[Mitral commissurotomy during pregnancy]. / Commissurotomie mitrale percutanée au cours de la grossesse.

The physiological hemodynamic changes of the circulation during pregnancy are the main cause of mitral stenosis (MS) decompensation. In pregnant women with MS, the blood volume increase, tachycardia and the obstacle to left ventricular filling are responsible of post-capillary pulmonary hypertension (PF). This hemodynamic stress associated to other conditions can trigger acute pulmonary edema or even cardiogenic shock leading eventually to an unacceptable maternal and fetal death. The percutaneous mitral commissurotomy (PMC) has been tested with success during pregnancy, with excellent short- and mid-term results. We report our experience on seventy patients requiring PMC during the third trimester of pregnancy, between March 1998 and June 2006. The PMC was successful in sixty nine out of seventy patients. All of them improved their NYHA class of that least one stage. None of them kept a residual mitral surface<1.5 cm2. The PMC permitted a spectacular clinical and hemodynamic improvement, and the course of pregnancy until end of term occurred in almost all cases.

[Haemangioma of the right atrium revealed by cardiogenic shock]. / Hémangiome de l'oreillette droite révélé par un choc cardiogénique.

Intracardiac haemangioma is a very rare primary benign tumour. A 20 year old female patient, with no significant previous medical history, presented to the emergency department with cardiovascular collapse and vague abdominal pains, with no peripheral signs of cardiac failure. The electrocardiogram showed sinus rhythm with diffuse reploarisation disturbances. Chest radiography revealed cardiomegaly (cardiothoracic index of 0.67) with a right paracardial opacity. Abdominal ultrasound showed a moderate peritoneal effusion and transthoracic ultrasound showed a tumour occupying the right atrial cavity but sparing the interatrial septum. The patient underwent emergency open heart surgery for tumour resection and right atrial wall repair with autologous pericardium. Histology confirmed a haemangioma. Follow-up at one month was uneventful. The clinical, diagnostic and therapeutic features of this case are underlined.

[Percutaneous mitral valvuloplasty in the pregnant woman Moroccan experience]. / Valvuloplastie mitrale percutanée chez la femme enceinte: expérience marocaine.

Pregnancy is one of the most important factors known to destabilize valvular heart disease. In particular, pregnancy is a major cause of aggravation in the clinical course of women with mitral stenosis (MS). Surgical treatment of MS during pregnancy may be hazardous for both mother and foetus. In this context, percutaneous mitral valvuloplasty using the Inoue balloon may constitute a particularly attractive alternative to surgery. We report the results of percutaneous mitral valvuloplasty achieved in a series of 11 pregnant women.

[Mixed form of total anomalous pulmonary venous connection: apropos of a case]. / Forme mixte du retour veineux pulmonaire anormal total: a propos d'un cas.

As opposed to partial anomalous of pulmonary venous connection, it is frequent and benigns, the total anomalous of pulmonary venous connection is extremely rare and more serious. The anomalous is severe because all pulmonary venous connection, instead of left heart it go to the right heart. The age of diagnosis is closely tied up anatomics characteristics, so various clinical cases are present. The TAPVC of new born is a surgical emergency, especially where it's block up and release++ cardiorespiratory distress syndrome secondary to OAP. For great children, the total anomlous of pulmonary venous connection can be assumed to a case of atrial septal defect. This study intend to clear up this clinical and anatomical polymorphism and to report an exceptional-form of this congenital anomaly which is mixed total anomalous of pulmonary venous connection.