Biomedical subjects
Publications and source records attributed to V Gallucci.
A case of triple valve involvement in acute bacterial endocarditis is reported. Replacement of aortic, mitral, and tricuspid valves and permanent epicardial pacing were successfully accomplished.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During a 6-year period, 24 patients, aged 7 days to 18 years, underwent palliative surgery for single-ventricle heart malformations; 22 has single-left ventricle with outlet chamber (14 with L-transposition); only two had type C malformation (van Praagh). They were subdivided according to physiology into two groups: the first included 15 patients with decreased pulmonary blood flow, whose main clinical feature was arterial desaturation; the second consisted of nine patients with increased pulmonary blood flow, who presented early with unmanageable heart failure. The first group was treated with a Blalock-Taussig shunt (typical or modified) in 12 cases (one death due to preoperative acute renal failure), with a Waterston or Potts shunt in two cases (both died early postoperatively), and by enlargement of the bulbo-ventricular foramen in one (who died at operation). No late deaths were seen and the clinical status of the survivors is judged optimal. Patients of the second group received a pulmonary artery banding plus a number of associated procedures: coarctation repair (2), ligation of a patent ductus arteriosus (2), Blalock-Hanlon atrial septectomy (1), tricuspid valve replacement (1). There was only one early death due to critical subaortic stenosis produced by a restrictive outlet foramen; however, there were five late deaths and two cases of surgical failure with persistent pulmonary hypertension. An analysis of the best palliative approach in patients with single-ventricle heart malformations is made, based upon the results of this series and taking into consideration the possibility of future intracardiac repair.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Two patients with fibromuscular dysplasia of the internal carotid artery have been studied. Our patients' clinical histories suggest that cerebral symptoms were due either to episodic arterial embolization or progressive arterial occlusion. The radiological features were characteristic. Surgery of cervical vessels was performed with benefit in both cases. Histopathology of the carotid arteries showed segmental lesions with alternating marked thickening and thinning of the media and irregular hyperplasia of the intima.
A case of intraoperative left ventricular rupture following mitral valve replacement, promptly detected and successfully treated, is reported, and the literature concerning 19 other patients successfully treated for this complication is reviewed. Routine inspection of the posterior atrioventricular groove and left ventricular wall is to be recommended after prosthetic mitral valve replacement and before cardiopulmonary bypass is discontinued, to allow recognition of the early signs of ventricular rupture.
The operative and long-term results of 72 patients with moderate to severe pulmonary hypertension, operated upon from 1970 to 1972 for isolated mitral valve replacement with Hancock prosthesis were analyzed. A correlation exists between pulmonary hypertension and high mortality risk as well as good hemodynamic recovery of the survivors in the late follow-up, often unrelated with other function tests (pulmonary ventilation and perfusion).
Explore the source record for details and available documents.
The authors report 8 cases of left heart rupture at the insertion of the posterior leaflet of the mitral valve out of 693 mitral valve replacements. Special attention is paid to the anatomy of this area and to the technique of removal of annular calcifications, when present. In reviewing the literature, the authors analyze the cases reported up to now with particular reference to the age of patients, number of valves replaced, size and amount of calcifications, volume of the left ventricular cavity, type and size of the prosthesis employed, supra- or subannular insertion, time between valve application and rupture of the heart, techniques of repair with cardiopulmonary by-pass with a beating or arrested heart. The authors maintain that this dramatic iatrogenic complication can be avoided in most instances with some modifications of the surgical technique which has been adopted in the last 200 mitral valve replacements.