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Biomedical subjects

Alessandro Giamberti

Publications and source records attributed to Alessandro Giamberti.

26 records · Page 2Linked to original sources
PubMed2003

Surgical treatment of tricuspid valve dysplasia in the neonatal period.

Tricuspid valve dysplasia, other than Ebstein's anomaly, is a very rare congenital heart defect. During the prenatal and/or the neonatal periods the clinical picture is very critical. We here report on a newborn infant with severe tricuspid valve dysplasia and 4/4 tricuspid regurgitation, giant right atriomegaly, functional pulmonary atresia with ductal-dependent pulmonary blood flow. The child was successfully submitted to implantation of a 15 mm pulmonary stentless heterograft valve using the top-hat technique.

Cardiopulmonary Bypass↗
PubMed2002

Early and late complications associated with transcatheter occlusion of secundum atrial septal defect.

OBJECTIVES: The goal of this study was to report the early and late complications experienced in atrial septal defect (ASD) transcatheter closure. BACKGROUND: Atrial septal defect transcatheter occlusion techniques have become an alternative to surgical procedures. A number of different devices are available for transcatheter ASD closure. The type and rate of complications are different for different devices. METHODS: Between December 1996 and January 2001, 417 patients (mean age: 26.6 +/- 19 years) underwent transcatheter occlusion of secundum type ASD. Complications were categorized into major and minor. Two different devices were used: the CardioSEAL/STARFlex in 159 patients and the Amplatzer septal occluder in 258 patients. RESULTS: Thirty-four patients experienced 36 complications during the hospitalization (8.6%, 95% confidence interval: 6.1% to 11.1%). Ten patients underwent elective surgical repair because of device malposition (three patients) or device embolization (seven patients). Twenty-four patients experienced 25 minor complications: unsatisfactory device position or embolization. Devices were retrieved using a gooseneck snare and/or a basket; 11 patients experienced arrhythmic problems. Other complications were: pericardial effusion, thrombus formation on the left atrial disc, right iliac vein dissection, groin hematoma, hemorrhage in the retropharynx and sizing balloon rupture. Two patients had late complications: peripheral embolization in the left leg one year after implantation of an Amplatzer device and sudden death 1.5 year later. CONCLUSIONS: Our series of patients with ASD by transcatheter occlusion shows that the procedure is safe and effective in the vast majority of cases. To further reduce the complications rate, the criteria of device selection according to ASD morphology and some technical tips during implantation are discussed.

Adolescent↗
PubMed2002

Totally anomalous pulmonary venous connection directly to the superior caval vein.

OBJECTIVE: Totally anomalous pulmonary venous connection directly to the superior caval vein is unusual. It is frequently associated with major congenital heart defects such as the syndrome of right isomerism. While improved results have been reported recently for the isolated form, complex cases are still associated with a higher mortality. METHODS: We undertook surgical correction in nine patients with direct pulmonary venous connection to the superior caval vein investigated in our institution from 1991 to 1999. In four of these patients, the venous anomaly was an isolated finding, while five patients with isomeric right atrial appendages had associated cardiac malformations rendering them unsuitable for biventricular repair. In one patient with an isolated form, the venous drainage was obstructed. Two patients with isomerism had previously undergone construction of an aortopulmonary shunt. Other associated surgical procedures in the patients with right isomerism were establishment of bidirectional cavo-pulmonary anastomoses in four cases and banding of the pulmonary trunk in one. RESULTS: There were neither early nor late deaths. Reoperation was needed in one patient because of pulmonary venous stenosis. In the five patients with right isomerism, two later underwent successful creation of the Fontan circulation. CONCLUSION: It is unusual to find direct drainage of all the pulmonary veins to the superior caval vein. When seen, the venous pathway is only rarely obstructed. For this reason, when associated with right isomerism, an aortopulmonary shunt should be constructed as initial palliation, with later repair of the anomalous pulmonary venous drainage at the time of construction of a bidirectional cavo-pulmonary anastomosis. When using this policy, the surgical results can be as good for the complicated variant as for the isolated form.

Child, Preschool↗
PubMed2002

Intrahepatic right-to-left shunting after the Fontan operation.

We describe two patients with right isomerism, corrected with a fenestrated Fontan operation, who suffered severe progressive cyanosis. Cardiac catheterisation in both revealed a massive right-to-left shunt from the inferior caval vein, through the liver, to a hepatic vein draining directly to the left side of the intra-atrial baffle. The anomalous vein was successfully ligated in both patients.

Child↗
PubMed2002

Arterial switch operation after multiple-stage left ventricular retraining.

Right ventricular dysfunction and tricuspid valve incompetence after atrial repair for transposition of the great arteries is an increasingly frequent problem. Left ventricular retraining to convert an atrial switch to an arterial switch is a well-known surgical option but can require a multiple-stage surgical approach. We report our successful multiple-stage experience with a 5-year-old girl.

Child, Preschool↗