Search PubMed⌕ Search

Biomedical subjects

E Donegani

Publications and source records attributed to E Donegani.

At least 37 records · Page 2Linked to original sources
PubMed1986

Myocardial protection by perioperative diltiazem drip: a clinical evaluation.

This study was undertaken to evaluate the potential role of a perioperative calcium-channel blocker (Diltiazem) infusion in improving myocardial preservation. Forty consecutive CAD patients were randomly assigned to a control (C; n = 20) and a treated (D; n = 20) group. In patients in the latter group diltiazem was continuously infused at 0.5 to 2.0 mcg/kg/min i.v. from anesthesia induction until the aortic cross-clamping, and from myocardial reperfusion till the 48th postoperative hour. During the preCPB phase hypertension occurred less frequently in group D (3 vs 12 cases, p = 0.0033). In the immediate postischemic period, depression of contractility and the need for inotropic support were observed in 3 cases in group D and in 9 in group C (p = 0.0384). Postoperatively, group D patients had a lower incidence rate of hyperkinetic arrhythmias or conduction disturbances (p = 0.0218), as well as of ECG signs of ischemia (p = 0.0016). Significant CK enzyme level increase was noted in 13 patients in group C versus 4 in group D (p = 0.0040). Two perioperative myocardial infarctions were diagnosed, both in group C. These clinical data show that continuous perioperative infusion of diltiazem can effectively increase myocardial preservation during ischemic arrest, without unfavorable effects on the hemodynamics, electrical activity or mechanical performance of the heart.

Benzazepines↗
PubMed1986

Diltiazem cold cardioplegia in coronary artery surgery: effects on myocardial function and ischemia.

This study was undertaken to evaluate the myocardial preservation obtained by adding a calcium channel blocker, diltiazem (200 mcg/kg of body weight) to cold potassium cardioplegia in 24 patients with coronary artery disease who underwent myocardial revascularization, and were randomly divided into a treated Group D and a Control Group C. No significant differences were noted between the groups in cardiac electrical arrest and recovery time, recovery rhythm, mechanical function recovery, inotropic support, stroke index, or cardiac index. After cardiopulmonary bypass, the stroke index decreased by 13.1% in Group D and by 20.7% in Group C; cardiac index increased in both--18.6% and 14.0%, respectively--but the results were possibly from compensatory heart rate increases. Peripheral deltaP/deltat and endocardial viability ratios decreased in both groups. Coronary sinus enzymes and serum CK were slightly lower in the treated group. Serum CK-MB, however, was significantly higher in the Control Group. Electrocardiographic ischemic changes occurred in four patients, all in Group C (p =.046). Hyperkinetic arrhythmias occurred in five of the controls, but in none of the treated patients (p =.018). One perioperative myocardial infarction was diagnosed in the Control Group. These data suggest that diltiazem has no negative side effects on hemodynamics or cardiac rhythm and does not reduce impairment of myocardial function due to ischemia, but it does decrease the incidence of ischemic lesions in patients undergoing coronary artery bypass procedures.

Journal Article↗
PubMed1981

[Effects of the administration of acebutolol in patients with chronic angina of effort].

12 patients suffering from chronic coronary insufficiency with signs of ischemia in the ECG, were treated orally with 200 mg of acebutolol t.i.d. for a period of 3 weeks. The following parameters were examined at the beginning of the therapy as well as at the end of every week: number of stenocardiac attacks, characteristics of pain, nitroglycerin consumption, B.P., H.R., respiratory rate, ECG, maximal exercise test, PEP, LVET, PEP/LVET at rest and immediately after effort. The treatment with acebutolol was effective inducing an improvement of subjective symptoms (reduction of stenocardiac crises, intensity and duration of angor, trinitrin pearls consumption) and an increase of effort tolerance. The utility of the therapy was also proved by the reduction of the systolic pressure and by the following decrease of hemodynamic overload and, therefore, of the heart muscle's work. This positive effect is due to the reduction of the myocardial oxygen consumption, modulated among others by the bradycardiac action of the drug. The cardioselectivity of acebutolol avoided to cause peripherical disorders usually observed with other non selective beta blocking drugs.

Acebutolol↗
PubMed1980

[Clinical experience with etomidate].

The effects of Etomidate, a new intravenous anaesthetic agent, were studied in 138 cases which underwent different procedures of variable duration under general anaesthesia. The effects on different organs and systems of this drug, alone or in association with other anaesthetics or adjuvants, were analyzed in this series. Clinical signs, plethysmography and electroencephalography were the main parameters studied. It was shown that Etomidate has a rapid, transient action and a high therapeutic index without any cumulative effects. In conclusion this drug is recommended as an excellent induction agent which could also be advantageously employed for short surgical procedures.

Anesthesia, Intravenous↗
PubMed1976

[Echocardiographic studies with a multiscanner apparatus].

This technique aims at obtaining a dynamic bi-dimensional image of the cardiac structures, which can be directly registered on videotape and photographed with Polaroid cameras. It is particularly useful -- in as much as it gives characteristic images -- for obstructive and non-obstructive hypertrophic myocardiopathies, in exudative pericarditis, in tetralogy of Fallot and mitralic stenosis.

Echocardiography↗
PubMedDate not supplied

The De Vega tricuspid annuloplasty. Perioperative mortality and long term follow-up.

One hundred and fifty-three patients undergoing De Vega tricuspid annuloplasty, with or without other associated cardiac procedures between January, 1979, and June, 1987, were evaluated. There were 136 hospital survivors. The follow-up was 98.1% complete for a mean of 3.7 years/patient. Operative mortality was 11.1%; preoperative NYHA class and length of CPB were significant risk factors of perioperative mortality. The actuarial survival of operative survivors at 9 years was 73.5 +/- 11.8%. There were 7 late cardiac deaths among a total of 12 late deaths. Eleven patients required reoperation (2.1 +/- 0.6% patient-year). In seven patients it was necessary for recurrence of tricuspid regurgitation; six of these had also a mitral prosthesis malfunction or a periprosthetic leak. Residual tricuspid regurgitation was judged as mild, moderate or severe in 29.9%, 11.9% and 4.3% of the patients respectively. De Vega tricuspid annuloplasty is the method of choice for mild and moderate tricuspid insufficiency; in selected cases, with a more severe degree of regurgitation, better results could be achieved with a different surgical approach.

Adolescent↗
PubMedDate not supplied

Coronary artery bypass grafting for unstable angina. Risk factors of operative mortality.

In order to identify factors affecting early mortality in patients undergoing CABG for unstable angina, several risk factors have been analysed in a group of 120 patients. Systemic hypertension and left ventricular impairment were shown to be significant risk factors (Systemic hypertension, P less than 0.01; EF less than or equal to 0.35, P less than 0.01; LVEDP greater than or equal to 20 mmHg, P less than 0.025). Overall mortality rate was 5% (6/120). No influence could be recognized for age, sex, previous MI, emergency surgery, extension of coronary disease, completeness of revascularization and mode of onset of symptoms.

Adult↗