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D De Zuttere

Publications and source records attributed to D De Zuttere.

3 recordsLinked to original sources

Late endocarditis-associated obstructive dysfunction of a tricuspid ball-cage-type valve. Doppler echocardiographic findings and therapeutic implications.

Thrombotic obstruction is rare in bacterial endocarditis involving prosthetic heart valves. A 45-year-old man who had three intracardiac, ball-cage-type prosthetic valves, presented with streptococcal septicemia. Major obstruction of the tricuspid Smeloff-Cutter valve and normal function of the two other prostheses were documented by Doppler echocardiography. Emergency replacement of the tricuspid valve alone was decided on the one basis of this echocardiographic diagnosis, and successfully performed. Operative findings confirmed the noninvasive findings.

Ampicillin

Nitroglycerin-induced decrease of carbon monoxide diffusion capacity in acute myocardial infarction reversed by elevating legs.

Hemodynamic and respiratory variables were measured in 18 supine patients with acute myocardial infarction uncomplicated by left ventricular failure. Measurements were done during a control period and then when pulmonary capillary bed filling was decreased by iv injection of 3 mg nitroglycerin (NTG) and finally when pulmonary capillary bed filling was increased by raising the patients' legs. Heart rate increased significantly (p less than .05) ventricular filling, and mean aortic pressures dropped significantly (p less than .001) after NTG injection. Heart rate and mean aortic pressure returned to control level and ventricular filling pressures increased significantly (p less than .001) after elevating patients' legs. Mean carbon monoxide diffusion capacity decreased significantly (p less than .01) from 9.8 +/- 3.4 to 8.5 +/- 2.9 ml/min X mm Hg after NTG injection and increased significantly (p less than .02) to 9.3 +/- 3.5 ml/min X mm Hg after elevating patients' legs. Pulmonary wedge pressure decreased significantly (p less than .001) from 15 +/- 5 to 8 +/- 4 mm Hg after NTG injection and increased significantly (p less than .001) to 10 +/- 4 mm Hg after elevating patients' legs. We conclude that NTG reduces pulmonary capillary filling and pulmonary diffusion by reducing the available pulmonary gas exchange surface.

Adult

[Septicemia associated with the presence of a pacemaker with endocavitary electrode].

Septicaemia on endovenous pacemaker electrodes is infrequent and difficult to detect. We report the case of a 64-year old woman with a diagnosis of prolonged fever that dragged on for several months before infection of her pacemaker was considered, then confirmed. Repeated Staphylococcus epidermidis isolates from blood cultures were no longer regarded as contaminations, and transoesophageal echocardiography revealed the presence of a "mass" on her endocavitary electrode, which had not been visualized on several previous échocardiographies. Surgical removal of the electrode was soon required in view of multiple septic emboli despite a bacteriologically effective antibiotic therapy. The outcome is favourable after a 6-month follow-up. The authors review the diagnostic and therapeutic problems created by infections on electrosystolic exciting electrodes.

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