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Biomedical subjects

S Saccani

Publications and source records attributed to S Saccani.

At least 37 records · Page 2Linked to original sources
PubMed1993

Prevention of deep venous thrombosis by a new low molecular weight heparin (Fluxum) in cardiac surgery.

The prophylactic deep venous antithrombotic efficacy of a low molecular weight heparin (LMWH) was compared with traditional unfractionated calcium heparin in 39 patients submitted to cardiac surgery. The patients were allocated at random to receive either LMWH-Fluxum 3200 IUaXa daily (Group A: 20 patients) or calcium heparin 5000 IU three times daily (Group B: 19 patients). Both treatments were started on the first day after surgery and continued over the fourth postoperative days. One or more risk factors for deep venous thrombosis in addition to the cardiac pathology were present in all the patients of group A and in 13 (72.2%) of group B. Mean times of surgery, blood loss during the perioperative period and number of blood units transfused in both groups were not statistically significant. The deep venous system was investigated by continuous wave Doppler and real time colour Echotomography. No evidence of thrombosis was detected in the two groups. Side effects and subcutaneous hematomas were present in only four patients of group B. Both drugs showed good tolerance, provoking no variations of the main laboratory parameters. We conclude that Fluxum (LMWH) for the efficacy and convenience given by a single daily dose, could represent an alternative choice in the prevention of deep venous thrombosis in cardiac surgery.

Female↗
PubMed1993

[Thallium-201 myocardial perfusion imaging after aortocoronary bypass in patients treated with sulodexide or ASA-dipyridamole].

The aim of this investigation was to compare the preventive effect of sulodexide, a glycosaminoglycan drug, tested versus ASA-dipyridamole association, on the occlusion of venous aortocoronary bypass. A group A of 23 patients, for a total of 22 anastomosis with internal mammary artery and 46 venous bypass, was treated with sulodexide 500 USL/day. A group B of 18 patients for a total of 19 anastomosis with internal mammary artery and 33 venous bypass, was treated with ASA-dipyridamole 300 mg + 400 mg/day. Three and 9 months after surgery, all patients underwent thallium-201 myocardial perfusion imaging, associated with ergometric test. At the first control after 3 months, reversible perfusion defect in one or more myocardial segments was observed in 8 patients of group A and 3 patients of group B (2 A patients and 1 B patient in non revascularized myocardial segments); after 9 months, reversible perfusion defects were observed in 4 A patients and in 4 B patients. After 3 months, non reversible perfusion defect imaging in non infarcted myocardial segments was observed in 2 A patients and in 1 B patient; after 9 months, in 1 patient of both groups. This research shows higher incidence, at first control after 3 months, of ischemic reversible perfusion defects in patients treated with sulodexide, with an evident improvement in some patients recontrolled after 9 months. At the last control after 9 months, the scintigraphic findings showed similar evidence of perfusion defects in both groups treated with sulodexide or ASA-dipyridamole, with concordant angiographic findings (78.6%). Our preliminary results are encouraging and suggest further widespread studies on sulodexide therapy.

Arterial Occlusive Diseases↗
PubMed1990

[Is a simultaneous correction of coronary, carotid and major peripheral arterial lesions indicated?].

The contemporaneous surgical treatment of coronary and vascular disease is still controversial. In the attempt to bring our contribution at this chapter, we present a case series of 69 patients, among 2149 operated on myocardial revascularization between January 1982 and December 1990, submitted simultaneously to aortocoronary bypass and vascular procedures, i.e. carotid endarterectomy or limbs' revascularization. The immediate and late results achieved through the combined surgical approach have shown a mortality slightly greater than the staged procedure. However, the absence of neurological or abdominal complication and the improvement in term of survival and life's quality encourage us to continue with this surgical strategy, whenever the clinical status of the patients and the pathological aspect of the lesions permit it.

Aged↗
PubMed1989

[Surgical therapy of post-infarct aneurysm of the left ventricle. Immediate and long-term results].

