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Two cases of aortic septal defect, diagnosed in life by means of cardiac catheterization, are described. An explanation is given of a method, used in these cases, whereby a correct diagnosis could be made before operation. Other methods for diagnosis and differential diagnosis are discussed.

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The coronary cineangiography of a man with an inferoposterior myocardial infarction is reported. An occlusion of the proximal right coronary artery and an occlusion at the origin passing around the left atrial wall of the circumflex artery was observed. A large collateral artery connected the right coronary artery and the distal circumflex artery. This vessel showed a significant stenosis of 70%. This case suggests that collateral arteries are not protected from atherosclerotic degeneration. Alternatively, since the exact caliber of the anastomosis before the occlusion of the recipient artery is not known, an extrinsic compression or kinking may have generated the stenosis at the time of the flow-related dilatation of the vessel.

As already stated in other articles, valves of certain types are at risk for dislocation of the disc. In order to demonstrate that this can still occur and that probabilities of dislocation still have to be adapted to in the future, the authors describe three disc dislocations and their outcome. From these cases it is clear that prosthetic disc embolization still has a very high mortality. These case reports also show the necessity of an emergency operation and the different time intervals available for intervention dependent on the location of the valve prosthesis (aortic-mitral position). Difficulties of interpreting the chest x-ray can exist owing to the presence of metallic sternal sutures. Whether routine reoperation is necessary in high-risk groups is discussed. Two prosthetic valves with their disrupted minor strut were sent back to the company. The results of extensive study of these valves are discussed. at East Carolina University on June 28, 2015 ves.sagepub.com Downloaded from 50 I FIG. 1. Embolized disc that mimics a metallic sternal suture.