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Biomedical subjects

F Fesani

Publications and source records attributed to F Fesani.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Digital angiography and surgery of the carotid: our experience].

Digital subtraction angiography (DSA) has became a common diagnostic procedure in the investigation of patients with cerebrovascular disorders. In these report is described a series of 80 cases previously examined in 8 different department of radiology, 59 with IV.DSA and 21 with IA.DSA. Thirty per cent of IV.DSA images were judged to be technically inadequate, so that further evaluations with conventional angiography have been needed, and in 3 patients (5.0%) the IV.DSA diagnosis was overturned. The authors recommend intraarterial digital subtraction angiography for evaluation of extracranial carotid occlusive disease always resulted the definitive diagnostic procedure in their experience.

Carotid Artery Diseases↗
PubMed1986

Cardiopulmonary bypass: a low T4 and T3 syndrome with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH).

Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the 'low T3 syndrome'. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 degrees C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.

Adult↗
PubMed1985

[Treatment of acute myocardial infarct by intracoronary thrombolysis and aortocoronary bypass].

Nine patients with acute myocardial infarction underwent intracoronary urokinase infusion within 3 hours after the onset of AMI, and subsequent coronary artery by pass grafting. After thrombolytic therapy 3 patients showed single-vessel disease, 2 double-vessel disease and 4 triple-vessel disease. The ventricular function was normal in 2 patients, moderately depressed in 5 and severely depressed in 2. The coronary artery by-pass grafting was performed from 6 to days after the onset of the acute myocardial infarction (average 37 days) and the average number of grafts performed per patient was 3.2. There was no operative death. The follow up period ranged from 24 to 38 months: 7 patients are in NYHA Class I and 2, symptomatic for dispnea, are in NYHA Class II. These preliminary data suggest than the coronary artery by-pass grafting after intracoronary urokinase therapy for acute myocardial infarction can be performed safely and the surgical results do not differ from those obtained with standard coronary artery by pass grafting.

Adult↗
PubMed1983

[Postinfarction aneurysm of the left ventricle. Considerations on its surgical treatment].

The clinical manifestation and the operative results of 15 patients with postinfarction ventricular aneurysm are reviewed. In 6 patients the lesion involved also the interventricular septum. The time interval between infarction and aneurysm resection varied. The main symptoms were those of congestive heart failure and angina, but often severe arrhythmias were also present. It is concluded that ventricular aneurysmectomy associated, whenever possible, with the myocardial revascularization and the repair of ventricular septum lesions is the treatment of choice of this often life-threatening disease.

Adult↗
PubMed1983

[Stenosis of the common trunk of the left coronary artery: operative indications and risks].

39 patients with left main coronary artery stenosis (17% of all coronary patients) have been operated of myocardial revascularization from January 1982 to May 1983. 21 patients had right coronary artery occlusion; 17 had peripheral coronary artery stenosis, 3.58 bypass grafts/patient have been implanted; in 11 patients (28%) myocardial revascularization was thought incomplete. There have been 2 postoperative deaths (5.1%) and 3 myocardial infarctions (7.7%). Authors believe that in this group of patients operative risk is higher than in patients with 3 vessel disease (less than 2% in 1982) because, in sight of the poor short-term prognosis with conservative therapy, there is surgical indication even in the presence of peripheral stenosis. Frequent clinic and haemodynamic critical status of these patients worsen operative risk so that any technical fault may be lethal.

Adult↗
PubMed1982

[Surgical treatment of infective endocarditis].

Since 1975 to 1979 24 patients affected by acute infective endocarditis were operated of valvular replacement. All patients presented increasing cardiac failure unresponsive to medical treatment; 48% of the cases had positive blood culture. In 5 patients the infective endocarditis occurred on previously implanted prosthetic valve. Surgical findings consisted in rupture of chordae tendineae, vegetation ad perforation of valvular cusps. Prosthetic valvular replacement was performed in all cases using mechanical valve (22) or porcine heterograft 85). Surgical mortality was 8,3%, while late mortality occurred on 12.5% of cases. The diagnostic considerations, concerning this disease, the surgical results and long term management are discussed.

