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J R Rumoroso

Publications and source records attributed to J R Rumoroso.

15 recordsLinked to original sources
PubMed1998

Prognosis of patients with a first episode of sustained monomorphic ventricular tachycardia.

AIMS: To evaluate the cardiac mortality in patients suffering from a first episode of sustained monomorphic ventricular tachycardia (SMVT). METHODS: 100 patients less than 75 years old were evaluated during a 50-month follow-up period. Patients were classified into four groups: myocardial infarction, dilated cardiomyopathy, normal heart and miscellany. Seventeen patients underwent a cardioverter-defibrillator implantation, two heart transplant, three aneurysmectomy and 10 other types of cardiac surgical proceedings. RESULTS: Patients with a left ventricle ejection fraction (EF)> or =50% presented a cardiac mortality of 5% compared with 38% of those with EF<50%. Etiology of underlying cardiomyopathy with an EF> or =50% was associated with a cardiac mortality of 5% (normal heart), 5% (myocardial infarction) and 9% (miscellany) compared to those with EF<50%: 33% (dilated cardiomyopathy) and 40% (myocardial infarction). Patients who experienced syncope during the first episode of SMVT showed a cardiac mortality of 31% compared to those 14% (P < 0.05) who did not experience. Patients with syncope, myocardial infarction and EF<50% showed a cardiac mortality of 68%. CONCLUSION: The present study shows that survival after the first episode of SMVT is closely related to EF and the existence of syncope. Patients with myocardial infarction and EF<50% had a worse prognosis when the site was the inferior wall.

Aged↗
PubMed1997

[Exercise-induced atrioventricular block. Significance of the ischemic component. Report of 4 new cases].

We report four new cases of exercise-induced atrio-ventricular block (appearing during treadmill exercise testing). The mechanism was ischemia in two patients and the conduction disturbance disappeared after coronary artery bypass grafting. The literature on this matter is reviewed. Also the etiology, the natural history and management are discussed in these cases.

Electrocardiography↗
PubMed1996

[Thrombocytosis and coronary disease. Report of a case].

We report the case of a young male with an inferior myocardial infarction who was treated with fibrinolytic agents and displayed a good evolution. The only cardiovascular risk factor that this patient had was an idiopathic thrombocytosis with abnormal platelet hyperreactivity tests. The angiogram showed an eccentric lesion of 60% in the left main coronary artery. A week later, after treatment based on anticoagulants and antithrombotic agents the angiogram was normal, and the lesion had disappeared. The association between these conditions is discussed the therapeutic approach is also discussed. A review of the literature is conducted.

Adult↗
PubMed1996

[Surgical treatment of partial anomalous pulmonary venous drainage].

OBJECTIVES: We studied all patients operated for partial anomalous pulmonary venous drainage and half-time follow-up. MATERIALS AND METHODS: Twenty-eight patients with a mean age of 5 +/- 5 years (5 patients were less than 1 year old). There were sixteen male and twelve female patients. Thirteen patients were symptomatic (47%). The drainage was to the superior vena cava in thirteen cases, to the inferior vena cava in eight cases, to the right atrium in five cases, mixed (to the superior vena cava and to the inferior vena cava) in one case and to the innominate vein in one patient. The diagnosis was made through echocardiography and catheterization in 25 patients, whereas nuclear magnetic resonance was performed in the last five patients. All cases were corrected through medium thoracotomy, except for the single case in which the drainage was to the innominate vein). In 27 patients, the pulmonary veins were guided to the left atrium through an enlarged present atrial septal defect or through a created atrial septal defect. In one case a direct connection was performed from the veins to the left atrium. After the surgical correction, all patients underwent a color-coded Doppler echocardiography study and a nuclear magnetic resonance study was performed in five patients. RESULTS: Twenty-seven patients survived after surgical correction. The patient with a mixed drainage developed an obstruction of the superior vena cava, the pressure gradient was 9 mmHg. He required a second surgical procedure followed with angioplasty on two occasions during a six month period. Two patients showed an ectopic atrial rhythm at some late time. The patient who died was one month old and had an associated pulmonary parenchymal sequestration. CONCLUSION: Partial anomalous venous connection is a congenital heart disease which has an easy surgical correction. Complications may arise after the surgical correction, among them obstruction of the superior vena cava and arrythmias are most frequently found. Obstruction is present when 50% of the caval area is occupied by the patch. The arrythmias occur following all surgical techniques. In order to decrease the arrythmias it is necessary to perform a good hemosthasis at the site of the patch, to leave the sinus node free of compression and to perform the atrial incision at the posterior wall. The diagnosis and the follow-up can be performed with non-invasive procedures.

