Introduction and importance: Primary intracardiac malignant mesothelioma is an extremely uncommon condition with a terrible prognosis. Because of its rarity, there have been extremely few examples described in the literature. Case presentation: We are reporting the instance of a 44-year-old lady who was referred to the department of cardiology for worsening dyspnea, palpitations, and a recent syncopal episode. On examination, the patient had signs of global heart failure. Cardiac imaging showed a tissue mass infiltrating the atrioventricular sulcus at the mitral valve level, responsible for severe mitral stenosis. Pleural effusion without an intrapleural mass was also noted. Urgent surgery was performed, including excision of the tumor mass, mechanical replacement of the mitral valve, and tricuspid plasty. The anatomo-pathological study concluded in cardiac mesothelioma. The patient was transferred back to the cardiology department 9 months after surgery due to severe left heart failure. TTE and TOE were performed and revealed tumor recurrence responsible for severe mitral stenosis. The course was marked by the onset of cardiogenic shock refractory to treatment, followed by the death of the patient. The case we are reporting seems to be the initial instance documented as exclusively primary intracardiac mesothelioma especially its lack of association with any other pleural sarcomatoid mesothelioma or asbestos exposure. Clinical discussion: In cases where a large atrial tumor is present, prompt surgical intervention is recommended to mitigate the risk of catastrophic embolization or valve orifice obstruction. The objective of surgical intervention is to excise the entire neoplasm with sufficient surrounding tissue, a feat that is infrequently achievable. Palliative debulking may be a beneficial intervention for patients who do not necessitate complete resection, particularly those experiencing relevant or rapidly escalating symptoms. Cardiac transplantation remains a viable option in the event of an unresectable malignant tumor. Conclusion: The short-term prognosis is poor. Surgical treatment remains the best treatment for this type of tumor. Total excision should be considered, but may not be feasible in all cases. Adjuvant chemotherapy may be considered.

