[Closure of patent ductus arteriosus by indometacin in the preterm infant a case report]

We report the case of a preterm neonate presenting with a respiratory distress syndrome and hemodynamic failure. Cardiac examination reveals a continuous murmur. Echocardiography showed a patent ductus arteriosus. This newborn received indometacin during three days. A spectacular improvement was noticed. Echocardiographic control revealed the closure of the ductus

[Cayler cardiofacial syndrome]

Asymmetric crying facies is due to hypoplasia or absence of the depressor anguli oris muscle . It is called Cayler cardiofacial syndrome when associated with congenital heart disease. We report the case of an infant girl with asymmetric crying facies and complex congenital heart disease that associate transposition of the great arteries, intracardiac total anomalous pulmonary venous return, coarctation of the aorta, atrial septal defect, patent ductus arteriosus, hypoplasia of the right and left pulmonary arteries and left juxtaposition of the appendenges. The infant has also other systemic anomalies: microcephaly, right auricular hypoplasia, bilateral renal hypoplasia and serious central nervous system anomalies. Asymmetric crying facies is a minor congenital anomaly that can be associated to other severe malformations

[Lower limp ischemia due to femoral artery thrombosis after rectal excinian in lithotomy position]

Lower limb ischemia is an unusual and severe complication of abdominal surgery. We report a case of left femoral artery thrombosis following elective low anterior resection for rectal cancer in lithotomy position. Despite thrombectomy and femoro-femoral bypass the patient lost the involved limb due to irreversible ischemia. We discuss the factors that my have a role in the occurrence of this complication

Optimization of low pre-operative hemoglobin reduces transfusion requirement in patients undergoing transurethral resection of prostate

To identify factors that influence peri-operative hemorrhage in view of reducing the need for transfusions in patients undergoing trans uretheral resection of prostate [TURP]. All patients undergoing TURP between January 1997 and December 1999 were identified using ICD 9CM coding and indexing system. Overall 430 patients were identified, however, 384 charts were included and reviewed for demographics, pre and intra-operative data and post-operative morbidity. Patients were divided into two groups on the basis of presence of significant hemorrhage. Overall 384 patients were analyzed. Nineteen patients had hemorrhage - group I whereas 365had no significant hemorrhage - group II. Mean age and co-morbidities in the two groups were similar. However, in group I, 58% presented with urinary retention compared to 33% in group II. In group I, factors that reached statistical significance include; operative time [p<0.05], mean resected tissue weight [p<0.02], and patient presentation [urinary retention] [p<0.032]. There was no significant difference in the two groups with respect to type of anesthesia [regional versus general] and histology of the resected tissue. Patients with mean pre-operative hemoglobin of 10.6% had a 37% transfusion rate. Operative time, weight of resected prostate tissue are inter related and are only partly controllable. Low pre-operative hemoglobin is the only reversible factor in reducing transfusion following TURP

Place du cerclage de l'artere pulmonaire dans les cardiopathies congenitales: a propos de 27 cas

We report our experience of 27 patients [with mean age of 9 months] that have had a pulmonary artery banding [PAB] for a congenital heart disease with pulmonary hypertension. We noted an early mortality of 14.8%. 14 patients could have total repair, 7 are waiting for repair and 2 developed pulmonary vascular disease despite the banding [one with tricuspid atresia and one with single ventricle]. PAB is a delicate operation, high early mortality is due to the bad cardiac and pulmonary condition of the children, such operation can be definitive in some very complex lesions; in the other cases it allows patients to grow and to be corrected some months later

Evolution des communications interventriculaires non operees

Three hundred three [303] cases about interventricular communications [IVC] confirmed by hemodynamic and/or angiographic exploration were studied. The age of discovering the cardiopathy is between 1 month and 69 years with an average of 4 years. Among 176 non-operated patients, 92 were followed, 44 among them kept a stationary state, 25 have a tendency to inter-ventricular communication closure and only 7 cases of complete closure were diserved. The evolution was favorable in 16 cases among which 9 deaths [9,7%]; this mortality is more often secondary to a cardiac failure [8 cases] in young nurselings [5 cases out of 9]. Out the surgical treatment, the spontaneous closure was more observed in the l.V.C. type 1[13,8%] than in the I.V.C. type II [4,7%]