[Aortic coarctation is correlated with bicuspid aortic valve and intracranial aneurysm: a case report and review of the literature]. / Associazione fra coartazione aortica, aorta bicuspide ed aneurisma cerebrale: descrizione di un caso clinico e revisione della letteratura.

Aortic coarctation is often linked to bicuspid aortic valve and only rarely to congenital aneurysm of the circle of Willis. It is possible that a common pathogenetic substrate determines this association, but it has not yet been demonstrated. In this report we describe the case of a 32-year-old woman, affected by previous anamnestic functional cardiac murmur. She has suddenly presented a hemorrhagic stroke due to the breaking of the sylvian artery, angiographically demonstrated and surgically corrected. On the same occasion aortic angiography revealed aortic coarctation. Later, an echocardiographic exam demonstrated the coexistence of bicuspid aortic valve. Afterwards the patient underwent angioplasty in order to correct aortic coarctation. Any coexisting cardiac and vascular disease may influence survival in unoperated adults with aortic coarctation, which can even be lethal. In this case the simultaneous presence of these three malformations was particularly dangerous since the patient was not enough symptomatic and so an early diagnosis was not possible. Therefore, we strongly recommend to perform echocardiography in every young patient affected by hemorrhagic stroke and to take into consideration the possibility of performing cerebral angiography in all cases of aortic coarctation.

[Acute mitral insufficiency secondary to dehiscence of a Carpentier-Edwards Physio ring: diagnosis with transthoracic echocardiography]. / Insufficienza mitralica acuta secondaria a distacco di anello di Carpentier-Edwards Physio: diagnosi con ecocardiografia transtoracica.

We describe a case of a 63-year-old patient admitted to our hospital because of cardiogenic shock. Past medical records showed anterior myocardial necrosis, myocardial surgery revascularization with apical aneurysmectomy and, 3 weeks before, another coronary artery bypass operation due to malfunction of the previous grafts and mitral annuloplasty with placement of a Carpentier-Edwards Physio no. 28 prosthetic ring. Transthoracic echocardiography revealed, in the middle of the mitral orifice, the presence of an echogenic structure with hypermobility and severe peri-ring mitral regurgitation due to dehiscence of the posterior side of the prosthetic ring. The diagnosis was finally confirmed by surgery and then mitral valve replacement was performed.