Case Report: Mycotic common carotid artery pseudoaneurysm in a child. A case report.

Extracranial carotid artery aneurysms in children are extremely rare, nevertheless associated with a great potential of thromboembolic episodes and rupture especially those with mycotic origin. The surgical treatment is very challenging, and there is still a controversy concerning revascularisation after the resection of the aneurysm. In this manuscript, we report the observation of an 8-year-old boy with the medical history of Leukemia who is admitted urgently for a mycotic right common carotid artery aneurysm, occurring after a chemoport infection who was operated on in our cardiovascular surgery department with surgical resection and ligation. It is the second report in the pediatric literature of a mycotic pseudoaneurysm situated in the common carotid artery, but the first documented by medical imagery. Through this case, we highlight that ligation of the infected carotid artery can be a safe and efficient alternative especially in Children.

[Study of the factors contributing to poor quality of life in chronic heart failure with reduced ejection fraction]. / Étude des facteurs de mauvaise qualité de vie de l'insuffisant cardiaque chronique à fraction d'éjection altérée.

BACKGROUND: The increasing prevalence and poor prognosis associated with chronic heart failure (CHF) have made the improvement of quality of life (QoL) one of the main goals in the treatment of CHF patients. Since little is known about the QoL in Tunisian patients with heart failure (HF), the current study was performed to assess QoL in a sample of Tunisian patients hospitalized with HF and to identify factors related to QoL. METHODS: In this prospective study, we evaluated patients with CHF attending the cardiology department of Habib Thameur University Hospital in a four-month period. Echocardiography was performed and patients with left ventricular ejection fraction of 45% or less were selected. QoL assessment was performed with a disease-specific instrument: the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in a sample of 100 selected patients. Relationships between health-related QoL and the studied variables were examined with bivariate correlations and binary logistic regression analysis. RESULTS: In the total sample (n = 100), mean age was 62.7 years. The majority were male (77%), married (76%), with a mean of 2.5 comorbidities, and in a New York Heart Association (NYHA) functional class III to IV (61%). Mean LVEF was 36%. Half of the patients had poor QoL on the total MLHFQ scale (median = 41.5) as well as on its physical (median = 17.5) and emotional (median = 11.25) domains. In univariate analysis, the following variables were related to poor QoL with p < 0.005: not being employed, suffering from hypertension, renal failure, anemia, being under a low-salt diet, having no regular physical activity, having the physical symptoms of HF, higher NYHA class and longer QRS duration. In multiple regression analysis, the main independent predictors of poor QoL on the total scale were higher NYHA functional class and renal dysfunction,. The data provided no evidence of an association between LVEF and QoL. CONCLUSION: This study has found that higher NHYA functional class and chronic kidney disease are risk factors for impaired QoL, independently of disease severity among patients with heart failure.

[A rare cause of pacemaker lead displacement: Twiddler's syndrome]. / Une cause rare de déplacement de la sonde de pacemaker: syndrome de Twiddler.

Twiddler's syndrome is a rare but potentially lethal complication of pacemaker implantation. It is usually diagnosed within 1 year after implantation. It is characterized by device malfunction caused by pacemaker lead displacement due to twisting of the box on part of the patient. Twiddler's syndrome has been described by in 1968 as a complication of pacemaker implantation. It has also been reported after defibrillator implantation and cardiac resynchronization therapy. We here report the case of a 89-year old female patient admitted with Twiddler's syndrome leading to pacemaker malfunction secondary to pacemaker lead displacement. She underwent lead repositioning and received appropriate advice.

Cerebral embolism complicating left atrial myxoma: a case report.

Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. Transthoracic echocardiography reveals a myxoma in the left atrium. Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected.

Ulcer like projection: a case report and follow up.

Here we report the case of a 57-year-old female with an aortic intramural hematoma that was treated with medical approach. Follow confirmed the favorable clinical evolution.

Cardiac metastasis from a renal cell carcinoma.

Here we report a case of asymptomatic right ventricular tumor, for which surgical removal was done. Pathology reveals that the mass is a metastasis of a renal carcinoma.