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Biomedical subjects

B Faidutti

Publications and source records attributed to B Faidutti.

At least 127 records · Page 7Linked to original sources
PubMed1980

[M-mode and two-dimensional echocardiography in evaluating mitral stenosis before and after commissurotomy].

A first group of 51 patients with pure or predominant mitral stenosis underwent M-mode (M) and two-dimensional (2D) echocardiography and cardiac catheterization (cath). After elimination of 3 incomplete cases, the series consists of 48 patients. 20 later underwent surgery. Quantitative correlations between M and cath are poor (r = 0.34, p less than 0.05); however, correlations between 2D and cath were excellent (r = 0.89, p less than 0.001). There were 4 major discrepancies between 2D and cath: 3 of these patients were operated upon and surgery confirmed 2D mitral valve area in all of them. 2D had served to diagnose all 6 cases of mitral calcifications seen at surgery; however, M provided 1 false negative and 5 false positive results with regard to diagnosis of calcifications. A second group consisted of 18 patients who had undergone mitral commissurotomy, 8 of these had a pre- and postoperative echocardiography. 10 also underwent postoperative cath. M appeared to be unable to predict correctly the presence or absence of a recurrence of mitral stenosis. Quantitative correlations between diastolic slope and mitral valve area at cath were poor. However, excellent correlations were found between 2D and cath, showing that 2D also serves to measure mitral valve area after commissurotomy.

Calcinosis↗
PubMed1980

[Results of long term surgical treatment of isolated stenosis of the left descending coronary artery].

The results of medical and surgical management of isolated stenosis (greater than or equal to 50%) of the left anterior descending artery were compared retrospectively in a series of 124 consecutive patients. 57 patients were managed medically (Group I). 28 (49%) presented with angina and 36 (63%) with a previous myocardial infarction. The stenosis was greater than 90% in 38 patients (67%) and was associated with severe left ventricular dysfunction in 28 patients (49%). The average ejection fraction was 53.8 +/- 2.5%. 67 patients were managed surgically (Group II): 58 (87%) presented with angina and 28 (42%) with previous myocardial infarction. The stenosis was greater than 90% in 58 patients (87%) and associated with severe left ventricular dysfunction in 19 patients (28%). The average ejection fraction was 61.7 +/- 2.4%. The average length of follow-up was 41.9 +/- 4.1 months in Group I and 46.2 +/- 3.5 months in group II. 6 patients died in Group I, 5 of a cardiac cause, compared to 4 patients (3 of a cardiac cause) in Group II, with an operative mortality of 1.6%. One patient in Group I had a new myocardial infarction compared to 6 in Group II, 3 of which (4.4%) occurred in the perioperative period. Angina regressed after therapy in 23 patients (40%) in Group I and in 48 patients (72%) in Group II (p < 0.01). Angina was unchanged or became more severe in 12 and 5 patients respectively. 34 patients (60%) on drug therapy were able to resume their professional activities as opposed to 26 (42%) in the surgical group (p < 0.05). It would therefore appear that surgery for isolated stenosis of the left anterior descending artery does not significantly reduce mortality, or prevent recurrence of myocardial infarction, but it does significantly improve anginal pain. The same conclusions are obtained when the patients are classified in different sub groups, "operable" patients or those with previous myocardial infarction or with poor left ventricular function. Finally, the surgical indications were "good" in 21 patients, symptomatic with a proximal stenosis greater than 75%, good ventricular contraction on angiography, an ejectionfraction of at least 50%, and good arterial run-off. In these cases surgery was successful with regression of anginal pain in 19 patients (90%) but complicated by secondary infarction in two of them. These results were better than those obtained in the other operated patients, in which the surgical indications were judged retrospectively to have been "inadequate". Therefore, in isolated stenosis of the left anterior descending artery, aorto-coronary bypass surgery should be reserved to patients with "good surgical indications".

Angina Pectoris↗
PubMed1980

[Nephrotomy using in situ hypothermic perfusion. Apropos of a case].

The case of a 14 year old boy, suffering from severe bilateral nephrolithiasis, secondary to cystinuria, is presented. The progressive increase of the lithiasis, the dilatation of the excretory system of the right kidney and the painful passage of stones justified surgical removal of the staghorn stones on the right. The nephrolithotomy was performed under hypothermic perfusion of the kidney in situ, with section of the renal artery. This allowed an exsanguineous nephrotomy and the complete removal of all the stones. Anatomical repair of the calyces was possible, renal artery was re-anastomosed and the opening of the renal vein sutured without difficulty. No complication was encountered in the postoperative period, renal function remaining good. The intravenous pyelogram at the 15th postoperative day showed a marked improvement of the hydronephrosis. The authors review the literature describing the different methods of ischemic nephrotomy and compare the advantages of the procedure chosen in their case with the others : these advantages are the good preservation of the kidney, a bloodless nephrotomy, the long time allowed for the procedure and the removal of all the stones, and the possibility to continue the operation ex vivo when necessary, even using microsurgery.

