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Biomedical subjects

E Congedo

Publications and source records attributed to E Congedo.

At least 19 recordsLinked to original sources

[Coronary spasm during coronary arteriography. Classification and interpretative criteria].

Coronary spasm during selective coronary angiography have multiple explanation. In some instances there is no true pathological implication (catether induced spasm), in other instances, instead, a clear relationship with "functional" angina and myocardial infarction exists. Moreover, in few occasions may only be a false positive radiologic image (apparent spasm). The angiographic features of coronary spasm, however, are always the same, indipendently from its clinical significance and pathophysiologic mechanism. In this paper the Authors are not limiting their experience to the morphologic description of this event, rather describe the clinical criteria which, together with angiographic picture, may be useful in the interpretation of the physiopathology of the coronary artery spasm.

Angiography

[Coronary arteriography. Review of 1000 consecutive personal cases].

One thousand coronary arteriography performed in the catheterization laboratory of the Department of Cardiology (University of Padua) from 1973 to 1978 were reviewed. Indication to perform a coronary arteriography was established in 668 patients with clinically suspected coronary artery disease and in 332 patients affected by different heart disease in whom the study of coronary arteries was judged to be usefull. The percutaneous technique was usually employed. The overall mortality rate was 0.2%; there were no death in the last three years. The overall morbility was 3.5% (2.3 from 1976 to 1978). The anterior descending artery appeared to be the most frequently and precociously affected area. There was a good correlation between severity of the atherosclerotic lesions and age or sex of the patients. We could recognize coronary disease, when present, on the basis of clinical evaluation in patients without different heart disease.

Adult

[Azygos or hemiazygos continuation of the inferior vena cava. An angiographic findings of 10 cases (author's transl)].

The angiographic findings of 10 cases with azygos (AC) or hemiazygos (HC) continuation of the inferior vena cava (IVC), associated with other congenital heart disease (0.5%), are described. Abdominal situs solitus was present in 7 cases, left isomerism in 3. In 5 cases IVC was to the left to the spine, bilateral in one. In 6 cases there was AC, HC in 2; in one both types of continuation were documented. It is important that this venous anomaly be diagnosed before cardiac catheterization; manipulation of the probe may be very difficult when saphenous approach is used. The correct use of the terms "Azygos", "Hemiazygos" and "Accessory Hemiazygos" are discussed.

Azygos Vein

[Traumatic tricuspid insufficiency. Clinical and therapeutic aspects. Report of three cases (author's transl)].

Three cases of traumatic tricuspid insufficiency are reported. The most consistent clinical and noninvasive cardiovascular findings were: previous nonpenetrating thorax trauma; non holosystolic murmur which increased slightly during inspiration on standing; electrocardiographic patterns of right atrial enlargement and right bundle branch block; unusual bulge along the mid-left heart border, seen on chest x-ray examination suggesting ventricular aneurysm; striking right ventricular dilatation wit paradoxical movement of the ventricular septum on ECHO. Cardiac catheterization led to definitive diagnosis by demonstrating a massive tricuspid valve incompetence with "ventricularisation" of the right atrial pressure. Some dyskinetic areas of the right ventrice, most likely due to the full-thickness contusion of the miocardial wall, seen on the right cineangiography, confirmed the diagnosis. The long-term clinical and haemodynamic follow-up was useful for monitoring the evolution of the disease. Surgery should be recommended in the presence of right-sided heart failure not relieved by adequate medical treatment, in view of the low operative risk.

Adult

[Ischemic alterations of the regional mechanical performance of the left ventricle. Study of parietal deformation as a vectorial time-dependent parameter and of pressure-length loops (author's transl)].

A study was carried out on 59 patients with significant stenosis (greater than or equal to 75%) in at least one coronary vessel. For each parietal region of the left ventricle the pattern of contraction was defined through a study of the regional deformation as vectorial time-dependent parameter and of the construction of the pressure-length loops. The different models obtained in basal conditions and through intervention (nitroglycerin and post-extrasystolic potentiation) were correlated with experimental data on ischemic alterations of the regional mechanical performance.

Cineradiography

[Correlations between the patterns--dynamic--of regional contraction and the ECG-enzymatic-clinical signs of myocardial infarction (author's transl)].

60 patients with clinical signs of coronary artery disease who had a hemodynamic examination were studied. The study of the regional dynamics using the deformation as a vectorial time-dependent parameter and the pressure-length loops, was carried out on a total of 420 parietal regions of the left ventricle: the basal ventriculography, the post-extrasystolic potentiation and the ventriculography after nitroglycerin were evaluated. The dynamic regional pattern was correlated with clinical-enzimatic signs of necrosis in the electrocardiogram. The possibility of correlating signs of necrosis with particular patterns of hypokinesia, akinesia, dyskinesia which differ from corresponding "static" forms of asynergy in active pressure development and deformation (even in a brief systolic interval) seems to confirm the physiopathologic interpretation of the regional phenomenon based on the ratio between viable not viable myocardium -- as primary cause.

Clinical Enzyme Tests

[Aortic insufficiency associated with interventricular communication. Natural history, angiographic diagnosis and surgical approach].

Clinical, electrocardiographic, radiological, hemodynamic and angiocardiographic data of 12 patients with ventricular septal defect (VSD) associated to aortic regurgitation (AR) have been analyzed. The trend of evolution of the AR has been evaluated and angiographic criteria to make a correct diagnosis have been pointed out. Nine patients have been followed up for a mean of 3.8 years. The severity of AR seemed to increase only in three cases: this demonstrates that AR associated to VSD is not always a progressive disease. The usefulness of various radiological views in evidencing the anatomy of both VSD and aortic valve has been discussed and findings of left ventriculogram and aortogram are detailedly described. The site of VSD and the type of lesion of the aortic valve may be crucial for indicating surgical intervention and its type. Indication for surgery is briefly discussed. Surgical technics are shortly summarized.

Adolescent