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Biomedical subjects

J I Gallo

Publications and source records attributed to J I Gallo.

18 recordsLinked to original sources
PubMed1986

Left ventricular filling dynamics: influence of left ventricular relaxation and left atrial pressure.

Peak rapid filling rate (PRFR) is often used clinically as an index of left ventricular relaxation, i.e., of early diastolic function. This study tests the hypothesis that early filling rate is a function of the atrioventricular pressure difference and hence is influenced by the left atrial pressure as well as by the rate of left ventricular relaxation. As indexes, we chose the left atrial pressure at the atrioventricular pressure crossover (PCO), and the time constant (T) of an assumed exponential decline in left ventricular pressure. We accurately determined the magnitude and timing of filling parameters in conscious dogs by direct measurement of phasic mitral flow (electromagnetically) and high-fidelity chamber pressures. To obtain a diverse hemodynamic data base, loading conditions were changed by infusions of volume and angiotensin II. The latter was administered to produce a change in left ventricular pressure of less than 35% (A-1) or a change in peak left ventricular pressure of greater than 35% (A-2). PRFR increased with volume loading, was unchanged with A-1, and was decreased with A-2; T and PCO increased in all three groups (p less than .005 for all changes). PRFR correlated strongly with the diastolic atrioventricular pressure difference at the time of PRFR (r = .899, p less than .001) and weakly with both T (r = .369, p less than .01) and PCO (r = .601, p less than .001). The correlation improved significantly when T and PCO were both included in the multivariate regression (r = .797, p less than .0001). PRFR is thus determined by both the left atrial pressure and the left ventricular relaxation rate and should be used with caution as an index of left ventricular diastolic function.

Angiotensin II↗
PubMed1984

Replacement of mitral valve chordae with autologous pericardium in dogs.

Glutaraldehyde-tanned autogenous pericardium was compared with untreated autogenous pericardium as a tissue for replacement of anterior chordae tendinae of the mitral valve. Tanned autogenous pericardial chordae have a marked fibrous reaction at their healing ends but retain central pliability. Untreated autogenous pericardial chordae become uniformly fibrosed and stiff. Both retain their length, heal well to the papillary muscle and cusp, and are considered as potentially useful chordal substitutes in the right circumstances. Some of the response of the host to implanted tanned xenograft tissue must be related to the consequences of tanning rather than a reaction to foreign tissue.

Animals↗
PubMed1982

Clinical experience with glutaraldehyde-preserved heterologous pericardium for the closure of the pericardium after open heart surgery.

A limited series of 58 patients had their pericardial cavity closed with a patch of heterologous glutaraldehyde-preserved pericardium. No patients have been lost to follow-up, which extends between 3 hours and 50 months with a mean of 21 months. No problems related to the patch have been detected. Nine specimens have been available for macroscopic examination and 5 for microscopic study with a maximum postimplant time of 6 months. The patch maintained its initial structure, remained acellular and offered a retrosternal and intrapericardial plane of cleavage.

Animals↗
PubMed1982

Glutaraldehyde-preserved heterologous pericardium for the repair of diaphragmatic defects: experimental study.

Glutaraldehyde-treated porcine and bovine pericardium was used to close diaphragmatic defects in 15 dogs. The animals were reoperated upon between 15 days and 15 months. There were no adherences between the heterologous patch and the adjacent structures in any dogs except one, in which the omentum was attached to the pericardium. Microscopically, the graft structure remained intact without cellular invasion. The graft was covered with a thin layer of fibrous tissue, more intense in the one case of omental adhesions. There were no macroscopic or microscopic differences detectable in the behavior of the bovine and porcine pericardium. Although the follow-up is relatively short, these materials appear to offer a valid nonadherent alternative for diaphragmatic repair.

Animals↗
PubMed1981

Open mitral commissurotomy.

We analyzed the results obtained in 163 consecutive patients with "pure" mitral stenosis who underwent operation by the open approach exclusively. Calcification was found in the mitral valve leaflets in 11% of the patients and left atrial thrombus, in 13.2%. A statistically significant relationship was discovered between history of previous systemic embolism and cardiac rhythm (p less than 0.005). The subvalvular apparatus was affected in 66.6% of patients; most of them were in New York Heart Association Functional Class III (p less than 0.005). The frequency with which annuloplasty had to be performed because of mitral insufficiency after commissurotomy was statistically higher (p less than 0.025) among patients in Functional Class III. Early mortality was 1.2% and late mortality, 0.2% per patient-year. Two patients required late reoperation (0.4% per patient-year). One was in Functional Class III and the other, Functional Class IV before the first operation. Three patients sustained a late systemic embolism (0.6% per patient-year). All survivors but 1 are in Functional Class I (84.4%) or II (14.9%).

