[Future interventional procedures for valve diseases]. / Zukünftige interventionelle Verfahren bei Herzklappenerkrankungen.

BACKGROUND: Percutaneous valve therapies represent one of the most innovative areas within interventional cardiology in the past 10 years. AIM: The aim of this work is to give an overview of current and upcoming therapeutic options. MATERIALS AND METHODS: In this manuscript, the results of a retro- and prospective literature research are summarized. RESULTS AND DISCUSSION: With the introduction of percutaneous therapies for valvular heart disease, patients who were previously considered too ill for surgery can now be treated. The percutaneous treatment of aortic or mitral valve disease has become standard therapy. Likewise, promising results have been obtained for percutaneous treatment options for pathologies of the tricuspid valve, which are still under intense investigation.

[Imaging in mitral valve interventions]. / Bildgebung bei interventionellen Mitralklappeneingriffen.

Percutaneous cardiac valve interventions have significantly extended the therapeutic options for patients with diseased cardiac valves. Technical miniaturization and major advancements in cardiac imaging techniques are the cornerstones of this successful development. Regarding mitral valve interventions periprocedural echocardiography in particular is of uttermost importance. This review describes the state of the art echocardiographic imaging techniques focusing on the clinically established mitral valve interventions: MitraClip® implantation, percutaneous closure of periprosthetic leaks and mitral balloon valvuloplasty.

Validity of ultrasonography for postoperative monitoring in pediatric urology.

PURPOSE: We studied the validity of ultrasonography for short-term followup in pediatric urology. MATERIALS AND METHODS: The study group comprised 137 children (187 urinary tracts) undergoing surgery at our hospital for congenital urological pathology between February 1982 and July 1992. The study protocol designed to evaluate urinary tract dilation postoperatively and monitor its progress, included ultrasound at discharge from the hospital, and repeat ultrasound between days 20 and 30, and days 45 and 60. Diuretic renography or excretory urography was indicated when urinary tract dilatation showed no signs of regressing or had increased on 2 consecutive evaluations. Ultrasound of the urinary tract was done to evaluate variations in the grade of dilatation of the pelves, calices, infundibula and ureters, and grade of hydronephrosis. RESULTS: Variations in the grade of dilatation of the infundibula and ureters were early sensitive indicators of the absence of obstruction. Using this protocol only 15 of the 187 urinary tracts (8%) corrected surgically needed further evaluation for suspected iatrogenic stenosis, including 3 with obstruction that required reoperation. No other cases of obstruction were detected during long-term followup. CONCLUSIONS: A series of sonographic evaluations performed within a short period and the greater significance attributed to more specific parameters, such as grade of dilatation of the infundibula and ureters, make ultrasound a valid means of monitoring urological cases postoperatively.

[Multiple splenic and renal abscesses caused by Candida albicans: a new diagnostic and therapeutic method using intraoperative echography and closure of the residual cavities with biological glue]. / Les abcès multiples spléniques et néphrétiques par Candida albicans: nouveau procédé diagnostique-thérapeutique par échographie intra-opératoire et fermeture des cavités restantes avec colle biologique.

The Candida albicans infection represents a rather frequent complication in immunodeficient patients, while the evolution towards the growth of multiple intraparenchymal abscesses constitutes a very rare event. The authors describe the diagnostic-therapeutic pathway chosen in a case regarding a young patient in treatment for leukemia , who was affected by multiple splenic and renal abscesses caused by Candida albicans. After a preoperative diagnosis through ultrasonography and C.A.T., a splenectomy was undertaken. Next the only healthy part of the spleen was removed and grafted into the omentum. By using the intraoperative ultrasonography on both kidneys, the abscess cavities were precisely located, aspirated and finally stuck with a human fibrin glue.

[Hepatic hemangioma in the neonate: description of a case treated surgically with favorable outcome]. / Emangioma epatico in età neonatale: descrizione di un caso trattato chirurgicamente con esito favorevole.

The authors describe a case of hepatic hemangioma in a newborn, treated by successful surgical resection. Neonatal hepatic hemangioma is able to produce congestive heart failure with high output, thrombocitopenia, spontaneous rupture with peritoneal hemorrhage and sudden death. The major symptoms are a palpable anterior abdominal mass, tachicardia, and congestive heart failure unrespansive to medical treatments; sometimes there are cutaneus hemangiomas. When diagnosis is made, surgical resection is necessary in the solitar hemangioma; for diffuse or multinodular hemangiomatosis radiotherapy, corticosteroids and hepaticartery ligation have been employed with some good results.