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Biomedical subjects

L Parenzan

Publications and source records attributed to L Parenzan.

117 records · Page 7Linked to original sources
PubMedDate not supplied

Anomalous origin of the left coronary artery from the pulmonary artery. Experience with 13 cases.

The authors present their clinical and surgical experience with 13 cases of anomalous origin of the left coronary artery from the pulmonary artery. The series confirms the existence of 2 different anatomical types of this anomaly depending upon the different development of the intercoronary collateral blood-flow: the "infantile" and the "adult" types. Mitral incompetence is a frequent associated anomaly which may sometimes be the presenting clinical feature, thus masking the underlying disease. The results with different surgical techniques performed in 7 patients are discussed.

Adult↗
PubMedDate not supplied

One stage correction of coarctation of the aorta associated with intracardiac defects in infancy.

A two stage surgical approach is usually prepared for symptomatic babies affected by coarctation of aorta associated with intracardiac defects, the preliminary operation being the resection of the coarctation. One stage correction has been attempted in six patients, ranging from 2 to 24 m. of age and from 3,2 to 9,7 Kg. of weight. The associated lesions were a large V.S.D. (3 patients), a V.S.D. with pulmonary stenosis, a mitral stenosis and a mitral insufficiency. The coarctation was approached through a left thoracotomy and the intracardiac defect through a midline sternotomy incision, after the patient was turned around. All patients survived and did well following the double procedure. The two-stage surgical approach is unnecessary and probably unadvisable for patients with coarctation of the aorta and associated intracardiac lesions.

Aortic Coarctation↗
PubMedDate not supplied

[Results of palliative operations in infants with pseudotruncus arteriosus (author's transl)].

A palliative procedure in patients with pulmonary atresia with VSD should improve arterial oxygen saturation, allow growth and development, and promotes a uniform dilatation of the pulmonary arteries. Thirty-three severely symptomatic patients, ranging from 5 days to 24 mths of age and from 2,4 to 11 kg of weight underwent a variety of palliative operations, including the ascending aorta-right pulmonary artery shunt (intrapericardial: 15 cases; extrapericardial: 14 cases), the Blalock shunt (4 cases). In two cases, both with absence of the left pulmonary artery, a Waterston shunt was performed using cardiopulmonary by-pass. The operative mortality was 20%. In two patients an additional shunt procedure was deemed necessary due to persistent cyanosis. All the survivors improved in terms of arterial oxygen saturation, growth and development. There were no late deaths (mean follow-up: 23 months).

Angiocardiography↗
PubMedDate not supplied

Pediatric heart transplantation without chronic maintenance steroids.

From 1986 to February 1993, 40 children aged 2 months to 18 years (average age 10.4 +/- 5.8 years) underwent heart transplantation. Indications for transplantation were idiopathic cardiomyopathy (52%), congenital heart disease (35%) with and without prior repair (71% and 29%, respectively), hypertrophic cardiomyopathy (5%), valvular heart disease (3%), and doxorubicin cardiomyopathy (5%). Patients were managed with cyclosporine and azathioprine. No prophylaxis with antilymphocyte globulin was used. Steroids were given to 39% of patients for refractory rejection, but weaning was always attempted and generally successful (64%). Five patients (14%) received maintenance steroids. Four patients died in the perioperative period and one died 4 months later. There have been no deaths related to rejection or infection. Average follow-up was 36 +/- 19 months (range 1 to 65 months). Cumulative survival is 88% at 5 years. In patients less than 7 years of age, rejection was monitored noninvasively. In the first postoperative month, 89% of patients were treated for rejection. Freedom from serious infections was 83% at 1 month and 65% at 1 year. Cytomegalovirus infections were treated successfully with ganciclovir in 11 patients. No impairment of growth was observed in children who underwent transplantation compared with a control population. Twenty-one patients (60%) have undergone annual catheterizations and no sign of graft atherosclerosis has been observed. Seizures occurred in five patients (14%) and hypertension was treated in 10 patients (28%). No patient was disabled and no lymphoproliferative disorder was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