[Echocardiography detection of intracavitary ventricular tumors]. / Echokardiographischer Nachweis intrakavitärer Ventrikeltumoren.

Intracavitary ventricular tumors were found in 3 male patients (newborn, and 18 and 23 years old) by 2-D echocardiography (metastasis of an osteogenic sarcoma in the right ventricle, teratoma embryonale growing from the retroperitoneum into the right ventricle, rhabdomyoma of the left ventricle). They all showed a uniform echo pattern and two of them were pedunculated. Wall motility, valves and cardiac dimensions were normal. In each case diagnosis was confirmed intraoperatively or at autopsy. Clinically the metastasis of the osteogenic sarcoma presented as obstruction of the superior vena cava, whereas the teratoma embryonale imitated tricuspid valve disease. The rhabdomyoma caused a systolic murmur and severe postpartal sinus bradycardia. It was successfully removed on the basis of echocardiography alone. 2-D echocardiography is a reliable, noninvasive diagnostic tool for evaluation of intracavitary, ventricular tumors.

[Percutaneous transluminal coronary angioplasty: results after a 5-year follow-up period]. / Perkutane transluminale koronare Angioplastie: Spätresultate fünf Jahre nach dem Eingriff.

In the first series of 50 patients in whom percutaneous transluminal coronary angioplasty (PTCA) was attempted, the procedure was successful in 32. 23/32 patients were followed up clinically over 62.2 +/- 5.6 (SD) months. Repeated non-invasive laboratory tests were carried out in 15/23 patients. Moreover, 11/15 patients were restudied by arteriography at the end of the follow-up period. Early recurrence of the stenosis occurred in 5/32 patients (16%) and was again successfully treated by a second PTCA in 2. 3 patients underwent surgery as requested. 22/23 (95%) remained symptom-free during the follow-up period. The results of the non-invasive laboratory tests were in close agreement with the clinical findings. Coronary arteriography performed at the end of the follow-up period revealed an excellent lasting effect of PTCA in 8/11 patients. 2 showed a slight progression of the three stenoses treated by PTCA, and in 1 patient late recurrence of the stenosis was suspected since he had been symptom-free up to 2 weeks prior to restudy. Thus, in patients who are suitable for PTCA, this treatment is of long-lasting effect and represents an excellent alternative to coronary artery bypass surgery.

[Mimicking of mitral stenosis by asymmetrical hypertrophic cardiomyopathy]. / Vortäuschung einer Mitralstenose durch asymmetrische hypertrophe Kardiomyopathie.

Pressure gradients between atrium and left ventricle were measured in 5 of 17 patients with the diagnosis of hypertrophic cardiomyopathy. The diagnosis was confirmed by echocardiography and angiography. In 2 patients the hypertrophic cardiomyopathy was obstructive for the left ventricular outflow tract. Mitral stenosis was suspected in 3 out of the 5 patients who presented atrial fibrillation or frequent premature atrial beats and atrial overload phenomena of a third heart sound (which was misinterpreted as mitral opening snap) together with radiological enlargement of left atrium. Cardiac catheterization revealed middle pressure gradients between 7 and 14 mm Hg over mitral valve in 3 patients. In 2 patients significant early and middiastolic pressure gradients were recorded only after left ventricular angiography (volume load) was performed. Based on the data from cardiac catheterization, mitral stenosis was diagnosed in one patient, surgery revealed normal mitral leaflets. Echocardiography showed normally mobile mitral leaflets as well as signs of interventricular septal hypertrophy in all 5 patients. (In the patient who underwent surgery echocardiography was performed after the operation.) There were no echocardiographic signs of left ventricular inflow obstruction. The pathophysiologic mechanism of myocardial hypertrophy mimicking mitral stenosis is unknown. It may be suspected that third heart sound, diastolic murmur and the left ventricular inflow obstruction apparent from the pressure gradient are due to diminished myocardial compliance, direct mechanical effects of septal hypertrophy and decreased mobility of anterior mitral leaflet. Mimicking of mitral stenosis exists. Hypertrophic cardiomyopathy should therefore be considered in the differential diagnosis of mitral stenosis. Echocardiography may be helpful in evaluation.

[Coronary fistulae (author's transl)]. / Beitrag zur Kenntnis der Koronarfisteln

Three patients with coronary fistulae are described, including one patient with a rare coronary-pulmonary double fistula. The clinical features, diagnostic aspects and radiological signs are reviewed.

[Echinococcus of the heart. Infundibular pulmonary stenosis due to a large solitary cyst of the ventricular septum (author's transl)]. / Beitrag zur Echinokokkuserkrankung des Herzens. Infundubuläre Pulomnalstenose durch grosse solitäre Zyste im Ventrikelseptum

An echinococcus cyst in the ventricular septum is described, which produced an infundibular pulmonary stenosis. Following angiography, surgical intervention could be accurately planned and proved successful. The incidence, course, radiological features and diagnosis of cardiac echinococcus are reviewed.

[Large solitary aneurysm of the left coronary artery. Plain films and angiography (author's transl)]. / Grosses solitäres Aneurysma der linken Koronararterie Thoraxröntgenbild und Angiographie

The diagnosis of coronary aneurysms has for a long time been made at autopsy. After a general review of coronary artery aneurysms, a large aneurysm of the circumflex branch of the left coronary is described; this was diagnosed by selective coronary angiography and successfully treated by surgery. The results are compared with six other reported cases of pre-operatively diagnosed coronary artery aneurysms. Since complications, such as rupture, embolisation or infarction, are common in large coronary aneurysms, early diagnosis is desirable. An abnormal bulge of the cardiac contour or circular calcification within or at the edge of the cardiac shadow may be suggestive of the diagnosis.

[Proceedings: Studies on myocardial perfusion by means of marked particles, injected selectively into the coronary system: an aid in preoperative evaluation of patients with coronary sclerosis]. / Studien der myokardialen Perfusion mittels markierter, selektiv ins Koronarsystem injizierter Partikel: eine Hilfe in der präoperativen Beurteilung von Patienten mit Koronarsklerose

Myocardial color scintigraphy using macroaggregates labeled with 99mTc and 131I were performed in patients with coronary heart disease. The particles were injected selectively into the coronary arteries. The scintigram was obtained using a color coded display system. The channel with the maximum counts was assigned the color red and each 10% change resulted in a different color. A count rate below 40% of the maximum was considered inadequate. 80 patients undergoing coronary surgery were evaluated postoperatively. Postoperative ventriculography documented improved contractions in 34 of 40 ventricular segments (85%) in which preoperatively an adequate perfusion was observed, whereas in only 13 out of 42 segments with preoperatively inadequate perfusion was an improvement in ventricular contractility observed.

[Proceedings: 70 mm photofluorography: a valuable aid in coronary angiographic studies]. / 70-mm-Photofluorographie: eine wertvolle Hilfe bei koronarangiographischen Untersuchungen

With the development of new intensifiers using cesium iodide as the input phosphor and having a spatial frequency of up to 4 lines/mm, it has become possible to obtain high contrast serial photographs using a 70 mm camera. In 48 patients undergoing coronary arteriography, 35 mm cine and 70 mm spotfilms were obtained at exposures as follows: 3 msec, 75-95 kV at 200 mA for the 35 mm cine (50 frames/sec) and 6-10 msec, 75-95 kV at 300 mA (4 FRAMES/SEc) for the 70 mm images. Image quality and diagnostic information of the two media were compared. 70 mm films were of excellent quality. The vessel edges showed up sharp, the pictures were high in contrast, and small arteries in particular could be well defined. 70 mm photofluorography offers many advantages which are discussed.