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Biomedical subjects

M Villani

Publications and source records attributed to M Villani.

At least 109 records · Page 6Linked to original sources
PubMed1975

[The current role of palliative operations in the surgical treatment of tetralogy of Fallot. A report on 172 operated cases (author's transl)].

172 consecutive palliative operations in patients with Fallot's tetralogy are presented. 19% of the patients were aged less than 6 and 45% less than 12 months. The overall mortality was 5.8%, but has been recently reduced with the improvement of anaesthesiologic and technical experience. In fact, during the last two years, 69 Waterston shunts (33 under 12, and 17 under 6 months of life) were performed with no deaths. On the grounds of this experience, indications of the different types of systemic to-pulmonary artery shunts are discussed, as well as problems related to the choice between one-stage and two-stages surgical correction. The authors' opinion is that palliative procedures still play an important role in the treatment of Fallot's tetralogy, although the future approach may well be early total correction. In their experience, the last approach is restricted to children over 18-24 months of life with favorable anatomy, and to all patients over 4 years of age.

Heart Arrest↗
PubMedDate not supplied

Tricuspid atresia with imperforate valve: angiographic findings and surgical implications in two cases with AV concordance and normally related great arteries.

The angiographic and intraoperative findings are described in two children with imperforate tricuspid valve with atrioventricular and ventriculoarterial concordance who underwent a successful Fontan operation. It is important from a surgical point of view to distinguish this rare variant of tricuspid atresia from the more classic form with absent atrioventricular connection. The characteristic feature of hearts with imperforate tricuspid valve is the presence of a normally formed right ventricle which, in the presence of ventriculoarterial concordance, can be used to support the pulmonary circulation. When the imperforate valve is large, it may be possible to remove it, and restore atrioventricular continuity. Alternatively, an atrioventricular type of Fontan repair using a valved conduit should be considered as the treatment of choice in the presence of a suitable pulmonary arterial tree and pulmonary valve.

Child↗
PubMedDate not supplied

Electrophysiological characteristics of the human atria after cardioversion of persistent atrial fibrillation.

BACKGROUND: In animal models, induced atrial fibrillation shortens the atrial effective refractory period (ERP) and reverses its physiological adaptation to rate. It is not clear whether this process, known as "electrical remodeling," occurs in humans. METHODS AND RESULTS: We determined the ERPs, at 5 pacing cycle lengths (300 to 700 ms) and in 5 right atrial sites, after internal cardioversion of chronic atrial fibrillation in 25 patients (14 in pharmacological washout and 11 on amiodarone). The ERPs were 195.5+/-18.8 ms in the washout and 206.3+/-17.9 ms in the amiodarone patients (P<0.0001). ERPs were closely correlated with the stimulation rates (r=0.95 in the washout and r=0.94 in the amiodarone group), and slope values indicating a normal (>/=0.07) or nearly normal (0.05 to 0.06) adaptation of ERP to rate were found in 77% of the 84 paced sites. The mean ERP was shorter in the lateral wall (198.1+/-17.9 ms) than in the atrial roof (203.3+/-21.5 ms) and in the septum (210.5+/-20.0 ms) (P<0.03). After 4 weeks of sinus rhythm, the mean ERP, determined again in 8 patients (4 in wash-out and 4 on amiodarone), was significantly increased compared with the basal study (221. 4+/-21.4 versus 197.8+/-18.3 ms, P<0.0001). CONCLUSIONS: After cardioversion of chronic atrial fibrillation, (1) atrial ERP adaptation to rate was normal or nearly normal in the majority of the cases, (2) a significant dispersion of refractoriness between different right atrial sites was present, and (3) ERPs were significantly increased after 4 weeks of sinus rhythm in both washout and amiodarone patients.

Adaptation, Physiological↗
PubMedDate not supplied

Ossifying parasellar chondroma. Case report.

The Authors report a case of cartilaginous tumor of the parasellar region, diagnosed as ossifying chondroma by virtue of the intense calcification it presented. Preoperative diagnosis was suggested by CT, which showed a characteristic honeycomb conformation, with alternate areas of greater or lesser density, without contrast enhancement. Angiography is, however, essential in planning the operation, which must on occasion be confined to partial resection only. This limitation may be acceptable where functionally important areas are concerned, since these neoplasms show an apparent tendency to only modest growth.

Adult↗
PubMedDate not supplied

Double outlet left ventricle: how should we repair it?

Two patients with D.O.L.V., V.S.D. and P.S. have been successfully corrected surgically. They represent the seventh and the eighth successful repairs of D.O.L.V. reported so far in the literature. Surgical correction was accomplished by an "extraventricular" type of repair, closing the V.S.D., interrupting the connection between left ventricle and pulmonary artery and creating a conduit between right ventricle and pulmonary artery. The conduit used was a fresh aortic homograft. An "intraventricular" type of repair of this rare congenital malformation has been also reported, but the authors believe that it is not applicable to all cases of D.O.L.V. and it is possibly more likely to incur complications, while the "extraventricular" one doesn't seem to have any contraindication. Preoperative diagnosis can be only achieved with careful angiographic study, including left ventriculography.

Adult↗