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E Zoia

Publications and source records attributed to E Zoia.

8 recordsLinked to original sources
PubMed1995

Fetal echocardiography in detecting anomalous pulmonary venous connection: four false positive cases.

Prenatal detection of congenital heart disease is possible from the 16th week of pregnancy, the ideal time being the mid-trimester, when most cardiac abnormalities can be detected. However, identification of anomalous pulmonary venous connection is difficult before birth and the sensitivity of fetal echocardiography in detecting this anomaly is low. Four cases are reported in which fetal echocardiographic findings obtained during the third trimester of pregnancy were highly suggestive of anomalous pulmonary venous connection. Right ventricular and atrial dominance associated with an enlarged coronary sinus or dilated superior vena cava were identified and considered to be indirect markers of the anomaly. No other cardiac anomaly was detectable. In all cases right ventricular and atrial dominance with dilated coronary sinus or superior vena cava were confirmed after birth despite the presence of normal pulmonary venous connections. These results confirm that the prenatal detection of this condition is difficult and should be based on the direct visualisation of anomalous pulmonary venous connections. The sole detection of indirect signs, such as right atrial and ventricular dominance with or without a dilated coronary sinus, superior vena cava, or inferior vena cava, does not warrant the diagnosis of anomalous pulmonary venous connection. Since the pulmonary venous flow in the human fetus is not as small as is commonly assumed, an anomalous drainage should be detectable when present and therefore should be specifically sought if the anomaly is suspected. The reasons for the presence of such transient cardiac anomalies remain obscure, but they might be related to functional or morphological rearrangement of the heart during fetal and perinatal life.

Echocardiography↗
PubMed1992

Epicardial damage induced by topical cooling during paediatric cardiac surgery.

OBJECTIVE: To study electrocardiographic changes in infants and children in whom topical cooling was used during surgical repair of congenital heart defects. DESIGN: A retrospective study of all patients who had surgical repair of congenital heart disease during cold blood cardioplegia and topical cooling from January to August 1990. Eleven patients (group 1) had topical cooling with ice and 15 (group 2) with cold saline. PATIENTS: All 36 paediatric patients operated on during this period. All the available electrocardiographic records were analysed. Ten patients in whom reliable records were not available were excluded. Twenty six patients entered in this retrospective study. INTERVENTIONS: Topical cooling with ice or with a slush of cold saline. MAIN OUTCOME MEASURE: Recordings from all the precordial leads were examined and scored as the sum of the maximum ST elevation (mV) in each precordial lead. The score obtained for each electrocardiogram was recorded together with the timing of the electrocardiogram (preoperative, arrival in intensive care unit immediately after surgery, postoperatively in the intensive care unit, and at discharge). RESULTS: There were no differences between the two groups in terms of demographic data, diagnosis, duration of ischaemia, and postoperative myocardial performance. There was temporary ST elevation during the first 48 postoperative hours in all the children in group 1 but in only seven of the 15 children in group 2 (Fisher's test, p less than 0.005). The mean (SD) score for maximum ST elevation was 1.34 (0.83) mV in group 1 and 0.52 (0.64) mV in group 2 (Student's t test, p less than 0.01). CONCLUSIONS: These temporary electrocardiographic changes in the presence of adequate myocardial performance were attributed to epicardial damage induced by hypothermicosmotic injury. The use of ice for topical cooling may damage the epicardium in children.

Adolescent↗
PubMedDate not supplied

[Intestinal intussusception: easy diagnosis in the 21st Century? Outcome of five years experiences].

UNLABELLED: Intussusception is an entity well codify in pediatric surgery, with guidelines well defined since years in terms of imaging and procedures. MATERIAL: From January '99 to Dec. '03, 25 children were admitted to the Department of Pediatric Surgery of the Children's Hospital of Milan. All the aspects related to the pathology have been evaluated in the study. RESULTS: 25 patients have been studied. 23/25 presented severe pain, 19/25 normal bowel movements in the last 3 hours and in 9/25 a mass were detected at clinical examination.19/25 were submitted to laparotomy after failure of reduction through barium enema, and in 17/19 a manual reduction were performed. Only 2 patients required a bowel resection with primary anastomosis. The analysis of the delay of diagnosis, the delta-T between beginning of the symptoms and first medical evaluation was of 16,23 h. (3-72), and the delta-T between the first evaluation and diagnosis was 18,7 h. The interval between diagnosis and surgery was of 4,3. CONCLUSION: Authors believe that intussusception still represent a challenge for medical and surgical emergency team, supported by the data in literature. Imaging procedures must not be constricted in case of minimal suspicions of intestinal intussusception.

Child↗
PubMedDate not supplied

[Diastolic dysfunction in cardiac surgery intensive care. Study methods, changes and prognosis].

The natural history of patients with coronary artery disease and diastolic dysfunction who underwent coronary artery bypass grafting (CABG) is not well known. The aims of our study were to evaluate the incidence of diastolic dysfunction, its evolution after CABG and its possible correlation with adverse in-ICU prognosis. We studied 88 consecutive patients scheduled for CABG with not severely depressed left ventricular function (ejection fraction > 35%) and multivessels disease. Buckberg cardioplegia was used for myocardial protection. Diastolic function was investigated by recording mitral and venous pulmonary flow by transesophageal Doppler echocardiography (TEE). TEE examination was performed in operative room pre and post-bypass, at ICU arrival and after three months. Diastolic dysfunction was defined as mild, moderate and severe. Adverse in ICU events were defined as: use of inotropic drugs or ventricular mechanical support, an ICU stay > 24 hours, perioperative myocardial infarction and death. The study group was compared with a control group. T-Student test was used; a p < 0.05 was considered significant. A reduced diastolic function was present in 77% of patients at baseline examination. Diastolic dysfunction did not worsen significantly after hypothermic cardiac arrest and reperfusion. It persisted during ICU stay and normalized after three months from CABG in the majority of patients (85%). Diastolic failure was not associated with an adverse ICU prognosis (adverse events: 18 versus 13%; p = ns).

Aged↗