Biomedical subjects
Publications and source records attributed to E Baruffi.
A 56-year-old woman with stenosis and incompetence of the mitral valve and clinical signs of congestive heart failure was found to have a communication between the left anterior descending coronary artery and the pulmonary trunk. A mitral valve prosthesis was inserted and the fistula was closed from within the pulmonary artery.
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Zinc and copper changes were studied in plasma, whole blood, urine and myocardium in 15 patients undergoing valve replacement in hypothermic cardiopulmonary bypass with hemodilution. During the cardiopulmonary bypass, a fall in plasma copper and zinc concentration was related to hemodilution. The zinc concentration also decreased in whole blood, but remained unchanged intracellularly. The urinary concentration of both cations, but not the output, decreased at the end of the operation in relation to the baseline values. The myocardial copper and zinc concentrations increased during the aortic cross-clamping period. The possible causes and significance of these changes are considered.
We report the successful removal of a mycotic false aneurysm of the descending thoracic aorta. The aneurysm developed after a sepsis secondary to Canadida albicans. General signs of infection were absent at the time of surgery, although the aortic wall was still infected. A Dacron graft was inserted after resection of the entire aortic wall, and irrigation of the left pleura with amphotericin B was started postoperatively. The patient recovered fully and is in good condition one year after the operation.
One case of mitral insufficiency due to traumatic rupture of the posterior chordae is described. The most consistent clinical and non-invasive cardiovascular findings were: previous non-penetrating thorax trauma; rapidly progressing congestive heart failure; loud apical systolic murmur; sinus rhythm; normal radiological evidence of the left atrium; echocardiographic disorderly movement and coarse fluttering of posterior leaflet, systolic fluttering of mitral valve, diastolic additional echoes between mitral leaflets and systolic ones into the left atrium (due to ruptured chordae?). This patient underwent a valvular replacement surgery. When attempting a diagnosis of this accident, while haemodynamic and angiographic data are helpful mainly in the definition of retrograde mitral flow severity, the echocardiographic findings appears to be more important to state precisely the site and the kind of the lesion.
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A total of 286 patients with mitral stenosis or predominant mitral stenosis underwent open heart mitral commissurotomy at the San Camillo Hospital between May 1969 and May 1975; mitral annuloplasty was performed on 71 patients, subvalvular apparatus correction on 43. The operative mortality rate was 0,7% (no deaths among the last 220 patients). Early results, evaluated from intraoperative data, clinical course, acoustic and polygraphic postoperative findings, were good in 228 patients (80%), fairly good in 41 (14%), bad in 17 (6%).
Reopening of ventricular septal defect after surgical repair was investigated -- from six months to five years after operation -- on 75 patients who had undergone closure of ventricular septal defect and on 65 patients who had undergone complete correction of tetralogy of Fallot. The complication appeared in 3 patients (4%) of the first group and in 4 (6%) of the second group, always early after the operation (from 24 hours to 2 months). All patients underwent reoperation - operative mortality rate was 66% in the first group and 25% in the second one. Operative mortality was higher in patients with cardiac and/or tricuspidal failure, also after prolonged preoperative medical treatment.
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