[Pulmonary hypertension associated with left heart diseases: pathophysiology, diagnosis, treatment].

Pulmonary hypertension (PH) is a common complication of diseases affecting the left heart, mostly found in patients suffering from heart failure. Left atrial hypertension is the initial driver of post-capillary PH. However, several mechanisms may lead in a subset of patients to structural changes in the pulmonary vessels with development of a pre-capillary component.

[Anticoagulation therapy during pulmonary embolism follow-up in clinical practice].

Patients with pulmonary embolism are a heterogeneous population and, after the acute phase and the first 3-6 months, the main issue is whether to continue, and hence how long and at what dose, or to stop anticoagulation therapy. In patients with venous thromboembolism (VTE), direct oral anticoagulants (DOACs) are the recommended treatment (class I, level of evidence B in the latest European guidelines), and in most cases, an "extended" or "long-term" low-dose therapy is warranted. This paper aims to provide a practical management tool to the clinician dealing with pulmonary embolism follow-up: from the evidence behind the most used exams (D-dimer, ultrasound Doppler of the lower limbs, imaging tests, recurrence and bleeding risk scores), and the use of DOACs in the extended phase, to six real clinical scenarios with the relative management in the acute phase and at follow-up.

Mechanical recanalization of total coronary occlusions with the use of a new guide wire.

The mechanical approach in the recanalization of total coronary occlusions consisted of the use of a new 0.014-inch standard coronary guide wire with jointless spring coil design that improves steering characteristics and tip stiffness. In addition, a 0.

Activation of the intracellular glutathione system by oxydative stress during cardiopulmonary bypass and myocardial perfusion.

The glutathione (GSH) system is the main defence of tissues against free radicals and red blood cells (RBC) are the most efficient sites for GSH redox cycle activation. Total GSH was assayed during cardiopulmonary bypass (CPB) in RBC and serum from the coronary sinus, peripheral arteries and veins in 18 children corrected of their cardiac defect. Our conclusions are: (1) RBC-GSH redox cycle is activated during heart ischaemia and reperfusion; (2) the activation of intracellular GSH system is preponderant compared with the extracellular one; (3) variations in intraerythrocytic total GSH during heart ischaemia and perfusion are detectable in peripheral veins and arteries, which can be the convenient sites for monitoring changes in the GSH cycle; and (4) increased total GSH levels are present in RBC before aortic crossclamping: at the beginning of mechanical ventilation in veins and, when CPB is started, also in arteries.

[Pneumothorax in severe chest injuries].

The authors reviewed CT scans and supine chest X-ray of 47 patients affected by severe thoracic trauma, examined in 1985-86. The sensibility of the two methodologies in the assessment of pneumothorax was compared. CT detected 25 pneumothorax, whereas supine chest X-ray allowed a diagnosis in 18 cases only.

[Late aortic dissection after aortic valve substitution. Considerations on 5 operative cases].

This study analyses the clinical course of five patients who developed acute ascending aortic dissection 45.8 months (17-87 months) after aortic valve replacement (AVR) and underwent reoperation in our Department. All except one had aortic insufficiency with mild dilatation of the ascending aorta.