heart failure in peripheral arterial disease in 4 patients (1.3%) and valvular heart disease in 1 patient. Patients with at least one cardiovascular comorbidity had significantly more severe forms of covid 19 compared to patients without comorbidities (46% vs 16% p <0.05). All deaths occurred in patients with cardiovascular co-morbidities Conclusion: Cardiovascular comorbidities are common in hospitalized patients with COVID 19 dominated by hypertension and ischemic heart disease. Cardiovascular comrobidities have a pejorative impact on the prognosis of... Background: Central blood pressure is superior to office blood pressure measurements in predicting cardiovascular end organ damage. Conclusion: Therapy based on SPC of Valsartan/amlodipine was effective in providing extensive BP control (office and central BP). for a of 36 Independent follow were identified by multivariate logistic regression. Results : A total of 116 patients were included. 41,1% were treated with DES, 23,3% with DEB and 8,6 % with POBA. 12,9% underwent CABG and 13,8% received MT only. During follow-up, 37,9% of patients had at least one MACE. The mean delay to the occurrence of the first MACE is 15 months. [95% CI 1,2 – 6,8]; p=0,008) and the absence of post-dilatation after ISR angioplasty (OR 1,32; [95% CI 1,0 – 1,35]; p=0,04). Conclusion : Determining of these factors is important in order to improve ISR angioplasty outcomes. The a ratio of 1.3. the risk increase in pulse and respectively). in pulse between two types of therapy which are internal electric shock (IES) and anti-tachycardia pacing (ATP)leading to reduction of severe ventricular arrythmia. Despite the implementation of DAI either in primary or secondary prevention, several studies have predefined scores identifying patients who can really benefit from this treatment. Method: Our study is a descriptive and analytical cohort including 80 patients implanted in the cardiology department of the Habib Thameur hospital from January2010to June2019. Data on mortality and its causes were collected from medical records. We looked for predictors of mortality. Results: Males were predominant (92%) in our population. Ischemic During a follow-up of 55 we ischemic of infectious endocarditis, case of electrical In multivariate analysis, the of inappropriate therapies(p=0.008), ischemic heart disease(p=0.066) and Conclusion: In our study we identified three predictor factors of mortality which are ischemic heart disease, inappropriate with SaO2 <= 90%, LVEF <= 50%, and redo surgery. At 06 months follow-up, the functional gain in the overall population was significant (p <0.001) (table). However, the improvement in the functional status of group 1 patients was not significant. Ultrasound data showed a significant decrease in Right atrium area from 28.6 ± 7.4 cm² to 22.1 ± 5.2 cm² (p <0.001), right ventrivular diameter from 41 ± 5 , 8 to 31.4 ± 7.1 mm (p <0.001) and systolic PAP from 46.3 ± 14.1 mmHg to 33.3 ± 7.3 mmHg (p <0.001 ). We also note an improvement in right systolic function in our series. Conclusion: are a strongly in The diagnostic and therapeutic management of these patients requires specialized human skills and a well-equipped technical platform within the framework of specialized functional units. have them during follow up. It was found that only the PACS was significantly lower in the population having had these two complications (7.2 ± 2.9 vs 9.4 ± 4.1, p = 0.049). There was no significant difference between the two compared groups according PALS and left atrium area. The analysis of the ROC curve (PACS vs stroke and / or AF) objected that patients with a PACS value less than 10% have a significantly higher incidence of stroke and AF (89% vs 61%, p = 0.03) with a sensitivity of 50% and a specificity of 74% (AUC= 0.65). In our study, we did not find an independent predictor of the onset of stroke and / or AF in the follow-up of an asymptomatic patient with severe or moderate MS: PACS <10% (p = 0.06; OR = 1.18; 95% CI: [0.9-1.14]) and PALS <25 (p = 0.11; OR = 1.06; 95% CI: [0.9-1.14]). Conclusion: Our study demonstrated that the lower values of left atrial strain can be a predictor of AF and or stroke. re-examination, we identified patients who had shown an improvement of the LVEF to reach a LVEF > 40%. Results : In all, 223 patients were enrolled in the study, based on initial LVEF, 87 (39%) patients were classified as having HFrEF. Among patients with reduced LVEF (mean age: 66.1; gender ratio: 1.55), 13.8% (12 patients) had shown an improvement of LVEF and then considered to have HFiEF and 86.2% (75 patients) had a persistent HFrEF.patients with HFiEF younger (mean age: 58.5 vs 67.7; p= 0.04), more recent onset of heart failure (de Novo HF: 22.9%; p=0.01) (25% vs 56%; 0.04). of HTA and AF were similar (HTA :41.7% vs 52%; 0.5 ; AF: 16.7% vs 28% ; 0.4). All patients with HFiEF were treated with