Between January 1982 and December 1986, 62 patients (59 male and 3 female) ranging in age from 37 to 69 years (mean 53) underwent resection of postinfarction left ventricular aneurysm. The indication for operation was angina in 23 cases (37%), congestive heart failure (CHF) in 7 (11.2%), angina and CHF in 29 (46.8%), rupture in 1; 2 patients were low symptomatic. Ventricular arrhythmias were present in 6 (9.7%) cases and previous systemic embolism in 4 (6.4%). Forty-seven (75.8%) patients had lesions of three coronary arteries with involvement of left main coronary artery in 4 cases; 10 (16.1%) had lesions of two vessels [left anterior descending (LAD) and/or right coronary artery]; 4 (6.4%) had only LAD artery involvement, and 1 had no significant coronary artery stenoses. Left ventricular ejection fraction (EF) was less than 0.30 in 22% of cases, between 0.30 and 0.40 in 25.4% and greater than 0.40 in 50%. The location of the aneurysm was anterolateral or apical (83.8%), posterior (14.5%) and lateral (1.6%). Left ventricular aneurysmectomy with myocardial revascularization was performed in 61 patients (bypass/patient = 2.7), with ventricular septoplasty in 20 and concomitant mitral valve replacement in 3 patients. LAD was grafted in 59.6% of anterior aneurysm. Operative mortality (30 days) was 4.8%, the late mortality, with a follow-up between 12 and 72 months (mean 38), was 6.7% and the actuarial 5 year survival rate was 85% (91% without operative mortality). In our experience, despite no evidence of any operative risk factors, no improvement was noted in radionuclide left ventricular ejection fraction in patients undergoing aneurysmectomy with ventricular septoplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Immediate and distant results of aorto-coronary bypass performed in patients with compromised cardiac contraction].

From March 1979 to December 1985 at Cardiac Surgery Department of Parma 1064 patients underwent myocardial revascularization. Of them, 82 (7.7%) with poor left ventricular function (ejection fraction less than 40%) were studied to evaluate the effects of coronary artery bypass grafting on surgical risk, survival, ventricular performance and late clinical status. Three vessels disease was present in 65.9% and severe stenosis of left main coronary artery in 21.9% of patients. There were 74 (90.2%) patients with a history of previous myocardial infarction and 8 (9.75%) with congestive heart failure. Mean ejection fraction was 32.21 +/- 3.6%. On biplane left ventricular angiography 60 (73.2%) cases had two or more akinetic segments and 22 (21.9%) only hypokinesia. Operative mortality rate was 4.9%; perioperative myocardial infarction occurred in 5 patients (6.2%). Mean follow-up was 37.64 +/- 9.23 months and survival rate, including operative mortality, was 91.3%. Among the long-term survivors 89.04% are asymptomatic and in 49% there was a significantly improvement of preoperative left ventricular ejection fraction. We conclude that myocardial revascularization should be performed also in patients with left ventricular dysfunction, because of improvement of quality of life.

Coronary Artery Bypass↗
PubMed1987

[Digital angiography and surgery of the carotid: our experience].

Digital subtraction angiography (DSA) has became a common diagnostic procedure in the investigation of patients with cerebrovascular disorders. In these report is described a series of 80 cases previously examined in 8 different department of radiology, 59 with IV.DSA and 21 with IA.DSA. Thirty per cent of IV.DSA images were judged to be technically inadequate, so that further evaluations with conventional angiography have been needed, and in 3 patients (5.0%) the IV.DSA diagnosis was overturned. The authors recommend intraarterial digital subtraction angiography for evaluation of extracranial carotid occlusive disease always resulted the definitive diagnostic procedure in their experience.

Carotid Artery Diseases↗
PubMed1983

[Correlations between Doppler velocimetry, arteriography and intraoperative findings in the study of carotid vascular diseases].

The present paper reports the results obtained in 54 patients who underwent a non invasive cerebral vascular examination by doppler technique, followed by a cerebral angiography: a total of 86 carotid arteries were compared. An overall accuracy between arteriographic and ultrasonographic results was found in 69 arteries whereas in 15 arteries there was a discordance; and in only 3 cases ultrasonographic findings resulted false negative. The Authors have also considered the emodinamic and anatomo pathological results obtained in 23 carotid arteries operated on, in order to evaluate ophthalmic test accuracy and noninvasive evaluation of Willis's circle. The Authors have reached the conclusion that doppler technique appears to be inadequate in case of turbulent flow due to arterial dilatation or to non significant stenosis. In addition they have noticed a better reliability of emodinamic findings and a poor accuracy of the ophthalmic test.

Adult↗
PubMed1980

[Is aortocoronary bypass indicated in patients with lesions of the common trunk of the left coronary artery incapable of complete revascularization?].

