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Biomedical subjects

A Cavallaro

Publications and source records attributed to A Cavallaro.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

The effect of body weight compression on axillo-femoral by-pass patency.

The influence of external compression on extra-anatomic bypass patency is still debated. The specific purpose of this study is the evaluation of ankle Pressure Index (P.I.) and Pulse Volume Recorder (P.V.R.) wave amplitude changes after 5 and 10 minutes of external bypass compression by body weight, lying on the side of the reconstruction. Eight patients with axillo-femoral bypass (mean follow-up 15.5 months) have been evaluated. The external body weight compression caused important changes of graft haemodynamics: (1) decrease in ankle Pressure Index at 5 min (p less than 0.005) or 10 min (p less than 0.0005); (2) decrease in P.V.R. wave amplitude at 5 min (p less than 0.005) and 10 min (p less than 0.025).

Aged↗
PubMedDate not supplied

Cross-over axillary by-pass. Treatment of subclavian or innominate artery obstructive lesions.

A 13-year experience consisting on 16 consecutive patients submitted to axillary-to-contralateral artery by-pass in the treatment of obstructive lesions of the subclavian or innominate artery is reported. Nine patients complained of typical subclavian steal syndrome. Extended patency with very satisfactory functional result was achieved in twelve patients. An extensive survey is made of the results of such procedure, as reported in the literature. The theoretical advantages in comparison with other kinds of extrathoracic procedures aiming at the same goal are briefly outlined.

Adult↗
PubMedDate not supplied

[Technical innovations in femoro-tibial reconstructions].

The literature on reconstructive femoro-tibial surgery includes distal by-pass implantation, personally considered the most interesting and most debated part. Four cases treated with double femoro-popliteal and popliteo-tibial reconstruction, three with the jump-by-pass technique and one with the sequential-by-pass technique are reported. Of these cases, three are complete with fluximetric and angiographic examination before, during and after the operation. Final results are considered satisfactory, notwithstanding certain inconveniences which were dealt with as they arose. Long-term follow-up permits some optimism for the future of this surgery, although the technical difficulties are by no means negligible.

Aged↗
PubMedDate not supplied

[Clinical-therapeutic aspects and surgical treatment of aortic coarctation associated with hypoplasia of the aortic arch in less than 3-month-old patients].

The surgical treatment of the CoAo plus Hypoplastic Aortic Arch is debated. The point is whether to treat or not the associated tubular hypoplasia performing an extended Resection and "End to End" Anastomosis (ERETE) or a subclavian flap angioplasty (Waldhausen). According to some report in the literature we called an arch hypoplastic if its diameter in the first or second portion was less than the patient body weight plus 1. Between January 1988 and December 1992 in our Institution 38 patients less than 3 months underwent aortic coarctation repair. In 14 cases we were able to consider the aortic arch as hypoplastic. These patients were aged between 3 days and 45 days (median 15 days), the body weight was between 2.6 and 3.9 kgs (median 3.2 kgs). 6 patients had CoAo as isolated lesion, in 3 cases there was Ventricular Septal Defect (VSD) associated. In 5 patients major intracardiac anomalies were associated (1 DORV, 1 TGA, 2 SV, 1 SV+Arterio-Ventricular discordance). In 7 cases in order to treat the arch an ERETE was performed. The other 7 patients had a Waldhausen procedure. In 5 cases a Pulmonary Artery Banding (PAB) was associated, in 1 case a palliative arterial switch operation. The hospital death was 43% (3 patients) in the ERETE group, and 28% (2 patients) in the Waldhausen group. The echocardiography and or angiography performed during the follow-up period showed a nice growth of the arch in both groups. Although from our present data it's impossible to get definitive conclusions, the ERETE doesn't give better result in terms of hospital death and long term aortic arch growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMedDate not supplied

[Role of ultrasonography in emergency surgery].

