Search PubMed⌕ Search

Biomedical subjects

G Stellin

Publications and source records attributed to G Stellin.

83 records · Page 5Linked to original sources
PubMed1982

Postoperative pathology of complete atrioventricular defects.

Necropsy data on 15 patients, who died after operations for complete atrioventricular defect (CAVD), were reviewed in order to analyze the possible determinants of death. Two infants had undergone a palliative procedure--pulmonary artery banding (Group I); three patients had had prosthetic replacement of one or both atrioventricular (AV) valves (Groups II); and the remaining 10 had had conservative repair with plastic reconstruction of the AV valves (Group III). The most notable pathological findings related to death were as follows: Group I, left ventricular hypoplasia in both infants; Group II, prosthetic dysfunction in all patients; Group III, extracardiac diseases in two-patients and cardiac lesions in six. In Group III severe pulmonary vascular obstructive disease (PVOD) was observed as an isolated finding in two patients and in combination with residual intracardiac anomalies in another two. Analysis of the incidence of PVOD demonstrated that irreversible changes may occur within the first year of life in babies with Down's syndrome, and that these changes well correlate with the calculated pulmonary vascular resistance (PVR) values. From the results of this study we have reached the following conclusions: (1) Prosthetic valve replacement has to be avoided because of a high incidence of prosthesis-related complications and the effectiveness of conservative repair; (2) residual untreated anomalies may affect the outcome of operation and should be accurately recognized and weighted preoperatively; (3) PVOD can occur in CAVD even before the first year of life and can be reliably assessed by the measurement of PVR. High degrees of PVOD frequently interfere with the surgical success, particularly when residual intracardiac anomalies are present. Therefore, we suggest that surgical correction be planned, when indicated, during the first 6 months of life.

Adolescent↗
PubMedDate not supplied

Prolonged ECMO support for virus-induced cardiorespiratory failure early after cardiac surgery.

Extracorporeal membrane oxygenation (ECMO) after cardiac surgery is a rescue for life-threatening respiratory or circulatory failure. Although ECMO support for short periods (<10 days) represents an effective means of respiratory and cardiac support, treatment for longer periods remains controversial. We describe successful long-term use of ECMO support (48 days) for acquired virus-induced respiratory failure complicated by circulatory collapse following heart surgery.

Child, Preschool↗
PubMedDate not supplied

Performance of the pulmonary autograft in four infants after the Ross procedure.

Pulmonary valve autografts have proven to be valid aortic valve substitutes in children. The objective of this study is to evaluate the performance of the pulmonary autograft (PAG) in systemic position and its adjustment to growth in four infants who underwent a Ross operation. Between April 1998 and January 2000, four infants whose aortic valve anatomy and function were judged unsuitable for a valve-sparing operation underwent successful Ross operation. All patients were followed postoperatively with echocardiograms to evaluate the function and the dimensional changes of the PAG within the systemic circulation. The PAG adjustments to growth were compared to the growth of the pulmonary root of healthy patients matched for body surface area, with the purpose to evaluate the effects of the systemic pressure on the pulmonary vascular wall, as a passive dilatation process versus a true and active structural adaptation. Median follow-up was 53 months (range, 48-65). There were no early deaths or reoperations. All patients were asymptomatic and in stable hemodynamic conditions. The PAG annulus grew according to body surface area without dilatation. PAG valve regurgitation was present but mild in three patients. Trans-PAG peak gradients were not significant. The PAG diameter at the level of the sinuses of Valsalva and sinotubular junction increased rapidly and steadily in all patients during follow-up compared to controls. The Ross operation in infants provides acceptable immediate surgical and hemodynamic results. However, significant midterm increases in PAG sinuses and sinotubular junction diameters require close and continued observation.

Aortic Valve Stenosis↗
PubMedDate not supplied

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy.

OBJECTIVE: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. METHODS: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. RESULTS: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. CONCLUSIONS: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.

Adult↗
PubMedDate not supplied

[Thoracoscopy: the pediatric experience in Padua].

INTRODUCTION: Thoracoscopy is an important option in the treatment of many thoracic pathologies; its use in children, however, is still limited. We have retrospectively evaluated the thoracoscopic activity in our pediatric surgery department in the last six years. METHODS AND PROCEDURES: Video-Assisted Thoracoscopy (VATS) has been routinely adopted in our institutions since 1997. The data of 115 patients who have undergone VATS were reviewed and analysed. RESULTS: There were 47 males and 68 females. Mean age at surgery was 66.08 (SD: 58.23) months. Mean body weight at surgery was 21.85 (SD: 16.26) Kg. The patients were divided in four groups according to the pathologies: Patent Ductus Arteriosus (PDA) (n = 95), Pleural Empyema (n = 14), Mediastinal Mass (n = 3) and Lung Disease (n = 3). Complicances were seen in two patients in the PDA group (one laryngeal nerve paralysis and one chylothorax) and one in the pleural empyema group (post-operative bleeding which required blood transfusion). CONCLUSIONS: VATS can be performed safely and with minimal morbidity. In our experience, early and late complications turned out to be quite low. This survey would support on-going development of thoracoscopy in children.

Age Factors↗
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↗