The communication between right pulmonary artery and left atrium is a very uncommon cause of right to left shunt. The 18th case in the world literature and the first case in France is reported here. Normal pressure in the right cavities and in pulmonary artery is evocative. Angiography assesses the diagnosis and precises the place and connections of the fistula. Surgical closing of the fistula must be promptly achieved in order to obviate embolic complications.

Child↗

PubMedDate not supplied

[Aorto-pulmonary windows. Report of fifteen cases (author's transl)].

Fifteen aorto-pulmonary windows have been operated on patients 1,5 months to 6 years old. 6 were associated with other cardiac malformations (ductus arteriosus, VSD, mitral insufficiency, aortic arch atresia). 5 cases died. 3 had other cardiac malformations associated. 10 have an average follow-up of 5 1/2 years. The authors insist on the severity of the cases with high pulmonary pressure, and advise operation during the first year of life.

Aorta↗

PubMedDate not supplied

[Comparative lipophilia of trandolapril and other converting enzyme inhibitors].

The lipophilicity of angiotensin converting enzyme inhibitors (ACE-I) available in France has been compared using two complementary methods. Studies have been performed both on active ACE-I and prodrugs. The first study used reverse phase high performance liquid chromatography (HPLC) in order to measure the n-octanol water partition coefficients. They were measured at 3 pH values (2.5, 4.7 and 7.4). The second study was performed on the basis of computer drawn chemical formula. The lipophilic area to hydrophilic area ratio was calculated from the three dimensional structure of each ACE-I. A calculated n-octanol water partition coefficient was then determined. Whatever the method, a broad range of values was seen. The HPLC n-octanol water partition coefficient ranged from -1.86 (captopril) to 1.02 (trandolaprilate). The lipophilic to hydrophilic ratio ranged from 1.33 (captopril) to 2.74 (trandolaprilate) and the computer determined n-octanol water partition coefficient ranged from -0.36 (perindoprilate) to 0.69 (quinaprilate). A strong correlation (r = 0.97 p = 0.0001) was found between the lipophilic/hydrophilic area ratio and the HPLC partition coefficient. The classification of the ACE-I was very close whatever the mode of determination. The less lipophilic ACE-I are lisinopril and captopril and the most lipophilic are quinalapril and trandolapril. Clinical consequences of such differences remain unknown.

Angiotensin-Converting Enzyme Inhibitors↗