[Multiple pulmonary hydatidosis associated with intracardiac cyst. Apropos of a case]. / Hydatidose pulmonaire multiple associée à un kyste intra-cardiaque. A propos d'un cas.

The authors report the case of a 48-year old woman who had bilateral pulmonary hydatid cysts revealed by haemoptysis and in whom an intracardiac hydatid cyst was discovered in the course of evaluation. The intracardiac cyst probably was the starting point for the migration of emboli to the lungs via the pulmonary arteries.

[Echographic evaluation of the severity of aortic stenosis in cases with associated mitral stenosis]. / Appréciation échographique de la sévérité du rétrécissement aortique en cas de sténose mitrale associée.

The echocardiographic findings of six patients with pure mitral stenosis associated with pure aortic stenosis were compared with the findings from a series of ten cases of pure aortic stenosis without mitral disease. Each patient also underwent haemodynamic studies in order to quantitate the severity of the stenoses. The aortic stenosis was of the same degree of severity in both series (0.71 +/- 0.24 cm2 and 0.73 +/- 0.16 cm2). The systolic separation of the aortic valve was greater than 1 cm in 4 of the 6 cases on echocardiography, corresponding to a false negative of tight aortic stenosis. This appearance corresponded to a doming of the aortic valve on 2D echocardiography. The wall thickness was significantly less in the AS + MS series than in pure SA series (1.13 +/- 0.13 cm compared with 1.52 +/- 0.21 cm; p less than 0.01). The wall was found to be thicker, the tighter the MS. Overall, the diagnostic criteria of the severity of AS on echocardiography (restricted opening of the valve and the severity of ventricular wall hypertrophy) were absent in the association of AS + MS. The absence of myocardial hypertrophy can not be fully explained. It could be related to a decreased filling on the left ventricle and therefore a smaller systolic ejection volume because of the mitral obstruction.

[Differential diagnosis between constrictive pericarditis and cardiac amyloidosis by computerized M-mode echocardiography]. / Diagnostic différentiel entre péricardite constrictive et amylose cardiaque par échocardiographie TM digitalisée.

A diastole is a non specific haemodynamic syndrome which may result from constrictive pericarditis or from a restrictive cardiomyopathy. The aim of this study was to differentiate these two types of condition by analysis of computerised M mode recordings of the left ventricle. Three groups of patients were studied: 5 cases of confirmed cardiac amyloidosis (Am); 5 cases of constrictive pericarditis confirmed surgically (CP) and 10 normal subjects (NL). The study was based on analysis of parameters of ventricular filling and of diastolic thinning of the LV free wall. A significant difference was observed between AM and CP but not between PC and NL. Amyloidosis was characterised by a reduction in the maximum velocity of endocavitary diameter lengthening (AM 0,84 +/- 0,56 cir/sec; PC 3,95 +/- 0,77, p less than 0,01), prolongation of the rapid filling phase (AM 0,42 +/- 0,17 sec; PC 0,16 +/- 0,06 sec, p less than 0,02) and a decrease in maximum velocity of free wall thinning (AM 0,45 +/- 0,23 th/syst/sec; PC 4,79 +/- 2,1, p less than 0,01). The diastolic thickness of the free wall was greater in the amyloidosis group (AM 1,73 +/- 0,61 cm; PC 1,05 +/- 0,21, p less than 0,05) and correlated with the reduction of maximum velocity of free wall thinning. Parameters of global diastolic filling did not distinguish the two conditions. The M mode recordings were therefore digitalised to provide graphs of chamber filling and wall thinning and their derivatives.(ABSTRACT TRUNCATED AT 250 WORDS)

[Thromboembolic and hemorrhagic complications in valve prosthesis patients]. / Accidents thrombo-emboliques et hémorragiques chez les porteurs de prothèses valvulaires.

567 patients with valve prostheses who received anticoagulant therapy were followed up by Professor Ben-Ismail's department at the Ernest-Conseil Hospital, over a period of 2 to 160 months (mean: 53 months). 220 of them had a mitral prosthesis, 183 had an aortic prosthesis and 161 had a double (153) or triple (8) valvular replacement. 66 patients (11.6%) presented a total of 85 thrombo-embolic episodes, i.e. a global incidence of 4.6 emboli per 100 patient-years. Amongst the thrombo-embolic incidents, there were 26 cases of valvular thrombosis, 47 cases of cerebral vascular accident and 11 cases of peripheral vascular emboli. The course was fatal in 18 cases. These accidents mostly occurred in the cases with mitral or polyvalvular replacements. More than one half of these patients were pursuing a regular and effective treatment. 55 patients presented a total of 60 serious haemorrhagic accidents, of which 10 died. This study reveals that the incidence of thrombo-embolic accidents is much higher in patients with mitral or tricuspid valve replacements and when the anticoagulant treatment is irregular or capricious. However, an apparently well managed anticoagulant treatment does not prevent the development of thrombo-embolic accidents and carries a significant risk of haemorrhage.