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F Faletra

Publications and source records attributed to F Faletra.

44 records · Page 3Linked to original sources
PubMed1985

[Myocardial revascularization in patients with severe ventricular impairment. Short-term follow-up].

To assess the influence of aorto-coronary bypass grafting on surgical risk and short-term survival of patients with marked impairment of left ventricular (LV) function, we evaluated--among 435 patients who underwent coronary bypass surgery between January 1981 and December 1982--22 cases with: LV ejection fraction (EF) less than or equal to 0.35 (mean 0.27 +/- 0.06), LV end-diastolic pressure greater than or equal to 15 mmHg (mean 19.9 +/- 6.9 mmHg.), presence of three or more dysfunctional (hypokinetic or akinetic) segments on biplane LV angiography, three vessels disease in 90.1%. All patients but two had angina refractory to medical therapy. Operative mortality rate was 4.5%. Perioperative non fatal infarction rate was 9.1%. There were three late deaths. Mean duration of follow-up was 10.5 +/- 8.3 months with a survival of 81.8%. In the survivors we observed: dramatic improvement in respect to angina (94.5% are asymptomatic) and quality of life; exercise performance improvement (75% of patients have a functional impairment less than or equal to 30% at treadmill test); significant improvement in global and segmental LV function (mean echocardiographic EF 0.37 +/- 0.10, p less than 0.001). Because of relative low surgical risk and encouraging short-term results, aortocoronary bypass grafting can be performed even in patients with important LV disfunction, when associated with severe angina.

Adult↗
PubMed1983

Value of two-dimensional echocardiography in the diagnosis of pericardial cysts.

Four adult patients with pericardial cysts were studied by two-dimensional echocardiography. In all cases echocardiography demonstrated a round echo-free structure, of varying size, related to one of the cardiac chambers, from which it was separated by a definite wall of echoes. M-mode echocardiography in the three cases in which it was performed, failed to yield the diagnosis. This report assesses the importance of two-dimensional echocardiography and its greater reliability and sensitivity compared with: (1) M-mode echo in identifying pericardial tumors and establishing their relationships to nearby cardiac structures, and (2) standard chest X-ray in differentiating solid masses from cysts and in defining the characteristics of cysts walls. Particular stress is laid on the role of two-dimensional echo cardiography leading directly to surgery in patient number 4, who had a teratoma and in whom early surgery was essential. The high sensitivity and the ability of the technique to differentiate solid from cystic masses and to define their relationships with cardiac chambers make it a reliable method for assessing pericardial cysts.

Adult↗
PubMed1980

[Left ventricular behaviour before and after left anterior descending coronary artery bypass graft. M-mode echocardiographic study in 30 patients (author's transl)].

30 coronary artery disease (CAD) patients (pts) were studied by echocardiography before and after left anterior descending (LAD) coronary bypass graft in order to evaluate left ventricular (LV) behaviour. Echocardiograms were recorded early pre- (48 hours) and post-operatively (mean 12 days) and at a mean distance of 12 months (6 to 15) after operation. The following parameters were considered: left ventricular end diastolic dimension (LVDD), right ventricular diastolic dimension (LVDD), right ventricular diastolic dimension (RVDD), diastolic thickness, systolic thickening and motion of the interventricular septum (IVS) and of the LV posterior wall (LVPW). 21 pts (70%) showed reduced systolic thickening (RST less than or equal to 30%) and 17 (57%) reduced systolic motion (RSM less than or equal to 3 mm) of the septum. Before surgery no patient showed IVS paradoxical movement, left bundle branch block, valvular regurgitation, shunt, LV aneurysm. A previous myocardial infarction was present in the story of 7 pts: anterior location in 4 pts, inferior in 3 pts. Soon after operation (mean 12 days) 4 pts showed normal IVS motion; in 7 pts it was reduced (less than or equal to 3 mm) and in 19 IVS was paradoxical. In 15 pts of this last group LVPW motion resulted remarkably increased after the bypass graft. The other echo parameters didn't show significant variation. Averaging 12 months after operation, IVS systolic thickening resulted normal in 21 of the 30 pts. (70%); in 14 of the last group of 21 there was a RST preoperatively. IVS motion resulted normal in 21 of the 30 pts (70%), reduced in 5 (17%), paradoxical in 4 (13%). LVPW motion returned to the preoperative value in all but 3 pts, in whom it remained elevated. The other echo parameters didn't show any significant variation. We conclude that: 1) IVS paradoxical motion is frequently recorded by echo shortly after coronary bypass graft surgery. 2) In most pts it is accompanied by an increased excursion of LVPW, probably compensatory in origin. Both tend to normalize within few months in most of the subjects.

