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Prosthetic ring annuloplasty is considered the gold standard technique for mitral valve repair, but it has been associated with some drawbacks. Suture annuloplasty is less expensive and may have some physiopathologic advantages. We reviewed the literature to assess clinical results of mitral suture annuloplasty. Thirteen series, each reporting more than 50 patients and published in the last 10 years, were included in the analysis. They comprised 1,648 patients with cumulative follow-up of 5,607 patient-years. Our review suggests that suture annuloplasty is a safe procedure, but a trend toward recurrence of annular dilatation with time was reported. In selected cases, suture annuloplasty is effective, and its mid-term clinical results are encouraging and compare well with those of prosthetic ring repair series. The quality of the results varies according to the particular annuloplasty technique used and to the mitral valve pathology treated. Recent technical modifications have been found to decrease the incidence of repair failure and promise to improve the reproducibility of the procedure. Further investigations are warranted to better assess the long-term results of suture annuloplasty, and to determine whether its theoretical functional advantages translate into a real clinical benefit.

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A case of intimal-type primary sarcoma of the thoracic aorta with unusual left arm embolization is reported.

Capsule endoscopy is being used increas− ingly in the diagnosis of obscure gastroin− testinal bleeding, with a better diagnostic yield than the more invasive push enteros− copy [1], and is now accepted as a first− line diagnostic tool in hemodynamically stable patients in this setting [2]. How− ever, because capsule endoscopy technol− ogy operates via 440−MHz radiofrequency signalling from the capsule to the belt− worn recorder, it is adversely affected by strong electromagnetic fields, and there are concerns regarding its use in patients with implanted electronic devices (e. g. cardiac pacemakers, implanted cardiover− ter defibrillators). In addition, the users manual for the M2A capsule (Given Imag− ing, Yoqneam, Israel) clearly states that capsule endoscopy is contraindicated in patients who have such types of devices fitted. Most of these patients are on chronic oral anticoagulant therapy, how− ever, and gastrointestinal bleeding is not uncommon in the course of their disease.