Adolescent↗
PubMed1980

[M-mode and two dimensional echocardiography for evaluation of mitral stenosis (author's transl)].

M-mode and two-dimensional echocardiography (echo) were performed in 51 patients with pure or predominant mitral stenosis. Echocardiographic assessment of the severity of the stenosis was compared to the results of cardiac catheterization (cath); surgical evaluation of the mitral valve area was also obtained in 20 patients. M-mode is an excellent method for the diagnosis of mitral stenosis. However two-dimensional echo is much better for the assessment of its severity; in the present study correlations with cardiac catheterization have been excellent (r = 0.89, p less than 0.001). Major disagreement between echo and cath were found in 4 patients; 3 of them have been operated on and surgery has confirmed the echo results in all 3. Two-dimensional echo has also allowed correct prediction in the presence of mitral calcifications in 6 of the operated patients, whereas several false positive and negative diagnosis was made on M-mode. Two-dimensional echocardiography is therefore an excellent non-invasive technique for the diagnosis of mitral stenosis, measurement of mitral valve area and identification of mitral calcifications.

Adult↗
PubMed1979

[Tetralogy of Fallot: results of 77 hemodynamic controls after complete correction].

77 patients (representing 91% of all survivors) underwent catheterization within 5 months of surgical repair of tetralogy of Fallot. The data show that residual pulmonary gradient is significantly higher in patients with infundibular and valvular stenoses than in patients with infundibular stenoses only, whereas the method of intracardiac repair (patch) had no influence on residual gradient. Significant pulmonary insufficiency was found almost exclusively when a patch was extended through the pulmonary annulus. Hemodynamic results were excellent in 37% of cases, good in 51%, satisfactory in 3% and unsatisfactory in 9%. Finally, primary intracardiac repair in children below 4 years of age yielded excellent or good results in all cases: this suggests that toal correction should be performed without previous aorto-pulmonary anastomoses in this youngest group of patients.

Cardiopulmonary Bypass↗
PubMed1979

[Permeability of venous aortocoronary bypass 5 years later].

47 consecutive patients who had undergone aorto-coronary venous bypass surgery (mean: 1.6 graft per patient) have been investigated after a mean follow-up period of 5 years and 9 months (range: 44-108 months). 52 grafts out of 73 were found to be patent (71 p. 100), the best patency rate being shown by grafts on the LAD artery (27/32 = 85 p. 100). Long-term graft patency may be associated with an improved left ventricular ejection fraction; 77 p. 100 of the total patients experienced a lasting clinical benefit from the operation.

Adult↗
PubMed1979

[Pulmonary valvular subatresia with intact interventricular septum in a newborn infant: role of prostaglandins in the immediate postoperative period].

The case is reported of a newborn with pulmonary valvular subatresia and intact interventricular septum and moderate right ventricular hypoplasia, treated with pulmonary commissurotomy alone. In the immediate postoperative period the ductus arteriosus closed, resulting in deep hypoxia and acidosis. With the infusion of PG E2 the ductus reopened and the baby's condition improved markedly. The ductus was kept open for 20 days, during which time adaptation of the right ventricle must have occurred. Indeed, after definitive spontaneous closure of the ductus, right ventricular output proved sufficient to insure satisfactory pulmonary perfusion.

Ductus Arteriosus↗
PubMed1978

Surgical techniques.

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Coronary Artery Bypass↗
PubMed1978

[Complete surgical correction of congenital cardiopathies in infants].

The results of total correction of congenital heart defects in the first year of life are presented. Overall surgical mortality in these generally highly symptomatic infants was 35%. The surgical risk is mainly related to the type of defect: mortality is low (10%) in uncomplicated septal defects and in transpositions of the great vessels, higher in the coarctation syndromes (30%), and considerable in complex heart defects. The weight of the infant seems to be another factor, surgical mortality being high when the patient's weight is less than 4.5 kg. Indications for palliative operation or total repair are discussed on the basis of the presented results.

Aortic Coarctation↗
PubMed1976

[Function improvement in levography following aortocoronary bypass].

Actively contracting segments, preoperatively akinetic, were found in 8 of 63 patients, evaluated 6-12 months after aortocoronary surgery by coronary angiography. Ejection fraction was increased from 48.1% (S.D. 15.7) to 68.3% (S.D. 11.4). These patients are characterized by two simple clinical parameters: 1. All patients had angina pectoris at rest or at minimum exercise except for one; 2. preoperatively, there was a discrepancy between severe ventriculographic and discreet Ecg findings. These findings prove that myocardial function in coronary artery disease can be impaired at rest by ischemia, without clinical signs of coronary insufficiency, such as angina pectoris. Even severe impairment of left ventricular function is no contraindication for coronary artery surgery, if caused by reversible myocardial ischemia.

Adult↗