Angina Pectoris↗
PubMedDate not supplied

Transthoracic high-frequency echocardiographic detection of atherosclerotic lesions in the descending portion of the left coronary artery.

To assess the ability of transthoracic high-frequency two-dimensional echocardiography to detect atherosclerotic lesions in the descending portion of the left coronary artery, 30 consecutive patients with suspected coronary artery disease underwent two-dimensional echocardiographic examination 24 to 96 hours before coronary angiography. The descending portion of the left coronary artery was arbitrarily divided into a mid segment (the portion of the coronary vessel embedded in the anterior interventricular sulcus) and an apical segment (the portion turning around the cardiac apex into the posterior interventricular sulcus). The mid segment was imaged in 24 and the apical segment in 25 of the 30 patients for a total of 49 out of 60 segments (82%). Comparison of the echocardiographically visualized segments with the corresponding angiographic segments indicated that a correct echocardiographic diagnosis of significant stenosis was made in 11 out of 12 segments. There were no false positive results. Thus the sensitivity and specificity of high-frequency transthoracic echocardiography in the detection of significant stenosis in the imaged segments were 92% and 100%, respectively. Compared with angiography, additional information concerning the status of the arterial wall, the presence of calcific plaques, and the cross-sectional extent of the obstructive lesions was obtained by echocardiography in eight patients.

Adult↗
PubMedDate not supplied

Color Doppler echocardiographic assessment of atrial septal defect size: correlation with surgical measurements.

In patients with atrial septal defect (ASD), color flow Doppler echocardiography provides visualization of the transseptal jet, the maximal dimension of which can be assumed to correspond to the maximal dimension of the true orifice. To test whether color flow Doppler echocardiography can provide an alternative method for measurement of ASD size, we studied 63 consecutive patients with echocardiographic evidence of ASD. In 48 patients the maximal dimension of the jet was measured in the parasternal, apical, or subcostal four-chamber view or in the parasternal short-axis view. In the remaining 15 patients transesophageal echocardiography was performed because of transthoracic views were inadequate. The transesophageal studies also measured, from two-dimensional images, the maximal transverse discontinuity in the atrial septum. All patients underwent surgical repair, during which the surgeon directly measured the maximal dimension of ASD. Linear regression equations were performed to compare transthoracic and transesophageal dimensions to those measured at operation. Correlation coefficients were as follows for transthoracic versus surgical measurements: r = 0.745, standard error = 4.35, p less than 0.001. Transesophageal measurements derived from both two-dimensional images and echocardiographic jet width showed similar excellent correlation with surgical measurements (n = 0.91, standard error = 4.33, p less than 0.001; and r = 0.919, standard error = 4.42, p less than 0.001, respectively). We conclude that ASD size derived from color flow Doppler echocardiography shows a good correlation with the anatomic maximal dimension observed at operation. Both transesophageal color flow Doppler echocardiography of jet width and direct surgical measurement of the defect provide an accurate estimation of ASD size.

Adolescent↗
PubMedDate not supplied

Transesophageal echocardiography in the evaluation of mediastinal masses.

To assess the diagnostic impact of transesophageal echocardiography in the evaluation of mediastinal masses, 30 patients with mediastinal abnormalities detected by routine chest roentgenogram underwent transthoracic and transesophageal echocardiography. Subsequently, 29 of the patients underwent computed tomography and 16 underwent magnetic resonance imaging. The location and structure of the masses as well as their relationship to the surrounding structures were assessed. Anatomic confirmation and histopathologic diagnosis of the mediastinal masses by surgical resection and biopsy was available for all patients. Transesophageal echocardiography was more accurate than transthoracic echocardiography in detecting mediastinal masses (90% versus 73%), in identifying their structure (100% versus 90%), and in evaluating their relationship to contiguous organs (89% versus 81%). No complication was observed during the examinations. Computed tomography correctly diagnosed the location, structure, and relationships in all patients but one; magnetic resonance imaging correctly evaluated the mediastinal masses in all 16 patients. Our study suggests that transesophageal echocardiography is a valuable and safe complementary method of evaluating mediastinal masses. Moreover, this technique allows the obstruction of vessels and heart cavities, valve regurgitation, and right and left ventricular function to be easily assessed.

Adult↗