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Biomedical subjects

V Gallucci

Publications and source records attributed to V Gallucci.

At least 145 records · Page 8Linked to original sources
PubMed1981

Pathological study of infective endocarditis on Hancock porcine bioprostheses.

A pathological study has been performed on 10 infected Hancock bioprostheses removed from nine patients who died of prosthetic endocarditis. The devices had been in place from 2 to 87 months (average 37.5), the interval between operation and onset of infection averaging 30 months. The offending organisms were Gram negative bacteria in three patients (Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens), Gram positive bacteria in two (Staphylococcus aureus and Streptococcus viridans), and fungi in four (Candida species in three and Aspergillus species in one). Gross examination of the explants revealed in most cases a vegetative endocarditis of one porcine valve leaflets. Septic embolization occurred in five cases owing to the high friability of the vegetations. Prosthetic valve incompetence was the commonest type to dysfunction observed because of tears, perforations, and even complete destruction of the cusps. Prosthetic valve stenosis following obstruction of the valve orifice by infected polypous masses was noted in two cases. Clumps of infective organisms were detected deep in the cusp tissue in most cases on histologic examination. Infection located on the paraprosthetic tissues, associated with ring abscess, valve detachment, and insufficiency, was observed only once. According to the results of investigation, endocarditis on porcine bioprostheses is associated with a better preserved native valvular ring as viewed at reoperation. Therefore surgical intervention appears appropriate in the presence of severe hemodynamic complications after adequate antibiotic treatment. However, infection of these particular prostheses still carries an extremely high mortality. In the present series, this poor outcome might be explained by the frequently associated septic and thromboembolic events.

Adult↗
PubMed1981

[Aortic coarctation with bilateral aneurysms of the subclavian arteries: surgical treatment].

The natural history of untreated coarctation of the aorta may be complicated by dissection or aneurysms of the ascending as well as of the descending thoracic aorta distal to the coarctation. We report a case of coarctation of the aorta in a young man associated to bilateral aneurysms of the subclavian arteries, one of which of great size. In a review of the most recent and largest series of adult patients undergoing surgery for aortic coarctation we were unable to find a similar case. In such a condition complete repair may be accomplished quite safely, preferably employing a multi-stage technique.

Adult↗
PubMed1981

[Method for radiological recognition of cardiac valve prostheses. Analysis of the various models used at the Cardiosurgery Center of the University of Padua].

A rapid identification of the type of prosthetic heart valve from the plain chest roentgenogram is often of extreme importance in the care of patients who have undergone prosthetic valve replacement. In the present report we have analyzed the radiographic appearances of 9 different models of mechanical and biological prostheses which are or have been employed at our Institution since 1969, with the aim of providing simple guidelines to identify these devices. For this purpose photographs were taken of the postero-anterior and left lateral chest radiograms of patients in whom these particular prostheses were implanted. Once the silhouettes of the radioopaque components of these devices have become familiar, the differentiation of the types and the recognition of the site of implantation is easy and rapid.

Bioprosthesis↗
PubMed1980

Double-chambered right ventricle: surgical experience and anatomical considerations.

Fourteen patients with double-chambered right ventricle underwent surgical treatment and repair of associated anomalies. The anomalous muscle band was isolated in 5 cases, associated with membranous ventricular septal defect in 7, with discrete sub-aortic stenosis in one and with double outlet right ventricle in one. All patients survived. The obstructing muscular band was a hypertrophic structure identifiable either with a displaced moderator band, still related to the anterior papillary muscle, or with a giant septoparietal band, inserting to the anterior free wall and occasionally present in normal hearts. According to this interpretation, referring the obstructive band to the septomarginal complex, double-chambered right ventricle should not be regarded strictly as a truncoconal malformation.

Adolescent↗
PubMed1980

Histological survey of the saphenous vein before its use as autologous aortocoronary bypass graft.

A histological examination has been carried out on the saphenous veins used in 150 consecutive patients undergoing aortocoronary bypass. Morphological changes were observed frequently and consisted mainly of fibrosis of the intima and of the medial longitudinal muscular layer. Intimal fibrosis was rarely severe enough to narrow the lumen significantly. Statistical analysis disclosed that the fibrosis of the intima and the medial longitudinal muscular layer do not increase with age. The use of frozen histological sections of the saphenous vein in patients undergoing aortocoronary bypass operations could be considered in order to discard unsuitable grafts and to direct the surgeon to alternative conduits.

Coronary Artery Bypass↗
PubMed1980

Left ventricular rupture following mitral valve replacement with a Hancock bioprosthesis.

A rare complication of mitral valve replacement with the Hancock bioprosthesis was observed in three patients presenting with prevalent mitral stenosis and normally-sized left ventricular cavity. In the patients, a deep erosion of the left ventricular free wall was present which evolved into cardiac rupture in one of them. The laceration is ascribed to the friction between a prosthetic strut and the myocardium; a disproportion between the "high-profile" device and the left ventricular chamber is suggested to explain this complication, which may be avoided by employing a "low-profile" prosthesis.

