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M Nivet

Publications and source records attributed to M Nivet.

At least 19 recordsLinked to original sources
PubMed1992

Systemic embolism as a complication of percutaneous mitral valvuloplasty.

Systemic embolism is a potential and severe complication of percutaneous mitral valve dilatation. In our series of 80 cases, the incidence of systemic embolism was 3.75% (3 cases). Two cases occurred during the procedure itself. The cause of embolism was different in each case: cruoric thrombus formation occurred in 2 cases during or after dilatation, and was attributable to inappropriate heparinization, and catheter and guidewire thrombogenicity. In both cases heparin administration was delayed or given at a lower dosage. In the third case, calcific embolism occurred several days after valve dilatation. We think that the embolic calcified fragment was detached from the mitral leaflet at the time of or after balloon inflation. In these 3 cases, intraatrial thrombus mobilization was not the mechanism of systemic embolism. In 2 cases, transesophageal echocardiography had been performed before dilatation and excluded the presence of an atrial thrombus the day before the procedure. It is concluded that, together with mobilisation of left atrial thrombi, which can be adequately detected by transesophageal echocardiography, catheter-induced thrombi represent a significant cause of embolic complications and must be prevented by giving full-dose heparin during the total duration of the procedure. Calcific embolism may also occur, and may become more frequent if mitral valve balloon dilatation is proposed to a larger number of patients with valvular and subvalvular calcifications.

Aged↗
PubMed1991

Intra-myocardial haemorrhage following recanalisation of a venous coronary arterial bypass by balloon angioplasty.

We report the case of a patient presenting an intra-myocardial hematoma after recanalisation of a saphenous aorto-right coronary arterial bypass graft implanted 10 years previously after posterior myocardial infarction. The intra-myocardial hematoma occurred immediately after recanalisation of the graft and was complicated by transient complete atrio-ventricular block. An acute increase of coronary capillary perfusion pressure may cause intramyocardial bleeding when capillary permeability is altered by prolonged ischemia or necrosis. In this case the resulting hematoma was limited to the segment of left ventricular wall affected by the previous necrosis and there was no further myocardial damage.

Angioplasty, Balloon, Coronary↗
PubMed1986

[Coronary stenosis after radiotherapy. Clinical study of 5 cases and review of the literature].

Coronary artery stenosis is one of the possible complications of radiotherapy to the mediastinum. Although less frequent than pericardial disease, anatomopathological studies have shown it not to be uncommon. Five cases with different clinical presentations are reported and the 30 previously described cases are reviewed. Radiotherapy was performed for Hodgkin's disease in 70% of cases and for carcinoma of the breast in 10% of cases. The average delay before onset of the symptoms was 4 years but in some cases delays of up to 10 years were observed. The most common presentation was an inaugural myocardial infarction (50 to 60% of cases). In other cases, angina of effort or typical spastic angina was observed. The coronary lesions were mainly proximal single artery stenosis affecting especially the left anterior descending artery. The typical histological appearances of the stenosis were intimal and sometimes adventicial fibrosis, occasionally associated with medial hyaline sclerosis. However, atherosclerotic lesions were also commonly present. This observation raises the question of the role of irradiation in the development of precocious atherosclerosis by coronary endothelial damage. This hypothesis is supported by the results of experimental studies and by the fact that several autopsy reports showed that the atheroma only developed in the irradiated zone. In addition, although the most demonstrative cases are those of young patients of 30 to 35 years of age, the responsibility of radiotherapy in the development or coronary pathology of older patients cannot be excluded, especially when none of the classical coronary risk factors are present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Sarcoma of the heart. Apropos of 2 cases].

Sarcoma of the heart is a very rare condition. We present here two cases with very different clinical expression. The first patient, a 15-year old girl, presented with extremely severe ventricular arrhythmia, whereas the second patient, a 63-year old woman, mainly had signs of congestive cardiac failure. A diagnosis of cardiac tumour was made in the first case on the basis of ultrasonographic results which clearly showed the tumour developed from the walls of the left ventricle. In the second case, the tumour involved the right ventricular wall, the deformation of which was undetected by ultrasounds and only suspected at angiography. Both patients died rapidly, and the diagnosis of sarcoma was confirmed at post-mortem examination.

Adolescent↗
PubMed1985

[Regression of post-infarction parietal dyskinesia after percutaneous coronary angioplasty].

