Ruptured subrenal aortic false aneurysm after laparoscopy

The authors report a rare case of ruptured subrenal aortic false aneurysm; which has been done for an ascitis exploration. The diagnosis has been done after an emergency surgical exploration. The following up was without any complications after 36 months

[Takayasu's disease]

Takayasu's disease is the most frequent vasculitis involving the aorta and its main branches. It affects young people and predominantly the female. The lack of pulsation in upper limbs is the most frequent circumstance of diagnosis but all of hypertension, aortic regurgitation or coronary arerial lesions could also lead to the recognition of that disease mainly while inflammatory syndrome exists. The diagnosis is based on the location and association of lesions [ectasia and stenosis of the aorta and its main branches] and/or pulmonary arteria. In other cases, it's confirmed by histopathology. The prognosis depends on arterial hypertension, brain ischemia and coronary arterial lesions. The treatment is essentially palliating: surgery in case of ischemy, corticotherapy in developing inflammatory syndrome

[Dilated cardiomyopathy in appearance primitive. about children [23 cases]]

It's a retrospective study of 23 cases of dilated cardiomyopathy in the child collected in different services of pediatrics [Ibn Rochd CHU and Sid Soufi] and in the Cardiology service of the Ibn Rochd CHU on a period of 8 years [1981 -1988]. The analysis of thee observations showed that: - The CMD of the child is a relatively rare affection - The middle age is of 3,8 years. 82,4% are young children of less than 6 years old, - The sharing is homogenous between the two sexes. - The family inquiry is imperative during all CMD of primitive behaviour. - The clinic board is that of a cardiac insufficiency [95,6%], the most often dramatic In the infant. - The electrocardiogram is constantly disturbed, but without any specificity for the cardiomyopathy. - The echocardiography is apriviled ged technique for the study of the dilated cardiornyopathies. It allows to set the diagnosis, to follow the evolution and to value the prognostic. - The medical treatment is based on the association of a rest, a salt-free diet, diuretics and digitalics. - The evolution is marked by a strong precocious mortality with possibility of a total recovery in almost a the cases. The etiology remains unknown and the prognostic stays difficult to value

[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

[Tuberculos pericarditis [about 220 cases]]

Between January 1977 and December 1989, 220 cases of tuberculosis pericarditis were diagnosed in the cardiology ward of the Medical School Ibn Rochd Hospital of Casablanca. They fell into three broad catergories: - acute pericarditis: 130 cases [59%] - sub-acute pericarditis: 40 cases [18%] - constrictive pericarditis: 50 cases [23%]. The average of the patients was 30 years, a majority being male [65%]. Forty-four cases of acute pericarditis were admitted with a tamponade. The cases of sub-acute pericarditis were distinguished by respiratory difficulties [95%] and signs of constriction [95%]. The cases of constrictive pericarditis were all characterized by the existence of Pick's syndrome [100%]. The diagnosis of tuberculosis was certain in 44 cases [20%], and was made with strong basis for assumption in the remaining 80%. We regret the 18 deaths that resulted during this study. Forty- three patients were seen again after an average delay of 47 months; development in 32 cases judged to be good, and stable in 7 other cases. Four later deaths were also recorded

[Surgical treatment of rheumatic valve disease]

Surgical treatment of rheumatic valve disease requires valve replacement or conservative treatment i.e. commissurotomy or valve prothesis. Indication of surgery depends on age, coexistent diseases, myocardium status. Post operative mortality depends on the type of surgery and on the causative valve disease. It is related to cardiac failure. Late mortality depends on the previous myocardium statuts. Late complications are restenosis, thrombosis, embolism and hemorrhage, prothesis desinsertion, valve degenerescence and bacterial endocarditis. post operative follow up has two objectives repeated assessment of surgery results and control of prothesis function

Recurrent carotid stenosis

Carotid endarterectomy is one of the most frequently operations performed on carotid atherosclerosis stenosis. Recurrent carotid stenosis is reported as varying from 16 to 22%. Two types of lesions are identified: fibromuscular hyperplasia and secondary atherosclerosis, occuring at variable date. Most of restenosis are asymptomatic. Non invasive techniques are now useful to their diagnosis: ultrasound, oculoplethysmography, carotid phono-angiography. Factors of restenosis remain unknown. Groups that are more likely to develop recurrent disease include women and patients in whom original disease developed at an early age. Patch angioplasty is the most performed technique in recurrent carotid stenosis