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Orazio Ferro

Publications and source records attributed to Orazio Ferro.

7 recordsLinked to original sources
PubMed2006

Effects of papaverine and glycerylnitrate-verapamil solution as topical and intraluminal vasodilators for internal thoracic artery.

BACKGROUND: Arterial spasm is described as an event occurring after left internal thoracic artery (LITA) harvesting. Many vasodilators have been used to treat or prevent LITA spasm. The aim of this study is to compare the effects between glyceril-trinitrate/verapamil (GV) solution and papaverine to treat LITA spasm and to determine the best delivery method. METHODS: One hundred consecutive ischemic patients were randomly assigned to three groups: group GV (n = 34, GV solution), group P (n = 33, papaverine), or group C (n = 33, normal saline). In each patient, pedicled LITA was harvested, thereafter sprayed with the randomized solution, and covered with a sponge. Fifteen minutes after heparin administration, LITA was distally divided; flow per minute was calculated after measuring the free flow for over 15 seconds; this is named "topical free flow." Then, the vasodilator was injected intraluminally and free flow per minute was measured; this is called "intraluminal free flow." RESULTS: Analysis of variance was applied to detect differences among groups; paired-sample t test was used for LITA topical free flow versus intraluminal free flow within single groups. Mean LITA free flows were as follows: group GV, topical free flow = 38.6 +/- 25.2 mL/min versus intraluminal free flow = 58.8 +/- 29 mL/min (p < 0.0001); group P, topical free flow = 45.4 +/- 38.9 mL/min versus intraluminal free flow mL/min (p < 0.0001); group C, topical free flow = 31.6 +/- 19.9 mL/min versus intraluminal free flow = 34 +/- 19.8 mL/min (p = 0.14). Topical free flow difference among the three groups was not statistically significant (p = 0.1); intraluminal free flow difference was statistically significant (p = 0.001). Intraluminal free flow in group GV and in group P were higher than intraluminal free flow in group C (p = 0.004 and 0.001, respectively). Intraluminal free flow of group P was higher than that of group GV; this difference did not reach statistical significance (p = 1.00). CONCLUSIONS: Glyceril-trinitrate/verapamil solution and papaverine are able to treat the spasm and increase the flow of the LITA, when they are used intraluminally. When used topically, these vasodilator agents do not ensure an optimal free flow.

Administration, Topical↗
PubMed2005

Functional predictors of exertional dyspnea, 6-min walking distance and HRCT fibrosis score in idiopathic pulmonary fibrosis.

BACKGROUND: Exertional dyspnea and exercise incapacity are the most prominent and disabling symptoms and the main contributors to health-related quality of life in patients with idiopathic pulmonary fibrosis (IPF). OBJECTIVES: There are no comprehensive studies on pulmonary function tests (PFTs), dyspnea, exercise capacity and radiographic scores in IPF. We therefore sought to investigate the functional variables that can predict dyspnea, exercise capacity and disease extent in IPF. METHODS: Thirty-four patients with IPF according to the ATS/ERS criteria underwent PFTs, Medical Research Council (MRC) dyspnea scoring, 6-min walking distance (6-MWD) and radiographic evaluation of fibrosis (HRCT score). RESULTS: The 6-MWD (% pred.) was more impaired than PFTs. Residual volume (RV) showed the best correlation with the extent of fibrosis (r = -0.67, p = 0.0001) and, together with the alveolar-arterial gradient for O(2) [DeltaP(A - a)O(2)], was an independent predictor of disease extent (R(2) = 0.44). PFTs showed significant though weak correlations with MRC score and 6-MWD. According to the regression analysis, DL(CO) and the HRCT fibrosis score were independent predictors of dyspnea, though they explained only 28% of the overall variance. FEV(1) and DeltaP(A - a)O(2) were independent predictors of 6-MWD (R(2) = 0.31). CONCLUSIONS: PFTs and lung volumes in particular are closely related to the HRCT score, a measure of the extent of IPF. The correlation of dyspnea score and 6-MWD to PFTs is limited, due to the complexity of mechanisms leading to exercise limitation in IPF. Therefore dyspnea and exercise performance are largely independent indices and should be followed together with PFTs and HRCT score in order to better assess the status and progress of IPF patients.

Aged↗
PubMed2005

Bullous emphysema versus diffuse emphysema: a functional and radiologic comparison.

The contribution of bullous emphysema (BE) to the functional impairment of patients with concomitant diffuse emphysema (DE) and the confounding effects of BE on functional measurements were investigated. Twenty-nine patients (Group I), with BE and DE were compared with a group of patients without BE matched, among other criteria, for radiographic extent of DE (Group II). Group I showed significantly lower PaO2, FEV1 and DLCO values and higher MRC score than Group II. In Group I the radiographic extent of BE and the extent of DE did not predict the functional impairment. The FEV1/FVC ratio in the subgroup with BE extent > 25% of total lung volume was higher than in subgroups with BE extent > 20% and 15%, respectively. In the same subgroups the correlation between DE and DLCO increased with the extent of BE. We conclude that BE contributes to the functional impairment of patients with concomitant DE. The confounding functional effect of bullae depends on BE extent: relatively milder obstruction can be observed with severe BE, whereas moderate BE causes modest deterioration of diffusing capacity, explaining the lack of functional-radiologic correlations in Group I. Therefore the computed tomographic scan is very useful in the work-up of BE with DE associated.

