[Anomalous origin of coronary arteries from the aorta]. / Naissance anormale des arteres coronaires a partir de l'aorte.

The authors report the series of 9 patients (6 male and 3 female, aged from 32 to 64 years) with anomalous origin of coronary arteries from the aorta discovered at coronary arteriography. In 4 cases, the circumflex, artery aries from the right coronary sinus and in 5 cases, the right coronary artery arises from the left coronary sinus. Severe atherosclerotic coronary disease was discovered in 5 cases. We conclude that aberrant coronary origin from the aorta is a rare congenital anomalous discovered usually at coronary angiography and certain patients with this anomalous can develop severe myocardial ischemia especially when a vessel runs between the aorta and pulmonary artery.

[Coronary arteriography in severe aortic valve disease]. / La coronarographie dans les valvulopathies aortiques sévères.

Three hundred and twelve patients with severe aortic valve disease underwent a pre-operative haemodynamic study including coronary arteriography either as routine (age more than 50 years) or because of chest pains, previous myocardial infarction or for patients with risk factors of coronary atherosclerosis. Significant coronary artery disease was present in 9% of all cases. Coronary artery disease was more frequent in patients with angina and in patients with previous myocardial infarction but none of these factors was specific. We conclude that except young patients < 40 years old, with no chest pain and no coronary risk factors, coronary arteriography is recommended in patients with severe aortic valve disease before aortic valve replacement.

[Twenty years result of a corrective surgery of tetralogy of Fallot in a 50 years old woman]. / Resultat a 20 ans d'une reparation complete d'une tetralogie de Fallot chez une femme de 50 ans.

The authors report the case of a woman operated at a 50 years of age for a tetralogy of Fallot with a good late result.

[Multiple coronary artery-left ventricular fistulae. A case report]. / Fistules coronaires multiples dans la cavite ventriculaire gauche. A propos d'un cas.

The authors report the case of a patient with multiple coronary artery-left ventricular fistulae discovered in coronary angiography for exertional angina.

[Percutaneous mitral commissurotomy and left ventricular function in severe mitral stenosis]. / Commissurotomie mitrale percutanée et fonction ventriculaire gauche dans le retrecissement mitral serré.

The purpose of this study was to determine the immediate effect of percutaneous mitral commissurotomy (PMC) on left ventricular (LV) performance. We studied 30 patients with severe mitral stenosis undergoing successful PMC by cardiac catheterization and angiography before and 5 minutes after PMC. All patients were in sinus rhythm and no patient had hypertension or clinical coronary artery disease. We conclude that the left ventricular end-diastolic volume and the stroke volume increased significantly immediately after PMC because of and increase in LV filling after relieving the mitral mechanical obstruction.

[Congenital aortic valve stenosis with left ventricular dysfunction: effect of percutaneous valvuloplasty]. / Retrecissement valvulaire aortique congenital avec dysfonction ventriculaire gauche: effet de la dilatation percutanée.

Two girls aged 6 and 15 years with severe congenital valvular aortic stenosis and left ventricular (LV) dysfunction underwent successful balloon aortic valvotomy (BAV). Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement (cardiothoracic ratio 0.7 and 0.65) was evident in the chest roentgenograms. Immediately after BAV, the aortic valve peak-to-peak gradients decreased from 60 to 8 mmHg and 120 to 30 mmHg respectively, the LV end-diastolic pressures decreased from 47 to 13 mmHg and 40 to 15 mmHg, the LV ejection fractions improved from 40 to 65% in the second girl. On follow-up (30 and 36 ms respectively), both patients were asymptomatic with normalization of LV function and without a change in the residual gradient a cross the aortic valve.

[The immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries]. / L'effet immédiat de l'atrioseptostomie de Rashkind sur la saturation systémique dans la transposition des gros vaisseaux.

The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.5 +/- 1.1 mm. The right ventricular saturation increased from 37 +/- 17% to 67 +/- 13% (p < 0.001). There was no correlation between the atrial septal defect diameter and the increase of systemic saturation after BAS.

[Coronary-pulmonary arterial fistula in the adult: report of 6 cases and review of the literature]. / Les fistules coronaro-pulmonaires de l'adulte: a propos de 6 observations et revue de la littérature.

Six new patients and 33 previously reported with coronary-to-pulmonary artery fistula were reviewed. The mean age at the time of diagnosis was 51 years. A male predominance was found (65%). Angina was the most common symptom. The artery mostly involved was the left anterior descending coronary artery and the fistula drained more often to the main pulmonary artery. The left-to-right shunt is small in the majority of patients and the associated significant coronary artery disease was detected in 18% of cases. Good results of surgical closure of the fistula are usually obtained. An alternative to surgical treatment is percutaneous transcatheter embolization of coronary artery fistulas.

[Cardiac retrograde arterial catheterization in children under 2 years of age. Indications, techniques and complications]. / Le catheterisme cardiaque par voie arterielle retrograde chez le nourrisson de moins de 2 ans. Indications, techniques et complications.

Thirty children (15 males and 15 females) under 2 years of age (mean age 14 +/- 6 months, range 1 to 24 months, mean weight was 8.3 +/- 2.5 kg) underwent diagnostic cardiac percutaneous femoral arterial and venous catheterization for congenital heart disease. The anticoagulation with heparin was not given in any patient. Appropriate arterial sheath varying from 4F to 5F were used for catheterization. The mean duration of the exploration was 38 +/- 16 mn. The mean duration of the left heart exploration was 9.5 +/- 2.5 mn. There were no hemorrhagic or ischemic complications in this series.

[Stratification of cardiac risk in unstable angina: value of troponin measurements]. / Stratification du risque cardiaque dans l'angor instable intérêt du dosage de la troponine.

Recent studies have identified patients with unstable angina and increased troponin I or T as a high risk population gaining benefit from adjunctive treatment with glycoprotein IIb/IIIa receptor antagonists and early reperfusion by coronary interventions.

[Immediate and mid-term results of balloon valvuloplasty in congenital aortic stenosis. Ten case reports]. / Résultats immédiats et à moyen terme de la dilatation aortique par ballonnet dans le rétrécissement aortique valvulaire congénital. A propos de 10 observations.

From 1987 to 2000, 10 patients aged 0.5 to 20 years with congenital valvular aortic stenosis underwent percutaneous balloon aortic valvuloplasty. In one patient, balloon valvuloplasty was unsuccessful, this patient had acute artery thrombosis requiring surgical intervention. Hemodynamically successful dilatation was achieved in 9 patients. The peak systolic pressure gradient was reduced from 76 +/- 35 to 32 +/- 16 mmHg (p < 0.001). Aortic valve regurgitation on angiography appeared or increased in 2 patients (up to grade 2 in the 2 patients). There was no deaths during the procedure. Follow-up was available in 7 patients One patient died during the follow up period. Restenose was found in only one patient 5 years after valvuloplasty and the efficacy balloon aortic valvuloplasty continued significantly in 5 patients (mean follow-up 35 +/- 18 months) with a residual aortic valvular gradient of 34 +/- 15 mmHg.