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Biomedical subjects

L Campolo

Publications and source records attributed to L Campolo.

At least 55 records · Page 3Linked to original sources

[Transluminal coronary angioplasty. Technic and immediate results].

Controlled crushing of the intimal plaque and of the underlying vessel wall are the determinants of transluminal dilatation of coronary stenoses. The technique of angioplasty has been recently modified in many laboratories, by the use of new catheters and dilatation policies. Data from the NHLBl Registry indicate a 59% primary success rate, being 29% and 12% respectively the failures due either to inability to cross or to dilate the stenosis. A retrospective analysis of successful procedures has highlighted factors that positively affect the results: recent onset of the angina, lack of calcifications, iterative ballooning at high pressures and the experience of the angiographer. Main complications were angina becoming unstable (5.7%) and acute coronary occlusion (4.4%); an emergency bypass operation had to be done in 6.3% of the cases, whereas myocardial infarctions scored 4.4% and hospital deaths less than 1%. Preliminary results of Centro De Gasperis concern 18 attempts to dilate LAD stenoses: primary success rate was 44% with a failure rate of 39% and 17% regarding inability to cross or only to dilate stenosis, respectively. The above results are less favorable than those reported in NHLBl Registry and very much less than those reported by selected laboratories; they are however acceptable in view of the suboptimal characteristics of the materials used and the limited experience of the team.

Adult↗

[Clinical and angiographic study of 51 patients with myocardial infarction aged up to 35 years (author's transl)].

The clinical and angiographic data of 51 patients 35 years-old or below with myocardial infarction were studied. The average age of the patients was 30.2 years. Cigarette smoking and familiar history for coronary artery disease (present respectively in 74.5 and 39.1 per cent of the patients) were the most frequent risk factors for coronary disease. The patients were divided into two groups without (group A) and with (group B) post-infarctional complications (angina, dangerous ventricular arrhythmias, left ventricular failure, re-infarction). The coronary arteries were normal in 46.1 per cent of the patients of group A, and in 11.1 per cent of the patients of group B (p less than 0,05). 33.3 per cent of the patients of group A were affected by 1 vessel disease and so were 40.7 per cent of the patients of group B (p = ns). 48.1 per cent of the patients of group B were affected by 2 or 3 vessels disease and so were 25 per cent of patients group A (p = ns). Left ventricular angiography revealed severe impairment of contractility in 70,3 per cent of the patients of group B and in 45.8 per cent in group A. A history of angina before myocardial infarction was connected with the presence of coronary artery disease in 87 per cent of patients.

Adult↗

[Post-infarction aneurysm of the left ventricle. Pre-operative parameters conditioning the surgical risk and remote results].

83 patients who underwent resection of postinfarction aneurysms involving the anterior wall of the left ventricle were studied to identify possible determinants of operative outcome, long-term survival and long-term improvement. The indications for aneurysmectomy (either isolated or combined with direct revascularization) were congestive heart failure, angina or life-threatening arrhythmias; six patients were asymptomatic at the time of surgery. Operative mortality rate was 14.4% (11.5% for patients operated more than 60 days following myocardial infarction). The over-all survival rate, at a mean follow-up of 31.5 months (range 2 to 82 months), was 74.39%; 80.88% of patient discharged from hospital, exhibited clinical improvement. Mean values of ejection fraction and excess ejection fraction were significantly higher in the group of operative survivors (31.28 +/- 8.26% and 0.17 +/- 0.08 respectively) than those of surgical deaths (20.25 +/- 8.37% and 0.08 +/- 0.06) (p less than 0.005); the coronary score was significantly lower in the group of survivors (6.81 +/- 2.35 vs 8.33 +/- 2.29) (p less than 0.025). Presence of arrhythmias increased operative mortality (33.3% vs 11.2%, p = 0.05), as did a low cardiac output, impaired contraction of the postero-lateral wall and mitral regurgitation. Long-term survival and improvement were not related to anyone of preoperative parameters taken into consideration: however, a higher percentage of clinical improvement was observed when myocardial revascularization was associated to aneurysmectomy (85% vs. 67.7%).

