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Biomedical subjects

L Stoica

Publications and source records attributed to L Stoica.

17 recordsLinked to original sources
PubMed2005

Blood warm reperfusion: a necessary adjunct to heart-valve surgery in low-risk patients?

AIM: The aim of this prospective, randomized study was to determine whether blood warm reperfusion improves myocardial protection provided by cold crystalloid cardioplegia in patients undergoing first-time elective heart-valve surgery, using cardiac troponin I release as the criterion for evaluating the adequacy of myocardial protection. METHODS: Seventy patients with a left ventricular ejection fraction greater than 40% were randomly assigned to 1 of 2 myocardial protection strategies: 1) cold crystalloid cardioplegia with no reperfusion or 2) cold crystalloid cardioplegia followed by 2-minute blood warm reperfusion before aortic unclamping. Cardiac troponin I concentrations were measured in serial venous blood samples drawn immediately prior to cardiopulmonary bypass and after aortic unclamping at 6, 9, 12, and 24 h. RESULTS: Randomization produced 2 equivalent groups. The total amount of cardiac troponin I released (7.17+/- 14.8 mg in the crystalloid cardioplegia with no reperfusion group and 5.82+/-4.66 mg in the crystalloid cardioplegia followed by blood warm reperfusion group) was not different (P > 0.2). Cardiac troponin I concentration did not differ for any sample in either of the 2 groups. The total amount of cardiac troponin I released was higher in patients who required inotropic support (9.14 +/-16.2 mg) than those who did not (4.73+/-4.52 mg; P = 0.009). CONCLUSIONS: Our study shows that adding blood warm reperfusion to cold crystalloid cardioplegia provides no additional myocardial protection in low-risk patients undergoing heart-valve surgery.

Aged↗
PubMedDate not supplied

Endovascular treatment of the traumatic rupture of the aortic isthmus.

The traumatic rupture of the aortic isthmus is a dehiscence of all or part of the aortic wall, occurring as a result of a closed thoracic trauma. Standard surgical technique requires left thoracotomy, aortic cross-clamping and use of the cardiopulmonary by-pass to prevent ischemic complications, in special the neurologic and visceral ones. The endovascular treatment of these lesions is a more simple solution and there are recent reports on the stent-grafting of the isthmic rupture of the thoracic aorta. We report three cases of successful endovascular repair of the aortic isthmic rupture and we discuss the emergency indications, the advantages and the limits of this technique.

Accidents, Traffic↗
PubMedDate not supplied

[Surgical treatment of pulmonary atresia with ventricular septal defect].

Pulmonary atresia with ventricular septal defect (PAVSD) is a complex cardiopathy represented by a complete obstruction between the right ventricle outflow and the pulmonary trunk associated with a ventricular septal defect (VSD) and major aortopulmonary collaterals (MAPCA). The goal of the unifocalization in the PAVSD is to prepare the pulmonary tree for the complete repair by connecting the MAPCAs to the central pulmonary arteries that should be enlarged. After that we can made the VSD or other intracardiac repair. This is a retrospective study on 31 patients. We report our results discussing the PAVSD classification and the strategy of the complete repair in comparison with other reported results.

Adolescent↗
PubMedDate not supplied

["Mammary loop" technique--new method of multiple coronary revascularization using internal mammary arteries].

The internal mammary arteries are "the gold standard" conduits for coronary by-pass because their' s patency is superior to the saphenous graft. There are some surgical techniques which allow to use the entire length of the mammary arteries: the Y graft, the T graft and the pi graft. We describe recently the "mammary loop" technique that allows to make a Y graft using only one internal mammary artery. This technique also simplifies the construction of a pi graft. In this article we present the variants of this technique and discuss the indications and our early experience results.

Coronary Artery Bypass↗
PubMedDate not supplied

Histoenzymological and ultrastructural changes of axillary lymph nodes with breast cancer metastases.

Histoenzymatic and ultrastructural changes were studied in axillary lymph nodes from patients with breast cancer by comparison between lymph nodes without metastases, with incipient metastases and completely metastatically transformed. Metastases is preceded by intense macrophagic reactions of lymph nodes, and prepared by the development of vascular stroma. Neoplastic cells in course of invasion presented an intense respiratory activity, while those replacing the lymphoid elements an accentuated synthesis of glycoproteins.

Acid Phosphatase↗
PubMedDate not supplied

Ultrastructural aspects in skin allergic vasculitis.

Twelve cases of skin allergic vasculitis were electronmicroscopically studied. The most striking changes were noticed at the level of capillaries, whose wall components were all affected, especially the endothelial cells. These presented at first adaptive changes, with swelling, microvillosities of plasmalemma protruding into the lumen, and many pinocytotic vesicles showing an intensely active transport. Followed different degrees of degenerative changes of cytoplasms and nuclei, the junctional complexes being interrupted, even discontinuous. The pericytes showed similar changes. The basement membrane was thickened, nonhomogeneous, with a spongy aspect, small discontinuities and some electron-dense depots. The endothelial cell damage and the discontinuity of basement membranes, as well as the alteration of pericytes allowed the migration of blood cells into interstitial spaces, followed by leucocytoclasia. As a consequence, in the perivascular tissue a polymorphous cellular infiltrate developed. The mechanisms and significance of these changes are discussed.

Capillaries↗
PubMedDate not supplied

Liver ultrastructural changes following portal circulation disturbances.

Liver cell changes produced in rats by the ligature of the portal vein and of the spleen pedicle were studied by electron microscopy. There were differences in the liver response to the various types of circulatory disturbances. The earliest and most marked lesions of hepatic cells were noticed in the case of portal vein ligature, and occurred at the level of rough endoplasmic reticulum, mitochondria and lysosomes. No significant changes in Kupffer cells. When the spleen pedicle was ligated, the hepatic cell changes were less obvious, but the Kupffer cells changes were more prominent, testifying and increased hetero- and autophagy.

Animals↗