[Results of surgical treatment of intracardiac total anomalous pulmonary venous return]

Total anomalous pulmonary venous return [TAPVR] has a rather low incidence [1-3%] of all congenital heart disease. Intracardiac TAPVR represent 25-30% of all TAPVR. To report our results and long-term follow-up of surgical management of intracardiac TAPVR. Retrospective study of 7 patients with intra cardiac TAPVR treated surgically between Mai 1992 and July 2007. The surgical technique has been an intra atrial procedure in all cases. We didn't report any early post-operative death. Early postoperative complications were principally pulmonary infections. We report one death at three months of follow-up caused by laryngeal stenosis. Late follow-up was good for all patients. Good result of surgical treatment of intracardiac TAPVR depends on early diagnosis and adequate surgical technique

[Substernal goiter: diagnosis and therapeutic problems]

Sudsternal goiter has particular nosological, diagnostic and therapeutic problems. This study is to study the epidemiologic and clinical particularities of this disease and to emphasize on therapeutic problems essentially surgical management. We report a retrospective study about 25 cases of substernal goiter operated in the Rabta hospital between January 1996 and December 2005. The mean age at operation was 61 years and sex-ratio was 0, 5. Patients were almost symptomatic. Surgery was carried by cervicotomy in all but one ease in which sternotomy was necessary. Histological exam didn't find any mailgnity signs in 95.6%of cases. Substernal goiter surgery is more delicat than the cervical one. Accurate diagnosis leads to good surgical results

[Prosthetic valve endocarditis about 14 cases]

Prosthetic valve endocarditis [PVE] is a serious complication of valve surgery. The aim of this study is to determine the diagnostic and therapeutic management for PVE. It's a retrospective study about 14 cases of PVE operated in the department of cardiovascular surgery of la Rabta hospital between January 1996 and December 2006. In two cases, surgery was performed emergently, in the remnant cases surgery was elective. The coagulase-negative staphylococcus [CNS] is the predominant cause of these PVE. Surgery consisted on seven mitral prosthesis replacements and seven aortic prosthesis replacements. Hospital mortality was 50%. In conclusion attention should he made to prevent endocarditis when possible. In case of PVE, an early diagnosis leads to eavlier application of appropriate therapies and improved outcome

Paralysie phrenique apres chirurgie pediatrique: interet de la plicature diaphragmatique. A propos de deux cas

Phrenic nerve injury is a recognized and severe complication after cardiac surgery. Diaphragmatic paralysis leads to difficulty of weaning the child from the ventilator. Surgical plication is an easy and safe procedure that result in early clinical and physiological improvements