ABSTRACT
The authors have studied rhythmic events happened during early post-operative period in 84 operated patients for endomyocardial fibrosis, synonym nowadays to chronic parietal endocarditis, in the Institute of Cardiology of Abidjan (Côte d'lvoire), from January 1977 to July 1991. The mean age has been 15.6 +/- 43 years old. Endocardectomy was left in 25 cases, right in 32 and at last bilateral in the 19 others. The surgical way has been a left and/or right atriotomy. Mitral and/ ortricuspide valvular surgery has been always realised. The absolute prevalence of patients having presented one or several arrhythmias, atrial tachycardia and premature ventricular beats. The favouring factors have been the period of exclusion of the aortic root from circulation and number of endomyocardectomy. Atrial fibrillation has been related to auricular volume. Most of nodal arrhythmias have appeared with surgery. Endomyocardial fibrosis surgery has been greatful in rhythmic plan in 16% of patients. Early post-operative arrhythmias have been responsible forone case of the death of the operated patients and they have been present in seven other cases of the death.
Subject(s)
Arrhythmias, Cardiac/etiology , Endocarditis/surgery , Endomyocardial Fibrosis/surgery , Postoperative Complications/etiology , Adolescent , Adult , Angiocardiography , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/epidemiology , Cardiac Catheterization , Cause of Death , Child , Child, Preschool , Chronic Disease , Comorbidity , Cote d'Ivoire/epidemiology , Electrocardiography , Endocarditis/complications , Endocarditis/diagnosis , Endomyocardial Fibrosis/complications , Endomyocardial Fibrosis/diagnosis , Female , Humans , Male , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Prognosis , Retrospective Studies , Risk Factors , Severity of Illness Index , Time FactorsABSTRACT
The authors report two cases of true aneurysms of the pulmonary artery (APA) associated with massive pulmonary valvular insufficiency. Both were associated with pulmonary artery hypertension and showed cystic medial necrosis at microscopic examination. One case had no associated defects while the other had a large ventricular septal defect and a small patent ductus arteriosus. Both were treated by aneurysmorrhaphy and a valvular procedure (valve replacement, valvuloplasty). The clinical results were excellent. Catheterization at 2 years showed no further aneurysm formation, no pulmonary hypertension, and mild pulmonary valve insufficiency in both patients. The literature concerning APA is reviewed and the etiology and the surgical treatment of APA discussed. A unique method of treating pulmonary valve insufficiency is reported.