Adolescent↗
PubMed1996

[Congenital stenosis of pulmonary veins in the adult].

We report a case of congenital bilateral pulmonary vein stenosis associated with a double-chambered right ventricle, ventricular septal defect and persistence of the ductus arteriosus in a 29 year-old female. The angiographic, echocardiographic and surgical findings are discussed. A precise diagnosis, the utility of the echocardiography and the surgical correction of this type of ostial stenosis is also reported.

Abnormalities, Multiple↗
PubMed1996

[Syncope associated with glossopharyngeal neuralgia and parapharyngeal tumor].

The reflex-induced cardiovascular syncope is rarely associated with facial neuralgia and neck neoplasms. We report the case of a male with vasopressor and cardioinhibitor syncopes, despite the implantation of a pacemaker. Because of a glossopharyngeal neuralgia, a neoplasm of the left parapharyngeal fossae is diagnosed. The pathophysiology and the therapeutic approach is discussed.

Aged↗
PubMed1995

Double-chambered right ventricle.

UNLABELLED: Between May 1974 and December 1993, 37 patients (0.75%) with a double-chambered right ventricle underwent surgical repair. The patients ranged in age from 11 months to 12 years (mean 4 +/- 1.1 years). Cardiac catheterization was performed in 36 patients. The proximal right chamber pressure was 118 +/- 10 mmHg and the mean ventricular gradient pressure was 75 +/- 10 mmHg. A ventricular septal defect was present in 36 cases and fixed subaortic stenosis in eight. Longitudinal right ventriculotomy, group I, was performed in 19 patients (51.3%): 11 had a perimembranous ventricular septal defect and eight an infundibular ventricular septal defect. Combined pulmonary arteriotomy and right atriotomy, group II, was performed in 18 patients (48.7%): 17 patients had a perimembranous ventricular septal defect. The ventricular septal defect was closed using a double velour patch in 26 patients, continuous suture in four and a Gore-Tex patch in six. In the ventriculotomy group one patient died shortly after the operation (following pulmonary complication), and ten patients required inotropic support. Two patients developed patch dehiscence and underwent reoperation. There were no complications in group II patients who underwent right atriotomy. Associated cardiac anomalies were corrected in all patients. Follow-up of 6.5 +/- 3.1 years after operation showed that 36 patients were alive and asymptomatic. CONCLUSION: the transatrial approach with pulmonary arteriotomy is an appropriate and effective double-chambered right ventricle correction even if it is associated with a perimembranous ventricular septal defect.

Child↗
PubMed1995

[Acute right ventricular insufficiency reversible following anthracycline treatment].

Anthracyclines are very effective antineoplastic agents for the treatment of acute leukemia. Early and late dose-related cardiotoxicity can occur. We present a 33 year old women who developed a reversible right heart failure fifteen days after receiving a treatment with doxorubicine. Severe regional wall motion abnormalities were appreciated through two-dimensional and Doppler-flow echocardiography, there was no evidence of impaired systolic or diastolic left ventricle function. Two weeks later, remission of acute right ventricle failure was obtained, echocardiographic assessment was normal at this time. Incidence of right ventricle abnormalities after treatment is discussed.