A prospective study was carried out to compare the value of ultrasound examination with conventional management in patients presenting with emergency surgical problems. During an 4 years period the authors followed 301 patients referred to the Ist Institute of Surgery of the University of Rome "La Sapienza". After immediate clinical evaluation one or more US examinations were performed in each patient following a standard protocol of study. Abdominal emergencies were the most frequent conditions, found in 75% of the cases and the acute abdomen due to trauma in 17.6% of the cases. The overall sensibility, specificity and accuracy of clinical examinations and US examinations were respectively of 88%, 33%, 70% and 95%, 94%, 95%. In 38 patients (12.7%), a diagnosis was made up by sonographic examination which had not been clinically expected (group A). The principal condition in this group was gynaecological pathology, found in 17 patients. In 161 patients (53.3%) sonography confirmed the first diagnosis clinically suspected (group B) and in 23 cases the second or third differential diagnosis (group D). Sonography made no contribution to the diagnosis in 77 cases (25,5%) and only in 2 cases was considered misleading. The result of this study demonstrate the usefulness of emergency ultrasonography in gynecological, gall bladder, pancreatic and vascular diseases. Moreover sonography must be considered the principal diagnostic tool in patients with trauma. In order to recognize gynecological diseases which can simulate appendicitis US examination must be considered necessary in young female patients. When appendicitis is suspected US is useful in children and in older patients too.

Abdomen, Acute↗
PubMedDate not supplied

[The use of the jejunum free flap in the reconstruction of the oral cavity].

The rapid development of surgical techniques in the head and neck area has greatly assisted in enabling reconstructive surgery to bring about prompt positive results. Radical tumor excision alone is no longer an acceptable treatment. Through new reconstructive techniques, psychological and social isolation of the patients, due to difficulties in such vital functions as chewing, speech, swallowing and breathing, can be reduced remarkably. In the past numerous techniques which employed myocutaneous flaps in the reconstruction of the oropharynx have been described. During the last ten years, however, many Authors have proposed the use of free flaps for this reconstructive surgery. Our Department presents its personal experience in reconstruction of the oral cavity using the jejunal flap, which facilitates superior physiological and histological adaptation when compared to that had with other flaps. Our histological study shows metaplastic transformation of the columnar epithelium into squamous epithelium (similar to oral cavity epithelium), phenomenon already observed in "cervix uteri" and anorectal area. The primary reconstruction with a free revascularized jejunal loop associated with mandibular replacement offers certain significant advantages such as satisfactory reconstruction of large defects, high flexibility of the flap and a productions of mucous which cleans the surface of transplants. Furthermore, the mesenteric foot tissue serves as good transplant material for extended soft-tissue loss. In agreement with a Study begun by Carrel in 1906 and that of Reuther (1982), we believe that reconstruction of large defects in the oral cavity by means of transplantation of the mucosa is the ideal treatment.

Adult↗
PubMedDate not supplied

[Carotid thromboendarterectomy: personal experience and review of the literature].

Carotid endoarterectomy (CEA) is known to prevent cerebrovascular accidents. Between February 1987 and December 1993 we performed 97 CEA on 82 patients (62 male and 20 female, median age 66 +/- 7.6 years) 95.1% reported previous hemispheric neurological accidents; 4.9% were asymptomatic. Operative indications for asymptomatic patients were high degree stenosis (> 70%) of the internal carotid artery and ulcerated plaques with a moderate degree (50%) of stenosis. Major events (transient ischemic attack and stroke) were recorded in 73.2% cases. Preoperative investigations consisted of Duplex scan, arteriography, and cerebral CT scan or NMR. Operative mortality was 2.06% (2 cases) and perioperative stroke was 5.1% (5 cases). The sensibility, sensitivity and accuracy of Duplex scan to detect ulcerated plaques was 88.7%, 85.2% and 87.5% respectively. At a median follow-up of 33 months (range 6-81 months) 74 (92.5%) patients are free of strokes whereas 1 patient died for stroke. In our series the annual incidence of stroke was 0.5%. Our results suggest that Duplex scan is a reliable exam to investigate the carotid axis and CEA is a safe operation that prevents future cerebrovascular accidents.

Adult↗