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Biomedical subjects

P Stritoni

Publications and source records attributed to P Stritoni.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Surgical treatment of infectious endocarditis in the active phase. Experience in 40 cases].

Despite recent advances in antimicrobial therapy infective endocarditis (IE) still remains a major surgical problem. All patients undergoing surgical treatment for IE at our Institution since 1970 were reviewed; among these in 40 IE was considered to be active at time of operation. Thirty patients were males and 10 females, ranging in age from 11 to 66 years (average 41); indications for operation were heart failure in 31, mycotic emboli in 5, and sepsis in 4. Nine were in NYHA functional class 11, 18 in NYHA class III, and 13 in class IV. Aortic valve replacement (AVR) was performed in 24 cases, mitral valve replacement (MVR) in 5 and multiple valve replacement (PVR) in 11. Overall hospital mortality was 15% (4.2% in the AVR group, 40% in the MVR group, and 27% in the PVR group). Postoperative follow-up was available in all survivors. Four patients died in the late postoperative period for not infective causes. Almost long-term survivors show, from 7 months to 10 years (average 58 months) postoperatively, a significant improvement. No complications related to the initial infective process were recorded. According to the results of the present study the following conclusions can be drawn: 1) active IE does not represent a contraindication to open heart surgery and prosthetic valve replacement; 2) the surgical results depend not only on the degree of cardiac failure, but mainly on its duration; 3) early surgical intervention affects favourably the prognosis, especially in cases of isolated aortic valve involvement; 4) the surgical management of IE removes the focus of infection.

Adolescent↗
PubMed1981

[Study of left ventricular function in chronic volume overload (author's transl)].

Have been studied 51 patients with aortic incompetency (AI), 46 with mitral insufficiency (MI) and 31 with congestive cardiomyopathy (CM) as example of a primitive myocardial lesion. The mean parametres calculated were: the left ventricular end-diastolic pressure (LVEDP), the ventricular volumes, the ejection fraction (EF), the end-sistolic pressure-volume ratio (Emax) and the eccentricity. In the chronic volume overload, the relationship between the pump performance and the contractility (EF-Emax) is parabolic with an initial plateau (myocardial failure without circulatory failure); the EF-Emax relationship, in the CM, is linear without a plateau. The LVEDP is a limiting factor of the pump-contractility relationship in the AI: for the same value of the contractility, the pump function is greater depressed if the LVEDP is 25 mmHg (loss of the preload modulation); in the MI and CM the depression of the pump performance is a function only of the depressed contractility. The end-systolic eccentricity is correlated with Emax: the changes in the geometrical shape of the left ventricular chamber is due to the depressed contractility.

Aortic Valve Insufficiency↗
PubMed1981

[Atresia of the left atrioventricular orifice with "normal" aorta (author's transl)].

Though atresia of the left atrioventricular (av) orifice can show multiple types of ventricular morphology and different ventriculo-arterial (va) connections, clinical prognosis and surgical reliability depend upon the size of the aorta. Two cases with "normal" aorta are reported. The first was a female baby, died at four months, who had atresia of the left av orifice with right main ventricular chamber, va discordance and moderate pulmonary stenosis. The fatal outcome was due to progressive restriction of the foramen ovale. The second patient was studied at six months, is still alive, and showed atresia of the left av orifice with left main ventricular chamber, va discordance and pulmonary blood overload. According to this type of anatomy, modified Fontan procedure is postulated as possible and reliable surgical correction.

Angiocardiography↗