Posterior wall as atypical localization of left atrial myxoma : Diagnosis and management.

Atrial myxomas are the most common benign cardiac neoplasms. Although the majority occur in the left atrium (LA) and are attached to the interatrial septum (75-80 % of cases), they can arise from any part of the LA and the cardiac chambers. We report the case of a 65-year-old woman who presented with features of worsening dyspnea and persistent headache. During transthoracic echocardiography, a suspected cardiac myxoma was found arising from the posterior wall of the LA.

Metastatic liposarcoma of the heart. Case series and brief literature review.

Secondary cardiac tumors are 20-40 times more frequent than primary lesions. Primary cardiac lesions are represented by myxomas when related to benign tumors, and by sarcomas in terms of malignant disease. Metastases to the heart from liposarcomas are very rare. We present three cases of secondary liposarcomas involving the left atrium, the right atrium, and the pericardium.

[Reliability of M-mode and B-mode echocardiography in detection of left intra-atrial masses (author's transl)]. / Affidabilita' della ecocardiografia M-mode/B-mode nella identificazione delle masse intra-atriali sinistre.

Although the role of echocardiography in the detection of left atrial masses is well established, reliability of the method is yet unknown. In 312 patients who underwent cardiac surgery, echocardiographic and anatomic findings were confronted. Pre-operative diagnosis was confirmed in the 8 cases with prolapsing tumors: in the remaining patients we had 5 false positive and 9 false negative diagnosis. So in our experience, sensibility has 73.5 and specificity 98.20.

[Fixed subvalvular left ventricular outflow tract obstruction. Comparison of the diagnostic usefulness of mono- and bi-dimensional echocardiography]. / Ostacolo all'efflusso del ventricolo sinistro sottovalvolare fisso. Confronto tra utilità diagnostica della ecocardiografia mono-bidimensionale.

Because Cross-Sectional Echocardiography offers the advantage of correct spatial orientation, it is said to permit a more exact localization of the level of the outflow tract obstruction and a determination of the nature of the lesion. Our experience confirms that B-Mode Echo is more reliable in diagnosing an extensive sub-valvular narrowing, while the existence of a thin sub-valvular membrane can also be detected by M-Mode examination. The latter has moreover proven very useful in that it records indirect signs of obstruction, such as a mid-systolic closure of the aortic cusps. We therefore suggest that both methods should be employed in studying these patients.

[The pathology of mitral porcine valves. Echocardiographic relief in 5 cases with intra-para-prosthetic regurgitation (author's transl)]. / Patologia delle protesi mitraliche porcine. Rilievi ecocardiografici in cinque casi con rigurgito intra-para-protesico.

Echocardiograms were performed in five patients with severe mitral porcine valve insufficiency due to the para-valvular leak in three cases and to a torn and flail cusp in two cases. We believe that diastolic fluttering of the vusps, decrease or increase of diastolic slope of either the stent or the anterior leaflet as well as decrease of the amplitude of motion of the leaflets cannot be regarded as typical diagnostic features as previously described. In our experience specific signs are only represented by a chaotic diastolic movement of one or both leaflets.

[Right atrial angiosarcoma. report of a case treated successfully by surgery (author's transl)]. / Angiosarcoma dell'atrio destro. Aspetti clinici, ecocardiografici ed istologici in un caso operato con successo.

A 32 years old male presented with symptoms and signs of congestive heart failure. The echocardiographic and angiographic examinations demonstrated a large right atrial tumor prolapsing in the right ventricle through the tricuspid orifice. The patient underwent successful surgical resection of the tumor. Histologically in the lesion was diagnosed as angiosarcoma.

[Mitral insufficiency due to rupture of chordae tendineae. The diagnostic usefulness of M-mode echocardiography (author's transl)]. / Insufficienza mitralica da rottura di corde tendinee. Utilità diagnostica della ecocardiografia bidimensionale.

Mitral insufficiency due to ruptured chordae tendinaee is not easily diagnosed by M-mode Echocardiography: of the several patterns that have been described, none has proven quite reliable. Two-dimensional study, on the other hand, seems to be more useful in that it permits to identify an abnormal movement of the involved leaflet which appears quite characteristic. Out of a group of 14 patients we were able to diagnose chordal rupture in 5 proven cases. Further investigation is necessary to ascertain specificity and sensitivity if this echo pattern.

[Echocardiographic aspects of prosthetic porcine valves. Observations on 125 personal cases (author's transl)]. / Aspetti ecocardiografici delle protesi valvolari porcine. Osservazioni in 125 casi personali.

Echocardiograms were performed on 111 prosthetic porcine valves in mitral position and 25 in aortic position. Satisfactory tracings were obtained in 68% of the mitral and in 80% of the aortic prosthesis. The characteristic appearance of the porcine prosthesis consists of two lines parallel to each other which represent the stent; the valve cusps reflect much thinner echoes with a box-like pattern similar to that of the normal aortic valve. The distance between the cusps varied from 12 to 17 for the mitral prosthesis and from 11 to 15 for the aortic prosthesis. The range of these values as well as the range of other parameters which were measured varies widely. We suggest therefore that a post-operative echocardiogram should be performed to get a baseline pattern useful for comparison with following controls.

[Echocardiography in obstructive hypertrophic myocardiopathy. Proposed index of severity of the obstruction]. / Ecocardiografia nella miocardiopatia ipertrofica ostruttiva. Proposta di un indice di gravità dell'ostruzione.

An obstruction index to estimate the left ventricle outflow gradient from the echocardiogram in patients with obstructive cardiomyopathies is proposed. It is based on the measurements of the mean distance between septum and anterior mtral valve leaflet, the total time of narrowing and the time of minimal and maximal narrowing. In the first group of patients studied, it seems to correlate fairely with the severity of clinical picture and with the gradient found at catheterization.