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,

, de mes chers condisciples et devant l'effigie d'Hippocrate, je promets et je jure, au nom de l'Etre suprême, d'être fidèle aux lois de l'honneur et de la probité dans l'exercice de la médecine

, Je donnerai mes soins gratuits à l'indigent et n'exigerai jamais un salaire au-dessus de mon travail

, Admis (e) dans l'intérieur des maisons, mes yeux ne verront pas ce qui s'y passe, ma langue taira les secrets qui me seront confiés, et mon état ne servira pas à corrompre les moeurs

, Respectueux (se) et reconnaissant (e) envers mes Maîtres, je rendrai à leurs enfants l'instruction que j'ai reçue de leurs pères

, Que je sois couvert (e) d'opprobre et méprisé (e) de mes confrères si j'y manque. RÉSUMÉ Introduction L'étude de la fonction du ventricule droit (VD) est très importante en chirurgie cardiaque car son altération est associée à une augmentation de la morbi-mortalité. Nous nous sommes intéressés à l

, Matériel et méthodes Etude prospective, observationnelle. Inclusion des patients pour chirurgie valvulaire. Les mesures échographiques ont été réalisées à 3 temps. A T0 (Préopératoire, thorax fermé), à T1 (Thorax ouvert, péricarde ouvert, avant la CEC) et à T2 (Après la chirurgie

, Les paramètres échographiques du VD étaient : le TAPSE, l'Onde S à l'anneau tricuspide, le 2DStrain de la paroi libre et les diamètres RV1-RV3 du VD. Deux voies d'abord sternotomie et mini-sternotomie pouvaient être pratiqué

, Résultats 30 patients ont été inclus : 23 valves aortiques (dont 5 « mini-sternotomie ») et 7 valves mitrales

, des 30 patients étaient sortis sous amines et aucun sous assistance mécanique, le groupe sternotomie entre T0 et T1 : le TAPSE, RV1 et RV3 augmentaient significativement

, les autres paramètres n'avaient pas de variation significative. Entre T0 et T2, tous les paramètres du VD étaient significativement altérés (p<0.001) : TAPSE, Onde S, 2DStrain Global et morphologie RV1-RV3

. Dans-le-groupe-mini-sternotomie, l'augmentation significative du TAPSE à la péricardotomie n'était pas retrouvée et on n'observait aucune différence significative

. L&apos;ouverture, du péricarde était un paramètre qui modifiait à lui seul significativement les mesures de morphologie du VD : ceci souligne l'importance du moment où nous effectuons des mesures échocardiographique

, L'altération plus importante du 2DStrain Global dans le sous-groupe ministernotomie pourrait s'expliquer par un temps de CEC prolongé

. L&apos;ouverture-partielle-du-péricarde, mini-sternotomie) semblait avoir un effet protecteur sur la fonction ventriculaire droite car aucun de ces patients n'a présenté d'altération des paramètres échographiques en postopératoire immédiat

, Mots clés : Echocardiographie, Ventricule droit, chirurgie cardiaque, p.2