Adolescent↗
PubMed1981

A safe technique for removal of massive left atrial thrombus.

Open mitral operation in patients with massive left atrial thrombus still carries a high mortality due to intraoperative embolism. To prevent this danger, we have standardized a surgical technique that includes careful handling of the heart and use of suction, blockage of the mitral orifice, and excision of subendocardial thrombus. Our total experience with massive left atrial thrombosis comprises 30 patients. Seven out of 8 patients operated on before our present technique was used died in the hospital of irreversible cerebral damage. The other 22 patients underwent operation with this technique, and the thrombus was removed without mortality or morbidity.

Heart Atria↗
PubMed1981

Heart valve replacement with the Hancock bioprosthesis: a 6-year review.

All patients who had a mitral or aortic Hancock valve replacement between June, 1974, and June, 1979, were reviewed. A total of 734 bioprostheses were implanted in 632 patients: 291 had mitral (MVR), 239 had aortic (AVR), and 102 had both mitral and aortic valve replacement (MVR + AVR). In 228 patients, an associated surgical procedure was necessary. It involved conservative valve operation in 205 of them. The hospital mortality was 9.6% (28) for MVR (11.5% with associated operation), 4.6% (11) for AVR (8.7% with associated operation), and 13.7% (14) for MVR + AVR (13.0% with associated operation). The follow-up period was between 1 and 6 years with a total follow-up of 934.6, 714.6, and 288.3 patient-years for MVR, AVR and MVR + AVR, respectively. The late mortality was 0.96% (9), 1.53% (11), and 2.08% (6) per patient-year for MVR, AVR, and MVR + AVR, respectively. The thromboembolic rate was 1.49%, 0.14%, and 2.08% per patient-year for MVR, AVR, and MVR + AVR, respectively. There were twelve valve failure (six wer due to rupture; four, thrombosis; one, insufficiency because of intrinsic failure; and one, stenosis without evident cause at reoperation). This represents a failure rate of 0.53%, 0.13%, and 2.08% per patient-year for MVR, AVR, and MVR + AVR, respectively. These results encourage us to continue our routine use of the glutaraldehyde xenografts as the safest valve substitute at present.

Adolescent↗
PubMed1980

The surgical management of left atrial thrombosis.

A series of 122 consecutive patients with left atrial thrombosis is reviewed. Positive diagnosis was achieved in only 40 cases (36%) based on the angiographic findings and the presence of coronary fistula. The main cause of mortality and morbidity was cerebrovascular embolism. A change in our surgical technique, including the occlusion of the mitral orifice, has so far eliminated this problem.

Adult↗
PubMed1978

Heterologous pericardium for the closure of pericardial defects.

Patches of glutaraldehyde-preserved porcine pericardium were transplanted orthotopically into 20 dogs to see if they might make a satisfactory pericardial substitute. Two dogs had mediastinal infections and were excluded from this study. All animals were reoperated on at regular intervals between 15 and 300 days. In 15 dogs there were no adhesions between the porcine pericardium and the host's epicardium. Histological study showed healing between both pericardiums and no degenerative changes in transplanted pericardium. Glutaraldehyde porcine pericardium has been utilized in 8 patients to close the pericardial cavity. There have been no problems related to the pericardial grafts after a maximum follow-up of 9 months.

Adult↗
PubMedDate not supplied

[Clinical experience with glutaraldehyde-treated porcine valvular xenografts].

We show the results obtained with 318 patients who had a Hancock prosthesis implanted in mitral and/or aortic positions, between June of 1974 and December of 1976. The maximal follow-up period (January 1980) was of 5.58 years, with a total follow-up of 1,129.8 patient years. The hospital rate of mortality was 10.3% (33/318), with 19 late deaths, which gives a linear index of late mortality for mitral, aortic, and mitro-aortic patients of 1.18%, 1.40%, and 3.82% patient-year respectively. The actuarial analysis of the results show a survival rate at 67 months of 89.5% for the aortics, 85% for the mitrals, and 70% for the mitro-aortics. In 12 occasions prosthesis complications developed (7 ruptures, 3 thrombosis, and 2 prosthesic disfunctions), which represents an incidence of 0.28%, 0.84%, and 2.72% patient-years for the aortic, mitral, and mitro-aortic patients respectively. Of the 15 thromboembolic accidents that developed, none had a fatal outcome, and their incidence for the aortic, mitral, and mitro-aortic patients was 0.28%, 2.19%, and 5.46% patient-year respectively. The actuarial analysis of thromboembolism shows that 98.9%, 98.3%, and 91,3% of aortic, mitro-aortic, and mitral patients respectively, were free of thromboembolism at 67 months postoperatively. The 99.3% of the patients that survived surgery have improved functionally, 80.4% having no symptoms from the cardiovascular point of view.

Animals↗