guideline-directed HF medical therapy. some The immediately onset of AVB was the only factor significantly correlated with the patient’s pacemaker dependency (p = 0.041). Conclusion : This study highlights the need for regular and prolonged rhythmic monitoring of cardiac surgery patients because a conductive disorder may occur late. and the cerebral veins in 1 patient. Superficial venous thrombosis was present in 20.8% of cases. Arterial involvement was present in 11.1% of patients. It included pulmonary artery aneurysms in 8 cases and occlusion of the central retinal artery in one patient. Other associated systemic manifestations were: skin and mucous membrane disorders (100%), articular (34.7%), ophthalmological (29.2%), neurological (27.8%) and cardiac involvement in 7 patients. Treatment was based on long term curative anticoagulation (70%), corticosteroid therapy (50%) and immunosuppressants (21%). Embolization was performed in two patients with good results. Conclusion : Our study illustrates the frequency and the polymorphism of vascular involvement in BD. The diagnosis of acute myocarditis the use of multiple diagnostic tests. The aim of this study is to evaluate the correlation between transthoracic echocardiography (TTE) and cardiac MRI (CMR) findings in acute myocarditis. our Left ventricular ejection fraction (LVEF) in 84% of cases. Three patients had a reduced LVEF.Two patients had a mid-range LVEF. Wall motion abnormalities (WMA) were in fourteen patients: segmental hypokinesia in nine patients, akinesia in four patients and only one case of global median follow-up of55months, 233 appropriate shock (87.3%) and 34 inappropriate shock (12.7%) were recorded. The incidence density of IEC was2.06 shocks/patient-year at one year,0.99shock/patient-year at 3 years and 0.50 shock/patient-year at 5 years. For appropriate shock (CEIA) this incidence density was1.72shock/patient-year at one year, 0.98shock/ patient-year at 3 years and0.42 shock/patient-year at 5 years. Spearman’s correlation coefficient is -1, which is in favor of decreasing this incidence density over time. For inappropriate shocks (CEII), this incidence density was0.33shock/ patient-year at one year,0.02shock/patient-year at3 years and0.09shock/patient-year at 5 years Spearman’s correlation coefficient is not significantly nonzero, which is in favor of a tendency towards stability as a function of time. We found that the incidence density of total IEC was decreasing over time. This decrease concerned the CEIA while the incidence density of CEII was stable during follow-up. A total of 174 patients (75 males and 99 females) this with a mean of 36.8 ± - 65]. Of the study population, 12.6 % underweight (male, 2.7%; female, 20.2 %), 30.5 % as normal weight (male, 49.3 %; female, 16.2 %), 31.0% overweight 36 %; female, 27.3 %) and 25.9% as obese (male, female, 36.4%). The mean BMI was 26.3±5.8 Kg/m2 extremes of 14.5 and 41.2 Kg/m2. Conclusion: In our study, hydration with bicarbonate serum has not shown any benefit in preventing Contrast induced nephropathy compared to hydration with physiological saline. A multi-center observational study is needed to confirm our results. Background : The occurrence of death in a young adult remains an event experienced as dramatic for the family as well as society and doctors. Sudden death at any age constitutes a medico-legal barrier to burial. Methods : We performed a retrospective study using autopsy data from the Department of forensic Medicine in Farhat Hached hospital. A review of all autopsies performed for 17 years was done. In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden cardiac death in persons aged between 18 and 35 years. Results : We collected 120 cases of sudden cardiac death during the studied period. The mean age of the studied population was 26.3 years. SCD is significantly more prevalent in young males. General etiologic categories include heritable and acquired cardiomyopathies and arrhythmia syndromes (30%), structural congenital heart diseases (12.4 %), coronary abnormalities (14.6 %) and other abnormalities. Conclusion : The evaluation of the young victims of SCD and their relatives is an effective strategy for the detection of familiar cardiovascular. Introduction : Sudden cardiac death (SCD) is defined as the unexpected natural death of a cardiovascular cause in any circumstance and at any age. Although SCD in the elderly is not exceptional, publications in this area are rare. Our study aimed to highlight the epidemic peculiarities of sudden cardiac death in elderly people in the center of Tunisia. Methods: We conducted a retrospective study over a period of 4 years (2017- 2020) on all cases of sudden cardiac death of the elderly subject (age over 60 years) autopsied in the Department of Forensic Medicine in the Hospital of Kairouan. Results: During the study period, 71 cases were recorded. The age of the decea

