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Biomedical subjects

M Villani

Publications and source records attributed to M Villani.

At least 91 records · Page 5Linked to original sources
PubMed1978

Open-heart palliative surgery for pulmonary atresia with ventricular septal defect and hypoplastic pulmonary arteries.

The surgical management of pulmonary atresia with ventricular septal defect (VSD) and hypoplastic pulmonary arteries poses difficult problems. Adequate palliation was achieved in two such patients by restoring continuity between the right ventricle and the pulmonary arteries by means of a woven Dacron patch. The VSD was left unrepaired. Angiography performed one month after operation showed the reconstructed pulmonary outflow tract to be widely patent and the pulmonary arteries to be enlarged. This approach may allow subsequent total correction by closure of the VSD in these hopeless patients.

Blood Vessel Prosthesis↗
PubMed1978

[Corrective surgery of double-outlet right ventricle and subaortic ventricular defect. Report of 12 cases surgically treated (author's transl)].

Experience with corrective surgery in 23 pts with double outlet right ventricle (DORV) and subaortic VSD is presented. The overall hospital mortality was 17%. Patients were divided into two groups: Group I includes seven cases without pulmonic stenosis and Group II sixteen cases with pulmonic stenosis. Six of Group II required a sistemic to pulmonary artery shunt earlier in life. Anatomic and clinical aspects in both groups are described as well as indication for surgery. The importance of angiocardiography for a precise diagnosis is emphasized. Problems related to management and complications are discussed; in particular how to avoid LVOTO in case of restrictive VSD and RVOTO in patients with pulmonic stenosis.

Adolescent↗
PubMed1978

[The Senning operation for correction of transposition of the great arteries (author's transl)].

The reported incidence of the main complications related to the Mustard operation for correction of transposition of the great arteries seems to be quite high: more than half patients develop arrhythmias and about one third develop venous (pulmonary or sistemic) obstructions. For these reasons we have reconsidered the type I (1959) Senning operation. Ten children below two years of age (body weight ranging from 3.9 to 12 Kg) have been operated on with this technique at our Institution. Nine were D-TGA and one L-TGA. One patient had a small VSD and three had mild pulmonary outflow stenosis (p less than 30 mmHg). All patients survived operation and none suffered from complications. At the time of the discharge from the Hospital all were in sinus rhythm. Late evaluation (24 hours EKG, cardiac catheterization, etc.) is in course. We believe that the Senning operation is easier to perform than the Mustard operation because of its more standardized technique which respects the internal geometry of the heart. Additional advantages are: 1) the intra-atrial conducting pathways are less likely to be damaged; 2) there is a minimal or no need for artificial tissues.

Child, Preschool↗
PubMed1978

[Renal failure and aortic coartaction. Report of two cases of newborns successfully treated (author's transl)].

Congestive heart failure may frequently occur in patients with isolated coarctation of the aorta within the first six months of life. Renal failure is on the contrary a very rare pathologic sequela. This is caused by a low renal blood flow related either to a poorly developed collateral circulation or in those instances of preductal coartation to an early closure of ductus arteriosus. Peritoneal dyalisis is very effective in these critically ill infants both in correcting biochemical abnormalitics and in supporting cardiac performance. Surgical treatment is however the only way to restore normal renal blood flow and good cardiac output. This report describes two patients with isolated coarctation of the aorta in whom renal failure developed within the first two months of life. Both patients were successfully treated by peritoneal dyalisis and subsequent surgical intervention.

Acute Kidney Injury↗
PubMed1978

The Senning operation for transposition of the great arteries.

The original Senning technique of interatrial transposition of venous return was selectively employed for physiological correction in 24 patients with transposition of the great arteries (TGA) ranging in age from 74 days to 26 months (median 7 months). Twenty-three had intact ventricular septum and one had a large ventricular septal defect and diaphragmatic subpulmonary stenosis. There were no hospital or late deaths, and at follow-up examination 1.5 to 12 months postoperatively, each patient was asymptomatic, in normal sinus rhythm, and had no clinical evidence of caval or pulmonary venous obstruction. Nine patients underwent cardiac catheterization and angiocardiographic studies between 1.3 and 9 months postoperatively which demonstrated widely patent venous pathways and effective "left" and "right" atrial contraction. This experience lends support to the continued use of the Senning technique for interatrial transposition of venous return.

Angiocardiography↗
PubMed1978

[Surgical management of ventricular septal defect and coarctation of the aorta. Observations on 40 cases, with particular references to infancy (author's transl)].

