Left ventricular performance in chronic mitral regurgitation: temporal response to valve repair and prognostic value of early postoperative echocardiographic parameters.

Background: The temporal response of the left ventricle due to the relief of volume loading after mitral valve repair, and the prognostic value of early changes in left ventricular size and function, are not fully documented. The purpose of this study was to analyze the evolution of left ventricular performance after surgery, and to evaluate how early postoperative echocardiographic parameters compare with late ventricular function.

Methods: We studied 58 patients with chronic degenerative mitral regurgitation using echocardiography, before, and 9 +/- 3 days and 38 +/- 6 months after mitral valve repair.

The limitations of echocardiography in the overall diagnosis of the morphological lesions associated with infective endocarditis: comparison of echocardiographic and surgical findings.

Echocardiography is commonly accepted as the method of choice for the non-invasive diagnosis of vegetations and other lesions associated with infective endocarditis. To assess the accuracy of echocardiography in the overall diagnosis of the morphological cardiac lesions we retrospectively analyzed and compared the preoperative echocardiographic data with the surgical findings of 120 consecutive cases operated for infective endocarditis. Transthoracic echocardiography (TTE) was used in 60 cases (51 with native and 9 with prosthetic valves), both TTE and transesophageal echocardiography (TEE) in 50 (26 with native and 24 with prosthetic valves) and only TEE in 10 patients who underwent emergency surgery.

Measurement of mitral valve area in mitral stenosis: four echocardiographic methods compared with direct measurement of anatomic orifices.

Objectives: This study sought to compare the mitral valve areas of patients with rheumatic mitral valve stenoses as determined by means of four echocardiographic and Doppler methods with those obtained by direct anatomic measurements.

Background: There has been no systemic comparison between Doppler-determined valve areas and the true anatomic orifice in a single cohort.

Methods: In 30 patients with mitral stenosis, the mitral valve areas determined by two-dimensional echocardiographic planimetry, pressure half-time, flow convergence region and flow area were compared with the values directly measured on the corresponding excised specimen by means of a custom-built sizer.

Papillary fibroelastoma of the mitral valve. A rare cause of embolic events.

A 66-year-old woman was admitted to our department with an 11-month history of multiple transient ischemic attacks and strokes. A 2-dimensional echocardiographic study revealed an intracardiac tumor attached both to the chordae and to the anterolateral papillary muscle of the mitral valve. The patient underwent excision of the tumor, which necessitated concomitant mitral valve replacement.

[Magnetic resonance in postoperative evaluation of aortic dissection].

The value of MRI was investigated in the demonstration of residual alterations and postoperative complications of aortic dissection. October 1988 to December 1992, fifty-nine patients were examined with MRI. The series consisted of 53 patients affected with type A and 6 with type B aortic dissection, all of them surgically treated.

Postoperative MR follow-up of type A aortic dissection.

Objective: We set out to study the efficacy of MRI in the demonstration of residual alterations and postsurgical complications of type A aortic dissection.

Materials And Methods: From October 1988 to December 1990, 28 patients, 18 patients with type I and 10 with type II aortic dissection, underwent MR examinations for postsurgical evaluation. Features evaluated included caliber of the aorta (a) above and (b) below the prosthesis; (c) redissection; (d) persistent intimal flap; (e) presence of abdominal vessels arising from the false lumen; and (f) status of thoracic supraaortic vessels.

[Fatal aortic dissection in a young woman at the 32nd week of pregnancy].

Aortic dissection in young women without Marfan disease is unusual. When it occurs it is often related to pregnancy. We report a fatal case of aortic dissection in a 29-year-old woman at the end of her first pregnancy.

Successful resection of a tuberculous pseudoaneurysm of the descending thoracic aorta: case report and review of the literature.

An aneurysm of the descending thoracic aorta was found in a 55-year-old woman. She had hemoptysis, fever, and weight loss beginning 1 month before hospitalization. A miliary tuberculosis developed after angiography.

Color Doppler echocardiographic assessment of atrial septal defect size: correlation with surgical measurements.

In patients with atrial septal defect (ASD), color flow Doppler echocardiography provides visualization of the transseptal jet, the maximal dimension of which can be assumed to correspond to the maximal dimension of the true orifice. To test whether color flow Doppler echocardiography can provide an alternative method for measurement of ASD size, we studied 63 consecutive patients with echocardiographic evidence of ASD. In 48 patients the maximal dimension of the jet was measured in the parasternal, apical, or subcostal four-chamber view or in the parasternal short-axis view.

Aneurysm of an aberrant right subclavian artery. Report of a surgically treated case.

A 53-year-old man was admitted for treatment of an aberrant right subclavian artery aneurysm that had been diagnosed 5 years earlier and had recently begun to enlarge. The aneurysm, which involved the right subclavian artery from its origin, measured 47 mm in diameter and about 10 cm in length. Because of the lesion's size and friability, a 2-stage operation was performed.

