PubMed Health⌕ Search

Biomedical subjects

F Glieca

Publications and source records attributed to F Glieca.

At least 37 records · Page 2Linked to original sources
PubMed1997

Unusual right coronary artery anomaly with major implication during cardiac operations.

We report a case in which an unrevealed high origin of the right coronary artery (almost 4 cm above the left coronary sinus) led to major complications during a routine atrial septal defect closure. We stress that, in absence of preoperative coronary angiography, coronary artery anomalies should always be considered and minimal ascending aorta manipulation and antegrade/ retrograde myocardial protection should be recommended.

Adolescent↗
PubMed1997

Lesions of the target vessel during minimally invasive myocardial revascularization.

BACKGROUND: Minimally invasive coronary artery bypass grafting has recently been introduced into cardiac surgery. In this report we discuss the incidence of surgically induced distal target vessel stenosis in patients who undergo the minimally invasive coronary artery bypass grafting procedure, which represents a major drawback of the procedure in our experience. METHODS: Doppler evaluation of mammary artery flow was performed postoperatively in all 55 patients who underwent minimally invasive coronary artery bypass grafting at our institution. Angiography was performed in the first 35 consecutive patients for control purposes and in 2 patients who complained of angina recurrence. RESULTS: In 32 of the first 35 consecutive patients, the anastomosis was found to be functioning normally and the distal left anterior descending artery was normal; in the remaining 3 patients we found mammary artery occlusion, anastomotic stenosis, and stenosis of the anastomosis and the distal left anterior descending artery in 1 patient each. A distal left anterior descending artery stenosis was found in the only 2 patients who underwent late angiography. CONCLUSIONS: Surgically induced distal target vessel stenosis represents a major drawback of minimally invasive coronary artery bypass grafting in our experience. Further improvement in the means of achieving coronary artery occlusion, as well as in anticoagulant and antiplatelet therapy, is mandatory before minimally invasive coronary artery bypass grafting can be confidently accepted into clinical practice.

Adult↗
PubMed1997

[Minithoracotomy myocardial revascularization: results of early angiographic control].

AIM OF THE STUDY: Minimally invasive direct coronary artery by-pass (MIDCAB) has been proposed as an alternative technical solution in different clinical settings. However, a systematic angiographic study of the results obtained using this new technique has not been published yet. This paper summarizes our preliminary angiographic results with MIDCAB. MATERIALS AND METHODS: From January 1995 to January 1997, 56 patients underwent MIDCAB. All patients were followed up regularly and underwent stress myocardial scintigraphy. A postoperative angiographic control was performed in 48 patients (87.2% of the total) at a mean postoperative interval of 1.7 +/- 2 months. RESULTS: One patient died in hospital. Five patients required further surgery using conventional techniques (either surgical or percutaneous). In 41/48 patients (85.4%), the mammary artery graft and the left anterior descending artery (LAD) were normal. In two cases, we found an anastomotic stenosis, in two cases there was a LAD lesion distal to the anastomosis (at the application site of the stay sutures), one case showed an anastomotic stenosis associated with a distal LAD stenosis, one case had a mammary graft occlusion and one case showed a thrombus-like image in the LAD proximal to the anastomosis. CONCLUSION: Systematic angiographic follow-up of MIDCAB patients seems mandatory in order to evaluate the effectiveness of the technical solutions utilized and to optimize various aspects of this new procedure.

Adult↗
PubMed1990

[Aortic valve replacement in a case of Takayasu's disease with polydistributed localization].

We report a case of a 49 year-old woman suffering from severe aortic regurgitation due to Takayasu's disease involving the ascending and abdominal aorta and the brachial arteries. The patient was managed successfully with aortic valve replacement. Considering the Literature data, the pathogenesis of the aortic insufficiency and the main surgical and anaesthesiologic problems related to the Takayasu's disease are discussed.

Adult↗
PubMed1990

[Infectious endocarditis. Role of surgical therapy].

The problem of infectious endocarditis (IE) is approached through a review of personal experience. The series examined consists of patients, 17 with active and 21 dormant infection. Furthermore 12 in the first group, 18 in the second had natural heart valves, while 5 in group I, 3 in group II had been given artificial ones. After an analysis of the aetiopathogenic, clinical and diagnostic aspects of the condition with emphasis on the fact that Staphylococcus aureus is currently more responsible for infections in natural valves and the epidermidis for acute prosthesis infections which have a higher early and late mortality rate (40% in hospital, 33.3% long-term), the paper discusses the criteria for surgical intervention. In line with opinions expressed in the literature, it is pointed out that, while the patient's haemodynamic status is certainly the main criterion for any decision, other factors such as embolism, impaired conduction, kidney failure and expansion of the infection to contiguous tissues, should not be under-estimated.

Endocarditis, Bacterial↗
PubMed1990

[What is the best treatment in massive pulmonary embolism: anticoagulants, thrombolytics or surgical embolectomy?].

