[Surgical repair of postinfarction left ventricular lesion type I]. / Riparazione chirurgica della lesione postinfartuale di I tipo del ventricolo sinistro.

Left ventricular rupture is the most frequent cause of death following myocardial infarction after ventricular arrhytmias and cardiogenic shock. Under these circumstances, only a prompt diagnosis and urgent surgical treatment can be lifesaving. A review of the literature is made and a simple surgical technique with GRF glue application is presented.

[Description of a case of type I left ventricular rupture with formation of a false aneurysm following mitral and aortic valve replacement]. / Descrizione di un caso di rottura del I tipo del ventricolo sinistro con formazione di un falso aneurisma dopo intervento di sostituzione valvolare mitralica ed aortica.

A 65 year old patient underwent surgery for mitral and aortic valves replacement. Four months later, a type I left ventricular rupture with pseudoaneurysm was discovered. The formation and surgical reparation are described.

[Endomyocardial biopsy in heart transplantation: the experience of the Naples Center]. / La biopsia endomiocardica nel trapianto cardiaco: esperienza del centro napoletano.

From January 1988 through August 1992, 38 cardiac transplants were performed. 385 endomyocardial biopsies (EMBs) from 32 cardiac allograft recipients were investigated. In 21 (5.45%) EMBs the specimens were inadequate for the diagnosis. In the remaining 364 EMBs the grades of acute rejection were: minimal in 213 (58.51%) EMBs, mild in 132 (36.26%), mild/moderate in 12 (3.3%) and moderate in 7 (1.93%). The most reliable histologic feature of acute rejection was the myocyte necrosis or damage in presence of pironinophilic mononuclear cell infiltrate, so our therapeutic protocol requires myocyte damage to perform an additional treatment, which was performed in 7 cases (1.93%). An intermediate grade mild/moderate, was introduced to classify the EMBs in which the myocyte necrosis was scant or not clear. In these patients another EMB was performed after 3 or 5 days. One patient died of chronic rejection 17 months after the transplant. Changes not related to acute rejection were: ischemic early or late necrosis; changes related to previous biopsy site; subendocardial infiltrate of mononuclear cells (Quilty's alteration); focal, diffuse or perimyocytic fibrosis and artefacts as contraction bands; nuclear or cytoplasmic vacuolar alterations. Some of these changes occasionally made the diagnosis hard or the specimens inadequate for the diagnosis. In spite of these diagnostic difficulties, the EMB is a safe and reliable invasive investigation which plays an important role in the management of rejection in cardiac allograft recipients.

[Non-prolapsing atrial myxoma. Description of a clinical and echocardiographic case]. / Mixoma atriale non prolassante. Descrizione di un caso clinico ed ecocardiografico.

A clinically and sonographically identified case of atrial myxoma with no prolapse due to its short peduncle is described with emphasis on the importance of 2D echocardiography given the lack of both clinical symptoms and Time Motion ultrasound data in atrial myxomas prolapsing through the mitral anulus into the ventricular cavity. In fact 2D echocardiography shows up the systolic-diastolic swing of the tumour mass between the lower third of the left atrium and the atrioventricular valvular plane.