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G C Salmaso

Publications and source records attributed to G C Salmaso.

6 recordsLinked to original sources

[The permanent electrostimulation with ventricular programmable pacemaker (author's transl)].

The purpose of this study is to evaluate the directions, reliability and long-term results of ventricular programmable pacemakers (PPM's). One hundred and ten PPM's, types Cordis and Medtronic, were implanted in 60 patients (pts) with intermittent or paroxysmal 2 degrees, 3 degrees a-v block and in 50 pts with S.S.S., mostly symptomatics, with a follow-up of 45 months. We did not observe either spontaneous or wrong reprogrammations nor circuit failure. In 92% of pts with Omni-Stanicor Cordis PM's, the stimulation was effective at the "lower" current amplitude, hence a longer life of the generator. Eighteen pts (16.3%) needed to raise ventricular rate (average 65 bpm): 6 pts for dizziness, syncopes or cardiac failure; 2 pts to control ventricular arrhythmias; 10 pts for a stable bradycardia lower than 50 bpm. In 11 pts with bradyarrhythmia due to S.S.S., cardiac output (CO) was measured both with thermodilution and echocardiography ("mitral valve echogram", being "r" of the two methods = 0.92), in spontaneous rhythm (63.3 +/- 3.13 bpm) and increasing artificially heart rate to 74.8 +/- 3.0 bpm; CO decreased from 4.65 +/- 0.13 l/min to 3.58 +/- 0.09 l/min, likely for the loss of atrial pumping. Similar results were obtained in other pts evaluated only with echocardiographic method after PM implantation: some of these underwent a further echocardiographic haemodynamic evaluation after 15 days of constant ventricular pacing at a mean rate of 75 bpm, with a different behaviour among them. This emphasizes the utility of PPM's in preserving spontaneous rhythm until bradycardia reaches dangerous levels and also the usefulness of echocardiography to evaluate, haemodinamically, the paced patient's ventricular performance.

Adult

[Echocardiographic recognition of Valsalva aneurysm. A case report (author's transl)].

M-mode echocardiography has proved in these last years to be a reliable method for the recognition and evaluation of several cardiac diseases, both congenital and acquired. The following is a case we have examined in which M-mode echocardiography has allowed us to diagnose a Valsalva sinus aneurysm combined with a bicuspid aortic valve causing a valvular steno-insufficiency. We discuss the genesis of an echogram situated in the left ventricular outflow tract. A very similar image had been ascribed in the past to the rupture of an aneurysm into the interventricular septum, which caused a filling of the septum itself in diastole and therefore the echogram described above. On the basis of two-dimensional echocardiography, angiography and the autoptic report we could exclude this hypothesis in our case. We suggest that the image might be due to a prolapse of the valvular leaflet in the left ventricular outflow tract and/or to the prolapse of the aneurysm itself in the tract between the valvular leaflet and the interventricular septum.

Adult

[Echocardiographic evaluation of cardiac output in patients with acute myocardial infarction (author's transl)].

Echocardiography is a non invasive technique particularly useful to assess both hemodynamics and left ventricular performances; different methods have been proposed to evaluate echocardiographically the cardiac output. The aim of this work is to suggest a new method (planimetry of the area enclosed by echoes from the mitral valve) stating its advantages and limits and to test three already known methods (cubes method, method of Lalani and Lee, method of Rasmussen and coll.) comparing them to thermodilution. In 24 patients admitted in our Coronary Care Unit for acute myocardial infarction 30 measurements have been performed simultaneously with echocardiography and thermodilution. Statistical analysis (correlation coefficient with the method of the square minimums and Student's 't') of the results has shown that the cubes method is unprecise (P = NS) and unbiased (d = 0.97 +/- 15.46); Lalani-Lee method is unprecise (P = NS) and biased (d = 9.64 +/- 21.36) by a systematic underestimate error concealed by the poor precision; Rasmussen and coll. method is precise (P < 0.01) but biased (d = --3.03 +/- 5.5), the systematic mistake being entirely due to the group of patients with abnormal hemodynamics. Our method is precise (P < 0.01) and unbiased (d = --0.04 +/- 9.62) in patients both with normal and abnormal hemodynamics. Therefore this method offers the following advantages: 1) it is unbiased, even in the presence of abnormal left ventricular performance; 2) it is sufficiently precise, having a correlation coefficient with thermodilution of r = 0.80; 3) it measures directly the amount of flow due to the atrial systole; 4) the measurement is rapid and hardly biased by the reader.

Acute Disease

[Association of Hashimoto's disease with carcinoma of the thyroid].

The Authors describe a case, which came under their observation, of indifferentiated neoplasia of the thyroid associated with Hashimoto's disease; treated surgically by total thyroidectomy, at a distance of over four years it did not show signs of recurrence. Consideration is also given to pathogenetic and clinical problems, as well as those of surgical therapy, which such a combination between autoimmune thyroditis and a neoplastic process may raise.

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