Mycotic aneurysm of both internal iliac arteries due to Candida albicans.

We report the case of a 21-year-old man, with a Candida-related endocarditis causing multiple emboli and bilateral false aneurysms of the internal iliac arteries. As the distal runoff vasculatures of both internal iliac arteries were occluded, these arteries required ligation. Although there were few consequences with the procedure, multiple emboli and recurrence of endocarditis after cardiac surgery led to the patient's death.

Atrial and vascular oxidative stress in patients with heart failure.

Heart failure is characterized by a great number of metabolic and histological defects, however, previous studies did not provide strong evidence of a correlation between the antioxidant status of myocardial tissue itself and cardiac function. The goal of our study was to assess, in patients with heart failure consecutive to dilated cardiomyopathy (DCM), alterations in norepinephrine (NE), lipid peroxidation (malonedialdehyde: MDA) and iron levels in different parts of the myocardium and aorta, in relation to functional parameters. Biopsied heart samples were obtained from 12 DCM patients and from 4 brain-dead organ donors (Controls).

[Cardiac papillary fibroelastoma, a rare valvular source of cerebral embolism: report of two cases].

Cardiac papillary fibroelastomas are very rare and benign tumors, usually involving heart valves. They are sometimes asymptomatic. However, they become serious illnesses when associated with clinical events, as systemic embolism.

Regional heterogeneity of decreased myocardial norepinephrine and increased lipid peroxidation levels in patients with end-stage failing heart secondary to dilated or ischemic cardiomyopathy.

Background: Regional alterations in norepinephrine (NE) and lipid peroxidation in the myocardium of patients with heart failure is not well known. This study was designed to investigate regional myocardial NE levels and lipid peroxidation index and their relationships with the functional parameters in two pathologic conditions: dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM).

Methods: Biopsied heart samples were obtained from 13 DCM and 10 ICM patients (orthotopic cardiac transplantation).

Direct, pleiotropic protective effect of cyclosporin A against simulated ischemia-induced injury in isolated cardiomyocytes.

Cyclosporin A is an immunosuppressor that prolongs graft survival but its use is limited by cardiotoxicity. The effects of cyclosporin A on several functional and biological characteristics were thus evaluated in rat cardiomyocytes in normal conditions and in a substrate-free, hypoxia-reoxygenation model of ischemia-reperfusion. Cyclosporin A (100 and 1000 ng/ml) did not induce cardiocytotoxicity in basal conditions.

The influence of extracorporeal circulation on the susceptibility of erythrocytes to oxidative stress.

Extracorporeal circulation (ECC), a necessary and integral part of cardiac surgery, can itself induce deleterious effects in patients. The pathogenesis of diffuse damage of several tissues is multifactorial. It is believed that circulation of blood extracorporeally through plastic tubes causes a whole body inflammatory response and a severe shear stress to blood cells.

[Adrenal metastasis from follicular thyroid carcinoma with intra-cardiac thrombus].

The authors report the case of a 57-year-old patient operated for adrenal metastasis from follicular thyroid carcinoma with intracardiac thrombus, who subsequently developed disseminated metastases leading to death 9 months after the operation. Adrenal metastases of thyroid carcinomas are rare and can be treated surgically when they are isolated. These metastases may appear many years after initial thyroid surgery requiring regular surveillance, especially by serum thyroglobulin assay in the case of well differentiated carcinoma.

Physiological and metabolic actions of mycophenolate mofetil on cultured newborn rat cardiomyocytes in normoxia and in simulated ischemia.

Mycophenolate mofetil (MMF) is a new immunosuppressive drug used to reduce acute rejection after heart transplantation. As with other immunosuppressive drugs, MMF therapy is associated with several adverse effects. However, the direct effects of MMF on myocardial tissue has not been yet evaluated.

Combined treatment of aortic type A dissection: ascending aorta repair and placement of a stent in the descending aorta.

Background: The established treatment modality of acute Stanford type A dissection includes repairing the ascending aorta and a variable part of the aortic arch and leaving the descending aorta untreated. We report a simultaneous approach of open repair of the ascending aorta with the transluminal placement of a stent in the descending aorta to minimize the consequences of an untreated descending aorta.

Methods: Two cases of type A aortic dissection are described, one case with the entry port in the descending aorta and the second case with the entry port in the aortic arch.

Clinical experience and Doppler echocardiographic assessment of the first one hundred ATS AP (advanced performance) prosthetic valve in the aortic position.

Background And Aim Of The Study: The ATS Medical mechanical bileaflet valve is composed of pyrolitic carbon and is available in two forms: Standard and Advanced Performance. The study aim was to evaluate the clinical results and define, in blinded manner, the Doppler echocardiographic characteristics of normally functioning ATS AP prostheses with respect to their size.

