Detection of a Left Superior Vena Cava during a Pacemaker Implantation in Cotonou.

Persistent left superior vena cava (LSVC) is a rare congenital anomaly. Its prevalence in the general population is 0.1 to 0.5%. LSVC is 5 times rarer when accompanied by an absence of the right superior vena cava (RSVC). We present the case of a 54-year-old man who carries a persistent LSVC without RSVC. Clinically, this patient presented a regular bradycardia at 40 per minute associated with a heart failure syndrome. The electrocardiogram diagnosed a complete atrioventricular block and transthoracic echocardiography showed dilated left heart cavities and a left ventricular ejection fraction of 50%. During the procedure of pacemaker implantation, the probe followed an unusual LSVC-coronary sinus-right atrium path and it was not easy to pass through the tricuspid orifice. We propose a review of the literature on this subject, focusing on the clinical implications of this malformation in cardiac stimulation and in other areas of cardiology.

[Prevalence of peripheral artery disease among diabetics in Parakou in 2013]. / Prévalence de l'artériopathie oblitérante des membres inférieurs et facteurs associés chez les diabétiques suivis en milieu hospitalier à Parakou en 2013.

We aimed to determine the prevalence of peripheral artery disease and its associated factors among diabetics. The cross-sectional study was conducted and included all diabetics admitted to the diabetic clinic at the Parakou University hospital during the period of 1st February and 31st July 2013. The diagnosis of peripheral artery disease was based on the Ankle Brachial Index (ABI)<0.9. The socio-demographics data, the data concerning the diabetes and its complications were recorded in each patient. They were 401 diabetics and 59.5 % were females. The mean age was 53.7±11.5 years. Among the diabetics, 168 fulfilled the criteria of PAD, the overall prevalence was 41.9 %. In total, 31.5 % were symptomatics according to Leriche and Fontaine classification. The main associated factors were the increase of age (P=0.01), the absence of activity with high income (P=0.004), the absence of physical activity (P=0.023), the duration of diabetes (P=0.007), the presence of peripheral neuropathy (P=0.003), the glycosylated hemoglobin≥7 % (P<0.001). After a multivariate analysis, only diabetes control was independently associated with arteriopathy (P=0,004). The PAD was more frequent among diabetics in Parakou. The associated factors must be taken into account in order to improve the management of the disease and to reduce the burden of the PAD.