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Biomedical subjects

G Pacileo

Publications and source records attributed to G Pacileo.

41 records · Page 3Linked to original sources

[Left ventricular systolic function in patients surgically treated for atrioventricular septal defect: echocardiographic assessment].

In order to assess the left ventricular systolic function we studied by echo 14 pts (8M, 6F) with complete atrioventricular septal defect (AVSD) who had undergone surgical repair. Mean age was 20.30 +/- 24.63 months, with a follow-up of 52.85 +/- 19.11%; in 6 pts Down syndrome was associated. Particularly, we tried to determine whether the following factors might affect the post-operative left ventricular systolic function: a) Down syndrome; b) residual mild mitral regurgitation; c) age of the surgical repair; d) length of the follow-up. As load-independent indexes of contractility, the left ventricular end systolic stress (LVESS)-circumferential fibre shortening velocity normalized for heart rate (VCFc) relationship and the LVESS/end systolic volume index (ESVI) ratio were chosen. All pts showed normal (mean +/- 2 standard deviations) or slightly higher values of LVESS/VCFc relationship; significantly, the only two pts with lower values had later undergone surgical repair. LVESS/ESVI ratio confirmed an inverse relationship between systolic function and age of the surgical correction (r = -0.75); no other factors (Down syndrome, residual mild mitral regurgitation, length of the follow-up) showed a significant correlation with the post-operative left ventricular systolic function. In conclusion, in our limited population, the age of the surgical repair appears to be the main factor affecting the post surgical left ventricular systolic function in pts with complete AVSD.

Child↗

[Isolated enlargement of the right atrium. Description of a successfully operated case].

We report a case of isolated right atrial enlargement. The patient was an 11 year old boy who had life-threatening supraventricular arrhythmias. Diagnosis was basically performed by Echo-2D Doppler. The surgical treatment performed on cardiopulmonary by-pass, was followed by immediate conversion to sinus rhythm. Histological examination showed chronic inflammatory aspects. Postoperative Echo-2D (2 years later) showed a moderate right atrial enlargement.

Atrial Flutter↗

[Basal left anterior oblique projection in 2-dimensional echocardiography: its usefulness in defects of the atrioventricular septum].

The defects of the A-V septum have been recently classified into classes with separate orifices and classes with common orifice on the basis of the presence or not of a tissue tongue which joins the two bridging anterior and posterior leaflets as single differential feature. The diagnostic usefulness of the subxiphoid projection by conventionally called left oblique anterior basal has been evaluated. It indicates in a single plan-section the two bridging leaflets together with the connecting tongue. In 18 cases of defect of A-V septum echo-angiographic correlation was made. The 2D-echo diagnosed in 10 cases a defect of A-V septum with common orifice and in 8 cases a defect of A-V septum with separate orifices. On the contrary the angiocardiography pointed out in 9 cases a defect of A-V septum with separate orifices. Ten of the eighteen patients examined underwent an operation, which has always confirmed the echocardiographical diagnosis; even in the unique case of echo-angio disagreement the diagnosis of 2D-echo was confirmed. Therefore we propose the above-mentioned projection in order to obtain a more accurate non invasive definition in the defects of A-V septum.

Echocardiography↗

Exercise capacity in young patients after total repair of Tetralogy of Fallot.

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. Measurement of physical activity is usually performed as a routine part of the patient's cardiac evaluation. The aim of this study was to examine the exercise performance of young patients operated on for tetralogy of Fallot, assessing the possible influence of known negative prognostic factors related to the surgical repair. The study group comprised 41 consecutive patients (29 male and 12 female, ages 11.2 +/- 3.9 years, range 6-16 years) operated on for tetralogy of Fallot. Patients in the study group were divided in subgroups in relation to the age of surgical intervention (before or after 2 years of life), the surgical approach (combined transatrial/transpulmonary approach or right ventriculotomy), and the presence of aortopulmonary shunts prior to performing total correction. Their data were compared with those of 33 aged-matched asymptomatic control subjects (19 male and 14 female, ages 11.9 +/- 1.3 years, range 11-16 years). Blood pressure and heart rate measured at rest were similar between control and Fallot groups. A normal increase in systolic blood pressure was observed in response to exercise intensity for all subgroups. No significant difference between control and Fallot groups was found under conditions of mild or moderate exercise or for diastolic blood pressure at rest and in response to exercise. Lower maximal heart rate and systolic blood pressure values were recorded in all patients when compared with the control subjects. Significant differences in peak workload were detected between control and Fallot groups and between the control and each subgroup; however, no difference was found between subgroups. In conclusion, despite their very satisfactory clinical status, all patients showed a reduced peak workload, irrespective of the surgical approach, age at surgery, and aortopulmonary shunts prior to performing total correction.

Adolescent↗