[Management of Constrictive Pericarditis : A study of 43 operated cases]. / Gestion de la péricardite constrictive : à travers l'étude de 43 cas opérés.

Chronic constrictive pericarditis is a rare condition characterized by clinical signs of right heart failure, due to the symphysis of the two pericardial leaflets. Our study focused on a retrospective analysis of 43 CCP surgery observations collected over an 11-year period (2003-2013). The mean age of the patients was 32 years; 65% were male; exercise dyspnea (95%) was the most frequent sign. Two main etiologies were observed: tuberculosis 58% and idiopathic causes 42%. All of our patients received a subtotal pericardectomy per median sternotomy, of which 95% had no cardiopulmonary bypass.

Conservative aortic valve surgery and supra-coronary tube: a case report.

Conservative aortic valve surgery is becoming an effective alternative to aortic valve replacement for patients with aortic insufficiency (AI) and ascending aortic aneurysms. It has become a crucial component of the therapeutic arsenal recommended by the learned societies. This paper reports the case of a patient with severe AI following dilatation of the supra-coronary aorta that underwent aortic plasty associated with a supra-coronary tube in the Cardiovascular Surgery Department 'A' of the Ibn Sina Hospital, Rabat, Morocco.

Left ventricular reverse remodeling after annular-mitral valve repair in end-stage heart failure of dilated cardiomyopathy: A case report.

INTRODUCTION: There are numerous patients with functional mitral regurgitation resulting from dilated cardiomyopathy. The decision between surgical correction and medical management of severe mitral regurgitation in heart failure is often difficult. CASE PRESENTATION: This is a 38-year-old women presented with recurrent symptoms of congestive heart failure. Transthoracic echocardiography revealed a dilated cardiomyopathy with global severe left ventricular dysfunction and severe functional mitral valve regurgitation. She underwent a mitral valve restrictive annuloplasty. The follow-up showed an improved of left ventricle dimensions and function. DISCUSSION: The novel annular repair techniques have an obvious potential to improve long-term competence of Mitral Valve Repair. Therefore, they could be considered as a viable therapeutic option in patients presenting with end-stage cardiomyopathy with severe mitral regurgitation. CONCLUSION: This study demonstrate the reverse left ventricular (LV) remodeling after effective mitral valve repair in advanced dilated cardiomyopathy and its impact on clinical outcome and repair durability.

[Self-inflicted cardiac injury : He "nailed" it]. / Plaie cardiaque auto-infligée : il l'a « cloué ¼.

INTRODUCTION: Nail guns are responsible for an estimated 14% of injuries among residential carpenters, intrathoracic injuries are rare but almost always require operative management with a sternotomy or thoracotomy. CASE REPORT: We report the case of a young carpenter who injured himself by accident during work. The nail perforated the right ventricle. He was operated and postoperative course was uneventful. CONCLUSION: This case highlights the importance of urgent and adequate management of these cases and the need to raise awareness about work safety among carpenters.

Anomalous origin of right coronary artery with interarterial course revealed by effort angina: case report.

Anomalous origin of coronary artery with interarterial course is recognized as a rare congenital heart disease. Its main manifestation is myocardial ischemia related to systolic compression of coronary arteries positioned between the great arteries. We report a case of a middle-aged man admitted in our department for an effort angina during nordic walking. A coronary angiography was performed showing an anomalous coronary artery with a birth defect giving a right common trunk of the circumflex artery and the right coronary artery. We proceeded to a multidetector computed tomography coronary angiography (MDCTCA) to describe this variant of an anomalous coronary arteries which revealed a birth defect in the left anterior sinus of the right coronary and the circumflex artery from a right common trunk passing between the aorta and the trunk of the pulmonary arteries. Magnetic resonance imaging (MRI), exercise stress test and myocardial perfusion scintigraphy were performed in order to objectify an ischemia. Despite the positivity of myocardial scintigraphy, we recommended to our patient to limit exercise with a regular follow-up since he is only symptomatic during a major effort. There are many types of anomalous coronary arteries and the anatomic variant of a right coronary artery that course between the great vessels represents a risk of adverse event and sudden death in young athletes. The choice of therapy is controversial and depends especially on the variant of anomalous coronary artery and the symptoms.