The aim of this work was to identify the best treatment available for massive pulmonary thromboembolism which still remains a frequent and sometimes lethal complication for surgical and non-surgical patients. The Authors underline the difficulties of diagnosis and the need for therapy at the earliest possible stage. At present, clinical management involves the use of: anticoagulants, thrombolytic agents and surgical embolectomy. In conclusion, the authors state that pulmonary thromboembolism, even when massive, has been transformed into a medically interesting pathology which can be cured using heparin and thrombolytic agents. However, surgical treatment is mandatory when patients reveal adverse effects to drug therapy, when medical therapy is insuccessful, or when patients are seriously ill with recurrent cardiac arrest.

Anticoagulants↗
PubMed1989

[Reversibility of left ventricular functional damage after valve replacement in patients with chronic aortic valve insufficiency].

The authors study retrospectively some preoperative echocardiographic findings and their importance as predictors of reversible myocardial dysfunction. The functional status of 57 survivors after isolated aortic valve replacement was evaluated with exercise testing and on this ground the patients, were divided into three groups: A (28 pts) greater than 60%; C (10 pts) less than 40%; B (19 pts) from 40% to 60%. The authors conclude that the postoperative improvement in functional status is strictly correlated with some preoperative echocardiographic indexes (end-diastolic dimension, end-systolic dimension, shortening fraction, mean end-systolic radius/thickness ratio, end-systolic wall stress, myocardial mass, ejection fraction) with are also predictive of operative mortality. The authors consider the principal values of beginning left ventricular impairment: a) end-systolic dimension greater than or equal to 5.5 cm; b) shortening fraction less than 27%; c) mean end-systolic radius/thickness ratio greater than 2.5; d) end-systolic wall stress greater than 240 mmHg.

Aortic Valve Insufficiency↗
PubMedDate not supplied

[Myocardial revascularization with the internal mammary artery. The indications, technics and results].

This report reviews 218 patients who underwent internal mammary artery (IMA) grafting alone or with vein graft between 1986-1989. Our experience with IMA started with a single attached graft for proximal left anterior descending lesions in young patients affected from stable angina. After that our indications became more extensive. One IMA was utilized in 209 cases, both two IMAs in the remaining 9. Sequential IMA graft was performed in 16 patients and free IMA graft in 8. There were 242 IMA anastomosis and 295 associated vein by-passes. The overall operative mortality was 2.3%. Perioperative complications include myocardial infarction in 3 (1.4%), reoperation for bleeding in 4 (1.8%) and sternal wound complication in 4 (1.8%). These results are comparable to those of patients having only saphenous vein by-pass during the same period. At the follow-up actuarial survival rate at 42 months was 94 1.8% and 90% of these patients were completely asymptomatic. We include that IMA grafting shows low operative risk and provide excellent short term results. Our findings and the high long term patency rate of this conduit encourage us to extend the indication to IMA and to perform those surgical techniques that make possible multiple mammary coronary anastomosis.

Angina Pectoris↗
PubMedDate not supplied

Valve replacement with the tilting disc Sorin prosthesis in patients with narrow aortic annulus.

The Authors summarize their 5-year experience of the clinical use of the Sorin tilting disc prosthesis in 40 patients (group A) with narrow aortic annulus, compared with a control group (group B: 116 patients) where a larger Sorin prosthesis was implanted. Follow-up lasted from 1 to 60 months, with a mean of 25.6 +/- 12.3 in group A and 20.4 +/- 11.9 in group B. Early and late mortality were low: 1/40 and 2/39 (2.5 and 5.1%) in group A and 4/116 and 9/112 (3.4 and 8.0%) in group B (p = NS): only two deaths, one in each group, were prosthesis-related. Actuarial survival was comparable: 91.2% (CL: 96.3-86.1%) in group A and 78.0% (CL: 87.6-68.4%) in group B, as were probability of being event-free and alive, non-reoperated and with few or no symptoms [group A: 61.7% (CL: 72.4-51.0%) and 77.4% (CL: 85.9-68.9%) respectively; group B: 78.8% (CL: 83.4-74.2%) and 61.1% (CL: 85.9-68.9%) respectively]. The Authors conclude that the Sorin tilting disc prosthesis is a reliable valve substitute in the narrow aortic annulus; they recommend that enlargement procedures should be confined only to patients with annulus size less than 19 mm.

Actuarial Analysis↗
PubMedDate not supplied

A comparative clinical assessment of a hollow-fibre membrane oxygenator (Capiox II) and a bubble oxygenator (Harvey 1500).

Personal experience is reported on the use of a membrane oxygenator, the Capiox II, which is clinically compared with a bubble oxygenator for medium-term perfusion. The characteristics considered were the efficiency of the heat exchanger, the oxygenating capacity, traumatic effects on the blood and the direct effect on the renal and cardiopulmonary systems. The Capiox II demonstrated a better oxygenating capacity, less platelet damage, a smaller variation in the free plasma haemoglobin, a significant difference in postoperative bleeding and blood transfusion requirements, but showed no variation in renal and cardiopulmonary function. The authors suggest that the Capiox II is to be preferred for extra-corporeal circulation of medium duration, for which it combines the advantages of both bubble and membrane oxygenators, while being less complex and costly than previously marketed membrane devices.

Blood Gas Analysis↗