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D A Bognolo

Publications and source records attributed to D A Bognolo.

11 recordsLinked to original sources
PubMed1987

Computed tomography for the evaluation of intrathoracic invasion by lung cancer.

We conducted computed tomographic examinations of the chest in 171 patients with lung cancer whose disease was subsequently surgically staged; routine mediastinal exploration was undertaken in all patients undergoing thoracotomy (151), and in 20 patients only anterior mediastinotomy or mediastinoscopy was performed. We have considered three groups of patients: In Group I (including all 171 patients) mediastinal lymph nodes were evaluated for metastatic involvement; nodes were considered diseased when greater than 1 cm. Sensitivity, specificity, and accuracy were 95%, 83%, and 89%. Among these 171 patients, 34 (Group II) had a central tumor otherwise considered operable, which was shown on plain roentgenograms to be in contact with the mediastinum; infiltration of hilar and mediastinal vessels and of mediastinal tissues was investigated preoperatively with computed tomography and then ascertained at thoracotomy. Sensitivity, specificity, and accuracy were 68%, 72% and 70%. Twenty-seven patients (Group III) had a peripheral tumor abutting the pleural surface and suspected to invade the parietal pleura and chest wall; patients with evident bone infiltration were excluded. Sensitivity, specificity, and accuracy of computed tomography were 50%, 90%, and 65%.

Adult↗
PubMed1986

Results of coronary bypass surgery in elderly women.

One hundred two female and 102 male patients all older than 70 years who underwent coronary artery bypass grafting (CABG) between 1978 and 1983 were matched according to age, anginal status, ejection fraction (EF), number of bypass grafts, and year of operation. These 204 patients were characterized by a mean age of 73 years, a mean EF of 64%, a mean of 3.2 bypass grafts per patient, and unstable angina in 82%. Statistical analyses were performed on the following variables in conjunction with patient sex to determine whether the two samples (women and men) can be considered representative of a single patient population: preoperative resting ECG, stress test result, number of diseased vessels, left ventricular end-diastolic pressure, presence of carotid artery disease, use of an internal mammary artery graft, incidence of operative death, perioperative myocardial infarction (MI), hospital complications, late MI, recurrent angina, late death, and cumulative survival. All differences were small and failed to reach statistical significance except that women had a higher incidence of recurrent angina-like chest pain and a higher incidence of ischemic changes in the preoperative ECG and men had a higher incidence of conduction abnormalities. We conclude that in this age group, CABG is equally beneficial to women and men in terms of survival, but may result in less subjective symptomatic benefit in women.

Aged↗
PubMed1979

Isolated chronic tricuspid insufficiency due to closed chest trauma: report of a case with long-term follow-up.

A case of isolated chronic tricuspid insufficiency due to closed chest trauma is described in this report. Studies for carcinoid syndrome were negative. At surgery the posterior leaflet of the tricuspid valve appeared to be torn and disrupted. The other leaflets were shortened and atrophic. The results of pre- and postoperative cardiac catheterization with long-term follow-up to the present, and the available literature on this rare entity has been briefly reviewed.

Aged↗
PubMedDate not supplied

Coronary bypass for left main disease in patients over 70 years of age.

Seventy-one consecutive patients over 70 years of age underwent isolated coronary bypass surgery for left main coronary artery (LMCA) disease between September 1975 and December 1982. All patients had angina; 6% were in NYHA functional class II, 30% class III, and 64% class IV. Intravenous nitroglycerin was required in 25% of patients. Resting electrocardiogram was abnormal in 91% of patients and stress testing performed in 24 patients was positive in all. Degree of left main stenosis graded by diameter was 60 to 70% in 24% of patients and greater than 70% in 76%. In addition to left main stenosis 66% of patients had significant triple vessel disease. Left ventricular end diastolic pressure (LVEDP) was elevated in 69% of patients while ejection fraction (EF) was low only 24%, without correlation between high LVEDP and low EF. Mean number of bypass grafts per patient was 3.4 +/- 0.6. Hospital mortality was 7% and mean post-operative stay was 10.4 +/- 2.0 days. Stepwise multiple regression analysis of 12 variables identified only unstable angina requiring intravenous nitroglycerin as a significant predictor of hospital mortality (p less than 0.01). Follow-up was complete with a late cardiac mortality of 4.5%. Seventy-five percent of surviving patients assessed their quality of life as good at a mean follow-up of 26 months. Coronary bypass for LMCA disease in a non-selected elderly population can be performed with low operative mortality and marked improvement in quality of life.

Aged↗
PubMedDate not supplied

Advantages of superior approach for mitral valve surgery.

Technical factors in mitral valve surgery (MVS) which may influence neurological complications, trauma to the left atrium and formation of atrial mural thrombi have not previously been described in detail. We have reviewed the records of 146 patients (pts) undergoing MVS through the superior approach between January 1974 and May 1981. The series consisted of 97 females and 49 males with a mean age of 57 +/- 18 years. All but 4 pts were in New York Heart Association functional class III or IV. Twenty-five pts underwent open mitral commissurotomy, 116 had valve replacement and 5 had annuloplasty. Concomitant procedures were coronary bypass in 47, aortic valve replacement in 18 and resection of left ventricular aneurysm in 3. Left atrial thrombi were removed in 21 pts. Thirteen pts (9%) died postoperatively. The causes of death were left ventricular failure in 7, arrhythmia in 4 and atrio-ventricular disruption in 2. Two of these pts also had cerebral dysfunction. Autopsy examination in 8 pts failed to reveal formation of fresh left atrial septal or posterior mural thrombus. Postoperative complications included transient neurologic injury presumed to be due to air embolus in 3 and postoperative bleeding from atrial suture line in one. The mean follow-up for the survivors has been 30 months. There have been 16 (12%) late deaths from 1 to 72 months (mean 15). Autopsy examination of 4 pts and surgical exploration in one other pt which failed to reveal organized left atrial mural thrombus. Only one late death was related to prosthetic thrombosis. This occurred following cessation of anticoagulations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