Obstructive lesions of the left common coronary trunk need surgery if our operability criteria: possibility of at least making a by-pass on the left descending anterior coronary branch and a not seriously compromised miocardial contractility exist. Of the 25 patients operated, there was a mortality of 8% and 3 intra-and post-operatory infarcts; two other patients died after some time (one for extracardiac causes). Other infarcts were not observed. 48% of the patients had incomplete riva-scolarization which after some time had an effect on the objective state of the patients but not on their survival. The authors conclude their studies by affirming that total surgical correction is indicated even on non susceptible patients on the basis of coronarography.

Anticoagulants↗
PubMed1980

[Gore-Tex prostheses in arterial reconstructive procedures (author's transl)].

The early and long-term results using the polytetrafluorethylene (Gore-Tex) are reported. In 20 patients, 12 ilio-femoral bypasses, 10 femoro-popliteal and 2 aorto-subclavian bypasses have been performed; 5 of these patients underwent simultaneously femoro-popliteal bypasses with Gore-Tex and ilio-femoral bypasses with Dacron. Only once the Gore-Tex was used as patch. The results have been satisfactory. However, longer follow-up and many more patients are needed to determine if the Gore-Tex will be the substitute for the autogenous saphenous vein in peripheral vascular reconstruction.

Aged↗
PubMed1980

[Prostheses reimplantation with porcine xenograft. Our experience (author's transl)].

The Authors explain the experience about the porcine xenograft, the results of the application of 98 bio-prostheses implanted between January 1976 and November 1979. The distribution of the implantations is: 52 mitral valve reimplantation; 16 aortic valve reimplantation, 2 tricuspid valve reimplantation, 26 xenograft were implanted with the association of another prosthesis or aorto coronary by-pass graft. The patients were selected for clinical criteria (age, sex, geographic provenance) and haemodinamic criteria. Three early embolism were checked, one lethal. The total mortality is of 9 patients: 4 patients were submitted to multiple surgical operation. The running of porcine xenograft is good on the middle term.

Adult↗
PubMed1979

[Congenital arteriovenous fistula between the subclavian artery and vein. (Discussion of a surgically treated case) (author's transl)].

The Authors report a case of a congenital arteriovenous fistula between the subclavian artery and vein in a 42 years-old woman. The clinical examinations are discussed for the exact classification and the topographic localisation. The surgical treatment (extirpation of the fistula) is necessary especially because arteriovenous fistulas have a tendency to progress, which may lead to severe cardiac insufficiency, aneurismatic dilatations and risks of endocarditis.

Adult↗
PubMedDate not supplied

[Prevention and treatment of infections in open heart surgery (author's transl)].

The incidence of bacterial infections in 207 patients who underwent cardiopulmonary bypass surgery is reported. The effectiveness of various prophylactic antibiotic therapies is debated on the basis of performed antibiograms and the results are compared with that obtained by other Authors using different treatments.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Experimental revascularization of acute myocardial infarct].

Late clinical and istological changes. The Authors studies clinical and istological changes in dogs underwent to actue myocardial ischemia and follow revascularization after six hours. The experience infer that while clinical and ECGraphic changes had a patency grow worsing after revascularization, istological changes presents a reduction of necrotic area with functional improvement of little myocardial areas strictly interested by ischemia.

Acute Disease↗
PubMedDate not supplied

Carotid endarterectomy under hypothermic extracorporeal circulation: a method of brain protection for special patients.

This study was undertaken to evaluate the efficacy of hypothermic extracorporeal circulation for cerebral protection in 17 patients having simultaneous carotid endarterectomy and cardiac operations. The cardiopulmonary by-pass (CPB) was conducted using total hemodilution. The body temperature was cooled to 25 degrees C and the heart was arrested with cardioplegic solution. The carotid endarterectomy was performed first followed by the cardiac operation. No neurological or cardiac complications occurred. These results support the reliability of hypothermic cardiopulmonary bypass as a method of providing cerebral protection during simultaneous cardiac and carotid surgical procedures.

Aged↗
PubMedDate not supplied

Asymptomatic patient reoperated on for severe proximal stenosis of circular sequential vein graft.

The case is described of a fifty year old man who underwent coronary bypass surgery using the circular sequential vein graft technique. At follow-up study (6 months after operation), despite his asymptomatic status, the effort test revealed antero-lateral myocardial ischemia. A coronary angiography showed a 90% proximal stenosis of the graft at 1.5 cm from the aortic anastomosis. The patient was reoperated on and the circular graft was reconstructed. Despite the severe stenosis this technique of myocardial revascularization has developed intercoronary anastomoses, improving the cardiac contractility and avoiding further clinical complications.

Coronary Artery Bypass↗