Bioprosthesis↗
PubMed1980

Tricuspid atresia with double-outlet left atrium.

Clinical and pathologic findings of an unusual case of cardiac malformation are presented. The main features were those of atresia of the right atrioventricular valve associated with two distinct atrioventricular orifices connecting the morphologically left atrium to the underlying morphologically left ventricle. Other distinguishing characteristics were ostium secundum atrial septal defect, normally related great arteries, with the aorta arising from the main ventricular chamber and the pulmonary artery from the anterior and right-sided outlet chamber, and infundibular and valvular pulmonary atresia.

Abnormalities, Multiple↗
PubMed1979

Fibrous tissue overgrowth on Hancock mitral xenografts: a cause of late prosthetic stenosis.

Severe prosthetic stenosis requiring reoperation seldom occurs after mitral valve replacement with the Hancock bioprosthesis. Two cases of prosthetic stenosis caused by tissue overgrowth on the atrial aspect of the cusps are reported. The patients, who had undergone mitral replacement with a Hancock valve implanted in the subannular position, developed the signs of congestive heart failure 5 and 6 years after surgery. In both patients, the hemodynamic data supported the clinical diagnosis of mitral restenosis and both underwent successful reoperation. Histologic examination showed that the pannus was formed by dense fibrous tissue with few vessels. It is suggested that the site of the bioprosthesis insertion is likely to have favored this complication since in this condition the protection of the sewing ring from tissue overgrowth is minimal.

Adult↗
PubMed1979

Anatomy of aortic atresia. Cases presenting with a ventricular septal defect.

The anatomy of 58 specimens of aortic outflow tract atresia was studied. All cases had situs solitus and levocardia, 37 had atrioventricular (AV) concordance, two had common inlet to a right ventricle and 19 had mitral atresia. The great arteries were normally interrelated in all cases. Fifty-one cases had an intact ventricular septum, while seven presented with a ventricular septal defect (VSD). Of the seven with VSD, in two it was associated with a common AV orifice draining exclusively into the right ventricle in the presence of a rudimentary left ventricular chamber. In one case a small VSD accompanied combined mitral and aortic atresia. In the other four cases the left ventricles and mitral valves were fairly normal in size; the VSD was subpulmonary in three cases, due to infundibuloventricular malalignment, and perimembranous in one. These last four cases are of particular interest since they could be amenable to surgical correction. Possible approaches to surgical treatment and morphologic features pertinent to them are described and discussed.

Aortic Valve↗
PubMed1979

Histology of pulmonary arterial supply in pulmonary atresia with ventricular septal defect.

A histologic study was performed on 22 specimens of pulmonary atresia with ventricular septal defect to 1) ascertain the existence of the main pulmonary artery; 2) distinguish the ductus arteriosus from the systemic collateral arteries (SCA); 3) establish the nutritive or functional nature of collateral circulation; and 4) evaluate the morphology of the distal pulmonary bed. Three cases had absent main pulmonary artery, one with and two without signs of infundibular septation. We suggest that absent main pulmonary artery may exist with both infundibular pulmonary atresia and persistent truncus arteriosus. SCAs have been found to have similar histological features as systemic muscular arteries of the same size--their medial muscular layer merges gradually into an elastic one at different depth inside the lungs. Injection of contrast material allowed us to demonstrate that these vessels are functional, since they inosculate into efficient pulmonary arteries ending in the respiratory units. When the distal pulmonary vascular bed is perfused by large SCAs, proliferative lesions like those found in large left-to-right shunts may occur. Early in infancy, banding of large, nonstenotic SCAs could protect the distal pulmonary vasculature. Moreover, total surgical repair should be associated with ligation of the SCA to avoid residual left-to-right shunt, if the pulmonary arteries can carry the full pulmonary blood flow.

Aorta, Thoracic↗
PubMed1979

[Pathology of the aorto-coronary bypass by autologous saphenous vein (author's transl)].

The success of aorto-coronary bypass operations, employing an autologous saphenous vein, depends mainly upon graft patency. Fortyone grafts have been examined by light micrsocopy, 35 of which were obtained from 23 autopsy cases and 6 were recovered at reoperation. Thirtythree veins had been in place for less than 20 days (early group) and 8 from 3 to 39 months (late group). In the early group, minimal to moderate mediointimal fibrosis was always detected. Graft occlusion due to recent thrombosis was observed in 13 cases; the cause of thrombosis was severe coronary narrowing distal to the insertion of the graft and atherosclerotic plaque ulceration at the site of the veno-coronary anastomosis. Among the late group, 3 veins were occluded by an old thrombus, and 3 by intimal leiomyocellular proliferation, with Alcian positive ground substance, while 2 exhibited a severe stenosis due to intimal phlebosclerosis. One of these last disclosed a vein atherosclerosis. The multiple pathogenetic factors, which are involved in the proliferative lesions, are reviewed.

Coronary Artery Bypass↗