Surgical approach for the treatment of secondary aortoenteric fistulae.
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Aorta, Abdominal↗
Biomedical subjects
G F Fadda
Publications and source records attributed to G F Fadda.
[Transcranial Doppler: diagnostic methodology].
The transcranial doppler is a kind of pulsed doppler (frequency 2 Mhz) which, by arrangement of the probe in particular regions of the skull (temporal, orbital, and occipital fenestra), permits the assessment of the flow velocity on the level of the main intracranial arteris, giving information about the perviety and the characteristics of the flow and about Willis polygon being functional. This non-invasive vascular diagnostic is methodology concerned, and, therefore, fundamental in the evaluation of patients suffering from cerebral-vascular insufficiency and likely to be operated by carotid-TEA.
Cerebrovascular Disorders↗
Reconstruction of the pulmonary artery in patients with lung cancer.
Between March 1990 and December 1992, we performed 17 resections and reconstructions of the pulmonary artery (PA) in patients with lung cancer. Three patients with intrapericardial infiltration of the PA underwent left pneumonectomy and PA angioplasty through a median sternotomy during cardiopulmonary bypass. The first patient survived in excellent general health for 25 months and then died of brain metastases; the second died of bronchopneumonia on postoperative day 24; and the third died of generalized tumor spread after 3 months. Fourteen patients had extrapericardial infiltration of the PA. They underwent sleeve upper lobectomy and PA reconstruction instead of pneumonectomy. In 6 patients we performed a sleeve resection of the PA, and in 8, the vessel was reconstructed using a patch of autologous pericardium. Two minor postoperative complications occurred. Three patients died after 14, 15, and 20 months; the remaining 11 are alive and well 5 to 31 months after operation. We conclude that PA reconstruction associated with sleeve lobectomy is an advantageous alternative to pneumonectomy in select patients with lung cancer. Intraoperative indications, surgical technique, and perioperative management are crucial to achieve good results. Reconstruction of the main PA during cardiopulmonary bypass in association with left pneumonectomy can be performed successfully. The long-term results need further evaluation.
Adult↗
Protection and revascularization of bronchial anastomoses by the intercostal pedicle flap.
We used an improved method for preparation of the intercostal pedicle flap for encircling bronchial anastomoses, and we studied its vascular supply after the operation. The flap was used in 56 patients undergoing various types of sleeve resection and in three patients undergoing single lung transplantation. The technique is simple, fast, and causes neither extra surgical trauma nor complications. It allows satisfactory isolation and sealing of the bronchial anastomosis. Even if complete anastomotic dehiscence occurs (one case), the flap preserves the continuity of the airway, thus avoiding bronchopleural fistulas or other complications. The postoperative arteriographic study of the intercostal artery supplying the flap (performed in 14 patients) demonstrated the full patency of the vessel in all cases. It also showed that a fine vascular network develops around the anastomosis early in the postoperative period.
Anastomosis, Surgical↗