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Biomedical subjects

F Vendrametto

Publications and source records attributed to F Vendrametto.

5 recordsLinked to original sources

Bail-out rotational atherectomy to ablate stent struts after treatment of a LAD bifurcation lesion with the Trousers technique.

We present a previously unreported complication of the "trousers" stent procedure used for treatment of a bifurcation lesion in the left anterior descending artery and the first diagonal branch. Closure of the main vessel occurred. A balloon, however, could not be advanced across the side-branch stent to open the struts toward the main branch. Therefore, a bailout rotational atherectomy was performed to ablate the stent that then allowed a further dilatation with a PTCA balloon. This procedure resolved a potentially lethal outcome for the patient who subsequently underwent uneventful coronary by-pass grafting.

Aged↗

[Coronary angioplasty compared with aortocoronary bypass in patients with multivascular coronary disease].

Over the past two decades the use of angioplasty has rapidly expanded. As technology and experience have advanced, operators are increasingly faced with two-vessel and three-vessel disease. Coronary artery bypass graft surgery and coronary balloon angioplasty are two possible approaches for patients with multivessel coronary disease. Randomized trials comparing these two different procedures have found no difference in early as well as late mortality between assigned treatment groups. The Bypass Angioplasty Revascularization Investigation (BARI) showed a better long-term outcome with coronary artery bypass in the subgroup of patients with treated diabetes (35% died within 5 years after angioplasty compared with 19% who underwent surgery). Repeat revascularization was more common after angioplasty. Surgery offers more complete revascularization, but morbidity is higher; angioplasty is less invasive but patients are more likely to need another revascularization procedure mainly related to the occurrence of restenosis. Restenosis is often associated with the recurrence of symptoms requiring further revascularization. The use of stents and inhibitors of glycoprotein IIb/IIIa, minimally invasive surgical techniques and all-arterial grafting have the potential to change the scenery of coronary artery revascularization in the next few years.

Angioplasty, Balloon, Coronary↗

[Intravascular echocardiography (ICUS) diagnosis of post-traumatic coronary dissection involving the common trunk. A case report and review of the literature].

A case is reported in which a 31-years-old man experienced coronary artery dissection with an acute anterior myocardial infarction following blunt chest trauma in a car accident. Due to ECG signs of acute myocardial infarction a coronary angiography was performed showing an abrupt occlusion of the mid part of the left anterior descending artery and a linear filling defect in the proximal portion of the vessel. Additional detailed intravascular ultrasound was performed, revealing a long intimal tear involving the left anterior descending artery and the left main. The patient underwent immediate coronary artery bypass surgery. Two vein grafts were made from aorta to the left anterior descending artery and the circumflex artery, respectively. Repeat angiography was performed early after the operation; dissection of the left main and the left anterior descending artery was still visible and the grafts to the left descending artery and the circumflex were patent.

Accidents, Traffic↗

Aortic pseudocoarctation. Description of two cases.

Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and kinking of the aortic arch. Regarded as a benign condition for a long time, several reports demonstrate that complications may occur so that a careful follow-up of patients affected by aortic pseudocoarctation is mandatory. In this context we describe two patients recently evaluated in our institution and review the literature to establish the most accurate diagnostic techniques (also considering newer noninvasive imaging modalities such as transesophageal echocardiography and nuclear magnetic resonance) and to evaluate the prognosis.

Aorta, Thoracic↗

Simulation of chronic mitral regurgitation.

In mitral regurgitation the left ventricle enlarges in order to increase its stroke volume because of the regurgitation through the mitral valve. The amount of this volume increase, and of the consequent increase in left ventricular mass, its dependent upon the amount of the regurgitant volume, but many other factors come into play, such as left ventricular pumping capability (contractility), the level of peripheral pressure, resistance and compliance of the arterial tree. The aim of this study is to predict the final left ventricular volumes and mass given the amount of mitral regurgitation. The predicted results are compared with actual data in real patients. In most cases prediction is fairly good; some discrepancies can be interpreted as an index of advanced decompensation.

Cardiac Output↗