[Is early stent thrombosis an inflammatory disease? A study of 1306 implantations]. / Thromboses precoces de stent: une maladie inflammatoire? A propos de 1306 implantations.

The authors tried to determine the clinical characteristics and predisposing factors of early stent thrombosis (EST) through the study of 15 patients who had had angiographically diagnosed stent thrombosis within 30 days of the implantation of the stent. The cases were compared to 29 control random patients collected between January 1, 2000 and August 31, 2001. Out of the 1306 patients who had been given coronary stents, 20 of them (1.5%) had an OO.. EST, representing 1.3 per patient. The patients, 12 males and 3 females, had a mean age of 62 + 10.3 years ranging between 46 and 77 years. EST occurred within 7.4 + 3.8 days (2 hours n 29 days) on average, in the left anterior descending branch (10 cases), in the right coronary artery (6cases) or in the left circumflex (3 cases) and finally in the postero-lateral branch (1 case). Stent recanalisation was performed within 3.4 + 2 hours (1-7 hours) on average. In spite of prompt revascularization, the problem progressed to MI in all cases and to subsequent death in 3 cases (20%). Procedure related variables of emergency PTCA, dissection, anatomical type B or C coronary lesions, related WBC count and C- reactive protein were significantly associated with EST while remained a rare event following PTCA. The incidence is low but the prognosis is still poor in spite of early intervention. Other studies are needed to confirm the probable inflammatory nature of this complication.

Quantitative MRI comparison of systemic hemodynamics in Mustard/Senning repaired patients and healthy volunteers at rest.

The purpose of the present study was to non-invasively compare ascending aortic blood flow and cross-sectional area (CSA) variations vs time in Mustard or Senning repaired (MSR) patients against those of healthy volunteers at rest. Velocity-encoded MR imaging was performed in 10 male patients (age range 18-24 years, median age 20.5 years) late after a Mustard or Senning correction, and in 10 male healthy volunteers (age range 21-25 years, median age 22.5 years), at the upper part of the ascending aorta. Both aortic cross-sectional area (CSA) and blood-flow variations were recorded over a complete cardiac cycle, with a 30-ms time of resolution. The body-surface area (BSA), the mean CSA over the systolic phase, and the BSA-normalized systemic ventricle power and work were significantly lower in the patient series compared with those of the volunteer series. The BSA-normalized right ventricle (RV) power and work of MSR patients were equal to 87 and 83% on average of those of the left ventricle (LV) of healthy volunteers. We conclude that, at rest, the mechanical performance of the systemic RV in MSR patients is significantly lower than that of the LV in healthy volunteers. Furthermore, the significantly lower aortic CSA found in MSR patients than in healthy volunteers may reveal an increase in the vasomotor tone.