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M Musci

Publications and source records attributed to M Musci.

27 records · Page 2Linked to original sources
PubMed1998

Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation.

OBJECTIVES: This prospective study examined types, frequency and time dependency of the electrophysiologic manifestation of the sinus node dysfunction after the Cox-maze III procedure--the technique of choice for the management of medically refractory atrial fibrillation-in patients with organic heart disease, chronic fixed atrial fibrillation and no preoperatively overt dysfunction of the sinus node. BACKGROUND: The original maze procedure was modified twice in order to reduce the high incidence of the sinus node inability to generate an appropriate sinus tachycardia in response to maximal exercise, and occasional left atrial dysfunction. Despite these modifications, postoperative disturbance of sinus node function can be frequently observed. METHODS: In 15 adult patients, standard electrocardiogram, 24-h Holter monitoring, power spectral analysis of heart variability, exercise testing, Valsalva maneuver and rapid positional changes were performed 3, 6 and 12 months after the Cox-maze III procedure and mitral valve surgery or closure of atrial septal defect. RESULTS: Electrocardiographic manifestations of sinus node dysfunction were identified in 12 patients at 3 months, in 6 patients at 6 months, and in 0 patients at 12 months after surgery. The heart rate response to exercise during the first 6 months was reduced in the maze group and became fully normal at 12 months. Power spectral analysis of heart rate variability showed very low power values at 1 month with inhibited cardiac autonomic activity and no response on sympathetic stress. A potential of recovery of cardiac autonomic activity was documented 12 months after surgery. CONCLUSIONS: The manifestations of sinus node dysfunction following the Cox-maze III procedure were time dependent and their frequency and intensity progressively decreased and disappeared within 12 months after surgery.

Aged↗
PubMed1998

Coronary angioplasty, bypass surgery, and retransplantation in cardiac transplant patients with graft coronary disease.

BACKGROUND: Graft coronary disease (GCD) remains the single greatest limitation to long-term survival of heart transplant recipients. Therapeutic strategies for the prevention or retardation of GCD in the cardiac allograft are limited; palliative coronary revascularization has been attempted. Because of the high mortality rate associated with advanced forms of GCD our institution offers the option of retransplantation in selected cases. The aim of this study was by analyzing retrospectively the outcomes of angioplasty, coronary bypass grafting, and retransplantation in cardiac transplant patients to attempt to identify subgroups of transplant recipients with graft coronary disease who may profit from myocardial revascularization. METHODS: Of the 989 patients undergoing 1016 heart transplantations (HTx) at our institution between 10/86 and 12/97, all were screened for the development of GCD. Analyzing routinely annual angiography, intracoronary ultrasound in defined study patients, and autopsy findings, GCD was diagnosed in 124 patients (110 male, 14 female) 2 to 107 months after HTx (mean 30 months). RESULTS: PTCA: Fourty-six out of 124 patients underwent 76 angioplasties at a mean of 50 +/- 30 months (range 4-91 mo) following cardiac transplantation. The primary success rate was 96% (73/76). The reason for the unsuccessful angioplasty attempts (n = 3) was failure to completely penetrate a stenosis of LAD in 2 patients and severe dissection of RCA, which required emergency surgery, in one. Angiographic restenosis occurred in 42% (31 of 76 lesions) and was diagnosed 11 +/- 11 months after the first angioplasty. There was no procedure-related death. CABG: Seven patients underwent bypass surgery at a mean of 67 months (range 6-128 months) after HTx. Elective surgery was performed in 2 patients with proximal severe triple-vessel disease (Type A lesion) and in 1 patient with severe tricuspid regurgitation who received a tricuspid valve replacement and concomitant single-vessel bypass surgery for proximal GCD (Type A lesion). One patient with combined Type A and B/C lesions required emergency surgery for dissection of RCA after an angioplasty procedure. Three patients with post-infarction unstable angina developed worsening congestive heart failure which required emergency surgery. Angiographically all these patients showed diffuse, distal arteriopathy (combined Type B/C lesions). The electively operated patients and the patient with dissection of RCA were successfully treated and survived beyond hospital discharge (overall survival for CABG in GCD patients 4/7 = 57%). After a mean follow-up of 10 months (range 2-32 months) all are in good clinical condition. All 3 patients with distal arteriopathy and emergency surgery died in hospital of left-ventricular failure (43%). Retransplantation: Eight patients underwent retransplantation at a mean of 54 months (range 6-96 months) after HTx. Six of 8 patients had successful operations and survived beyond hospital discharge with a one-year-survival rate of 75%. In a mean follow-up of 31 months (5-68 months) 3 of 6 retransplant recipients developed a recurrence of GCD. CONCLUSION: The presence of angiographic distal arteriopathy should be considered a significant factor in patient selection for coronary revascularization procedure. Coronary angioplasty is to be considered as a method of treatment for severe, local stenoses (Type A lesion). PTCA may be applied in these selected cardiac transplant recipients with primary success and complication rates comparable to routine angioplasty but with an increased rate of restenosis especially in small vessels (diameter < 2.5 mm). The distinction between Type A lesions in large (diameter > or = 2.5 mm) and small vessels may be important not only with respect to restenosis but also with respect to long-term benefit. The overall survival did not differ between GCD patients with and without PTCA, suggesting this treatment to be largely palliative. (ABSTR