Methods: One hundred patients (63 men, 37 women; mean age 63.

Fatal cardiovascular complications in a patient with Ehlers-Danlos syndrome type IV and dextrocardia.

A report is presented of a 31 year female patient with Ehlers-Danlos syndrome type IV who presented a bilateral renal artery dissection and a hematoma of the ascending aorta simultaneously. She had had an uneventful delivery six months before. We also discovered a situs solitus with dextrocardia in this patient.

Endovascular treatment as first choice in chronic intestinal ischemia.

The purpose of this study was to define the place of endovascular treatment in chronic intestinal ischemia (CII). We report here a series of 19 consecutive patients treated with percutaneous angioplasty of the intestinal arteries. We excluded patients with acute ischemia, from the study.

Chronic mesenteric ischemia: imaging and percutaneous treatment.

Chronic mesenteric ischemia (CMI) is rare and is often diagnosed late. Fatal malabsorption-related complications or acute ischemic events occur in the absence of treatment. Diagnosis depends on careful acquisition of a medical history and elimination of other conditions.

A spontaneous rupture of the external iliac vein revealed as a phlegmasia cerulea dolens with acute lower limb ischemia: Case report and review of the literature.

We reported a case in a previously healthy 45-year-old woman of spontaneous rupture of the left external iliac vein, which was revealed as a phlegmasia cerulea dolens with acute lower limb ischemia. A tear on the anterior surface of the vein was discovered during an emergency laparotomy, and the rent was repaired successfully. Twenty-four hours later, the leg swelling increased, and at the reexploration, the common iliac vein was found to be occluded by an organized thrombus as the result of a well-endothelialized membranous band (Cockett or May-Turner syndrome).

[Four years followup of complicated Cockett syndrome treated by iliac vein endoprosthesis].

The purpose of this study was to check the long-term patency of the left common iliac vein endoprosthesis in Cockett syndrome and to confirm this appropriate etiological treatment in complicated cases. Three patients had respectively a pulmonary embolism, left common iliac vein occlusion with protein S deficiency, and venous claudication (Paget-von Schroetter syndrome) as complications of the Cockett syndrome. Treatment with endoprosthesis was performed.

[Cardiogenic shock complicating extensive infarction with ventricular septal defect. Circulatory assistance and heart transplantation].

A 47 year old man had a massive anterior myocardial infarction with cardiogenic shock with a left parasternal murmur. Coronary angiography showed occlusion of the left anterior descending artery for which angioplasty resulted in failure. There was antero-lateral-apical akinesia and a ventricular septal defect (VSD) with a left-right shunt (Qp/Qs = 1.

Fracture-embolization of duromedics valve prosthesis and microscopic uncommon lesions.

We report a sudden leaflet fracture of a Duromedics mitral valve 6 years after implantation. The patient had cardiogenic shock and complained of asthenia, orthopnea, and tachycardia. Transesophageal echocardiography showed the lack of one leaflet of the prosthesis and regurgitation.

Fracture embolization of a Tekna mitral prosthesis: case report.

The modified Duromedics-Tekna bileaflet pyrolitic carbon mechanical prosthesis was reintroduced by Baxter in 1990. This report details the first case of sudden leaflet fracture of a Tekna mitral valve five years after implantation, which was managed successfully by replacement with a St. Jude Medical mechanical prosthesis.

Cardiac pheochromocytoma.

Primary pheochromocytomas of the heart are extremely uncommon. In this report, we present the case of a patient with primary cardiac pheochromocytoma arising from the interatrial septum. Metaiodobenzylguanidine-scintigraphy was negative and diagnosis was confirmed by a positive octreotide scintiscan.

Perceived health status in patients over 70 before and after open-heart operations.

Aim: to evaluate improvement and predictors of improvement in patients' perceived health status after cardiac surgery in older patients.

Methods: three hundred and seventy-seven patients from three different departments of cardiac surgery completed the Nottingham Health Profile questionnaire before and 1 and 2 years after open-heart surgery. We analysed pre- and postoperative data and pre- and postoperative Nottingham Health Profile scores.

[Long-term hemodynamic function of the transplanted heart].

The aim of this study was to identify the long-term haemodynamic changes of the transplanted heart. Between 1987 and 1997, 136 patients required cardiac transplantation at Dijon hospital. During follow-up, 76 patients aged 51.

Surgical outcome of traumatic rupture of the thoracic aorta.

Background: The aim of this study was to point out the results of different techniques of spinal cord protection in surgically-treated patients with traumatic thoracic aorta (TTA).

Methods: A multicentric study was carried out involving 182 patients with TTA. Four patients died before surgery.