Hemodynamic observations on long-term complete circulatory exclusion of the right heart.
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Biomedical subjects
Publications and source records attributed to V Gallucci.
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Complete obstruction of the abdominal aorta at the renal artery level is often a difficult surgical problem in case of long standing thrombosis, short suprarenal aortic space, and extensive periarterial inflammatory reaction. Six patients in whom revascularization of the lower extremities was performed through a prosthetic by-pass from the thoracic aorta to the femoral arteries, were reported here. One patient underwent also a left nephrectomy for renal hypertension, chronic renal artery obstruction, shrunken kidney. Both the short and long term results have been satisfactory in all cases.
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A patient with end-stage dilated cardiomyopathy underwent implantation of a pulsatile external biventricular assist device as a bridge to heart transplantation. The device insertion was guided by transesophageal two-dimensional echocardiography that proved extremely helpful in allowing expeditious and precise positioning of both right and left atrial withdrawal cannulas.
A patient with successful combined heart and kidney transplantation is reported. This case suggests that occurrence of kidney rejection may allow diagnosis of simultaneous unsuspected heart rejection, thus indicating an immunologic advantage in combined transplantation of organs from the same donor.
In the cardiovascular Surgery Department of the University of Padua, where the first heart transplant operation in Italy took place in November, 14, 1985, in a period of six months, nine heart transplants have been performed. The post-operative follow-up of these patients included, among other tests, a chest X-ray, which has given us many morphological and functional data concerning both the circulatory and the pulmonary systems.
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The results are reported of radiologic investigations carried out without contrast medium in 70 selected patients with pulmonary thromboembolisms. The frequency of different signs is reported. Attention is stressed of the following data: 1) value of some semeiologic findings both hilar (hilar amputation, arterial dilation) and parenchimal (increased translucency, hypoperfusion), mainly compared with previous radiographic examinations; 2) frequency of atelectasis with its various findings; 3) significance of the evolution referred both to the infarction and the thromboembolic pattern.
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This communication is concerned with the long-term results of the first 113 patients who underwent single or multiple heart valve replacement with the Hancock-SGP bioprosthesis at the Department of Cardiovascular Surgery, University of Padova Medical School, in a two years period (March 1970-March 1972). Hospital mortality was 18.5%; of the 92 survivors, whose follow-up is now 5 to more than 7 years, the authors report the clinical reevaluation, the complications and the causes of late death. Hemodynamic reevaluation has been performed so far in 26 patients and the prostheses have shown to function properly both in the mitral and the aortic position. The data available to date indicate that the glutaraldehyde preserved porcine valve is durable and its use is warranted in any valvular position.
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