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Biomedical subjects

G Di Eusanio

Publications and source records attributed to G Di Eusanio.

At least 19 recordsLinked to original sources
PubMed2006

Urgent/emergent surgical revascularization in unstable angina: influence of different type of conduits.

AIM: In patients with unstable angina (UA) undergoing nonelective myocardial revascularization we compare the outcomes of skeletonized bilateral internal mammary arteries (BIMA) vs left internal mammary artery (LIMA) and saphenous vein grafts (SVGs) vs SVGs only. METHODS: Between January 1997 and December 2003, 758 patients: 612 (80.7%) males, mean age 62+/-12 years, underwent nonelective coronary artery bypass grafting (CABG) for unstable angina; 205 (27%) were operated emergently and 553 (73%) urgently. BIMA were employed in 320 (42%) patients (Group B) , isolated LIMA and/or SVGs in 332 (44%) patients (Group M) and only SVGs in 106 (14%) (Group S). RESULTS: In-hospital mortality (B=5.9%, M=4.5% and S=7.5%), and perioperative myocardial infarction (B=2.2%; M=1.9%, S=3.7%) were similar between the 3 groups (P=NS). Actuarial survival at 1, 3 and 7 years was 98.7%, 97.5% and 96.2% in group B, 99.3%, 94.8% and 89.4% in group M (P< 0.057 at 7 years follow-up) and 98%, 93.2% and 84.3% in group S (P=0.001). At 7 years follow-up, the event-free cardiac survival (92% vs 89.1%, P=0.045), angina-free survival (98.6% vs 95.8%, P=0.056), reoperation-free cardiac survival (98% vs 96%, P= 0.05) and infarct-free cardiac survival (98.7% vs 96.9%, P=0.062) showed a consistent trend to be superior in group B. Multivariate analysis identified age >65 years (P= 0.02), left ventricular ejection fraction (LVEF) <35% (P= 0.01), >1 ischemic irreversible area (P= 0.03) as independent predictors for late deaths, while the use of the LIMA (P= 0.006) and both mammary arteries (P= 0.001) decreased the risk of late deaths. CONCLUSIONS: The use of BIMA in nonelective CABG for UA is safe and effective. There is a trend, however, toward a survival benefit with improved freedom from late cardiac events (recurrence of angina, freedom from reoperation and infarction).

Aged↗
PubMed1998

Constrictive pericarditis presenting as unexplained recurrent pleural effusion: a case report.

Constrictive pericarditis may exceptionally present as pleural effusion of unknown origin and this form of presentation may cause diagnostic problems. We report a case of subacute constrictive pericarditis in which there were recurrent pleural effusion with no other signs of the disease and the initial echocardiographic study was nondiagnostic. For this reason the patient was initially considered to have primary pulmonary or pleural disease. On the basis of the subsequent development of signs of systemic congestion and the results of computed tomography, Doppler echocardiography and cardiac catheterization, which were consistent with constriction, it was concluded that the patient had constrictive pericarditis. A complete resolution of pleural effusion and signs of systemic congestion was observed following pericardiectomy.

Acute Disease↗
PubMed1991

Left ventricular aneurysm secondary to Behçet's disease.

A 16-year-old boy with Behçet's disease who was seen with thrombophlebitis of the leg was found to have coronary artery occlusion with postinfarction left ventricular aneurysm. Recurrent femoral artery aneurysms and orogenital ulceration developed in him. The diagnostic features together with successful treatment of this patient and a discussion of Behçet's syndrome are presented.

Adolescent↗
PubMed1988

Giant left atrium and mitral valve replacement: risk factor analysis.

Giant left atrium (GLA) associated with mitral valve disease (MVD) has been reported as a significant risk factor in mitral valve surgery with mortality ranging from 8%-32%. Plication of the left atrium has been suggested to reduce postoperative left ventricular failure, respiratory failure and mortality. The 203 consecutive patients with MVD operated upon between 1980 and 1986 were reviewed and divided in two groups: group A without GLA (165 patients) and group B with GLA (38 patients = 19%). The pertinent preoperative and intraoperative notes and the early and late postoperative course were reviewed and correlated. The hospital mortality was 2.4% in group A and 2.6% in group B. Late mortality, at a mean follow-up of 54 months was 4.3% in group A and 5.4% in group B. In this series, GLA was not a significant risk factor in MVR and did not affect early and late results as compared with cases without GLA. Plication may not be required in absence of extracardiac signs of compression.

Cardiomegaly↗
PubMed1986

Intracaval and intracardiac leiomyomatosis of uterine origin.

Intracaval leiomyomatosis of uterine origin is a rare disease. Extension to the right heart is exceptional. Based on the review of 11 cases reported in the literature and the case presented herein, which was treated successfully, the diagnostic and therapeutic problems are discussed. Diagnosis should be suggested when a female patient operated on previously for myofibroma of the uterus by hysterectomy, presents with a picture of cardiac myxoma. Diagnosis can be confirmed by iliocavogram and computerized tomography of the abdomen. Excision calls for a cardiac procedure under extracorporeal circulation and caval exploration which may be performed either simultaneously or as a two stage procedure.

