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Biomedical subjects

A Mazzucco

Publications and source records attributed to A Mazzucco.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Hypoplastic left heart syndrome with restrictive atrial septal defect and congenital pulmonary lymphangiectasis.

The presence of a restrictive atrial septal defect in hypoplastic left heart syndrome represents a surgical emergency and may negatively affect survival after operation. A neonate with such a disease association, requiring septectomy upon birth developed intractable respiratory failure due to congenital pulmonary lymphangiectasis. The therapeutic implications of this rare pathologic condition are discussed.

Fatal Outcome↗
PubMedDate not supplied

Extracardiac shunt for nitric oxide-resistant pulmonary hypertension.

An interatrial extracardiac shunt was used to manage severe postoperative pulmonary hypertension, refractory to inhaled nitric oxide, in an infant undergoing repair of ventricular septal defect. The rationale, technique, and potential applications of this method are discussed.

Administration, Inhalation↗
PubMedDate not supplied

Clinical results of heart transplantation in recipients over 55 years of age with donors over 40 years of age.

Between November 1985 and November 1991, 180 patients underwent heart transplantation at our institution; 55 of these patients (31%) were over 55 years of age. Eighteen patients (10%) received hearts from donors who were over 40 years of age (mean age, 47 years; range, 40 to 55 years); (group 1); 37 hearts (21%) were from donors who were under 40 years of age (mean age, 23 years; range, 8 to 38 years). Mean recipient age was 59 years (range, 55 to 64 years) and 57 years (range, 55 to 68 years) in groups 1 and 2, respectively. The main indication for transplantation was ischemic heart disease in group 1 and dilated cardiomyopathy in group 2. Perioperative mortality and intensive care assistance were similar in the two groups. Survival was 88% versus 84% at 1 year and 81% versus 80% at 4 years in groups 1 and 2, respectively. Although infections were more frequent in group 1 (0.27 versus 0.11 episode/patient), the incidence of acute rejection was comparable in the two groups (1.50 versus 1.65 episode/patient). Angiographic and echocardiographic controls showed normal graft function up to 4 years, with low incidence of chronic rejection in both groups. We conclude that heart transplantation in patients over 55 years of age with donors over 40 years of age offers excellent short-term and mid-term results. The consideration of older donors makes heart transplantation a valid therapeutic option for selected patients in the sixth and seventh decade of life, in spite of chronic donor shortage.

Adult↗
PubMedDate not supplied

Implantation of an external biventricular assist device: role of transesophageal two-dimensional echocardiography.

A patient with end-stage dilated cardiomyopathy underwent implantation of a pulsatile external biventricular assist device as a bridge to heart transplantation. The device insertion was guided by transesophageal two-dimensional echocardiography that proved extremely helpful in allowing expeditious and precise positioning of both right and left atrial withdrawal cannulas.

Cardiomyopathy, Dilated↗
PubMedDate not supplied

Coronary artery spasm in heart transplant recipients.

Coronary artery spasm has rarely been observed in the transplanted, denervated heart. We report two patients who had coronary artery spasm after orthotopic heart transplantation that was documented by coronary angiography while ECG and Holter monitoring showed ischemic changes. Both patients were treated with calcium antagonists with no further evidence of this complication; however, one patient died suddenly at home after calcium antagonists were arbitrarily withdrawn. We believe that coronary artery spasm in heart transplant recipients may occur more frequently than expected. Careful monitoring of 24-hour ECG should be considered routinely in the follow-up of such patients, and when coronary spasm occurs it should be aggressively treated.

Adult↗
PubMedDate not supplied

Combined heart and kidney transplantation: a case report.

A patient with successful combined heart and kidney transplantation is reported. This case suggests that occurrence of kidney rejection may allow diagnosis of simultaneous unsuspected heart rejection, thus indicating an immunologic advantage in combined transplantation of organs from the same donor.

Adult↗
PubMedDate not supplied

Palliative surgery for single ventricle heart malformations.

During a 6-year period, 24 patients, aged 7 days to 18 years, underwent palliative surgery for single-ventricle heart malformations; 22 has single-left ventricle with outlet chamber (14 with L-transposition); only two had type C malformation (van Praagh). They were subdivided according to physiology into two groups: the first included 15 patients with decreased pulmonary blood flow, whose main clinical feature was arterial desaturation; the second consisted of nine patients with increased pulmonary blood flow, who presented early with unmanageable heart failure. The first group was treated with a Blalock-Taussig shunt (typical or modified) in 12 cases (one death due to preoperative acute renal failure), with a Waterston or Potts shunt in two cases (both died early postoperatively), and by enlargement of the bulbo-ventricular foramen in one (who died at operation). No late deaths were seen and the clinical status of the survivors is judged optimal. Patients of the second group received a pulmonary artery banding plus a number of associated procedures: coarctation repair (2), ligation of a patent ductus arteriosus (2), Blalock-Hanlon atrial septectomy (1), tricuspid valve replacement (1). There was only one early death due to critical subaortic stenosis produced by a restrictive outlet foramen; however, there were five late deaths and two cases of surgical failure with persistent pulmonary hypertension. An analysis of the best palliative approach in patients with single-ventricle heart malformations is made, based upon the results of this series and taking into consideration the possibility of future intracardiac repair.

Adolescent↗
PubMedDate not supplied

Simplified excision of a left atrial myxoma.

A simple technique for the excision of left atrial myxomas is described. This technique, which is quick and effective, and does not require the employment of prosthetic material, can be used when left atrial myxomas are located outside the fossa ovalis.

Female↗
PubMedDate not supplied

Successful treatment of intraoperative rupture of the left ventricle after mitral valve replacement: report of a case and review of the literature.

A case of intraoperative left ventricular rupture following mitral valve replacement, promptly detected and successfully treated, is reported, and the literature concerning 19 other patients successfully treated for this complication is reviewed. Routine inspection of the posterior atrioventricular groove and left ventricular wall is to be recommended after prosthetic mitral valve replacement and before cardiopulmonary bypass is discontinued, to allow recognition of the early signs of ventricular rupture.

Female↗
PubMedDate not supplied

Pulmonary hypertension in mitral valve surgery.

The operative and long-term results of 72 patients with moderate to severe pulmonary hypertension, operated upon from 1970 to 1972 for isolated mitral valve replacement with Hancock prosthesis were analyzed. A correlation exists between pulmonary hypertension and high mortality risk as well as good hemodynamic recovery of the survivors in the late follow-up, often unrelated with other function tests (pulmonary ventilation and perfusion).

Adolescent↗