[Surgical treatment of tricuspid regurgitation associated with left valvular heart disease: about 162 cases]. / Réparation chirurgicale de l´insuffisance tricuspide associée à une valvulopathie du cœur gauche: à propos de 162 cas.

Tricuspid regurgitation (TR) is a prognostic factor associated with the outcome of patients undergoing surgical treatment of left valvular heart disease. The purpose of this study was to evaluate the postoperative outcome of patients with tricuspid regurgitation associated with left valvular heart disease and to identify factors associated with surgical failure. We conducted a retrospective study of 162 patients over the period January 2009 to July 2019. The study included all patients undergoing surgical treatment of TR and left valve repair. The average age of patients was 39.70 years ± 10.8, with a female predominance. We performed 47 (29%) tricuspid prosthetic annuloplasties, 103 (63.5%) De Vega´s annuloplasties and 12 (7.5%) posterior ring reductions or replacements out of 162 tricuspid valve repairs. Patients´ outcome was marked by clear improvement in morphological and functional echocardiographic parameter means. Surgical failure was reported in 24 (14.8%) patients. Four patients died within 30 postoperative days, reflecting a hospital mortality rate of 2.46%. The causes of death were refractory right ventricular failure (2 cases), and severe left ventricular failure (2 cases). Factors related to failure of tricuspid repair were: severe pre-operative tricuspid failure, postoperative pulmonary hypertension (> 60mmHg) and preoperative RV/LV ratio > 0.6. The results of this study provide a better understanding of the outcomes of patients undergoing surgical treatment of tricuspid failure and provide information on the indications for surgery.

Echinococcosis of the heart: clinical and echocardiographic features in 12 patients.

UNLABELLED: We describe the clinical and echocardiographic features in 12 patients with hydatid cyst of the heart who were screened between 1985 and 2001. Presenting symptoms have a wide variability but the main symptom was precordial pain. The electrocardiogram was always abnormal and showed T wave inversion in 8 cases, ST depression in 5 cases, incomplete right bundle-branch block in one case and atrial fibrillation in one case. Transthoracic echocardiography and transoesophageal echocardiography constitute the imaging procedure of choice for the diagnosis of cardiac hydatid cyst with a high sensibility, specificity. Computed tomography (CT) was performed in all patients and confirmed the echocardiographic data. MRI was performed in one patient with right atrium hydatid cyst location and confirmed the echocardiographic data. CONCLUSION: In the presence of atypical symptomatology in a patient coming from an endemic area of hydatid cyst, the diagnosis of cardiac echinococcosis is possible.TTE and TEE are the imaging procedure of choice and sufficient for the diagnosis of cardiac hydatid cyst. CT and/or MRI provide more information about the extension of echinococcus disease in other intra- or extrathoracic locations.