Normalisation of abnormal segmental wall motion is rarely observed after myocardial revascularisation by aorto-coronary bypass when the territory revascularised is the site of post-transmural infarction dyskinesia. In particular, normalisation of segmental wall motion is extremely rare when dynamic tests designed to detect potential for improvement (trinitrin test and post-extrasystolic potentiation) are negative. We present the case of a 41 year old man who had anterior and septal wall dyskinesia 2.5 months after antero-septal infarction which was not improved by trinitrin. Dilatation of the left anterior descending artery by percutaneous coronary angioplasty was undertaken because of recurrent effort angina. Control angiography at 6 months showed almost complete normalisation of left ventricular contraction. This myocardial recovery is paradoxical because the trinitrin test did not show potential for improvement. The case illustrates the possibility of normalisation of segmental abnormalities of left ventricular contraction after revascularisation of the dyskinetic zone by percutaneous coronary angioplasty.

Adult↗
PubMed1985

[Cor triatriatum of adults. Apropos of 2 new surgically treated cases in adults].

The authors report two cases of cor triatriatum in a 54 year old woman undergoing open heart surgery with a preoperative diagnosis of mitral stenosis, and a 24 year old woman in whom the diagnosis had been made before surgery. Resection of the abnormal intra-left atrial fibrous membrane successfully restored normal haemodynamics in both cases. The main clinical and diagnostic features of the condition are described.

Adult↗
PubMed1983

[Thyrotoxicosis, then hypothyroidism caused by iodine overload (amiodarone) associated with neuropathy. Failure of plasma exchange].

A 54-year-old woman, with no previously documented thyroid disease, treated with amiodarone (200 mg/day, five days a week for 33 months) for paroxysmal tachyarrhythmia complicating mitral stenosis, suddenly developed extremely severe thyrotoxicosis. After therapeutic failures with carbimazole and propylthyrouracil (PTU) associated with beta-blockers, she was transferred to intensive care for plasma exchange (PE). Two PE were performed, temporarily aggravating the cardiovascular status of the patient, with no secondary improvement. The quantity of T3 removed was very small, about 1,000 ng per exchange. On the 14th day PTU had to be discontinued (toxic thrombopenia) and only symptomatic treatment was maintained (assisted ventilation, digitalis, hyperalimentation). In the 4th month, while the patient had a high total serum iodine, hypothyroidism developed due to partial block of the organification of the iodine with high TSH and fixation; this state also lasted 4 months. Spontaneous recovery was observed after 8 months. In addition a severe peripheral neuropathy was observed during the hyperthyroid phase confirmed by electromyography, distinct from the signs of thyrotoxic myopathy. This gradually regressed over 7 months and may be attributed to amiodarone therapy. The association of these two successive types of thyroid disorder due to amiodarone is an exceptionally rare phenomenon. Severe thyrotoxicosis generally requires long-term symptomatic therapy, its natural course being towards spontaneous regression. PE are ineffective on the circulating hormonal levels and were dangerous because of the underlying cardiac disease. The development of hypothyroidism at the 4th month is explained by the persistent iodine overload, and therefore prolonged surveillance after withdrawal of therapy is advised. The neurological complication of amiodarone was quite distinct from the hyperthyroid myopathy.

Amiodarone↗
PubMed1982

[Creatine kinase BB with atypical migration. Possible role of IgA in its formation].

We studied the behaviour of an atypical CK in one female patient. Using exclusion-diffusion chromatography of the serum, on Sephadex G 200, we observed the simultaneous elution of a CK-BB and IgA. We demonstrated that this eluate contained the components responsible for this atypical CK. The study of the behaviour of this enzyme complex reveals a resemblance with that of immune complexes.

Aged↗
PubMed1978

[Paradoxical displacement of the interventricular septum with impairment of filling of the left ventricle. Echocardiographic and hemodynamic diagnosis. Apropos of 3 cases].

An unusual type of displacement of interventricular septum, the inverse of that found normally, was found by echocardiography in 3 cases: 2 with pulmonary arterial hypertension and 1 with constrictive pericarditis. In two cases catheterisation showed the haemodynamic picture of mitral obstruction, and in 1 case the typical findings on auscultation of mitral stenosis were present. The echocardiogram and anatomical studies showed that the mitral valve was normal. The obstruction was due to displacement of the septum towards the left ventricle during diastole. Because of this displacement, the septum came into contact with the mitral valve, and caused impairment of the filling of the left ventricle.

Adult↗
PubMed1977

[Myocardial infarction and heterozygous sickle cell anemia. Apropos of 2 cases].

Thromboses are a classical complication of sickle cell disease in the severe homozygous form. In the heterozygous individual, although the risk of severe thromobotic episodes is small, it must nevertheless be recognised. The authors report two cases of myocardial infarction in patients whose coronary arteries were relatively free from atherosclerosis; they were young men, with the heterozygous form of sickle cell disease AS. The part played by inheritance, the factors favouring vascular occlusion, and the possibility of preventing such episodes are all discussed.

Adult↗