[Calcification of mitral anulus and mitral valve prolapse. Description of a case with severe mitral valve insufficiency]. / Calcificazione dell'anulus mitralico e prolasso valvolare mitralico. Descrizione di un caso con insufficienza metralica severa.

We report the case of a women, 40 years old, suffering from a severe mitral insufficiency caused by the simultaneous presence of three anatomical anomalies: mitral valve prolapse, mitral anulus dilation and calcification. Such degrees of calcification are generally found in older people and in association with a similar degeneration of all the fibrous skeleton of the heart. Whereas the association of mitral valve prolapse with mitral anulus dilation has been clearly remarked, a few cases (16 as a whole in our knowledge) with scanty details documented the possibility of an associated mitral anulus calcification.

[Experiences with coronarography using digital technics]. / Esperienze di coronarografia con metodica digitale.

The authors report their experience with the application of digital techniques to coronary angiography, over the past 2 years. One hundred and fifty coronary angiographies were performed, with excellent results. Indications for surgical by-pass arose for 64 patients, 35 of whom have already undergone surgery. Coronary angioplasty procedures (PTCA) were needed in 13 cases; on 12 the procedure has already been carried out. The difficulty to provide the cardiac surgeon with images in movement has been overcome by recording the images passing on the TV monitor directly on a professional magnetic tape. On the basis of our initial experience, we may affirm that the application of digital techniques to coronary angiography does not modify the technical approach to the exam and, therefore, does not reduce its invasiveness. On the other hand, the examination can be performed using the software commonly found in many units used for digital angiography. From a morphological point of view, the images seem to be superimposable to the conventional ones, especially since sequences of 25 images/second can be acquired with a 512 matrix. The potentials of digital techniques to provide functional data and information on anatomic lesions are very interesting, even though they are still to be fully demonstrated.

[Selective coronarography and left ventriculography using iopamidol in the early phase of myocardial infarct]. / Coronarografia selettiva e ventricolografia sinistra con iopamidolo nell'infarto miocardico in fase precoce.

The new techniques for an early treatment of acute myocardial infarction (AMI), such as thrombolysis and percutaneous transluminal angioplasty, often necessitate rapid and accurate radiological evaluation of coronaric lesions and left ventricular function. The aim of the present study was to evaluate both safety and tolerability of selective coronarography (SC) and left ventriculography (LVG), with iopamidol 370 mg I/ml as a contrast medium, in the acute phase of AMI. Thirty-nine patients aged 26-29 years, were examined: 18, group A, within 4 days (mean 2.6 +/- 0.8 SD) and 21, group B, within 5-15 days after AMI (mean 8.8 +/- 3 SD). Contrast media (cm) dosage varied from 150 to 300 ml (2.43-5.5 ml/bw). During the procedure, ECG was continuously recorded; left ventricular pressure was registered immediately before and 30 minutes after cm administration. During the following 9 days ECG tracings and plasmatic cytolysis enzymes were monitored. During the examinations no patient complained of any symptoms. After LVG slight elevations in end diastolic pressure were detected in all patients (mean increase 4.7 mmHg), which were not relevant from a clinical point of view. In 11/39 cases ventricular tachycardia was observed, which spontaneously ceased. During SC no change in ECG tracings was registered except in one patient, group A, in whom complete transitory heart block was detected. After SC no alteration in instrumental and biochemical parameters was registered except in one patient, group B, in whom a reinfarction due to right coronaric artery occlusion was observed. In conclusion, our results suggest that both SC and LVG with iopamidol are safe techniques also in the early phase of myocardial infarction.

[Ultrasonographic findings and integration with computerized tomography in pathology of the abdominal wall]. / Rilievi ecografici e integrazione con Tomografia Computerizzata nella patologia della parete addominale.

Ultrasonography (US) plays a major role in the study of the anterior and lateral abdominal wall. Our experience refers to 150 patients examined over a 5-year period, who were divided into two groups according to disease etiology: 72 patients suffered from iatrogenic and 78 from non-iatrogenic conditions. The first group was mainly composed of alterations caused by anticoagulation therapy, e.g., hematomas, and recent or previous surgery, i.e., 19 incisional hernias and 19 inflammatory-abscess processes. The second group included above all 32 cases of abdominal wall hernia, 18 neoplasms, 13 traumas with abdominal wall involvement only and 12 inflammatory processes. US yielded valuable pieces of information to diagnose iatrogenic conditions, even for small or non-relevant conditions. Moreover, US allowed non-iatrogenic conditions to be located and identified, accurately demonstrating abdominal wall layers involvement. US was also very useful in the patients whose physical examination is of no use or difficult, e.g., in the patients with much pain and trauma or obese patients. CT was used in selected cases only, as a complement to US, when a more detailed spatial assessment of wide or deep lesions was necessary.