[Cor triatriatum. Anatomical forms and surgical treatment of 6 consecutive cases]. / Coeur triatial. Formes anatomiques et traitement chirurgical de 6 cas consécutifs.

Six cases of cor triatriatum documented and operated on at Henri-Mondor hospital between 1980 and 1984 are reported. Ages at the time of surgery ranged from 8 months to 57 years. Four of the 6 patients presented with pulmonary hypertension. Anatomic types consisted of 4 diaphragmatic types and 2 more complex malformations. Associated lesions were present in all but one patients. They consisted mostly of interatrial defects (depending on their position with regard to the intra-atrial membrane, they play a determinant role in the symptomatology) and of a left superior vena cava (which might play a role in the embryogenesis of the malformation). Except for one early postoperative death, results of surgery were excellent for all patients, with a mean follow-up of 5 years. This series, compared with the literature, allows precising the embryologic and anatomic aspects of the malformation and the surgical techniques in complex types.

[Staphylococcus, the most frequent agent of serious complications of acute sinusitis in children. 5 cases]. / Le staphylocoque, agent le plus fréquent des complications graves des sinusites aiguës de l'enfant. Cinq observations.

The high incidence of staphylococcal infection in severe forms of orbital cellulitis is reviewed with 4 case reports of children with complications of acute sinusitis due to staphylococcal infection. Three cases of thrombosis of the sinus cavernosus due to ethmoidal extension were observed, complicated in one case by fatal purulent meningitis. In one case, the sinusitis was a mixed staphylococcal and anerobic infection with orbital cellulitis and subcutaneous gas gangrene. No organism was isolated in the fifth child who had exophtalmos due to retroorbital cellulitis, but a rapid recovery was obtained with anti staphylococcal antibiotics after failure of inappropriate antibiotics. In conclusion, all periorbital cellulitis complicating sinusitis should be prescribed active anti staphylococcal antibiotics. In addition low dose anti coagulant therapy and prophylactic treatment against cerebral aedema are recommanded because of the risk of extension of the infection by thrombophlebitis of the sinus cavernosus and of intracranial propagation of the periorbital aedema.