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Biomedical subjects

B Peronace

Publications and source records attributed to B Peronace.

At least 19 recordsLinked to original sources
PubMed1985

[Replacement of the mitral and aortic valves with bioprostheses. Long-term results].

The purpose of the study was to analyze the medium-term results (late mortality, thromboembolism, valve failure) in patients who underwent bioprosthetic valve replacement at "A. De Gasperis" Cardiovascular Surgery Division. From October 1975 to December 1982, 195 patients were consecutively operated on and discharged (118 with mitral prosthesis, 54 with aortic prosthesis, 22 with mitral and aortic prosthesis, 1 with mitral and tricuspid prosthesis). We reviewed 115 (97.45%) of 118 patients with mitral prosthesis (mean follow-up 46.61 months) and 54 (100%) patients with aortic prosthesis (mean follow-up 38 months). Eleven late deaths (2.4%/pt-yr) and 13 thromboembolic events (2.8%/pt-yr) occurred in patients with mitral prosthesis, 6 late deaths (3.5%/pt-yr) and 5 thromboembolic events (2.9%/pt-yr) occurred in patients with aortic prosthesis. Actuarial survival curves and actuarial incidence of thromboembolic event-free patients at 5 years are, respectively, 91.2% and 87.3% in patients with mitral prosthesis, 82.8% and 86.3% in patients with aortic prosthesis. The risk factors for thromboembolism were analyzed. Reoperation was requested in 14 cases (10 mitral and 4 aortic prostheses) for prosthetic leak (6 patients) or valve failure (8 patients). In linearized terms, the rate of valve failure requiring reoperation is 1.3%/pt-yr for mitral prostheses and 1.1%/pt-yr for aortic prostheses. The medium-term results suggest that the bioprostheses are, at the present time, an effective choice to the mechanical prostheses, nevertheless they are not free from risks of thromboembolic complications.

Adolescent↗
PubMed1982

Results of valve replacement surgery with mechanical prostheses.

The clinical study is reported of the results of heart valve replacement surgery with a new pyrolytic carbon tilting disc prosthesis manufactured in Italy. From March 1977 to January 1981, at the "De Gasperis" Cardiosurgery Center, this prosthesis has been implanted in 644 patients: 283 for mitral valve replacement, 240 for aortic valve replacement, and 121 for the replacement of both mitral and aortic valves. To have a sufficiently long period of post-surgery follow-up, we considered the results of 207 patients (124 cases of isolated mitral valve replacement and 83 cases of isolated aortic valve replacement), who underwent surgery consecutively from March 1977 to December 1979. The hospital mortality was 10.5% for mitral valve replacement and 4.8% for aortic valve replacement. All patients who were discharged from hospital, except 2, were subjected to clinical, electrocardiographic, phonocardiographic, echocardiographic and radiological checks. The average follow-up period was approximately 20 months: clinical results were satisfactory. The probability of survival, expressed by actuarial curve, was, three years after surgery, 94% for patients who underwent mitral valve replacement and 97.5% for those who underwent aortic valve replacement. The probability of embolism was, three years after surgery, 8.5% for patients with mitral replaced and 5% for aortic. Even if further confirmations are needed the mortality rate and the probability of embolism related to this new prosthesis, are lower, over the same period of follow-up, than that found in the groups of patients who underwent valve replacement surgery, at the same Center, with Starr-Edwards and Björk-Shiley prostheses. The phonocardiographic and echocardiographic characteristics of this new prosthesis were also investigated.

Adolescent↗
PubMed1982

[Discrete subaortic stenosis. Considerations on 64 cases surgically treated].

The AA. reviewed our experience concerning 64 patients operated on for discrete subaortic stenosis due to a fibrous membrane, between 1975 and 1981 at the Department on Cardiac Surgery "A. De Gasperis" in Milan. The clinical and hemodynamic features, the indication for operation, the surgical management and the immediate and long-term results are described. No patients died at surgery or afterwards. Only in three cases complications were noted (2 atrioventricular block, 1 pleural empyema). Of all the patients 95% were asymptomatic after operation; only three cases presented symptoms correlated with the cardiac malformation, but still they were greatly improved, compared to their preoperative status. As discrete subaortic stenosis is a progressive disorder, the operative risk is poor and the results are good, surgical treatment is recommended in symptomatic patients and if the haemodynamic gradient is 50 mmHg or greater.

