[Right atrial flutter or tachycardia?]. / Trzepotanie czy czestoskurcz prawoprzedsionkowy?

We present a case of 67-year-old patient with recurrent persistent atrial macroreentry after surgical removal of left atrial myxoma. The macroreentry was cavo-tricuspid isthmus dependent with a pseudo-atypical atrial flutter morphology and variable cycle lengths between 290 and 340 ms.

[Infective endocarditis in a patient with multiple myeloma. A case report]. / Infekcyjne zapalenie wsierdzia w przebiegu szpiczaka mnogiego -- trudnosci diagnostyczno-terapeutyczne. Opis przypadku.

A case of a 59 year old male with infective endocarditis is presented. Antibiotic therapy seemed effective, however, inflammation laboratory parameters increased two weeks after clinical improvement and body temperature normalisation. Subsequent extensive laboratory investigations revealed multiple myeloma. The patient underwent successful aortic valve replacement and received pharmacological therapy for multiple myeloma. Difficulties in diagnosing and treatment of patients with infective endocarditis who have other concomitant diseases, are discussed.

Long-term results of Fontan procedure in 43 patients.

BACKGROUND: The Fontan operation eliminates the systemic hypoxemia and ventricular volume overload characteristic of prior forms of palliation, however, late outcome of systemic venous and right atrial hypertension were unknown when the procedure was initially proposed. AIM: We assessed the late mortality and the present clinical status atresia and other forms of univentricular heart who had modified Fontan procedure performed between 1981 and 1998, and survived early perioperative period. METHODS: We reviewed the clinical records of 43 early survivors of the modified Fontan procedure. Patients' outcome and late mortality rates were determined and present clinical status was ascertained in all patients. RESULTS: Late overall survival was 76.8%. Reoperation and late complication rates steadily declined according to surgery modification and homografts exclusion. Late mortality was increased only in patients with important atrio-ventricular valve dysfunction and valve replacement. Ninety seven percent of surviving patients are currently in New York Heart Association class I or II. CONCLUSIONS: Our 20-year experience with modified Fontan procedure for tricuspid atresia and various forms of univentricular heart has resulted in improved outcome with most survivors now leading lives of good quality into adulthood.

[Plethysmographic assessment of pulse wave may be helpful in the detection of prosthetic valve dysfunction--a case report]. / Krzywa pletyzmograficzna moze byc pomocna w rozpoznawaniu dysfunkcji wszczepionej zastawki.

A case of a 63-year-old female with prosthetic mitral and aortic valves is described. The long-term post-operative period was complicated by infective endocarditis, persistent atrial fibrillation requiring pacemaker implantation and total a-v node ablation as well as ischaemic stroke which occurred one year before present hospitalisation. This time the patient was admitted to the hospital due to progressive heart failure. Transesophageal echocardiography showed a cyclic intermittent opening of both prosthetic valves full opening was present during every second cardiac cycle. The same phenomenon was documented using plethysmographic recording of a pulse wave from a finger. The patient underwent prosthetic valve replacement. Intraoperatively, a fibrous tissue ingrowth was detected.