[Recurrent transient ischemic stroke in a young patient with papillary fibroelastoma of the mitral valve and hyperhomocysteinemia. A case report].

International audienceWe describe a case of a young patient admitted for recurrent ischemic stroke caused by a papillary fibroelastoma of the mitral valve and a hyperhomocysteinemia. A papillary fibroelastoma is a benign cardiac tumor which can be associated with serious embolic complications. A moderate plasma level of hyperhomocysteinemia is considered as a risk factor of ischemic stroke. The authors suggest that this association increases the risk of ischemic stroke in their patient. The tumor was surgically removed to avoid new embolic events associated with a vitamin B supplementation. After surgery and acid folic supplementation, no recurrence was observed

Noninvasive assessment of left main coronary stent patency with 16-slice computed tomography

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[A pericardial effusion].

International audienc

Is N-terminal pro-brain natriuretic peptide superior to clinical scores for risk stratification in non-massive pulmonary embolism?

International audienc

Heterogeneous geographic distribution of patients with aortic valve stenosis: arguments for new aetiological hypothesis

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Assessment of coronary artery stents by 16 slice computed tomography

OBJECTIVE: To analyse coronary stents with multislice spiral computed tomography (MSCT) in comparison with coronary angiography. PATIENTS AND METHODS: 310 patients referred for conventional coronary angiography underwent MSCT on the next day (16 × 0.75 mm cross section, 420 ms rotation, 110 ml contrast agent intravenously at 4 ml/s). Two independent blinded reviewers analysed the MSCT. RESULTS: 143 patients had previous stenting (232 stents) and 190 (82%) of the 232 stents were detected. Intrastent lumen was interpretable in 126 (64%) of the detected stents. Lumen interpretability depended on stent diameter: for stent diameter > 3 mm, 81% of lumens were interpretable, as against 51% with ⩽ 3 mm stent diameter (p < 0.001). Restenosis detection likewise depended on stent diameter: with small stents (⩽ 3 mm), sensitivity and specificity of MSCT were 54% and 100%, respectively; positive and negative predictive values were 100% and 94%. For stents with > 3 mm diameter, corresponding values were 86%, 100%, 100%, and 99%. CONCLUSION: 16 slice MSCT allows analysis of in‐stent lumen in about half of all stented angioplasties. It performs better when stent diameter is more than 3 mm and may offer a non‐invasive alternative to conventional coronary angiography for monitoring stented coronary arteries. Technical progress may improve interpretability and hence increase the yield of MSCT in this application

[Acute heart disease in search and rescue helicopter missions, from French Navy. A retrospective study from 2000 to 2007].

International audienceBACKGROUND: Search and rescue helicopters from the French navy conduct ambulance and search and rescue missions near the western coast of the French Britain. The team on board includes military doctor and paramedic. Operations in this area are challenging due to long distances and severe weather conditions. METHODS: We studied retrospectively 205 search and rescue missions from 2000 to 2007 with special emphasis on acute heart disease and operative conditions. RESULTS: 12.2% of the missions (25/205) concern acute heart disease dominated by myocardial infarction elevation myocardial infarction. All of the patients are male. Most of them are seafarers and the others come from ferries with a median age of 53.4 years. Sixty-two percent of the missions were carried in darkness. The median range is about 80 nautical miles. Two patients died during search and rescue missions. All patient are hospitalized. CONCLUSION: Ambulance and search and rescue mission near the western coasting of the French Britain are a challenge. Using a heavy helicopter from French Navy was the best way to carry medical treatment to seafarers and passengers of ferries suffering from acute heart disease