An unusual cause of multiple embolic strokes: cardiac myxoma, about a case.

Cardiac myxomas are the most common primary intracardiac tumors, accounting for 50% of all cardiac neoplasms, with an estimated frequency of 0.5/million/inhabitants/year. Presenting symptoms are related to cerebral or peripheral embolism, and/or intracardiac obstruction. Thus, urgent management of myxoma is mandatory due to embolism's risk. Herein, we report the case of an 82-year-old woman with a myxoma of the left atrium, revealed by a multiple ischemic strokes, to raise awareness of this entity.

Use of neocords in the treatment of mitral valve prolapse: about 6 cases.

INTRODUCTION AND IMPORTANCE: Mitral insufficiency is a common valve disease with a prevalence of 2% and increases after the age of 65. This is the second valvulopathy operated after aortic stenosis. The surgical management of mitral insufficiency has been completely changed in recent years. The mitral valvular replacement with was the gold standard; is currently preceded by conservative surgery thanks to the emergence of reproducible and durable surgical techniques. The aim of our study is to highlight the place of Neogortex in the treatment of mitral valvular prolapse. METHODS: This is a retrospective study that includes 6 adult patients operated on for mitral insufficiency by prolapse of the large valve between October 2016 and June 2018 in the Cardiovascular Surgery Department A of the Ibn Sina Hospital in Rabat, Morocco. RESULTS: We collected 6 patients. The average age is 56 years. The clinical presentation was made of dyspnea in the 6 patients. On the echocardiographic level, all patients had mitral insufficiency due to prolapse of the large mitral valve in 2 patients and a restriction of the play of the valve by shortening of the ropes in 2 patients. The 6 patients were operated. The technique was the installation of a prosthetic ring with neogortex fixation between the free edge and the abutment and a tricuspid plasty type Devega. The operative sequences were simple. CONCLUSION: Mitral valve repair gives satisfactory results in terms of survival and symptomatic improvement with a low operative risk.

Conservative management of spontaneous coronary artery dissection: a case report.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) that mainly occurs in young women with no risk factors and no coronary atherosclerosis. Diagnosis is made by invasive coronary angiography (CA), computed tomography coronary angiography (CTCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The rarity of this entity as well as the complications of invasive treatment make it difficult to choose therapy between conservative management, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). We report a case of a 36-year-old woman presented with non ST elevation myocardial infarction (NSTEMI) related to spontaneous dissection of coronary arteries (left main trunk, left anterior descending artery and left circumflex artery) treated medically with spectacular results at 2 months, controlled by CTCA.

Primary cardiac hydatid cyst presenting with massive pericardial effusion: a case report.

BACKGROUND: Cardiac hydatidosis is a rare manifestation of Echinococcus infection. It represents 0.5 to 2% of hydatic disease (Mustafa et al., Can J Cardiol 22:2, 2006). The most common localization is the myocardium of the left ventricle but can also touch the right ventricle, atrium, pericardium, interventricular septum, and pulmonary artery. Clinical presentation is varied ranging from clinical latency or minor symptoms to cardiogenic shock and sudden death. The present case describes a primary pericardial hydatid cyst, a very exceptional localization of cardiac hydatidosis, which can lead to a delayed diagnosis or to an erroneous treatment that can expose the life of the patient to complications and death if it is not considered. Diagnosis can be established by cardiac imaging and hydatid serology. Therapy management should combine both surgery and medical treatment by albendazole or mebendazole. CASE PRESENTATION: We report a 70-year-old woman from Sale, who was admitted for dyspnea New York Heart Association (NYHA) class IV evolving in a febrile context with signs of right heart failure related to a rupture of a primary pericardial hydatid cyst with pre-tamponade. The diagnosis was confirmed by echocardiography, computed tomography scan (CT scan), and hydatic serology, and the patient was operated and put on albendazole for 3 months with favorable clinical course. CONCLUSIONS: The aims of this article are to consider the diagnosis of cardiac hydatid cysts in the presence of pericardial effusion, especially if there is a prior history of hydatid disease, a contact with animals, or when it occurs in an endemic country, and to be able to make a differential diagnosis with cardiac imaging in order to avoid its complications and to guide the management.