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Biomedical subjects

A M Calafiore

Publications and source records attributed to A M Calafiore.

At least 91 records · Page 5Linked to original sources
PubMed1990

[What is the best treatment in massive pulmonary embolism: anticoagulants, thrombolytics or surgical embolectomy?].

The aim of this work was to identify the best treatment available for massive pulmonary thromboembolism which still remains a frequent and sometimes lethal complication for surgical and non-surgical patients. The Authors underline the difficulties of diagnosis and the need for therapy at the earliest possible stage. At present, clinical management involves the use of: anticoagulants, thrombolytic agents and surgical embolectomy. In conclusion, the authors state that pulmonary thromboembolism, even when massive, has been transformed into a medically interesting pathology which can be cured using heparin and thrombolytic agents. However, surgical treatment is mandatory when patients reveal adverse effects to drug therapy, when medical therapy is insuccessful, or when patients are seriously ill with recurrent cardiac arrest.

Anticoagulants↗
PubMed1989

[Blood platelet count and bubble oxygenators. Changes induced by the oral administration of dipyridamole].

The changes in thrombocythemia in patients subjected to extracorporeal circulation (ECC) and pretreated with dipyridamole per os have been examined and compared with a control group in whom the drug was not used; in all patients a circuit with bubble oxygenator was employed. Measurements were carried out before sternotomy, 10' and 60' after ECG, 1 h after the start of intensive therapy and on the 1st surgical day. The variations in thrombocythemia were assessed in consideration of the thrombocythemia/Ht ratio, so as to eliminate the dilution variable. On the basis of the results obtained, it is considered that preoperative treatment with dipyridamole is effective in limiting the fall in thrombocythemia during ECC. The effect of the drug is prevalent in the initial stage of ECC, probably reducing platelet aggregation to non-biological surfaces of the circuit.

Administration, Oral↗
PubMed1989

[Reversibility of left ventricular functional damage after valve replacement in patients with chronic aortic valve insufficiency].

The authors study retrospectively some preoperative echocardiographic findings and their importance as predictors of reversible myocardial dysfunction. The functional status of 57 survivors after isolated aortic valve replacement was evaluated with exercise testing and on this ground the patients, were divided into three groups: A (28 pts) greater than 60%; C (10 pts) less than 40%; B (19 pts) from 40% to 60%. The authors conclude that the postoperative improvement in functional status is strictly correlated with some preoperative echocardiographic indexes (end-diastolic dimension, end-systolic dimension, shortening fraction, mean end-systolic radius/thickness ratio, end-systolic wall stress, myocardial mass, ejection fraction) with are also predictive of operative mortality. The authors consider the principal values of beginning left ventricular impairment: a) end-systolic dimension greater than or equal to 5.5 cm; b) shortening fraction less than 27%; c) mean end-systolic radius/thickness ratio greater than 2.5; d) end-systolic wall stress greater than 240 mmHg.

Aortic Valve Insufficiency↗
PubMed1979

[Mitral valve substitution, using the Lillehei-Kaster prosthesis].

Personal experience acquired in the course of 177 mitral valve replacements with a Lillehei-Kaster prosthesis up to June 1977 is discussed. Intraoperative mortality was 8.5%. Postoperative mortality (as at 31-12-1976) was 5.3%. The clinical, radiological, and ergometric findings were fully satisfactory. Haemodynamic examination at rest and during effort revealed improved pressure and heart capacity values. The mean transprosthetic gradient at rest was 5.61 and rose to 13.53 (after uncalibrated effort). Thromboembolism was noted in 5 patients (3.1%), as in the literature. The haemodynamic features and low thrombogenicity of the Lillehei-Kaster prosthesis would thus appear to make it a sound replacement for the mitral valve.

Adolescent↗
PubMed1978

[Major complications of median sternotomy].

After examining the modalities of sternal perfusion and the techniques of median sternotomy, with special regard to closure techniques, personal experience of 1000 sternotomies is reviewed. Complications may be major or minor, incidence was 1,8% and total mortality two cases. After reviewing the various causes of sternal dehiscence, reported and personal experience of the various techniques for preventing and treating the complication is discussed.

Adolescent↗
PubMed1977

[2 cases of subaortic stenosis with subvalvular diaphragm complicated by postendocarditis aortic insufficiency].

Two cases of patients with discrete subaortic stenosis complicated by aortic regurgitation resulting from the sequelae of bacterial endocarditis and treated by valvular replacement are described. A correct preoperative evaluation was due to echocardiographic data and pressure curves; left ventriculography did not show any evidence of subaortic obstruction in any of the cases. In one patient, bacterial endocarditis involved mitral valve too, which was replaced by an artificial prostheses. Bacterial endocarditis is very rare in patients with discrete subaortic stenosis, but it must be regarded as a factor complicating the natural history of cardiopathy.

Adult↗