Acute Disease↗
PubMed1995

[Univentricular heart with left morphology with permeable atrio-ventricular valves. Study of the bulbo-ventricular foramen with color echo-Doppler. Importance for the surgical repair].

INTRODUCTION AND OBJECTIVES: Bidimensional and color-coded Doppler echocardiography were used to study 19 patients with univentricular heart, permeable atrioventricular valves, muscular bulbo-ventricular foramen and an anterior rudimentary chamber. We evaluated the influence of the foramen upon the size of the great vessels, and in consequence the most appropriated surgical techniques. MATERIAL AND METHODS: The foramen was measured in two projections at the end of the systolic period, and its area was calculated, according to the body surface, with the formula S = pi (D1/2 x D2/2). Indexes lower than 2 cm2/m2 were considered as restrictive. We studied 19 patients that presented a mean age of 11 +/- 12 years (range 1 day-39 years). The patients were classified in two groups. Group A: patients who had transposition of the great vessels (13 cases). Group B: patients who had normal connection of the great vessels (6 cases). Each group was classified in two subgroups: subgroup 1, patients who presented a restrictive foramen, and subgroup 2, patients who presented a normal foramen. In this study, we evaluated the associated cardiac anomalies. RESULTS: Group A. Thirteen cases. The index value for the whole group was 2.47 +/- 1.18 cm2/m2. The first subgroup included 6 cases with a restrictive foramen, 2 patients presented pathology of the arch. Four patients had a pressure gradient between the ventricle and the rudimentary chamber beyond 20 mmHg. The index of this subgroup was 1.68 +/- 0.39 cm2/m2, the median was 1.7. Seven cases, with a normal foramen, were included in the second subgroup, six of them had pulmonary valve stenosis, and the other one had undergone a pulmonary artery bandage 2 months before. Only one patient had a gradient pressure at the foramen beyond 20 mmHg. The index for this second subgroup was 3.34 +/- 0.83 cm2/m2. GROUP B: Six patients with normal connection of the great vessels were included. The index was 1.56 +/- 1.17 cm2/m2. The first subgroup included 3 cases with a restrictive foramen. The index was 0.72 +/- 0.29 cm2/m2 (range 0.41-1) and the median was 0.75. Pressure gradient between the ventricle and the rudimentary chamber was greater than 20 mmHg. Three patients with a normal foramen were in the second subgroup and here, the index was under normal limits 2.4 +/- 0.52 cm2/m2 (range 2.1-3), the median was 2.1. One patient underwent a pulmonary artery bandage two months before. CONCLUSIONS: Bulbo-ventricular foramen size/body surface index may exert an influence on the size of the vessel connected to the rudimentary chamber. The index vary in a negative way with the evolution time, or in those cases with transposition of the great vessels after a pulmonary artery bandage. Whenever the foramen is restrictive, the pulmonary artery or the aorta have a smaller diameter and the pressure gradient between the ventricle and the rudimentary chamber rises.

Adolescent↗
PubMed1995

Intermittent aortic regurgitation following aortic valve replacement.

Intermittent aortic regurgitation is an unusual complication following a mechanical prosthesis replacement in the early postoperative period. Arterial pressure recording and echocardiographic assessment were enough to diagnose the prosthetic dysfunction. Reexploration of the valve confirmed the dysfunction, which was caused by a pannus of previous aortic valve replacement with the pulmonary valve. The pannus impeded normal closure of the leaflet in an intermittent way during diastole. Reorientation of the valve corrected the aortic insufficiency. Doppler ultrasound was a very useful noninvasive technique in order to evaluate the suspected prosthetic valve dysfunction in the immediate postoperative period.

Adult↗
PubMed1994

[Angioplasty of the stenotic Blalock-Taussig].