Adult↗

[Single vessel coronary disease. I. Differences in clinical and prognostic aspects and in surgical results in isolated lesions of the anterior descending branch and of other coronary branches].

This study includes 290 patients having a 75% or greater stenosis of a sinlge coronary vessel, divided into two groups: 205 cases with isolated lesions of the left anterior descending coronary artery (LAD) and 85 with a stenosis of the circumflex (CF) or of the right (RCA) coronary artery. The following data have been compared in the two groups: -- characters of angina; -- results of stress testing; -- extent of left ventricular contraction impairment; -- natural history of unoperated patients; -- surgical risk; -- long term survival of operated patients; -- effect of medical or surgical treatment on symptoms. Results were as follows: -- LAD patients had slightly more severe symptoms and lower exercise tolerance than CF and RCA patients; -- no significant differences were noted as regards left ventricular contraction; -- five year survival rates were only slightly different both regarding unoperated patients (80 +/- 5% survival in LAD disease group; 86 +/- 5% in CF and RCA disease) and operated cases (83 +/- 5% in LAD lesions, 86 +/- 7% in CF and RCA disease); -- surgical risk was relatively low in both groups; -- progress of symptoms after bypass surgery was very favourable. Based on these results, indications for surgery in single coronary vessel disease are discussed.

Adult↗

[The bicycle electrocardiographic test for secondary prevention of coronary insufficiency. Results of a screening on 11,362 Italian workers (author's transl)].

A series of multi-phase mass screenings has been carried out in a number of working communities for locating, in their early stage, some socially important disease. The bicycle electrocardiographic test has been used for diagnostical purposes in order to single out all subjects affected by latent coronary heart disease and to evaluate the method as a means of prevention for the population. In the whole case-history, consisting of subjects free from coronary disease and with normal blood-pressure, mostly young or middle aged, the prevalence of positive electrocardiographic tests has been of 0.96%. The incidence of ischemic heart disease in 39 subjects with positive exercise test controlled after two-five years has been of 19%. Since the percentage of subjects with positive exercise test is extremely low on account of the not high occurrence of ischemic heart disease in our country as well as of the limited sensitivity of this method, it is believed that the electrocardiographic exercise test is not a satisfactory tool for secondary prevention of coronary disease in the Italian population.

Adult↗

[Aorto-coronary bypass. On 200 cases surgically treated (author's transl].

200 patients underwent bypass graft for treatment of severe coronary vessel disease. The bypass vein grafts were 316; single grafts in 100 cases, double in 85, triple in 14 and in 1 case a patient received 4 grafts. In 57 cases a previous coronary endarterectomy was performed. The flow in the graft at the end of the operation was more than 40 cc/min. in 80% of cases. 22 patients died. Postoperative myocardial infarction occurred in 14% of the patients. The mortality was higher in the preinfarction angina group, and less in the chronic angina group without concomitant surgery (7,2%) and is statistically in direct relation to the functional condition of the left ventricle (2,8% in patients with end diastolic left ventricular pressure less than 20 mmHg and without akinetic areas). Relief of angina was observed in 87% of the surviving patients. Postoperative coronarography, catheterism and left ventriculography was performed in 46 patients. Only 2 of the 15 cases with postoperative angina had the graft patent. Significant improvement of the left ventricular function with disappearence or regression of akinetic areas was observed in 9 patients. Our experience indicates that the value of this operation cannot be entirely known at the present time.

Adult↗

[Evaluation of cardiac performace in 222 patients with pulmonary sarcoidosis (author's transl)].

Electrocardiogram at rest, blood pressure, systolic intervals (PEP/LVET), cardiothoracic ratio and circulation time were evaluated in 222 sarcoidotic subjects without cardiac symptoms and with no past or present history of cardiac disease. Very few, slight alterations were observed and were probably not the result of sarcoidotic myocardial involvement. Abnormalities distribution according to stage on the basis of chest-x-rays findings and the duration of sarcoidosis did not appear significantly different. Prospective study is being undertaken to determine which of the observed abnormalities may represent precursors or symptoms of sarcoidotic cardiac involvemenet.

Adolescent↗