Images in cardiovascular medicine. Mitral valve varix.

International audienceA 39-year-old man presented with atypical angina and hemoptysis. This soldier traveled regularly to the Middle-East and Africa. Initial clinical examination was within normal limits, as were also the ECG, biochemistry, and hematologic blood samples..

Near-Fatal Multiple Organ Dysfunction Syndrome Induced by Plasmodium malariae

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ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Minor postoperative morbidity should not be neglected

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Le coeur artificiel

L'incidence de l'insuffisance cardiaque ne cesse de croître dans les pays occidentaux, avec un impact majeur sur les individus et les sociétés de ces pays. La diminution du nombre de donneurs d'organes pour les programmes de transplantation cardiaque a favorisé le développement des cœurs artificiels partiel et total. Développé dans la seconde moitié du vingtième siècle, le cœur artificiel peut apporter une solution thérapeutique efficace à de nombreux patients. Ces prothèses cardiaques peuvent être utilisées dans l'urgence, éventuellement dans l'attente d'une greffe, qu'elles ne contre-indiquent pas mais dont elles améliorent au contraire les résultats. Elles peuvent aussi être implantées de façon permanente et définitive, pour les malades récusés pour la transplantation. Le but de ce travail est de relater l'histoire de la recherche et des réalisations industrielles et cliniques des cœurs artificiels depuis les débuts.PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Cardiac surgery in any context of left-sided infective endocarditis?

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Reply to the Letter regarding Flecher et al. "Cancer on a pacemaker lead": Is it MICE (Mesothelial Incidental Excrescence).

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Increased valvulo-arterial impedance differently impacts left ventricular longitudinal, circumferential, and radial function in patients with aortic stenosis: A speckle tracking echocardiography study

International audienceBACKGROUND: In aortic stenosis (AS), the left ventricle (LV) should face an increased afterload that is due to both the stenotic aortic valve and the peripheral vascular resistance (PVR). Valvulo-arterial impedance (ZVa ) is a recently introduced parameter, which permits the evaluation of global LV afterload in AS. Aim of this study was to assess the influence of increasing ZVa on the longitudinal, circumferential, and radial components of LV mechanics. METHODS: A total of 126 patients (mean age: 80.1±12.0 years, males: 47%) with severe AS (aortic surface 5.1 mm Hg/mL/m(2) ). ZVa increase from Q1 to Q4 was associated with a progressive reduction in GLS and GCS (ANOVA, both P<.0001). GRS was relatively insensitive to ZVa increase, a significant reduction of GRS appearing only in Q4 patients with respect to Q1 (29.7±16.4 vs 20.7±13.2%, P=.01). CONCLUSIONS: Left ventricle myocardial fibers show a different response to afterload increase. Subendocardial fibers function is impaired earlier, whereas mid-wall circumferential fibers remain substantially unaffected, providing interesting insights into the mechanisms of LV dysfunction in AS

Apico-aortic conduit: a readily available technical modification

International audienceWhen neither surgical valve replacement nor transcatheter aortic valve implantation is possible, performing an apico-aortic conduit remains a therapeutic option. This procedure has become rare and the rigid angled apical connectors usually used to facilitate ventricular anastomosis are no longer commercially available. We described the technique that we performed on a 60-year-old patient with readily available material