[Aortic isthmic stenosis: clinical study and postoperative follow-up by MRI. Report of a case]. / Stenosi istmica dell'aorta: studio clinico e follow-up postoperatorio mediante risonanza magnetica nucleare. Descrizione di un caso.

A case report. Nuclear Magnetic Resonance (NMR) is the most recent non-invasive diagnostic technique which can provide high quality anatomic and functional data. The absolute safety of the method make it suitable for follow-up of patients who have undergone aortic surgery. The authors report the case of a 12-year-old girl suffering from isthmic coarctation of the aorta for which both traditional methods (echocardiography and angiography) and NMR were used. Following bypass surgery with a dacron implant in the stenotic tract of the aorta, the patient was followed up using transthoracic echocardiogram and NMR. The latter method was found to be most efficacious in providing anatomic and functional information after surgery, enabling an optimal follow-up of these patients.

[A new method for calculating the mass of the left ventricle by angiocardiography]. / Una nuova metodica per il calcolo della massa del ventricolo sinistro mediante angiocardiografia.

The authors describe a simplified method to determine left ventricular volume and mass from the ventricular silhouette, taken from a right oblique anterior angiographic projection at 30 degrees, used to measure the telediastolic surface and major axis, and of measuring the telediastolic thickness of the ventricular wall in the postero-lateral segment of the silhouette taken from a left oblique anterior angiographic projection at 60 degrees. Sixty-four ventricular silhouettes were analysed in patients undergoing left kineventriculography for coronaropathy and ventricular mass was determined using both the new and traditional methods. Using the new method mass values (mean value 87.85 g/sq.mt. and SD 34.04) were obtained which were significantly correlated (r = 0.999) with values obtained using the standard method (mean value 88.02 g/sq mt and SD 34.11). The practical advantages of the new method are discussed (simplicity of calculating equation without determining the minor axis of the ventricular silhouette), together with its limits due to the monoplanar technique used to calculate the volume and the measurement of wall thickness in those cases in which the postero-lateral wall is considered the most representative of the mean thicknesses of the left ventricular wall. Lastly, the paper discusses the possibility of applying this method to non-invasive procedures, such as the two dimensional echocardiogram, where more reliable mass values could be obtained even in the event of non-uniform wall thickness.

[Electrocardiographic indices of reperfusion and limitation of the necrotic area in acute myocardial infarct]. / Indici elettrocardiografici di riperfusione e di limitazione dell'area di necrosi nell'infarto miocardico acuto.

The aim of this study was to assess the evolution of ST segment displacement and the formation of new Q waves in relation to the late angiographic demonstration of recanalization of the infarct-related vessel in 36 patients with acute myocardial infarction admitted in our Institution within 8 hours from the onset of symptoms. Eighteen patients were treated with intravenous urokinase (200,000 + 1,200,000 UI) followed by sodium-heparin 1,000 U/ev/hour for 48 hours and calcium-heparin 3,000 UI/10 Kg/12 hours from the third day to discharge. Eighteen patients were treated from admission only with calcium-heparin as seen before. All the patients have been followed with serial electrocardiograms; we evaluated the sum of ST displacements (ST12) and Q waves score (Q12) in the 12 standard leads on admission, and on the twelfth, twenty-fourth, forty-eighth hour, and on discharge. On the basis of the late angiographic findings and apart from the treatment, we divided the patients into 2 groups: patients with recanalization of infarct-related vessel (20 patients, 55.5%) and patients with occlusion of the infarct-related vessel (16 patients, 44.6%). We did not observe statistically significant differences between the 2 groups for decrease of ST segment displacement of formation of new Q waves, even if reperfused patients showed a more rapid and complete decrease of ST segment displacement and a more rapid formation of new Q waves with respect to occluded patients. Our data indicate that from a clinical point of view electrocardiographic indices are not a sensitive marker of recanalization of infarct-related vessel.(ABSTRACT TRUNCATED AT 250 WORDS)