Background. Cardiac involvement is an uncommon presentation of hydatid disease. In this study, we aim to analyze the experience of surgical treatment of cardiac and great vessels echinococcosis in our cardiovascular and thoracic surgery department. Methods. Through a 16-year period, from 2000 to 2015, 27 patients underwent surgery for cardiac and great vessels hydatid disease. The clinical, operative, and postoperative data were analyzed through this retrospective and descriptive study. Results. Most of our patients came from a rural area. The most common symptom was chest pain. The diagnosis was mainly made by transthoracic echocardiography, which has shown the right ventricle as the most frequent location of the disease. All patients received surgical treatment under cardiopulmonary bypass, and only six surgeries were performed without cross-clamping the aorta. Inhospital mortality rate was 7.4%. Conclusions. Cardiac hydatidosis is a rare but potentially serious condition whose treatment is mainly surgical even for asymptomatic patients owing to its possible fatal complications. The surgery outcomes are usually satisfactory. Follow-up examinations are highly recommended to detect recurrences. (C) 2020 by The Society of Thoracic Surgeons

The main objective of this study is to evaluate the performance of the predictive model (EuroSCORE II) on a Tunisian population to validate its use in our country.

Introduction. The occurrence of a cardiogenic shock is a rare presentation after scorpion envenomation. The treatment includes classically the use of inotropes and specific vasodilators. Case Presentation. We report a case of an 11-year-old boy presenting with cardiogenic shock and pulmonary edema after a scorpion sting. Despite adequate management at the emergency department and intensive care unit, the patient’s hemodynamic status worsened rapidly, justifying his transfer to our department for ventricular mechanical assistance by venoarterial extracorporeal membrane oxygenation. The following outcomes were favorable and the boy was discharged home on day 29 without aftereffects. Conclusion. This is the first report of successful use of extracorporeal membrane oxygenation for the treatment of cardiogenic shock after scorpion envenomation.

The Video can be viewed in the online version of this article [http://dx.doi.org/10.1016/j.athoracsur.2016.09.027] on http://www.annalsthoracicsurgery.org.A 25-year-old woman, with a history of uterine fibroid removal a year earlier, was admitted for dyspnea and generalized edema. Three weeks before admission, the patient underwent total hysterectomy with bilateral salpingo-oophorectomy for uterine leiomyoma. On physical examination, the patient had a rapid respiratory rate at 22 breaths per minute, and vesicular breath sounds were decreased in both lungs. She had a distended abdomen dull on percussion and bilateral lower limb swelling. Thoracoabdominal magnetic resonance angiography revealed an extended mass invading the inferior vena cava and thrombosis of the hepatic veins. Echocardiography showed a 33 × 32 mm echogenic mass in the right atrium originating from the inferior vena cava. The patient was diagnosed as having intravenous leiomyomatosis of the uterus with intracaval and cardiac extension. Open heart surgery was performed under sternotomy, median laparotomy, and cardiopulmonary bypass. The tumor was resected and entirely extirpated through the right atrium (Fig 1 and Video). The postoperative period was uneventful. The Video can be viewed in the online version of this article [http://dx.doi.org/10.1016/j.athoracsur.2016.09.027] on http://www.annalsthoracicsurgery.org. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJhZTk1NmQ5OGIyNGE2ODcyMjY1YmUzNzVkN2M0NWY2YiIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc4NTE4NDk4fQ.hVkR80xbtue8vRYZ4k13Nn7FnXpPgFj-ZmJwtgkWrMfSBCQ6Q9YZ1SAx2IZk1bcNT7wvcgSa4ZwjFV0raMOiPdPnWavcjZx1wQjNoNCUMzt71nzx_-J666W3UXtGf2S8VAiZMN01GQytJIGGQzsirybVji-bDZqOAXlywL5uutX1eNRuelMl5n7y05kGL7isJDzORFcJVY6XezjynTCF4fROD0TDGbISj9RN0OpL5oMph29bBLeFZ7h_hA5i1KnPCwfaBJt6tV1hqXq4RzW6iUouBN8guYk4ReosWuB1ILZPhYyEHknlhDFw07UH4ny9zYjAeEjF5KSsSu3mzNdcCA Download .mp4 (14.26 MB) Help with .mp4 files Video

The right ventricle is an uncommon location for cardiac myxoma. Its most common complications are pulmonary embolism and obstruction due to pulmonary valve tumor. We report the case of a 11-year old child with repetitive syncopes admitted to Cardiology ward. Echocardiography showed a right ventricular myxoma of 2cm obstructing the pulmonary orifice. Emergency surgical excision was performed under cardiopulmonary bypasss with favorable postoperative course. Anatomo-pathological examination of the surgical specimen confirmed the diagnosis of myxoma. At 18 months follow-up, there was no evidence of tumor recurrence.

L'endocardite du céur droit touche dans la plupart des cas la valve tricuspide, notamment chez les toxicomanes. L'infection isolée de la valve pulmonaire est rarement retrouvée. Nous rapportons dans cette observation le cas d'une jeune femme âgée de 32 ans chez qui le diagnostic d'endocardite communautaire de la valve pulmonaire a été confirmé. Cette observation est d'autant plus intéressante qu'elle survient chez une patiente sans antécédents de toxicomanie, avec néanmoins la notion de communication interventriculaire restrictive. La patiente a été opérée en urgence devant l'image de grosse végétation très mobile sur les données de l'échographie cardiaque transthoracique. La chirurgie a été pratiquée sous circulation extracorporelle et la valve pulmonaire a été remplacée par une bioprothèse. Les hémocultures et la culture de la valve ont retrouvé un staphylococcus aureus sensible à la Méticilline. L'évolution postopératoire a été favorable avec un recul de 06 mois sans récurrence infectieuse.