Adult↗
PubMed1981

Eight years' experience with intracardiac repair of tetralogy of Fallot. Early and late results in 175 consecutive patients.

The early and late results of intracardiac repair of 175 cases of tetralogy of Fallot during the period 1969 to 76 are reviewed. Overall hospital mortality was 8%, with a 5% mortality in patients over 2 years of age. Late mortality was 1%. Both early and late mortality and morbidity were related to the right ventricular to left ventricular peak systolic pressure ratio measured at the end of the operation. During the eight year period, a fall in mortality from 37 to 15% was recorded in patients less than 2 years of age. As a result of the experience gained during this period, we have now adopted a more active policy towards reconstruction of the right ventricular outflow tract while remaining aware of the potential problems of pulmonary regurgitation.

Adolescent↗
PubMed1979

Traumatic intercostal hernia due to a nonpenetrating injury in a child.

Herniation of the lung is a recognized, though rare, complication of thoracotomy and penetrating chest injury. Closed chest injury is usually associated with rib fractures, laceration of the lung, and rupture of the diaphragm, bronchus, and aorta. It is unusual for the intercostal muscles to be ruptured in a closed chest injury. In this case, herniation of the lung may result.

Child↗
PubMed1979

Open heart surgery in first year of life using profound hypothermia (core cooling) and circulatory arrest. Experience with 134 consecutive cases.

Between April 1970 and December 1977, 134 infants aged 2 days to 12 months underwent open heart surgery using profound hypothermia and total circulatory arrest. The technique of bypass (core) cooling is described. Results are reviewed for 4 principal diagnoses: 'simple' transposition of the great vessels, total anomalous pulmonary venous connection, ventricular septal defect, and Fallot's tetralogy. A mortality of 44 per cent in 32 cases during the first 3-year period has been reduced to 22 per cent in 102 cases during the subsequent 5 years. The overall mortality for the entire period was 28 per cent. The policy for the management of each diagnostic group is outlined.

Cardiac Surgical Procedures↗
PubMed1978

Total anomalous pulmonary venous connection (surgical technique, early and late results).

Between March 1970 and October 1977, 36 patients underwent correction of total anomalous pulmonary venous connection. The ages ranged from 5 days to 16 years; 27 (75%) were under 1 year and 19 were under 3 months of age at the time of surgery. The overall mortality was 33%. Supracardiac connection was the commonest type and was associated with the lowest hospital mortality (30%). The highest mortality occurred in the mixed and infracardiac types and was related in part to the presence of associated intracardiac anomalies. The use of hypothermia and circulatory arrest in infancy has resulted in a considerably lower hospital mortality compared with cases operated on under conventional cardiopulmonary bypass. The mortality in 23 infants (under 1 year of age) was 26% using circulatory arrest and was lowest when correction was performed within the first three months of life (18%). All four infants operated on with standard cardiopulmonary bypass died, whereas this technique was found to be safe in older children. The surgical technique using a left anterolateral thoractomy with a trans-sternal extension is described. This technique gives an excellent exposure for fashioning a long anastomosis and has been associated with a low incidence of postoperative pulmonary complications. There have been no late deaths and all survivors, who are in excellent condition up to seven years after correction, have a normal exercise tolerance.

Adolescent↗
PubMed1978

Early and late results of aortoplasty with a left subclavian flap for coarctation of the aorta in infancy.

Between February, 1969, and December, 1976, 45 consecutive infants younger than 6 months old underwent aortoplasty with a subclavian flap for the relief of coarctation of the aorta. All infants had persistence of the ductus arteriosus, and 58 percent had associated intracardiac anomalies. The over-all hospital mortality rate was 24 percent, nad no deaths occurred in infants with coarctation associated with patent ductus arteriosus only. All the deaths were in the group of patients under 2 months of age who had associated intracardiac defects. Follow-up over a 7 year period shows no clinical, hemodynamic, or angiographic evidence of recoarctation in any of the survivors.

Aortic Coarctation↗
PubMedDate not supplied

[Clinical and hemodynamic long-term result of substituting the mitral valve using a Beall prosthesis].

A follow-up study of 31 patients, 1 1/2 years after they underwent a mitral valve replacement with a Beall prosthesis, is reported. Eighty-four per cent of the patients experienced marked improvement of symptoms and are fully active. Late cardiac recatheterization has showed a decrease of pulmonary wedge pressure, both at rest and under exercise. The prosthesis area has been found to be smaller than the original size. Hemolysis related to the prosthesis is of moderate degree and the incidence of systemic embolism was 3.1%.

Adolescent↗