[Myocardial infarction in an infant without coronary artery birth anomalies]. / Infarctus du myocarde chez un nourrisson sans anomalie de naissance des artères coronaires.

The anomalous origin of the left coronary artery is almost the only cause of neonatal myocardial infarction. Other rare causes have been proposed when haemodynamic studies have shown a normal coronary tree. An 18 months old child, born prematurely at the 6th month of pregnancy (in a moribund condition), presented with a postero lateral myocardial infarction and congestive cardiac failure resistant to drug therapy. Angiography showed anormal coronary tree, massive mitral incompetence and a left ventricular aneurysm. The mechanical complications of the infarct were treated surgically with a good result, 2 years postoperatively. The possible aetiologies of the infarction are discussed: embolism, thrombosis, blood disorder, infection, and cardiorespiratory failure at birth in a premature baby. This case shows that the complications of myocardial infarction in childhood may be treated surgically without coronary revascularisation when the coronary arteries are normal. The exact cause of the infarction remain uncertain.

Anatomical correction of transposition of the great arteries.

This method of true anatomical repair of transposition of the great arteries (TGA) avoids the transection and suture of the coronary arteries and does not require any tubes of foreign material. Because the transection goes through the infundibulum under the aortic annulus, the complete aortic root together with the coronary arteries and a muscular subvalvular rim can be sutured to the pulmonary annulus. The technical simplicity of this procedure allows its application in TGA with intact ventricular septum in the newborn when the left ventricular pressure is still high or after the left ventricle has been "prepared" by previous banding of the main pulmonary artery.

Isolated ventricular discordance and complete atrioventricular canal in situs inversus. Report of successful surgical repair.

Isolated ventricular discordance is a very rare malformation, most often lethal in the first months of life. A patient with this lesion survived to age 9 years in spite of the coexistence of a complete form of atrioventricular (A-V) canal. Surgical repair with a Mustard procedure was associated with correction of the endocardial cushion defect. Situs inversus itself caused no problem. Although permanent complete A-V block occurred, the result has been satisfactory so far. This case is thought to be the first successful correction of this malformation.

[Long term results (5 years) of the first 50 consecutive operations following Mustard's technique for simple transposition of the great vessels]. / Résultats à long terme (5 ans) des 50 premières interventions consécutives selon la technique de Mustard pour transposition simple des gros vaisseaux

The long-term results of Mustard's operation for simple transposition of the great vessels have been studied in a homogenous series of the first 50 consecutive cases operated on by G. Lemoine. The overall mortality was 20% over the 5 year follow-up period. Serious arrhythmias or conduction defects can usually be picked up immediately postoperatively; on the other hand, stenosis of the venae cavae or of the pulmonary venous channels may come on very late and unexpectedly as growth takes place. Reoperation must be carried out to remove these stenoses when they are troublesome.

[Ostium primum and mitral cleft and aortic subvalvular stenosis. Apropos of 2 operated cases]. / Ostiun primum et fente mitrale avec sténose sous-valvulaire aortiques. A propos of 2 cas opéres

The two case reports are of children of 10 and 8 years of age with an ostium primum defect, with a mitral cleft and a stenotic fibrous ring below the aortic orifice. In the first case, the cause of the obstruction to left ventricular ejection was found at catheterisation, and in the second case it was an operative finding. In both cases there were large gradients, about 100 mmHg. The subaortic blockage was resected in both cases. A review of the literature has not revealed any similar case.

[Closure of ventricular septal defects. Comparison of 2 technics]. / La fermeture des défauts septaux interventriculaires.Comparaison de deux techniques

To be correctly done, closure of a ventricular septal defect must be sound, and must also avoid damage to the conducting tissue. These two essentials are somewhat contradictory, since in order to avoid the bundle of His in its position along the postero-inferior edge of the ventricular septal defect (VSD) in the membranous septum, the sutures inserted into this region must be superficial, and therefore weak. It is for this reason that the published series continue to show evidence of a significant number of post-operative shunts and atrio-ventricular blocks, as much in the closure of isolated VSDs as in the treatment of Fallot's tetralogy. This paper compares two techniques of suturing the prosthetic material which is used to close the VSD: the classical technique, in which it is intended to avoid the bundle of His by working below it, on the right side of the interventricular septum, and a different technique in which the sutures are applied directly to the free edge of the interventricular communication.