Adolescent↗
PubMed1982

[Ventricular septal defect associated with aortic insufficiency: observations on 40 patients surgically treated].

Since 1970, forty patients with ventricular septal defect (VSD) and aortic insufficiency (AI) have undergone surgical treatment in our institution. In the majority of the patients (60%) the VSD was subcristal. In sixteen cases the aortic valve was replaced, whereas in 9 patients the valve was repaired and in 15 subjects simple closure of the VSD was deemed to be sufficient to correct the AI. There have been 2 hospital and 4 late deaths. The A.I. seems to be due to two different pathogenetic mechanisms in supra- and subcristal V.S.D., with the faster progression in the supracristal ones. With simple patch closure of the V.S.D. we had the best late results, good results were obtained with the plasty of the aortic leaflets while the worst late results were found in the group which had undergone aortic valve replacement. For this reason the Authors recommend surgical intervention as soon as AI shows up.

Adolescent↗
PubMed1980

[Aortic valve replacement with Starr-Edwards and Björk-Shiley prosthesis. Long term results and statistical analysis of some risk factors (author's transl)].

285 patients who underwent aortic valve replacement between 1972 and 1977 have been studied. 197 patients had a Starr-Edwards prosthesis and 88 patients had a Björk-Shiley prosthesis, both groups presented similar risk factors. The follow-up varied between a period of 6 months minimum and 72 months maximum, the mean period is 3.6 years. The statistical results have been realized based on the multi-factor analysis (cluster) which were the basis to define the homogeneous groups of patients with the Starr prosthesis and the Björk prosthesis. One may observe the best survival percentage after 72 months from surgery date in patients with the Björk prosthesis comparing them with those patients who underwent aortic valve replacement with the Starr prosthesis (resp. 93 and 71%). The difference is important from the statistical point of view. The embolic incidence after such a period is nearly equal (16% for Björk and 14% for Starr). The cluster analysis of the considered parameters (age, duration of symptoms before surgery, NYHA class, C/T) did not evince real and proper risk factors such to condition, at long term, the results even if differences in mortality and in embolic incidence, with regards to the relation with NYHA class and symptoms; duration, have been observed. One may conclude that one of most important risks derives form the type of used prosthesis.

Adolescent↗
PubMed1980

[Mitral valve replacement by Starr-Edwards and Björk-Shiley prostheses, long term results and statistical analysis of some risk factors (author's transl)].

304 patients have been studied between 1972 and 1977 after mitral valve replacement. 133 patients had a Starr-Edwards prosthesis and 171 patients had a Björk-Shiley prosthesis; both groups presented similar risk factors. The follow-up varied between a 6 months and a 72 months period for both types of prosthesis with a mean period of 3.2 years. The statistical results were based on the cluster system and he outcomes helped us to realise curves of homogeneous groups of patients who underwent mitral valve replacement with Starr and Björd prosthesis. One observed that 4 years from date of surgery the survival percentage is 84% for those patients with the Starr prosthesis and 78% for Björk prosthesis; with regards to the log rank test this difference is insignificant. Considering the probability of embolism one observed a percentage of 10% of the patients with the Björk prosthesis and of 18% with the Starr prosthesis; this difference is insignificant from the statistical point of view. The cluster analysis of the considered parameters (age, type of valve defect, NYHA class, duration of symptoms before surgery, C/T, size of left atrium) did not evince real and proper risk factors at least not such to condition the long term results. The only observed relationship is the one between the major incidence of embolism and great left atrium. One may conclude that not exist differences in long term results between both prostheses when placed in mitral valve.

Adolescent↗
PubMed1975

[Multivalvular replacement: short and long term results in 367 cases (author's transl)].

Early and late results of 273 mitro-aortic, 66 mitro-tricuspid, 28 mitro-aortic-tricuspid valvular replacements performed between 1964-1973, were evaluated. The hospital mortality rate was 17, 5 percent for mitro-aortic, 30, 5 percent for mitro-tricuspid, 10, 7 percent for mitro-aortic-tricuspid replacement. The best results obtained in patients with mitro-aortic replacement, the worse one in patients with mitro-tricuspid replacement, that present also a poor functional rehabilitation. The actuarial curves were calculated: 9 years after operation the probability of survival was of 67 percent for patients operated of mitro-aortic valvular replacement and 47 percent for patients operated of mitro-tricuspid replacement.

Acute Kidney Injury↗