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I Meddeb

Publications and source records attributed to I Meddeb.

5 recordsLinked to original sources

[Cardiac myxoma. Surgical treatment. About 20 cases].

INTRODUCTION: Cardiac myxoma is the commune cardiac tumors. Their clinical status depends in the anatomic type. The aim of this study is to evaluate our results and to compare them for literature. PATIENTS AND METHODS: From January 1990 to June 2004, 20 patients (8 males and 12 females) with mean age of 49 years underwent surgical treatment of cardiac myxoma. The tumors were in left atrium in 14 cases, in right atrium in 4 cases and biatrial in 2 cases. Surgical treatment consisted in complete resection of the tumor in all cases associated with partial atrial septal resection in 9 cases. RESULTS: There is not death in the postoperative outcome. The mean follow up is 50 months. The late mortality rate was 10%. All patients are asymptomatic and the echocardiography control showed no tumor recurrence. CONCLUSION: Cardiac myxoma is the communist primary tumor of the heart. Diagnosis is based upon echocardiography. Surgical management has well out come with low morbidity and mortality. Late results are satisfactory but regular screening is recommended although risk of recurrence is low.

Female↗

[Determining factors in mitral valve reconstructive surgery. Report of 150 cases].

150 patients had mitral valve repair for mitral valve incompetence. There were 57 males and 93 females with a mean age of 22 years. 60% of the patients were in Class II NYHA and 40% in Class III and IV. Type I was present in 18 patients, type II in 98 and type III in 34 cases. Mitral repair included correction of valve prolapse, valvular enlargement with pericardial patch and annuloplasty with semi-rigid ring in 128 cases and PTFE patch along the posterior leaflet in 12 cases. The perioperative mortality rate was 2.6%. All patients had early post-operative echocardiography. According to this, mitral regurgitation was absent or tiny in 135 patients, grade II in 10 cases and grade III in 2 cases. It was moderate or important in twelve patients. In the late post-operative period. All the others patients were reoperated upon for mitral dysfunction in a mean time of 37 months. The reason for reoperation was in the majority of the cases the recurrence of mitral regurgitation related to increase of valvular and sub valvular disease. The late mortality rate is 7%. Out of 126 reviewed survivors on the long run, 71 patients are asymptomatic in class I, 53 patients in class II and 2 patients in class III NYHA. The estimated mitral regurgitation by echography in those patients is absent or trivial in 96 cases. grade II in 29 cases and grade III in one case. Mitral valvuloplasty is the preferred procedure in mitral insufficiency surgical management. It is associated to a low early mortality and morbidity rate. Despite the need for reoperation in about 10% of the cases in the long follow-up, mitral repair offers a good quality of life without anticoagulant treatment.

Adult↗

[Vascular complications in infectious endocarditis. Apropos of 86 cases].

During a 20 year period, 285 patients were hospitalised for infectious endocarditis (IE) in the Department of Cardiology of the Ernest-Conseil Hospital in Tunis and 86 of them, i.e. 30%, developed a vascular complication (VC). Among these 86 patients, there were a total of 108 lesions, including 52 neurological complications, 14 peripheral acute ischemic syndromes, 16 peripheral arterial aneurysms, 9 aortic aneurysms, 7 pulmonary embolisms, 6 splenic infarctions and 4 coronary lesions. The mortality in this patient group proved to be slightly greater than in the series as a whole, in particular concerning patients with multiple lesions and those with an artificial valve. No prognostic difference was seen between patients with a VC of aneurysmal type and of ischemic type, but the presentation and severity of lesions was very variable. The vascular complication was a presenting feature of IE in almost 40% of cases. The organism found most often was the streptococcus, above all in ischemic type IE as well as in the total patient group. Similarly, the preferential site was aortic, above all for aneurysmal type IE. Ultrasonography revealed a higher incidence of vegetations in this series of patients, above all in ischemic type VC, but anatomical studies have shown this to be an investigation of moderate sensitivity and poor specificity, poorly correlated from a prognostic standpoint with the risk of embolism. The conclusion of the study is above all the need to prevent such complications: embolic complications by early antibiotic treatment and valve replacement and aneurysmal complications by methodical routine angiographic evaluation and appropriate treatment.

Adolescent↗