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A Calibre

Publications and source records attributed to A Calibre.

3 recordsLinked to original sources

[Repolarization anomalies in postoperative ECG after aorto-coronary bypass].

The authors studied 164 patients admitted in 1994 to their rehabilitation centre less than 5 weeks after a coronary artery bypass graft. They performed an ECG on admission and noted the presence and localization of repolarization abnormalities such as a flat or negative T wave as well as the presence of QRS abnormalities, such as conduction disorders or sequelae of necrosis. The abnormalities were compared with the presence and severity of the pericardial reaction on ultrasonography and in the revascularized territories. Two-thirds of patients presented repolarization abnormalities in the anteroseptoapical (ASA) territory, regardless of the intensity of the pericardial reaction. 88% of patients with no QRS abnormalities (75 patients), had an ASA repolarization abnormality. 80% of patients presenting sequelae of isolated inferior necrosis had normal ASA repolarization. The intensity of the pericardial reaction does not determine the presence of postoperative repolarization abnormalities, but rather "myocardial" abnormalities and especially sequelae of inferior necrosis which "normalize" ASA repolarization in 80% of cases, which raises a doubt about the mechanism of these repolarization abnormalities.

Arrhythmias, Cardiac

[Systemic cholesterol embolism].

The authors report two cases of cholesterol embolism and review the literature on this subject. Cholesterol crystal emboli are very serious complication of atheroma, generally situated in the aorta and usually in patients in their sixties. The frequency of cholesterol embolism is 20% in autopsy studies in this population. The embolic process accounts for the polymorphic clinical feature. Clinical signs are always delayed in relation to triggering factors. The symptoms can sometimes simulate a systemic disease. Cutaneous signs are present in 40 to 75% of cases. Acute renal failure is present in 30% of cases. Other signs may also be observed: alteration of the general state, fever, neurological disorders, pain of the lower limbs, myalgia, gastrointestinal haemorrhage or perforation, ischaemic colitis, pancreatitis, mesenteric or coronary angina. A triggering factor is revealed in 80% of cases: aortic surgery, retrograde aortic catheterization, fibrinolysis or oral anticoagulant treatment. The prognosis is poor due to the clinical context, the patient's age and the absence of any specific treatment. The short-term mortality is 60 to 80% according to various series. The best treatment is prevention: carefully assess the indication for an endovascular procedure in an atheromatous patient; if necessary, perform transoesophageal ultrasonography to evaluate the risk; whenever possible change the incision in vascular investigations or operative procedures in high-risk patients.

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