[Evaluation of the therapeutic action of D-L carnitine in acute myocardial infarct (AMI) by changes in the serum myoglobin concentration curve. II. Concluding remarks].
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Acute Disease↗
Biomedical subjects
L Paloscia
Publications and source records attributed to L Paloscia.
[Myocardial revascularization with the internal mammary artery. The indications, technics and results].
This report reviews 218 patients who underwent internal mammary artery (IMA) grafting alone or with vein graft between 1986-1989. Our experience with IMA started with a single attached graft for proximal left anterior descending lesions in young patients affected from stable angina. After that our indications became more extensive. One IMA was utilized in 209 cases, both two IMAs in the remaining 9. Sequential IMA graft was performed in 16 patients and free IMA graft in 8. There were 242 IMA anastomosis and 295 associated vein by-passes. The overall operative mortality was 2.3%. Perioperative complications include myocardial infarction in 3 (1.4%), reoperation for bleeding in 4 (1.8%) and sternal wound complication in 4 (1.8%). These results are comparable to those of patients having only saphenous vein by-pass during the same period. At the follow-up actuarial survival rate at 42 months was 94 1.8% and 90% of these patients were completely asymptomatic. We include that IMA grafting shows low operative risk and provide excellent short term results. Our findings and the high long term patency rate of this conduit encourage us to extend the indication to IMA and to perform those surgical techniques that make possible multiple mammary coronary anastomosis.
Angina Pectoris↗
Extracoronary atherosclerosis in patients with ischemic heart disease. Evaluation by continuous wave Doppler 123.
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Adult↗
Valve replacement with the tilting disc Sorin prosthesis in patients with narrow aortic annulus.
The Authors summarize their 5-year experience of the clinical use of the Sorin tilting disc prosthesis in 40 patients (group A) with narrow aortic annulus, compared with a control group (group B: 116 patients) where a larger Sorin prosthesis was implanted. Follow-up lasted from 1 to 60 months, with a mean of 25.6 +/- 12.3 in group A and 20.4 +/- 11.9 in group B. Early and late mortality were low: 1/40 and 2/39 (2.5 and 5.1%) in group A and 4/116 and 9/112 (3.4 and 8.0%) in group B (p = NS): only two deaths, one in each group, were prosthesis-related. Actuarial survival was comparable: 91.2% (CL: 96.3-86.1%) in group A and 78.0% (CL: 87.6-68.4%) in group B, as were probability of being event-free and alive, non-reoperated and with few or no symptoms [group A: 61.7% (CL: 72.4-51.0%) and 77.4% (CL: 85.9-68.9%) respectively; group B: 78.8% (CL: 83.4-74.2%) and 61.1% (CL: 85.9-68.9%) respectively]. The Authors conclude that the Sorin tilting disc prosthesis is a reliable valve substitute in the narrow aortic annulus; they recommend that enlargement procedures should be confined only to patients with annulus size less than 19 mm.
Actuarial Analysis↗