Unilateral pulmonary oedema complicating mitral regurgitation: diagnosis and demonstration by transoesophageal echocardiography.

One aetiology of unilateral pulmonary oedema is mitral valve disease. We report three cases of right pulmonary oedema caused by acute mitral regurgitation. These reports underline the diagnostic value of transoesophageal echocardiography, which rapidly visualised severe mitral regurgitation with retrograde jet directed toward the right pulmonary veins. Two patients underwent prompt cardiac surgery.

[Outcome of patients with chronic respiratory insufficiency treated at home with tracheotomy and assisted ventilation]. / Devenir des insuffisants respiratoires chroniques traités à domicile par trachéotomie et ventilation assistée.

60 patients were studied with severe chronic respiratory failure (IRC) and a permanent tracheostomy treated with domiciliary ventilation (VADT). The study commenced from the time of the tracheostomy and included length of survival (by the actuarial method) quality of life, subjectively and objectively (progress of blood gases in a stable clinical state and cumulative length of periods in hospital). Factors influencing the decision for tracheostomy and VADT were examined. Restrictive cases benefitted from the technique as much from the improved quality of life as from the duration of survival (77% at 5 years). Patients with an obstructive or mixed pattern had a 5 years survival of 73% after the first episode of acute or chronic respiratory failure which was 73% better than comparable patients given neither a tracheostomy nor oxygen therapy. The five years survival of 42% on VADT in our series compares favourably with the main series published. In our opinion the improved survival in these patients (which tends to rejoin that of the general population) and the improved quality of life justifies the use of this treatment in severe obstructive IRC, despite a greater demand and cost of this treatment than those with a restrictive defect.