[Correlation between previous coronary artery stenting and early mortality in patients undergoing coronary artery bypass graft surgery]. / Corrélations entre antécédents d'angioplastie coronaire et mortalité précoce après chirurgie coronaire.

BACKGROUND: In this study, we examine the effect of previous percutaneous intervention on the rate of adverse perioperative outcome in patients undergoing coronary artery bypass graft surgery (CABG). METHODS: Outcomes of 240 CABG patients, collected consecutively in an observational study, were compared. Gp A (n=35) had prior PCI before CABG and Gp B (n=205) underwent primary CABG. RESULTS: Statistically significant results were obtained for the following preoperative criteria: previous myocardial infarction: 48.6% vs 36.6% (P=0.003), distribution of CAD (P=0.0001), unstable angina: 45.7% vs 39% (P=0.04). For intraoperative data, the total number of established bypasses was 2.6 (GpA) vs 2.07 (Gp B) (P=0.017), with the number of arterial bypass grafts being: 20% vs 13% (P=ns). Regarding the postoperative course, no significant difference in troponine I rate, 24-hour bleeding: 962 ml (Gp A) vs 798 ml (Gp B) (P=0.004), transfusion (PRBC unit): 3.63 (Gp A) vs 2.5 (Gp B) (P=0.006). Previous PCI emerged as an independent predictor of postoperative in-hospital mortality (OR 2.24, 95% CI [1.52-2.75], P<0.01). CONCLUSION: Patients with prior PCI presented for CABG with more severe CAD. Thirty-day mortality and morbidity were significantly higher in patients with prior PCI.

[Mycotic aneurysm of the ascending aorta: report of 2 cases]. / Les anévrismes mycotiques de l'aorte ascendante: à propos de deux cas.

Infection in the vascular tree has been proved to be one of the greatest challenges for cardiovascular surgeons. Mycotic aneurysm of the ascending aorta is unusual, life threatening pathologic entity and develops mainly after open heart procedure. We report two cases of mycotic aneurysm of the ascending aorta occurring after prosthetic replacement of the aortic valve.

[Brucella endocarditis of native valves. Report of 3 cases]. / Les endocardites brucelliennes sur valves natives. A propos de 3 cas.

Brucella endocarditis is a rare but a serious complication of human brucellosis. We report 3 cases, the diagnostic was suspected by the patient's history of systemic brucellosis in two cases and established by the culture of native valve material in the third. All the patients underwent surgery for non control of the infections, one patient died in immediately postoperative period by acute cardiac failure. For the other patients, there were no early or late mortality and no recurrence after a follow up of respectively 6 and 84 months. The diagnostic of brucella endocarditis needed a very high degree of clinical suspicion, it requires an early management valve replacement is in the majority of cases, followed by adequate and prolonged antibiotic treatment.