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Biomedical subjects

E Quaini

Publications and source records attributed to E Quaini.

43 records · Page 3Linked to original sources

Intrapericardial hydatid cyst. Report of a case successfully operated.

Hydatid disease of the pericardium is rarely observed. The case of a 42-year-old man with intrapericardial hydatid cyst is presented. The first symptom of the disease was severe chest pain with electrocardiographic evidence of Q waves and T negative waves suggestive of myocardial necrosis. The two-dimensional echocardiography revealed large cystic image localized in the lateral-inferior wall of the left ventricle. Surgical treatment was carried out without the aid of cardiopulmonary by-pass, although this had been contemplated. The patient is asymptomatic and all electrocardiographic abnormalities regressed three months after the operation. The development, natural history, complications, diagnosis and surgical therapy of intrapericardial echinococcosis are discussed.

Adult↗

[Emergencies in valvular surgery].

Ninety patients who underwent emergency cardiac valve surgery from January 1976 to December 1981 are reported. Patients were divided in two groups: those operated on native valves are included in group I; patients with prosthetic valves operated because of leakage or malfunction, in group II. In group I (57 patients) the aetiology was: rheumatic heart disease (34 cases); acute endocarditis (16 cases); sequelae of recent endocarditis (2 cases); luetic infection (1 case); sequelae of myocardial infarction (1 case); rupture of mitral chordae in mixomatous valve (3 cases). The emergency operation was prompted in 22 patients by cardiogenic shock, in 13 patients by intractable pulmonary edema, in 21 patients by low output syndrome, in one case by ventricular arrhythmias. In group II (33 cases) the causes of reoperation were: in 27 cases leakage (in 13 due to active endocarditis); in 6 cases variance of the occluder or thrombosis. The emergency originated in 12 cases from cardiogenic shock, in 11 cases from intractable pulmonary edema, in 9 cases from low output syndrome, in 1 case from ventricular arrhythmias. Twenty-six patients died perioperatively in group I and 17 in group II. Mean follow-up in group I was 26 months. Among 27 patients there were two deaths; 25 patients are alive and well (one has been reoperated again). Mean follow-up in group II was 21 months. Among the 15 patients observed there were 6 deaths (3 after re-reoperation); 9 patients are alive and well (one has been re-reoperated).' The Authors feel that surgery is mandatory in all such patients to ensure satisfying long term results, in spite of high perioperative mortality rate.

Adolescent↗

[Stenosis of the left coronary trunk. Results of aorto-coronary bypass in a series of 46 patients].

Forty-six patients were operated on from 1979 to 1980 in the Department of Cardiovascular Surgery "A. De Gasperis" in Milan, to relieve left main coronary artery stenosis. There was only one death (2,1%) in a patient with "untractable angina". Three patients had per-operative infarction. No other complication were noted. The follow-up varies from 4 to 30 months: 40 patients are asymptomatic, 2 are improved, 1 patient had a recurrence of angina after 15 months. There were no deaths nor myocardial infarctions in the long-term follow-up.

Adult↗

[Chronic mitral insufficiency secondary to coronary arteriosclerotic cardiopathy. Results of surgical treatment in 16 cases].

Our experience with 16 patients operated upon for chronic mitral insufficiency secondary to coronary artery disease is reported. The patients ranged from 40 to 65 years in age; all were in class III or IV of the N.Y.H.A. classification (10 in class IV), 3 were resuscitated from ventricular fibrillation and 11 had a cardiac index less than 2.2 1/min/m2. 15 patients had replacement of the mitral valve with a mechanical or biological prosthesis and 1 had mitral valve repair. 11 of the 16 patients also underwent aorocoronary bypass procedures. There were 2 deaths within the first 30 days following the operation (operative mortality 12.5%) and 6 more deaths during the follow-up period. 6 patients died of heart failure, correlated in 3 cases with extremely severe impairment of left ventricular function (wall motion abnormalities in all segments of the ventriculographic perimeter). Death was sudden in 2 cases. In the 8 surviving patients the clinical result is good. Preoperative factors affecting post-operative prognosis are investigated and guidelines of the indications for the surgical treatment are discussed.

Adult↗

Pregnancy in patients with mechanical prosthetic heart valves. Our experience regarding 98 pregnancies in 57 patients.

Ninety-eight pregnancies in 57 patients with mechanical (ball or tilting disc) prosthetic heart valves are described. Sixty-one pregnancies developed in 36 patients with a mitral prosthesis, 12 pregnancies in 9 patients with an aortic prosthesis, 17 pregnancies in 10 patients with both mitral and aortic prostheses and 8 pregnancies in 2 patients with mitral and tricuspid prostheses. All patients were in I or in II NYHA class at conception and no significative change was noted during pregnancy. All the patients were treated with oral anticoagulant therapy at conception. Different kinds of antithrombotic and antiembolic prophylaxis were employed. There were 13 voluntary interruptions of pregnancy and 37 spontaneous abortions. In the 47 newborn 2 malformation complications (1 warfarin syndrome, 1 cleft palate) and 4 haemorrhagic complications (without sequelae) were noted. Two fatal thromboses of a mitral prosthesis occurred; systemic embolic complications were noted in 7 cases. These observations suggested different incidences of complications regarding the antithrombotic and anti-embolic prophylaxis. The authors point out the high risk of thrombotic and embolic complications and the low rate of successful outcome of pregnancy in these patients.

Abortion, Spontaneous↗