Aged↗
PubMed2005

The early outcome in patients undergoing off-pump coronary artery bypass grafting: our experience.

BACKGROUND: Many studies confirm that beating heart surgery is an alternative to on-pump myocardial revascularization. However, the clinical conditions of patients are currently considered as a major landmark in the indication for beating heart surgery. This retrospective non-randomized study was carried out to evaluate the efficacy and the advantages of this surgical technique when anatomical criteria are used to choose the surgical strategy. METHODS: From February to December 2003, 222 consecutive patients underwent isolated myocardial revascularization: 76 (34%) with an off-pump coronary artery bypass (OPCAB) and 146 (66%) with an on-pump coronary artery bypass (ONCAB) procedure. Selection for surgical treatment was based on coronary anatomy. All patients were stratified for mortality risk class according to the EuroSCORE system. Operative and postoperative data were analyzed. RESULTS: Morbidity and mortality did not differ significantly between the two groups but the release of creatine kinase-MB fraction was significantly higher in the ONCAB group (48.7 +/- 55.3 vs 20.8 +/- 16.6 U/ml, p < 0.001). Patients at high surgical risk were dealt with a more complicated clinical outcome; logistic regression analysis showed that this class was an independent risk factor for postoperative complications in both groups. CONCLUSIONS: We did not find any statistical difference in hospital mortality and morbidity either using ONCAB or OPCAB; however a lower release of creatine kinase-MB in beating heart revascularization group suggests that OPCAB reduces myocardial injury and preserves cardiac function when anatomical criteria are considered for patient selection.

Aged↗
PubMed2004

Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery.

OBJECTIVE: In order to reduce remote cardiac events associated with graft occlusions, arterial conduits are being increasingly utilized in coronary artery bypass grafting (CABG). While the internal thoracic artery (ITA) is the graft of choice for CABG, it is sometimes difficult or impossible to obtain a complete arterial revascularization only with ITAs in three-vessel diseases. We present our experience with total arterial myocardial revascularization with bilateral internal thoracic artery (BITA) and right gastroepiploic artery (rGEA). METHODS: From April 1994 to January 2004, 174 patients (165 male, mean age 55.9+/-7.4) underwent coronary artery bypass procedure with exclusive use of BITA and rGEA. Left ventricular ejection fraction ranged from 20 to 68% (mean 55.9+/-6.8%). Seven patients (4%) had poor ejection fraction (<0.30), 23 (13, 2%) had acute myocardial infarction, 14 (8%) had left main disease. The mean CPB time was 96.9+/-15.7 min and the mean cross clamping time was 70+/-14.2 min. The mean number of distal anastomoses was 3.3+/-0.5 per patient. RESULTS: Early mortality was 1.7%. The patients were followed for up to 9 years (mean follow-up time 6.3+/-2.6 years). Actuarial freedom from cardiac death (including hospital death) was 97.6%, at 9 years after the operation. Actuarial freedom from angina and cardiac events at 9 years was 79, 5% and 77, 6%, respectively. No perioperative myocardial infarction occurred. None of the patients needed a redo-CABG after leaving the hospital. CONCLUSIONS: This study indicates that the myocardial revascularization in young patients with three-vessel disease using exclusively pedicle BITA and rGEA provides excellent 9-year patient survival and improvement in terms of freedom from return of angina pectoris and freedom from any cardiac-related event. These results encourage the more extensive use of BITA and rGEA in selected patients with three-vessel coronary disease.

Angina Pectoris↗
PubMedDate not supplied

Right gastroepiploic artery graft: long-term clinical follow-up in 271 patients--experience of a single center.

BACKGROUND AND AIM: We present our experience in the use of right gastroepiploic artery (rGEA). Long-term clinical results are reported. METHODS: From April 1994 to June 2005, 271 patients (257 males, mean age 56.2 +/- 7.1) underwent coronary artery bypass grafting with the use of rGEA. Preoperative, perioperative, and postoperative data were retrospectively collected and clinical results and survival were examined. The end points of follow-up were death and recurrence of cardiac events such as angina and myocardial infarction (MI). The mean follow-up was 8.2 +/- 2.9 years. RESULTS: Left ventricular ejection fraction ranged from 0.20 to 0.68 (mean 0.55 +/- 0.7). The mean cardiopulmonary bypass time was 96.8 +/- 15.8 minutes and the mean cross-clamping time was 69.7 +/- 14.2 minutes. The mean number of distal anastomosis was 3.3 +/- 0.7 (range 2 to 5). Early mortality was 2.6% and postoperative MI occurred in three patients. There were 21 (7.9%) late deaths and three of them (1.2%) were cardiac related. Actuarial 10-year-survival of all deaths, including in-hospital death, was 70.8%+/- 9.9%. No abdominal complications occurred during or after rGEA harvesting. Seven patients have been suffering of recurrence of angina. Angiography was performed only on those patients with recurrent angina. CONCLUSION: The rGEA can be considered as a valid arterial conduit, relatively easy to harvest, safe to use with low perioperative risks, and good mid- and long-term results. The low early and late rate mortality and the satisfactory clinical results are good reasons for using routinely this conduit in selected patients.

Adult↗