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Biomedical subjects

B Dander

Publications and source records attributed to B Dander.

At least 37 records · Page 2Linked to original sources

[Coronary aneurysm. Report of a case of inflammatory etiology and review of the literature (author's transl)].

The case is presented of a 31 year old man with anteroseptal myocardial infarction, whose chest X-ray showed an anomalous protrusion along the left cardiac border. After 6 months, the increase in size of such protrusion lead to left ventriculographic and coronariographic examination: the presence of a large nonfistulous bisaccular coronary aneurysm was documented along the anterior descending branch of the left coronary artery. Cardiac surgery consisted in resection of the coronary aneurysm and of the left ventricular post-infarction area, and was followed by good surgical and angiocardiographic result. Histological examination showed the wall of the coronary aneurysm to be composed of collagenous bands in the absence of elastic components, with hemosiderin and fibrino-hematic deposits and scattered granulocytic infiltrates. An infective etiology is hypothesized for the coronary parietal lesion, leading to a coronary pseudo-aneurysm an subsequent myocardial infarction.

Adult↗

[Interatrial defect functionally cancelled by a left atrial myxoma within the framework of embolizing mitral stenosis and insufficiency].

The case is presented by a 54 year-old woman, studied because of a clinical diagnosis of mitral valve disease, in which echocardiographic and angiocardiographic examination afforded the diagnosis of left atrial tumor. The surgical finding was of a large myxoma implanted on the atrial septum and prolapsing into the mitral opening and engaging with a branch into an atrial septal defect of the cavalis superior type. Some considerations are made on the times of possible origin and growth of the tumor; the complete absence of the increased pulmonary flow in the presence of a large interatrial communication suggested an early beginning of the tumor that, obstructing the defect, might have hindered the hemodynamic derangement.

Diagnosis, Differential↗

[M.-mode and two-dimensional echocardiographic diagnosis of pseudoaneurysm of the left ventricle (author's transl)].

The echocardiographic features of a case of postinfarction pseudoaneurysm of the left ventricle are described. M-mode echocardiography displayed an echo-free space behind the posterior left ventricular wall and two-dimensional echocardiography defined the saccular contour of the pseudoaneurysm and its probable communication with the ventricular cavity. A second echocardiographic examination--a week later--revealed a marked enlargement of the pseudoaneurysm and a characteristic fast backward early systolic motion of the ventricular wall interposed between left ventricular cavity and the saccular aneurysm; this motion is interpreted as a passive displacement of the ruptured wall during ventricular systole, and allows a differential diagnosis with similar echocardiographic M-mode aspects, due to pericardial effusion, pleural effusion or pericardial cysts. Echocardiography findings were confirmed by angiocardiography and the surgery. Echocardiography seems to be a safe method for early non-invasive diagnosis of left ventricular pseudoaneurysm.

Echocardiography↗

[Echocardiographic patterns in discrete subvalvular aortic stenosis (author's transl)].

Ten patients with angiocardiographic and hemodynamic evidence of discrete subvalvular aortic stenosis were examined by M-mode-echocardiography. Different echocardiographic patterns were identified: the most frequent appeared an abnormal systolic movement of aortic valve leaflets, less frequently a discrete linear echo was observed in the outflow tract of the left ventricle; in one case the echocardiogram showed no abnormality of the left ventricular outflow tract or aortic valve morphology. In half of the cases the left ventricular outflow tract was narrowed. No correlation was found between echocardiographic measurements and severity of the subaortic lesion, as expressed by peak systolic pressure difference between the left ventricle and the aorta. It is concluded that M-mode-echocardiography: - may furnish helpful criteria in the diagnosis of discrete subaortic stenosis, but the absence of such criteria does not allow to exclude the existence of the malformation; - is not quantitatively useful in the assessment of subaortic stenosis.

Adolescent↗

[Echocardiographic evaluation of the results of mitral commissurotomy].

The AA. relate the results of an echocardiographic study carried out on some patients with mitral stenosis associated or not with mitral regurgitation or with other valvular disease. Ten patients who had to undergo to surgical commissurotomy, were studied before and in the early post-operative period. The M-mode echocardiography appeared to be always available to diagnose the mitral stenosis, but not to quantify it. On the other side the two dimensional echocardiography is proven to be a useful method in the quantitative study of the mitral area and particularly when it is applied in the evaluation of the surgical results of comparing the pre and post-operative examinations. The data obtained were analysed with statistical method.

Adult↗

[Postinfarction left ventricular aneurysm. A method for volume determination and its correlation with hemodynamic and angiographic parameters (author's transl)].

