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Biomedical subjects

M Cotrufo

Publications and source records attributed to M Cotrufo.

At least 127 records · Page 7Linked to original sources
PubMed1984

Acute thrombosis of Sorin tilting disc mitral prostheses.

We observed four cases of prosthetic thrombosis in 77 patients who had had a tilting disc valve (Sorin model) inserted in the mitral position. In all cases, the clinical findings on admission consisted of congestive heart failure, absence of prosthetic closing click and mitral regurgitation murmur. M-mode and cross-sectional echocardiography were invariably diagnostic. Surgery was performed without delay and consisted of thrombectomy in one case and valve replacement with porcine xenograft in three. Examination of the explanted prostheses disclosed fibrous tissue overgrowth surrounding the valvular ring, as well as thrombotic vegetations on the ventricular and atrial sides. The disc appeared blocked in a semiopening position at an angle of 45 degrees. Our experience suggests that the thrombosis is secondary to disc malfunction itself produced by periannular tissue growth. It is related to the porosity of the fabric which surrounds the metal ring, the valve design and its orientation. Correct anticoagulation therapy, performed in all cases, had no significant effect on tissue overgrowth. The high postoperative mortality rate depended on the severity of the preoperative clinical condition of the patients.

Acute Disease↗
PubMed1984

Bacterial endocarditis of the aortic valve associated with diaphragmatic sub-aortic stenosis--account of two operated cases.

We report two cases of subvalvular aortic stenosis associated with a postendocarditic aortic valvular insufficiency. Although the aortic valvular disease had been diagnosed preoperatively, only the direct intraoperative observation and the histological examination of the removed valve revealed evidence of the endocarditis. Because of the seriously altered condition of the valvular tissue, treatment in both cases consisted of implantation of a mechanical prosthesis. Follow-up revealed no evidence of septic relapse.

Aortic Valve↗
PubMed1984

Echocardiographic assessment of the subaortic root after implantation of high or low profile mitral prostheses.

In order to evaluate the influence of the profile of mitral prostheses on the outflow tract of the left ventricle, 99 patients underwent M-Mode echocardiography before and after surgery. In 67 cases high profile mitral prostheses had been implanted (48 mechanical and 19 biological); in 32 cases low profile mitral prostheses had been implanted (22 mechanical, 10 biological). Echocardiography showed that the implantation of high profile mitral prostheses did not induce changes of left ventricular diastolic and systolic dimensions ( EDDLV and ESDLV ) while induced significant reduction of left ventricular outflow tract (LVOT) dimension and LVOT/ EDDLV index with subsequent changes in transaortic flow. On the other hand, low profile prostheses did not induce significant changes of left ventricular dimensions, LVOT and LVOT/ EDDLV index. Finally, low profile biological mitral valve prostheses ( Liotta type) induced a significant increase of post-operative dimension of LVOT and LVOT/ EDDLV index. Authors conclude: that the implantation of high profile mitral prostheses changes LVOT dimension and transaortic flow and, that M-Mode echocardiography is a reliable technique to point out these changes.

Adult↗
PubMed1984

Ascending aorta to femoral arteries by-pass: a safe surgical technique of lower limb revascularization in high risk patients undergoing coronary artery by-pass.

The coexistence of a coronary artery obstructive disease (CAOD) with aorto-iliac obstructive disease (AIOD) often represents a surgical problem. Because of left main coronary disease (LMCOD) the contemporary correction of AIOD should be performed with a simple non traumatic procedure. The case of a high risk patient in whom aortoiliac obstructive disease has been corrected with the implantation of a bifurcated vascular prosthesis from the ascending aorta to the bilateral common femoral arteries, and with a double aorto-coronary by-pass, is reported.

Aged↗
PubMed1983

Ostium secundum atrial septal defect: is it a minor cardiac lesion?

One-hundred-ten cases of ostium secundum atrial septal defect, surgically treated from 1975 to 1980, are reported. The early postoperative deaths were two (1.81%), both due to acute left ventricular failure. In the postoperative complications, along with arrhythmia, is left ventricular failure markedly represented (4 cases). These observations can be suggestive of a major role of left ventricular function in the natural course of atrial septal defect and its treatment, and could emphasize the importance of preoperative left ventricular study, effective intraoperative myocardial protection, and early operation (age two years), in order to prevent left ventricular involvement and failure.

Adolescent↗
PubMed1983

A plea for combined cardiac and non-cardiac surgery.

The authors experience with combined cardiac and non-cardiac surgery is reported. Fourty-seven patients underwent contemporary surgical treatment for a cardiac disease and an associated non-cardiac lesion, usually represented by a cholelithiasis, or hernial defects. Two deaths were observed with 4.25% mortality rates. Specific advantages of contemporary cardiac and non cardiac surgery are recorded.

Adult↗
PubMed1981

[Surgical treatment of biliary lithiasis associated with acquired valvulopathy].

Personal experience in the treatment of acquired valvulopathies and biliary calculosis in one operating stage is reported. After examination the risk factors determining onset of bile calculosis in valvulopathic patients, the surgical techniques adopted and the special advantages obtained by associating the two operations at the same session are illustrated.

Adult↗
PubMed1980

Prosthetic creation of a double outlet left ventricle: clinical experience of five cases.

Five clinical cases were treated with the implantation of an apical-aortic conduit. Two adult patients were affected by obstructive myocardiopathy associated to subaortic membrane in one case, and three children by different forms of aortic stenosis (subaortic tunnel in one case; subaortic tunnel associated to severe coartation of the thoracic aorta in one case; aortic annulus hypoplasia in one case). A double outlet left ventricle has been created in all cases by implanting a composite prosthesis between the apex by implanting a composite prosthesis between the apex of the left ventricle and the aorta. The extracardiac conduit consisted of an apical curved connector and a valved dacron tubular prosthesis. The site of implantation was the supraceliac abdominal aorta in three cases and the ascending aorta in two cases. All patients survived the operation and one late mortality was observed for cerebral bleeding. The surviving patients have been restudied with satisfactory data.

Adult↗
PubMed1980

[The preoperative evaluation of factors influencing low output syndrome in cardiac surgery (author's transl)].

For a preoperative evaluation of the factors influencing low output syndrome significatively in open heart surgery where statistically studied 15 factors upon a pattern of 400 patients operated with extracorporeal circulation: age, sex, weight; functional class; cyanosis; pulmonary hypertension; cardiopathy; arterial blood hypertension; myocardiopathy; left ventricular end-diastolic pressure; cardiac index; cardiothoracic index; aortic clamp duration; reoperation; extracorporeal circulation technique. Significant risk factors are: myocardiopathy; aortic clamp duration; functional class; pulmonary hypertension; reoperation; cardiac index; cardiothoracic index and arterial blood hypertension. These factors increase the studied pattern mean risk respectively of a 17.6%; 27.8%; 17.5%; 14.5%; 13.7%; 10.7%; 8.8% and 8.7%. Also myocardial protection technique was considered to be a significant risk factor, since mean risk for low output syndrome is much higher for these patients operated with the coronary perfusion, normothermy and simple hypothermy than for those operated with hypothermia and pharmacologic cardioplegia.

Adolescent↗