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Biomedical subjects

G Aru

Publications and source records attributed to G Aru.

18 recordsLinked to original sources
PubMed1986

The use of intraluminal prosthesis in the surgical management of aortic dissection.

The treatment of acute aortic dissection requires expeditions and reproducible operations aimed at avoiding rupture of the dissection or its antegrade or retrograde progression. In 12 type A and 11 type B dissections the aorta was repaired using an intraluminal prosthesis to reduce the risk of hemorrhage and its related complications. Overall mortality rates were 33% in type A and 36% in type B patients, similar to that observed in patients operated with other techniques, but the incidence of intraoperative bleeding was possibly reduced and the cross-clamping time was significantly shorter. This method of repair is a sound alternative to conventional anastomotic suturing, particularly in clinically compromised patients and in the hands of surgeons on call, who may lack the experience of dealing with a particularly fragile aortic wall.

Aged↗
PubMed1984

Dehiscence of aortic valve prostheses: analysis of a ten-year experience.

Up to the end of 1982, reoperation for dehiscence of an aortic prosthesis was necessary in 5% of patients operated on for primary aortic valve replacement in the previous decade at the University of Padova Cardiac Surgery Center. This complication occurred early (median time to diagnosis 4 months) and was associated with an elevated 30-day operative mortality (27%, 70% CL 19-37%). This is probably (P = 0.09) related to preoperative heart failure. The follow-up of the traced surviving patients (92%) indicates a continuing poor prognosis with a 6-year survival rate of only 13.5% (70% CL 5.0-30%). All the events were cardiac related and directly or indirectly connected with the persistence or recurrence of dehiscence that was observed in 72% of the cases. In the face of these results, a retrospective study has been performed to identify, on the basis of the available data, the subsets of patients more prone to develop this complication. Our results suggest that a significant increased risk (P less than 0.001) can be identified in patients presenting with bacterial endocarditis (12.2% rate), in patients with concomitant aneurysm of the ascending aorta (10.9%) and in patients with degenerative regurgitation or severe calcifications of their native valve, with rates of 7.0 and 6.0 respectively. In these situations particular care is required to avoid undue stress on the annular tissue. We also suggest the use of buttressed interrupted sutures.

Adult↗
PubMed1983

Mitral valve prosthesis dehiscence necessitating reoperation. An analysis of the risk factors involved.

Between January 1970 and December 1981, a total of 21 reoperations for periprosthetic leak were performed on 20 patients out of 999 with previously implanted prosthetic mitral valves. In most of them reoperations were performed within the first year, since the initial procedure and the leading indications were intractable congestive heart failure or infection of the mitral prosthesis. The mortality rate was 30% and was related to the preoperative cardiac functional status. The preoperative variables significantly related to an increased incidence of dehiscence of the mitral prosthesis necessitating reoperation were a degenerative disease (P = 0.016) or an infective endocarditis (P = 0.0006) of the native valve, both causing mitral regurgitation. Rheumatic disease, type of prosthesis, supra- or subannular insertion, age of the patient, and operative year, were not significant, neither were calcifications that are probably neutralized by the routine use of special surgical techniques. It is suggested that the use of techniques specifically designed to eliminate periprosthetic leak in patients affected by mitral regurgitation due to degenerative or infective disease of the native valve, might lead to a further reduction of reoperations for this complication.

Adolescent↗
PubMed1983

Acute mitral regurgitation after blunt chest trauma.

We treated a case of isolated acute mitral incompetence due to complete transection of the anterior papillary muscle produced by blunt chest trauma. The excellent results obtained with conservative therapy suggest that this approach be used in other similar cases. The pertinent medical literature is reviewed.

Adolescent↗
PubMedDate not supplied

[Bicycle ergometry exercise tests: a comparison between 3 protocols with an increasing load].

A group of 26 male long-distance runners performed 3 cycle ergometer tests of progressively increasing intensity up to exhaustion. The tests were performed on 3 different days. The workload increased as follows: 30 Watts every 3 min (test I), 10 Watts every min (test II), and 30 Watts every min (test III). Ventilatory and gas exchange measurements were averaged every 30 sec during each test. The heart rate (HR) was monitored continuously by ECG. In each test the anaerobic threshold (AT) was determined using ventilatory and gas exchange indices (VE, VCO2, VE/VO2). The work load on exhaustion and power at AT were the same comparing test I with test II, but these values were significantly higher in the 30 Watts/1 minute test. Conversely, maximal oxygen uptake (VO2 max) and the VO2 observed at anaerobic threshold were comparable in the 3 protocols. The slopes of VO2, VCO2, VE and HR against the work load (Watts) were identical in test I and II, but were slower in test III. However, no differences in the ventilatory and heart rate patterns versus oxygen uptake were observed comparing the three exercise tests. These results suggest a good comparability between the 30 Watts/3 min test and the 10 Watt/1 min protocol. Furthermore, for workloads below AT, a steady state was attained at the 3rd minute of each phase during test I, while oxygen uptake and other cardio-respiratory variables were underestimated during the protocol in which phases of 30 Watts were maintained only for 1 minute.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Palliative surgery for single ventricle heart malformations.

During a 6-year period, 24 patients, aged 7 days to 18 years, underwent palliative surgery for single-ventricle heart malformations; 22 has single-left ventricle with outlet chamber (14 with L-transposition); only two had type C malformation (van Praagh). They were subdivided according to physiology into two groups: the first included 15 patients with decreased pulmonary blood flow, whose main clinical feature was arterial desaturation; the second consisted of nine patients with increased pulmonary blood flow, who presented early with unmanageable heart failure. The first group was treated with a Blalock-Taussig shunt (typical or modified) in 12 cases (one death due to preoperative acute renal failure), with a Waterston or Potts shunt in two cases (both died early postoperatively), and by enlargement of the bulbo-ventricular foramen in one (who died at operation). No late deaths were seen and the clinical status of the survivors is judged optimal. Patients of the second group received a pulmonary artery banding plus a number of associated procedures: coarctation repair (2), ligation of a patent ductus arteriosus (2), Blalock-Hanlon atrial septectomy (1), tricuspid valve replacement (1). There was only one early death due to critical subaortic stenosis produced by a restrictive outlet foramen; however, there were five late deaths and two cases of surgical failure with persistent pulmonary hypertension. An analysis of the best palliative approach in patients with single-ventricle heart malformations is made, based upon the results of this series and taking into consideration the possibility of future intracardiac repair.

Adolescent↗