated segment or in the left main coronary stem after angioplasty in a branch of this artery. The authors report 4 cases of patients who developed new coronary stenoses within a few weeks of PTCA, interpreted as traumatic complications of the initial procedure due to a lesion of the intima with a secondary fibrotic reaction and luminal narrowing.

[Thrombolysis and intravenous beta-blockaders in the acute phase of myocardial infarction].

Since proof exists of the individual efficacy of thrombolytics and intravenous beta-blockers in the acute phase of myocardial infarction (MI), it seemed to us logical and interesting to combine them. The aim of this retrospective study was to evaluate the safety and potential benefit of this drug combination for left ventricular function. We compared 40 patients (group I) of mean age 53.

[Massive poisoning by naftidrofuryl with severe disorders of rhythm and conduction].

The authors report the case of a 35-year old woman with normal heart who voluntarily poisoned herself by swallowing 6 grams of naftidrofuryl. She developed disorders of atrioventricular conduction and a ventricular-like arrhythmia with collapse which resolves after mechanical ventilation. Data from the literature indicate that naftidrofuryl possesses class I electrophysiological properties which must not be ignored and which account for the cardiac effects observed in this particular case and in cases of parenteral overdosage already reported.

[Auricular flutter preceding by several years the discovery of Steinert's disease. 3 cases].

The large frequency of arrhythmias and conduction disorders in the course of Steinert's myotonic dystrophy is well known; most of the time, the muscle disease is already known when the heart disease is discovered. The authors report three cases of young subjects (2, 31 and 35 years) in whom an atrial flutter without obvious etiology preceded by several years (14, 2.5 and 2 years) the diagnosis of muscular disease.

[Infarction with angiographically normal coronary vessels. (20 cases)].

Over 8 years, 20 cases of infarction with normal coronary angiography have been reported, representing 0.9% of the patients who underwent a coronary angiography after a myocardial infarction. The main characteristics of these patients are compared with those taken from the literature.