Adult↗
PubMed1982

[Water-electrolyte and acid-base changes during extracorporeal circulation].

Changes in fluid, electrolyte and acid-base balance were evaluated in 8 patients during extracorporeal circulation. H2O increase and osmolarity and colloid osmotic pressure decrease, due to priming and perfusion technique used for cardiopulmonary by pass, were found. Mild respiratory alkalosis was also present. K+ serum, because of KCL supplements, was always maintained within the normal values, while Na+ serum concentration was low, despite of large amounts of Na+ infused during perfusion. After examination of disturbances in fluid, electrolyte and acid-base balance, the Authors report the performed corrections and emphasize the importance of a prompt recognition and the immediate therapy of these changes to avert serious cardiac impairments during extracorporeal circulation or during the immediate postoperative period.

Acid-Base Equilibrium↗
PubMed1982

[Indications and technic of surgical treatment of pulmonary embolism].

Authors describe the surgical technique for pulmonary embolectomy and review the cases of the patients undergoing such operation. On the basis of the obtained results, Authors think that the unsuccessful cases are mainly due to the very deteriorated preoperative clinical state of these patients and to associated illness. Authors believe that the familiarity with this kind of procedure and the prompt decision to perform it before a further worsening of the clinical conditions have a positive influence on its results and that surgical indication should not be limited to the patients in cardiac arrest, but instead extended to those cases showing rapid deterioration of the clinical state.

Adult↗
PubMed1982

[Extensive calcifications of the left atrium].

The clinical and surgical features of eight patients with extensive calcifications of the left atrial wall and mitral valvular disease, has been reported. Seven patients underwent to prosthetic replacement of the mitral valve and one to prosthetic replacement of the mitral and aortic valve. Beside the valvular replacement, the authors stress the importance of the surgical removal of the atrium wall calcifications, in order to avoid the postoperative haemorrhagic and embolic complications.

Adult↗
PubMed1980

[Is aortocoronary bypass indicated in patients with lesions of the common trunk of the left coronary artery incapable of complete revascularization?].

Obstructive lesions of the left common coronary trunk need surgery if our operability criteria: possibility of at least making a by-pass on the left descending anterior coronary branch and a not seriously compromised miocardial contractility exist. Of the 25 patients operated, there was a mortality of 8% and 3 intra-and post-operatory infarcts; two other patients died after some time (one for extracardiac causes). Other infarcts were not observed. 48% of the patients had incomplete riva-scolarization which after some time had an effect on the objective state of the patients but not on their survival. The authors conclude their studies by affirming that total surgical correction is indicated even on non susceptible patients on the basis of coronarography.

Anticoagulants↗
PubMed1980

[Gore-Tex prostheses in arterial reconstructive procedures (author's transl)].

The early and long-term results using the polytetrafluorethylene (Gore-Tex) are reported. In 20 patients, 12 ilio-femoral bypasses, 10 femoro-popliteal and 2 aorto-subclavian bypasses have been performed; 5 of these patients underwent simultaneously femoro-popliteal bypasses with Gore-Tex and ilio-femoral bypasses with Dacron. Only once the Gore-Tex was used as patch. The results have been satisfactory. However, longer follow-up and many more patients are needed to determine if the Gore-Tex will be the substitute for the autogenous saphenous vein in peripheral vascular reconstruction.

Aged↗
PubMed1980

[Prostheses reimplantation with porcine xenograft. Our experience (author's transl)].

The Authors explain the experience about the porcine xenograft, the results of the application of 98 bio-prostheses implanted between January 1976 and November 1979. The distribution of the implantations is: 52 mitral valve reimplantation; 16 aortic valve reimplantation, 2 tricuspid valve reimplantation, 26 xenograft were implanted with the association of another prosthesis or aorto coronary by-pass graft. The patients were selected for clinical criteria (age, sex, geographic provenance) and haemodinamic criteria. Three early embolism were checked, one lethal. The total mortality is of 9 patients: 4 patients were submitted to multiple surgical operation. The running of porcine xenograft is good on the middle term.

Adult↗