Combined open-heart valve surgery and elective abdominal operations.

From January 1970 to December 1984, at the "A. De Gasperis" Division of cardiac surgery in 73 patients an open-heart valvular operation and an elective abdominal surgical procedure were simultaneously performed. Abdominal surgery was indicated for: cholelithiasis (41 cases), hernia (22 cases), uterine fibroleiomyomas (7 cases), pregnancy (1 case), marginal ulcer after gastric resection (1 case), association of cholelithiasis and hernia (1 case).

[Replacement of the mitral and aortic valves with bioprostheses. Long-term results].

The purpose of the study was to analyze the medium-term results (late mortality, thromboembolism, valve failure) in patients who underwent bioprosthetic valve replacement at "A. De Gasperis" Cardiovascular Surgery Division. From October 1975 to December 1982, 195 patients were consecutively operated on and discharged (118 with mitral prosthesis, 54 with aortic prosthesis, 22 with mitral and aortic prosthesis, 1 with mitral and tricuspid prosthesis).

[Discrete subaortic stenosis. Considerations on 64 cases surgically treated].

The AA. reviewed our experience concerning 64 patients operated on for discrete subaortic stenosis due to a fibrous membrane, between 1975 and 1981 at the Department on Cardiac Surgery "A. De Gasperis" in Milan.

[Aneurysms of the Valsalva sinus. Study of ten treated subjects (author's transl)].

The study includes 10 patients affected by aneurysm of Valsalva sinus who underwent surgery. The aneurysm involved the "non coronary" sinus in 5 cases and the right coronary sinus in 5. All the aneurysms prolapsed into the right cardiac chambers.

[Ebstein's malformation. Report of 9 cases surgically treated (author's transl)].

Nine patients with Ebstein's malformation have undergone surgical repair since 1971. Their ages ranged from 10 to 49 years. Two patients were in functional class II and six in III.

[The incomplete atrio-ventricular canal. Operative and long term results in 100 cases (author's transl)].

100 patients with endocardial cushion defect of the partial type underwent surgical correction between the years 1957-1975. The age of patients ranged from 3 to 57 years with a mean of 18 years. In 89 patients there was a mitral insufficiency.

[Supravalvular aortic stenosis. Report of twelve cases (author's transl)].

Twelve patients having supravalvular aortic stenosis were operated. Indication to the surgery was set up with a pressure gradient across the stenosis greater than 50 Hg millimeters and/or in a presence of important symptoms and/or with electrocardiographic signs of left ventricular hypertrophy. The technique and results of operation are described.

[Cardiac fibroma: a successfully operated case and a review of the literature (author's transl)].

A case of cardiac fibroma in a three years old child successfully operated on is presented. The tumor was localized on the interventricular septum and was provoking an obstacle in the outflow of the right ventricle. The preoperative diagnosis was formulated by angiocardiography.

[Congenital coronary fistulas: report of six operated cases (author's transl)].

The authors report of their own experience of 6 patients suffering from congenital coronary fistula. In 3 cases the fistula originated from the right coronary artery and in the other 3, from the branches of the left coronary artery. In 2 cases the fistula ended in the right atrium and in 4 cases in the right ventricle.

[Rupture of interventricular septum secondary to blunt chest trauma. Report of a case surgically treated with success (author's transl)].

A case of interventricular septal defect secondary to blunt chest trauma is reported. It was characterized by a disconnection of the interventricular muscolar septal in the anterosuperior part of the heart wall. The diagnosis, suspected by clinical and instrumental parameters, was definitely confirmedy by hemodynamic and contrastographic examination.

Ten years' experience in heart valve replacement with artificial prostheses: immediate and long-term results in 1812 cases.

A ten year follow up of 1,812 patients who underwent heart valve replacement with artificial prothesis between October 1963 and December 1973 is reported. Hospital mortality was 8.5% for aortic valve replacement; 13.

[Surgical treatment of cardiac abnormalities associated with corrected transposition of the great arteries (author's transl)].

Twelve patients with corrected transposition of the great arteries, who underwent surgical repair, are reported. In four cases a ventricular septal defect was present; in six cases, a ventricular septal defect and pulmonary stenosis and in two an incompetence of the systemic atrio-ventricular valve. The anatomic types of corrected transposition and the pertinent diagnostic characteristics were reviewed and discussed.

[Aorto-coronary bypass. On 200 cases surgically treated (author's transl].

200 patients underwent bypass graft for treatment of severe coronary vessel disease. The bypass vein grafts were 316; single grafts in 100 cases, double in 85, triple in 14 and in 1 case a patient received 4 grafts. In 57 cases a previous coronary endarterectomy was performed.