Angioplasty, Balloon, Coronary↗
PubMed1997

[Surgical therapy of chronic atrial fibrillation with the "Cox/Maze-III-operation"].

UNLABELLED: We examined the results of simultaneous surgical treatment of chronic atrial fibrillation using a Cox/Maze III operation during mitral valve surgery (n = 12), atrial secundum defect closure (n = 1), combined operation (mitral valve and atrial secundum; n = 1) and thrombectomy from the left atrium (n = 1). Mean preoperative atrial fibrillation was 5.1 years (range 0.5-12 years). In the mean follow-up period of 13.1 months (1-24 months), 14 patients (93%) had sinus rhythm. CONCLUSION: (1) The surgical treatment of chronic atrial fibrillation using a Cox/Maze III operation can be performed without increased perioperative or postoperative risks; (2) Cox/Maze III operation represents an effective surgical treatment of chronic atrial fibrillation.

Aged↗
PubMed1996

Applications of liquid chromatography-mass spectrometry interfacing systems in food analysis: pesticide, drug and toxic substance residues.

This paper reviews applications of different LC-MS techniques for the determination of xenobiotic substances in foods. Specific examples of contaminants discussed are pesticides, herbicides, insecticides and drugs; concerning toxic substances, mycotoxins, phycotoxins, cyanobacterial toxins, mutagenic and heterocyclic amines and beta-carbolines, arsenic, tin and inorganic halogen compounds, packaging materials and various epoxy resins are considered. Advantages and limitations are outlined for the different LC-MS interfacing systems (particle beam, thermospray, atmospheric pressure ionization with electrospray, ionspray and heated pneumatic nebulizer). The impact of developments in instrumental analysis on methodology and the limitations of the various LC-MS methods are discussed. Further, the coupling of LC with element-selective detection systems such as inductively coupled plasma mass spectrometry is discussed, with emphasis on speciation of trace toxic elements in foods.

Chromatography, Liquid↗
PubMedDate not supplied

On-line purge-and-trap-gas chromatography with flame ionization detection as an alternative analytical method for dimethyl sulphide trace release from marine algae.

The release of dimethyl sulphide (DMS) by the seaweed Ulva spp at trace level was studied in aqueous solutions at different salinities, temperature and light intensities. For this purpose, the purge-and-trap technique combined with gas chromatography-flame ionization detection was used. The analytical method was evaluated in terms of linearity range, limit of detection, precision and accuracy by considering 10@1000 (w/v) and 30@1000 (w/v) synthetic seawater as aqueous matrices. Calculation of the recovery function evidenced a matrix influence. The method of standard addition was then used for an accurate determination of DMS in synthetic seawater reproducing the matrix effect. DMS fluxes were analysed in batch cultures of Ulva spp reproducing the conditions which usually occur in the Sacca di Goro lagoon (Northern Adriatic Sea, Italy).

Chlorophyta↗