Three-dimensional versus two-dimensional transesophageal echocardiography in mitral valve repair.

Objectives: We sought to compare the diagnostic performance of 3-dimensional (3D) versus 2-dimensional (2D) echocardiography in patients with regurgitant mitral valve.

Background: An accurate assessment of morphology and function of the mitral valve is essential for surgical repair. Two-dimensional echocardiography has certain spatial limitations that could be overcome by 3D imaging.

[Primary prophylaxis with the implantable cardioverter-defibrillator in heart failure: a clinical point of view].

The implantable cardioverter-defibrillator (ICD) is one of the great inventions of modern cardiology. Its use for the prevention of sudden death in patients with left ventricular dysfunction has meant that clinical cardiologists are now fully involved in decision-making on the implantation of these devices. The majority of clinical trials, which have used low ejection fraction as the only or main criterion for patient recruitment, have shown that ICD use leads to a significant improvement in survival.

[Mitral valve repair for mitral regurgitation].

We analyzed the results of mitral valve repair in 81 consecutive patients with severe mitral regurgitation. Of these patients, 66.6% had myxomatous degeneration, 11% ischemic disease, 8% chordal rupture, 5% congenital disease, and 3.

Sustained monomorphic ventricular tachycardia associated with unrepaired double-chambered right ventricle.

Double-chambered right ventricle (DCRV) is a congenital anomaly characterized by the division of the ventricular cavity into two chambers separated by an abnormal hypertrophied muscular band or by severe hypertrophy of the muscle wall. Two adult patients with a diagnosis of DCRV presented sustained monomorphic ventricular tachycardia. In both cases, the clinical tachycardia was induced with programmed stimulation.

Utility of adenosine 5'-triphosphate in predicting early recurrence after successful ablation of manifest accessory pathways.

Objectives: The purpose of this study was to determine whether administration of adenosine 5'-triphosphate (ATP; 20-40 mg) after successful ablation of accessory pathway (AP) with manifest preexcitation is useful for detecting residual conduction and predicting early recurrences.

Background: The reported incidence of recurrence of AP conduction after an initially successful procedure is 5% to 10%. Little information on the variables related to early recurrence has been reported.

[Left ventricular dysfunction induced by monomorphic ventricular arrhythmias: large improvement in ventricular function after radiofrequency ablation of the arrhythmic source].

Left ventricular systolic dysfunction related to ventricular arrhythmias is a relatively poorly understood entity. To increase our knowledge base, we describe 5 patients in whom the link between ventricular dysfunction and ventricular arrhythmia was unequivocally established. All patients had repetitive monomorphic ventricular arrhythmias and left ventricular systolic dysfunction (ejection fraction < or =40% and end-diastolic size > or =55 mm).

[Does the EuroSCORE identify patients at minimum risk of mortality from heart surgery?].

Introduction And Objectives: Risk of hospital death is one of the key factors considered by the clinical cardiologist when weighting indications for surgery. Risk estimation scales establish distinct levels of risk in quantitative terms. The aim of the present study was to investigate whether a low EuroSCORE value corresponds to low mortality in our setting.

[Infectious endocarditis: degree of discordance between clinical guidelines recommendations and clinical practice].

Introduction And Objectives: The present study was made to investigate the degree of discordance between the recommendations of clinical guidelines and actual practice in the care of patients with infectious endocarditis.

Material And Methods: Data was gathered on 34 patients that were admitted to our hospital for native valve infection over a 4-year period. The degree of discordance (%) was obtained by comparing each clinical history with a catalog of 15 specific actions recommended in the clinical guidelines for four consecutive phases: pre-diagnosis, hospital diagnosis, antibiotic treatment, and surgical treatment.

[Vasovagal syncope in pediatric patients: a medium-term follow-up analysis].

Introduction And Objectives: Little information is available on the evolution of pediatric patients with vasovagal syncope. We therefore aimed to assess the medium-term clinical outcome of children evaluated by tilt testing for syncope of unknown origin.

Patients And Method: Fifty-one children under 17 years of age who had undergone tilt testing were identified from a data base and studied prospectively.