Le myxome du ventricule droit est une localisation très rare des myxomes cardiaques. Les complications les plus fréquentes sont l'embolie pulmonaire et l'obstruction par la tumeur de la valve pulmonaire. Nous rapportons le cas d'un enfant âgé de 11 ans admis en Cardiologie pour des syncopes à répétition. L'échographie cardiaque met en évidence un myxome du ventricule droit de 2cm, obstruant l'orifice pulmonaire. L'exérèse chirurgicale est pratiquée en urgence sous circulation extracorporelle, avec des suites opératoires favorables. L'examen anatomopathologique de la pièce a permis de confirmer le diagnostic de myxome. Le suivi à 18 mois ne montre pas de récidive tumorale.

Right heart endocarditis mainly affects tricuspid valve, especially in drug users. Isolated pulmonary valve infection is rare. We here report the case of a 32-year old young woman whose diagnosis of community-acquired pulmonary valve endocarditis was confirmed. This study is even more interesting because pulmonary valve endocarditis has occurred in a patient without a history of drug addiction; nevertheless, it wasn't associated with restrictive interventricular communication. The patient underwent emergency surgery due to the visualization of large and mobile vegetation on transthoracic heart ultrasound. Surgery was carried out under extracorporeal circulation and pulmonary valve has been replaced with a bioprosthesis. Bloodcultures and valve culture showed methicillin-sensitive staphylococcus aureus. Postoperative evolution was favorable, with a follow-up of 06 months without recurring infections.

BACKGROUNDthe cardiac sarcomas, although very rare, represent the quasi-totality of the primitive sly tumors of the heartAIMit is about a retrospective study of two cases of cardiac sarcomas operated in Sahloul university hospital of Sousse.CASESit is about a woman and a man: The respective ages were 22 and 45 years. The clinical pattern of the patients was polymorphic and the diagnosis put by cardiac echography. Both patients had a surgical resection and a chemotherapy. Both patients died in 13 and 18 months after the diagnosis.CONCLUSIONbecause of the extreme rarity of the cardiac sarcomas, there is no precise therapeutic strategy. The only consensus concerns the surgery as soon as the diagnosis of cardiac tumor is put. The prognosis of these tumors is extremely redoubtable with a survival which does not exceed 2 years after the beginning of the symptomatology.

Abdominal aortic aneurysm is extremely rare in infant and is generally due to infection, umbilical artery catheterization, vasculitis, connective tissue diseases and tuberous sclerosis. At the absence of these evident causes, it is a congenital primary aortic aneurysm which is exceedingly rare and only a few cases have of which have been reported. Here we report two cases of aortic wall reconstruction done by a Gore tex patch. The immediate result is excellent with a reestablishment of the femoral pulse and an excellent Doppler control. The problem which we may face in the future is probably the aortic out come with this Gore tex patch a continaons follow up of these patients is necessary.

We studied fifty one patients (40 men and 11 women) under going valve replacement from 1990 to 2002 for aortic regurgitation and had left ventricular dysfunction. 45% patients were in class III or IV of New York Heart Association (NYHA). All patients were investigated by echocardiography (left ventricular ejection fraction [LVEF] < 50%) - Peroperative mortality was 5.8% due to myocardial failure. 81.4% of survivors were followed duering a mean period of 24 months (rangis from 3 to 67 months) after valve replacement.

From May 1991 to July 2003, 19 patients (9 men and 10 women), of 30 years average age were operated in our department service for surgical cure of cardio-pericardial hydatid cysts. The TEE constitutes the examination of choice in the cardio-pericardial diagnosis of hydatid cyst. The surgery under CPB is the technique of choice, we practiced used 15 times. The left ventricular localization is most frequent. We deplore only death into post-operative immediate. The post-operative was course simple at the majority of our patients. 17 patients could be controlled remotely of the intervention with 35.5 months an average passing. We deplore 2 late deaths. No relapse was observed.