BACKGROUND: Balloon angioplasty is a useful therapeutic method in some congenital heart diseases. We show our experience of stenotic Blalock-Taussig angioplasty, which was effective in six cases. PATIENTS AND METHODS: Six symptomatic patients with different congenital heart diseases, reduced pulmonary blood flow and a previous Blalock-Taussig shunt (it was classic in three patients and modified in another three) underwent the procedure. Conventional angioplasty was performed in four cases and coronary angioplasty technique, under monorail system, was applied in the other two. RESULTS: After angioplasty, we observed an increase in the minimum luminal diameter from 1 +/- 0.7 to 4 +/- 0.5 mm (p < 0.01), a reduction in the percentage of the stenosis from 77 +/- 15 to 13 +/- 13 (p < 0.01) and an increase in oxygen saturation from 63 +/- 10% to 82 +/- 5% (p < 0.05). The effectiveness of the technique in an extreme case of a thrombosed Blalock-Taussig, hours later the surgery, is reported. In the follow-up, we observed a symptomatic improvement, stable oxygenation levels, and a tendency in the hematocrit reduction. CONCLUSION: We consider that angioplasty of Blalock-Taussig shunt is indicated in those symptomatic patients, in whom a complete surgical correction is contraindicated. We demonstrate the effectiveness of the procedure, the coronary angioplasty, under monorail system is very useful for the stenotic modified Blalock-Taussig. It can be an effective technique when there is a postoperative thrombosis of the fistula.

Anastomosis, Surgical↗
PubMed1994

[Ventricular hernia: a case report and review of the literature].

We report a case of one young patient with symptoms of palpitations and ventricular and supraventricular arrhythmias documented in the 24-hours Holter record. He had a deformity of silhouette and pericardial calcification in the chest roentgenogram. In the computed tomography and the magnetic resonance employed in the evaluation of structural anomalies, dates compatible with ventricular herniation, across one parcel of pathologically calcified pericardium, were present. The probable etiology, operatory findings and the management of those patients are discussed.

Adult↗
PubMed1994

[The efficacy of verapamil in sustained monomorphic ventricular tachycardia].

We present a 36-year-old male without overt cardiac disease who suffered, since he was 15 years old, from sustained monomorphic ventricular tachycardia of left bundle branch block with a right axis, lasting for several hours; sometimes, syncope was a clinical form of manifestation. Electrophysiologic study, twenty-four hours Holter recording, cardiac catheterization and blood analysis were not useful in order to find its etiology. Efficacy of different drugs, like Mexiletil, Amiodarone, Atenolol and Verapamil (at a dose of 240 mg/day) were tested through multistaged graded-treadmill stress-testing using the Bruce protocol. Ventricular tachycardia was suppressed by administration of Lidocaine. Oral verapamil given at a dose of 360 mg/day prevented the induction of the arrhythmia, the efficacy was tested with maximal treadmill exercise and twenty-four hours Holter recording.

Adult↗
PubMed1994

[Propafenone efficacy in preventing supraventricular tachycardia in childhood].

OBJECTIVES: In order to study the efficiency of oral dose of propafenone in preventing childhood supraventricular tachycardias, we have treated 38 children without left ventricular dysfunction. METHODS: The mean age has been 8 +/- 4.7 years old. All of them had suffered at least two episodes of supraventricular tachycardia, and eleven had undergone a previous antiarrhythmic treatment. The initial dose of propafenone has been 6.5 +/- 2.1 mg/kg/24 h (in 3 doses), which has been increased in case of inefficacy. RESULTS: We have not advised neither side-effects, nor proarrhythmic effects, during a follow-up of 13 +/- 6 months. Propafenone has been efficient in preventing supraventricular tachycardias in all patients. The initial dose has been efficient in 17 patients, and we have increased the initial dose up to 11.1 +/- 3.7 mg/kg/24 h in 21 patients. The mean effective dose has been 8.9 +/- 3.6 mg/kg/24 h. We stopped treatment in 14 patients after been 6 months without supraventricular tachycardias. CONCLUSION: From our study, we conclude that propafenone has been efficient in preventing supraventricular tachycardias in childhood with a dose of 8.9 mg/kg/24 h. We have not found side-effects.

Administration, Oral↗