Introduction The incidence, characteristics, and prognosis of pulmonary embolism (PE) in Coronavirus disease 2019 (COVID-19) have been poorly investigated. We aimed to investigate the prevalence and the correlates with the occurrence of PE as well as the association between PE and the risk of mortality in COVID-19. Methods Retrospective multicenter study on consecutive COVID-19 patients hospitalized at 7 Italian Hospitals. At admission, all patients underwent medical history, laboratory and echocardiographic evaluation. Results The study population consisted of 224 patients (mean age 69 ± 14, male sex 62%); PE was diagnosed in 32 cases (14%). Patients with PE were hospitalized after a longer time since symptoms onset (7 IQR 3–11 days, 3 IQR 1–6 days; p = 0.001) and showed higher D-dimers level (1819 IQR 568–5017 ng/ml vs 555 IQR 13–1530 ng/ml; p < 0.001) and higher prevalence of myocardial injury(47% vs 28%, p = 0.033). At multivariable analysis, tricuspid annular plane systolic excursion (TAPSE; HR = 0.84; 95% CI 0.66–0.98; p = 0.046) and systolic pulmonary arterial pressure (sPAP; HR = 1.12; 95% CI 1.03–1.23; p = 0.008) resulted the only parameters independently associated with PE occurrence. Mortality rates (50% vs 27%; p = 0.010) and cardiogenic shock (37% vs 14%; p = 0.001) were significantly higher in PE as compared with non-PE patients. At multivariate analysis PE was significant associated with mortality. Conclusion PE is relatively common complication in COVID-19 and is associated with increased mortality risk. TAPSE and sPAP resulted the only parameters independently associated with PE occurrence in COVID-19 patients.

No abstract

No abstract

Aims We sought to analyze the early and follow-up results of minimally invasive video-assisted mitral valve repair. With particular focus on degenerative disease, results were stratified according to type of lesion, strategy of repair and surgical technique. Methods We retrospectively built a database over 241 patients who received mitral repair for severe regurgitation through right minithoracotomy in the 2009–17 period. Cause was degenerative in 92.1%, restrictive in 5.8% and mixed in the remainders. Clinical and echocardiographic follow-up (98.7% complete, average duration 2.9 years ± 1.4) was obtained through contact of in-house and territorial cardiologists. Recurrent mitral regurgitation at follow-up was defined as being at least mild-to-moderate (2+). Results Operative mortality was 1.7%, and related to the technique in one case. Five-year actuarial survival was 95% ± 2; there was no valve-related death and one reoperation. At follow-up, we observed eight cases of 2+ regurgitation and one instance of 4+ regurgitation (4-year actuarial freedom: 92% ± 4). Freedom from recurrent regurgitation was significantly lower in the ‘restrictive’ subgroup vs. the ‘degenerative’ subgroup (P = 0.02); no statistically significant difference in freedom from recurrence was observed among patients who received mitral repair using a ‘resect’ vs. ‘nonresection’ strategy (P = 0.46), and in those who received the Totally Endoscopic technique (endoaortic balloon occlusion, no costal spreading) vs. controls (external aortic clamp, costal spreading) (P = 0.98). Conclusion Durability of minimally invasive mitral repair is optimal. Nonresection repair techniques are at least noninferior to previous approaches based on leaflet resection.

Abnormally high uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-SESTAMIBI) in the right ventricle and in the septum was observed in a 47-year-old woman initially presenting with dysarthria and left hemiparesis. Endomyocardial biopsy demonstrated a high-grade malignant non-Hodgkin's lymphoma. Complete remission was achieved by combined cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy and radiotherapy of the heart and mediastinum. The post-remission single photon emission tomography (SPET) 99mTc-SESTAMIBI study showed a homogeneous distribution pattern, in agreement with echocardiography computed tomography and magnetic resonance imaging. Increased uptake of 99mTc-SESTAMIBI, a myocardial perfusion agent, has been observed in some benign and malignant tumours. It may prove to be useful in the diagnosis and follow-up of malignancies.