[Results of surgery in cyanogen congenital heart disease]

This study concerns 54 patients with cyanogen congenital heart disease operated by "Terre des Hommes" between 1976 and 1986. These cardiopathies are divided as following: tetralogy of Fallot [37 cases], trilogy of Fallot [5 cases], double outlet of ventriculus dexter cordis [5 cases], transposition of great vessels [2 cases], tricuspid atresia [2 cases], complex cardiopathy [2 cases], single ventricle [1 case]. The surgical treatment has been only palliative in 10 cases, curative after a palliative anastomosis in 3 cases, and curative directly in 4l cases. 13 patients have undergone a palliative intervention of Blalock-Taussig in 10 cases, Blalock-Hanlon with banding of pulmonary artery in 1 case and Brock in 2 cases. During the corrective reparation, we practiced an infundibulotomy in 40 cases, a wideness of the pulmonary tract by patch in 21 cases, a pulmonary valvular commissurotomy in 10 cases, a direct shutdown of the interventricular septal defect in 5 cases, a shutdown of the interventricular septal defect by patch in 34 cases, a direct sutura of the lnteratrial septal defect in 9 cases, a shutdown of the foramen ins cases, and a shutdown of the anastomosis of Blalock-Taussing in 3 cases. We noticed only one precocious death and two tardive deaths. The post-operative results after an average recoil of 5 years and a ha lf according to criteria of Hazan show: - a good result in 78% of the cases. - a mean result in 14% of the cases. - and a bad result in 8% of the cases

Apparently primitive dilated cardiomyopathy. About 30 cases

This retrospective study was conducted in the Cardiology Unit of the University Hospital Ibn Rochd Casablanca. Thirty cases of primary cardiomyoparhy were recorded between 1980 and 1985. -Frequency of the disease [0.42%] was underestimated. - The mean age of the patients was 37.5 years; Most of them were males [73%]. - The clinical picture was a cardiac failure [96.6%] which was bilateral in 73.3%. - Electrocardiogram was always disturbed, but there was no specific sign. Q and QS waves of transmural fibrosis were frequently associated [33.3%]. -Echocardiography was a privileged technique for studying the dilated cardiomyopathy; it allows the diagnosis and the study of the ventricular function which is an important element in the prognosis evaluation. Treatment remains disappointing, based on the combination of rest, salt free diet associated which diuretics and digitalis. - Etiology is still unkown and the prognosis poor. - Death rate was 23.3%. Mean duration of survival was 12 months. - Two cases of this disease were of interest: a post-partum myocardiopathy and an alcoholic myocardiopathy

Chronic cor pulmonary resulting from tuberculosis

From 1977 to 1985, 78 patients with Chronic Cor Pulmonale resulting from antecedent tuberculosis have been treated in the cardiology department of Ibn Rochd Hospital, Casablanca, Morroco. The responsability of tuberculosis is predominant in the setting of the disease [30%]. Eight years was the mean time elapsed between the tuberculosis and the Cor Pulmonale. All patients were seen with right heart failure. The most frequent complications were acute respiratory failure [80%], supra-ventricular arrythmias [18%] and digestive tract bleeding [6.5%]. 42% died, most of them from acute respiratory failure. Survival rate was 52% nearly eight years after the onset of the cor pulmonale

Permanent cardiac stimulation

Our study covers twenty cases of "permanent electro-systolic pacers" used in the Cardiology Department of the Ibnou Rochd Hospital in Casablanca from 1976 to 1984. Our series have noted that: - The average relatively young age of our patients [48] with a predominance of complete congenital auriculo-ventricular blocks [BAV]. - The indications of stimulation have to be permanently watched because of the vital risk to our patients of repeated fainting and cardiac refractory insuffiency. - The almost exclusive adoption of endo-cavitory wey with the use of litium sentry batteries [QRS-] and monopolar probes. A conventional clinical, electrical and radiological supervision has been set up. - Immediately after the operation, where we have noted two displaced probes, which were put back in position on the ventricular right at the point level, and one infection of the casing put right by a change of batteries and probe. - The long term evolution after a period of 14 months is clear cut: - one case of worn sheath. - one case of displaced probe. - and two cases of worn out batteries. The reintervention in order to change the failed material has been practised in all cases

Pulmonary hypertension secondary to pulmonary asbestos. About 3 cases

After having during twenty years in a factory using asbestos cement, three morkmen have presented pulmonary fibrosis that manifested itself by a severe dyspnea, cough and expectoration, radiologically by diffuse pulmonary lesions with basal predominance and linear disposition, associated to a pleural calcification characteristic of the asbestosous origin. During the evolution, this pulmonary fibrosis has been complicated by chronic cor pulmonale: right ventricular hypertrophy and a pulmonary hypertension in those cases

Prinzmetal angina. About 2 cases

The authors report two characteristic cases of Prinzmetal angina and recall the main clinical, electric and angiographic features of this disease. The current therapeutic approach is also stated

[Operative results of open heart surgery to 47 cases of congenital cardiopathies-Second part: cyanogen heart diseases]

The second part of the surgical results of 47 congenital heart diseases deals with the cyanotic type. From 1970 to 1976, 18 patients were operated on [among them, 15 cases of Fallot's tetralogy]. The immediate and longer term results of this surgery are analysed