[Computerized tomography of hydatid cyst of the heart in children].
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Biomedical subjects
Publications and source records attributed to M Fourati.
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Circulation antigen and sera antibodies were measured in 122 sera obtained from 87 patients with proved hydatic echinococcosis: the sera were obtained before and after surgical treatment. Circulating antigen was detected by E. L. I. S. A., and was present in 21% of the sera. Antibodies were present by conterimmunoelectrophoresis in 56%, by haemagglutination in 72%, E. L. I. S. A. IgG in 87%, E. L. I. S. A. IgM in 54%, E. L. I. S. A. IgA in 53%, E. L. I. S. A. IgE in 25% of the sera. No evident correlations between these results and the localisation could be found, nor with anatomical integrity of the cyst, or the surgical treatment date. Only the presence of IgE or circulating antigen could suggest the high level passage of hydatic proteins, bringing to mind a fissuration of the cyst wall.
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We report a case of complex congenital aortic stenosis with obstruction at all three levels of the left ventricular outflow tract (subaortic, aortic, and supravalvular aortic stenoses) associated with a mitral malformation, coarctation of the aorta, and the Wolff-Parkinson-White syndrome. The subaortic stenosis was corrected by excision and myotomy, and the supravalvular stenosis by a widening prosthetic operation with a Dacron patch extending as far as the aortic ring, at which level a Björk-Shiley No. 17 aortic prosthesis was inserted. The mitral valve was replaced by a Lillehei-Kaster prosthesis. The coarctation of the aorta was not significant and was left alone. Permanent pacing was needed because of peroperative surgical section of the bundle of His. Reviews of the literature and the various techniques used to widen the left ventricular outflow tract are included.
A case is reported in which the entire pulmonary venous return was abnormal, being retro-cardiac. Unusual features were the age at which the abnormality was discovered (14 years), and the anatomical type of abnormality of pulmonary venous return. The return effectively emptied into a posterior cavity which was "a diverticulum of the right atrium" which had a wide communication with the "normal" right atrium, which in turn communicated with the left atrium by a highly placed Ostium Secundum. The muscular septum which separated the highly placed auricle of the left atrium and the "diverticulum" was removed, and vertical partitioning allowed a right and left atrial cavity to be reconstituted. The post-operative progress was uneventful.
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The authors report 9 cases of hydatic cyst of the heart which they have encountered over an 8 year period. They illustrate the variable nature of this parastic illness, which may stimulate almost and cardiovascular disorder. The various clinical presentations and the methods of diagnosis and treatment are presented: the clinical picture is of little help in establishing the diagnosis. This is made at three levels: the history (country of origin where the disease is endemic, or other associated cyst), the presence of Xray of a swelling of the heart which is later calcified, and the presence on the electrocardiograph of ischaemic changes, which may be severe enough for necrosis. They emphasise the importance of serological tests to make a formal diagnosis of the condition, and a repetition of such tests as part of the postoperative follow-up. Surgical treatment (usually by an open heart technique) is the rule. It may be coupled with medical treatment with anti-malarials (paludrin of flavoquin).
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