[Echocardiographic follow-up of insulin-dependent diabetics]. / Seguimiento ecocardiográfico en diabéticos insulinodependientes.

Results of echocardiographic test made on 29 patients with Diabetes Mellitus type I, under 14 years of age, on two occasions with an average of 33 months between test are presented. Anomalies were detected in approximately 30% of patients and persisted in re-evaluations of those patients with more than three altered parameters. Decrease of septal movement, as an index of myocardial contractibility affectation, is the only parameter which increased rate with time. Authors do not find any correlation between echocardiographic anomalies and age, sex, duration of diabetes, insulin doses and glycohemoglobin values. Due to high incidence of echocardiographic anomalies detected, they recommend these test be conducted periodically on type I diabetics, even though relation between control of the illness and long-term complications still appears to be uncertain.

Swan-neck deformity: mechanism and surgical treatment.

There are several forms of swan-neck deformity which are amenable to surgical treatment with good results, if based on an adequate study of the mechanism. Selection of the most suitable surgical procedure must be based on the pathological type.

Endocardial cushion defects: an anatomical study of 54 specimens.

An anatomical study of 54 specimens with endocardial cushion defect is described. The material was divided into two groups, according to the morphology and attachments of the anterior component of the anteroseptal mitral leaflet. We suggest that there is no divided or undivided anterior common leaflet. There are always two anterior leaflets, a mitral and a tricuspid one, separated by a commissure; depending on the degree of straddling of the mitral component over the interventricular septum, this will protrude into the interventricular septum or into the anterior papillary muscle of the right ventricle. Thus, the commissure separating the mitral and the tricuspid components will lie over the interventricular septum or will be quite separate in the right ventricle. In the latter case the straddling mitral component gives the false appearance of an undivided anterior common leaflet. The septal tricuspid leaflet was found to be underdeveloped or absent but we were not able to find any clefts or divisions in it. We suggest that this leaflet derives solely from the division of the posteroinferior endocardial cushion into two halves, right and left. The left half later becomes the posterior component of the normal anteroseptal mitral leaflet. Associated anamalies are also reviewed.