[Conservative surgery in rheumatic aortic insufficiency]. / Chirurgie conservatrice pour insuffisance aortique rhumatismale.

The mechanism of rheumatic aortic regurgitation is retraction of the three cusps leading to lack of coaptation. The authors describe a technique of aortic valve repair by extension of the cusps using autologous pericardium, undertaken in 52 patients (mean age 21 +/- 5 years) and report the short and medium term results. There were no operative deaths or reoperation for technical failure. The postoperative echocardiographic examinations showed absent or minimal aortic regurgitation in 45 patients (87%) and moderate regurgitation in 7 patients (13%). The echocardiographic results at 2 years were stable: no patient was reoperated for deterioration of the valvuloplasty. This technique is reproducible and reliable is selected patients.

[Correction by a calcium inhibitor of a coronary spasm occurring during aortocoronary bypass]. / Correction par un inhibiteur calcique d'un spasme coronaire survenu en cours de pontage aorto-coronarien.

A case of recurrent coronary artery spasm after coronary revascularization under cardiopulmonary bypass is related. The spasm, which occurred under nitroglycerin perfusion, was suspected on the ECG tracing and confirmed during immediate reoperation. It was successfully treated with bepridil, a calcium-channel blocking agent. The use of such agents after cardiac surgery is discussed.

[Clinical use of nitroglycerin as an hypotensive agent during general anesthesia for caesarean section. Report of a case (author's transl)]. / Utilisation de la nitroglycérine intraveineuse en solution aqueuse comme agent hypotenseur au cours d'une césarienne. A propos d'un cas.

Nitroglycerin in aqueous solution has been used as hypotensive agent during a caesarean section, in a patient who presented an arterial hypertension not controled by administration of four antihypertensive agents (acebutolol, clonidine, dihydralazine, alpha-methyl-dopa). Nitroglycerin continuous infusion started two hours before caesarean section at the dose of one milligramme over one hour and stopped several hours after.