On the hypothesis that encroachment on left ventricular performance by postinfarction aneurysm (An) is related to its size, a method was investigated for the measurement of aneurysmal dimensions. On radioopaque plastic casts grossly ellipsoidal in shape with addition of masses in different position to simulate aneurysms, satisfactory data for volume calculation were obtained by the association of the ellipsoid formula applied to the contractile portion with the formula of the hemispheroid applied to the aneurysmal section, the difference between real and calculated volumes being not more than +/-5%. In 100 Pts. with previous myocardial infarction, showing at ventriculography akinetic-diskinetic segments of the left ventricular wall, the absolute volume of An and its percentage value of the total left ventricular volume (V An%) were measured. A statistical correlation was studied with other hemodynamic and angiographic parameters of left ventricular function. Cardiac index and angiographic stroke volume decreased with increasing V An%, but with a low correlation, of no statistical significance; only for An with a volume of 60% or more C.I. and SV were constantly reduced. The LVEDP, higher than normal in 80% of the cases, rose with increasing V An%, but with a correlation of low statistical significance. The EDV increased progressively and significatively with increasing V An%, resulting therefore in relation with the extension of noncontracting segment.

Angiocardiography↗

Echocardiographic diagnosis of congenital left ventricular - right atrial communication.

2 patients, aged 8 mth and 48 yr, referred for a clinical diagnosis of ventricular septal defect, were studied by ultrasound. In both a fluttering and an anterior bowing of the systolic segment of the tricuspid valve was found, consistent with a left ventricular--right atrial communication. Diagnosis was confirmed by angiography and open-heart surgery, showing in 1 patient a supravalvular defect, and an infravalvular one in the other. The postoperative echocardiograms of the tricuspid valve were normal. Ultrasound appears to be a safe and simple method in detecting this rare cardiac abnormality.

Echocardiography↗

[Post-extrasystolic potentiation for the study of regional left ventricular asynergy (author's transl)].

In 120 P. with ischemic heart disease, left ventricolar wall motion was analyzed from the left ventriculogram in a regular sinus beat as compared to the first beat following one or more premature ventricular contractions (PExP). The response of asynergic segment to PExP was determined with a qualitative as wall as a quantitative technique. Of a total of 225 asynergic segments, 62% showed a positive response to PExP. In the absence of pathologic Q waves in the electrocardiogram, the response was positive in 77% and negative in 23% of the cases. In the presence of Q waves, PExP was present only in 33% of the cases (p less than 0.001). In respect to the severity of asynergy, 68% of 145 hypokinetic segments and 52% of 80 akinetic-dyskinetic segments responded to PExP; in the presence of pathologic Q waves, the number of positive responses decreased to 36% in the case of segmental hypokinesis, and to 31% in the case of more severe asynergy. The study of PExP has appeared as an useful diagnostic technique, capable of detecting a residual myocardial function in left ventricular asynergic segments, even in the presence of electrocardiographic signs of infarction.

Adult↗

[Bypass aorto-coronarico. Correlazione tra dati clinici, emodinamici ed angiografici e risultato operatorio in 100 casi (author's transl)].

In 100 consecutive patients, subjected to myocardial revascularization by aorto-coronary saphenous vein bypass grafting with a standard technique, several clinical, hemodynamic and angiographic data were studied in correlation with the short-term prognosis. The operative mortality (6% on the whole) appeared to be strictly correlated with the degree of left ventricular impairment. Among the considered hemodynamic indices (LVEDP, CI, EDV, EF), EF was the most significant one: mortality was 0% if EF was normal, but raised to 15 and 40% respectively, when this was moderately or severely reduced. The operative risk was heavily aggravated if 4 or more indices of left ventricular impairment were present, mortality being 45% versus 1% in patients with abnormality of 3 or less parameters. The extension of coronary artery involvement proved to be a lesser prognostic factor than the degree of complements of the surgical revascularization. No correlation was found between the preoperative value of the hemodynamic parameters and the incidence of perioperative myocardial infarction (18% in the total series).

Adult↗

[Idiopathic cardiomyopathies in children: a description of two rare cases (author's transl)].

Two cases of idiopathic cardiomyopathy in children are described. Although classifiable respectively as of the non-obstructive or dilating type (in case 1) and of the restrictive type (in case 2), some peculiar clinical and angiocardiographic aspects could be found which differentiated them from the typical forms. In case 1 multiple semilunar dilatations were present at the posterobasal level of the left ventricle. In case 2 the restriction of the ventricular chamber with markedly reduced compliance affected only the left ventricle, with marked dilatation of the left atrium and right side cavities. As occurs in the field of idiopathic cardiomyopathies, intermediate forms of anatomical variations can be found with clinical and angiographic atypical features.

Adolescent↗