Forty patients with V.S.D. and coarctation of the aorta were operated on at Department of Cardiac Surgery, Ospedali Riuniti Bergamo. Surgical management of infants with V.S.D. and coarctation depends on the magnitude of the left to right shunt. Patients may therefore be divided into two groups: 1) those with aortic coarctation and a small V.S.D., who have normal or slightly elevated pulmonary artery pressure. If surgery is required, these patients can be successfully treated by repairing the coarctation alone. Ten cases in our series were operated on using this approach without deaths; 2) patients with coarctation and large V.S.D. and pulmonary hypertension. The management of these infants is controversial. One stage repair was used in four cases without deaths. On the other hand, nine out of 11 patients in whom the V.S.D. was left unrepaired at the same operation died, giving a 81.8% mortality rate. Repair of coarctation with simultaneous banding of the pulmonary artery was equally affected by high mortality. With this approach in 13 patients there were seven deaths, giving a 53.8% mortality rate.

Age Factors↗
PubMed1978

[Clinical use of a minicomputer in heart surgery intensive care units].

The Authors present three respiratory parameters useful to estimate the respiratory and hemodynamic conditions of a cardiac patients before these turn into obvious pathological clinical pictures. The parameters are: alveolar-arterial oxygen difference, respiratory index and arterial-venous pulmonary shunts. The sophisticated mathematic calculations necessary to calculate and to elaborate such data are made, in few seconds, by a minicomputer which is very easy to work with. A clinical example in which the above-mentioned data have been employed helps to demonstrate their extreme usefulness.

Blood Gas Analysis↗
PubMed1977

A simple stain for nerve fibres.

A modification of Wilson's crystal violet staining for renin granules is able to show both centra and peripheral nerve fibres on paraffin sections with reproducible results. Fixation, pH and temperature are critical. This stain is considered to demonstrate nerve fibres on account of its capacity to combine with proteolipids.

Animals↗
PubMed1977

[Regenerative gastritis of the peptic ulcer: cytological diagnosis and cytohistological correlation (author's transl)].

The AA., having already illustrate the cytohistological characteristics of regenerative gastritis of the peptic ulcer, propose some differential cytological criteria with regard serious chronic atrophic gastritis and differentiated adenocarcinoma. The AA. conclude, also as result of reviewing their survey (621 cases) that the perfect knowledge of such criteria that any dubious cytological diagnosis and mistaken positives can be reduced to accettable terms.

Adenocarcinoma↗
PubMed1977

[Congenital mitral valve malformations. Anatomical lesions and surgical treatment in paediatric age (author's transl)].

Congenital mitral valve malformations are diverse. When they present clinically in infancy medical treatment is often ineffective. Mitral valve replacement with prosthesis in children carries an high operative and postoperative risk. For these reasons the Authors have undertaken in 1972 a cooperative study which includes: 1) a surgical classification of the congenital mitral valve lesions; 2) a systematic attempt to repair the mitral valve. Over 43 observed cases, 18 have been operated upon. Eleven cases (61%) presented associated cardiac lesions. Hospital mortality was 16% (3 cases). There have been either mortality nor morbidity in the follow-up period. Eight cases have been recatheterized two years after the operation. The pulmonary artery pressure has significantly decreased and the mitral insufficiency disappeared almost completely. The classification, suggested by the Authors, is explained in details.

Angiocardiography↗
PubMed1976

[Aneurysm of the left ventricle in infants. Report of two cases successfully treated (author's transl)].

Aneurysm of the left ventricle in infants is quite a rare cardiac malformation. In this paper two cases are described, six and seven years old respectively, the first one with a subvalvular annular type of aneurysm, the second with an apical type, both surgically treated with success. Ths most known and most frequent aetiological factors are discussed as well as their possible complications. Surgical treatment (aneurysmectomy) is emphasized as the only effective therapy to date.

Angiocardiography↗
PubMed1976

Congenital malformations of the mitral valve in children. Pathology and surgical treatment.

A systematic study of congenital mitral valve malformations was undertaken on a surgical basis in an attempt to develop techniques of valvular reconstruction adapted to the various lesions. Forty-seven children between the ages of 4 months and 12 years (average 6 years, 4 months) have been operated upon between January, 1970, and March, 1976. Valvular lesions were classified into four group: Group I, mitral insufficiency owing to valvular lesions: Group II mitral insufficiency with subvalvular lesions; Group III, mitral insufficiency and stenosis; Group IV, stenosis. Associated lesions (ventricular or atrial septal defects, coarctation, or aortic valve stenosis) were present in 31 patients (65 per cent) and were corrected during the same operation. Valve reconsruction was possible in 38 patients whereas valve replacement was necessary in 9 patients. In the valve repair group there were three operative deaths (8 per cent), no late deaths, one reoperation for residual ventricular septal defect, and one myocardial infarction. In the valve replacement group of 9 patients, there were three operative deaths, three late deaths, and one case of repeated embolization. Thirty-one of 38 patients in the valve repair group were classified into Functional Class I after the operation (86 per cent), 2 were in Class II, and one in Class III. Minimal or moderate regurgitation and cardiomegaly persisted in the majority of the patients. Pulmonary artery pressure significantly decreased, however, as demonstrated by postoperative catheterization in 17 patients.

Child↗