[Circulatory assistance in high-risk coronary angioplasty]. / Assistenza circolatoria nell'angioplastica coronarica ad alto rischio.

Femoral vein to artery cardiopulmonary by-pass was used during coronary angioplasty in five high risk patients. In four patients the target vessel supplied more than half of the viable myocardium; in one of these, the ejection fraction of the left ventricle was less than 20%. In one patient the relative contraindications for surgery were the patient's age and the presence of concomitant renal failure. Cardiopulmonary support was established by using cut-down cannulae insertion in three patients and by using the percutaneous system in two. In the latter, the support was stand-by, but the abrupt closure of the artery ten minutes after the end of the successful procedure, required the prompt activation of the support and the patient was treated with emergency saphenous graft. The use of the cardiopulmonary support either as a prophylactic or as a stand-by, enabled coronary angioplasty to be performed on these high-risk patients. The clinical and anatomical data relative to the five patients as well as the possible use of the cardiopulmonary support system either as a prophylactic or standby application during high-risk PTCA are discussed.

[Corrected transposition of the great vessels. A clinical review of 21 cases (author's transl)]. / Trasposizione corretta dei grossi vasi. Rassegna clinica e strumentale di 21 casi

Clinical and instrumental features of 21 cases of congenitally corrected transposition of the great vessels are reviewed. We confirm the rarity of the isolated form of the disease and its frequent association with ventricular septal defect and pulmonary stenosis. Electrocardiographically, the inversion of the first vectors is represented more frequently by the absence of the q wave on the left precordial leads than by the presence of the q wave on the right precordial leads; a very frequent electrocardiographic feature is a positive T wave on the right precordial leads. The angiographic image of the two ventricles in the lateral projection where they appear as crossing each other in their upper part were described. We confirm the poor results of the surgical treatment of the disease and the non-benign prognosis, because of the other associated cardiac anomalies.