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P Arciprete

Publications and source records attributed to P Arciprete.

At least 19 recordsLinked to original sources
PubMed2004

Characteristics, associations and outcome of absent pulmonary valve syndrome in the fetus.

OBJECTIVES: To assess in a population of 21 fetuses diagnosed with absent pulmonary valve syndrome (APVS) the accuracy of prenatal diagnosis, the incidence of extracardiac and chromosomal anomalies and the perinatal outcome. METHODS: This was a retrospective observational study of 21 fetuses with a confirmed diagnosis of APVS. All of them underwent fetal echocardiography and a detailed anatomical scan. Karyotyping was performed in 20/21 cases, with fluorescent in-situ hybridization analysis to detect the 22q11 microdeletion performed in 16/21 cases. The following variables were retrieved from databases and evaluated: indication for referral, gestational age at diagnosis, presence of cardiomegaly, branch pulmonary dilatation, associated anomalies or intrauterine growth restriction, and fetal/neonatal outcome. Autopsy reports and postnatal surgical/medical files were available for confirmation in all cases. RESULTS: Prenatal diagnosis of APVS proved correct in all cases, with only three cases occurring not in association with tetralogy of Fallot. Additional cardiovascular anomalies were present in five cases (24%). Extracardiac anomalies were found in nine cases (42.8%), and were associated with chromosomal anomalies in five cases (24%). The 22q11 microdeletion was present in 4/16 cases (25%). Fetal/neonatal outcome was as follows: nine terminations of pregnancy, three intrauterine deaths, six postnatal deaths. The remaining three (14.3%) neonates were alive after surgery. Cardiomegaly and marked branch pulmonary dilatation were present in 16 and 15 cases, respectively, and were associated with bronchomalacia in virtually all cases. CONCLUSIONS: APVS can be reliably diagnosed and characterized prenatally. The association with major chromosomal anomalies or 22q11 microdeletion is consistent with previous findings. The relatively poor survival rate is due to the high rate of terminations, associated genetic anomalies and bronchomalacia. Bronchomalacia is present in the overwhelming majority of cases featuring cardiomegaly and marked branch pulmonary dilatation.

Chromosome Disorders↗
PubMed2000

[Telemedicine in neonatal emergencies].

UNLABELLED: Telemedicine is the transmission of medical notices and images among remote sites, that uses adequate audio-video systems. OBJECTIVE: To increase the quality and the amount of medical informations, avoiding unnecessary carriages. Among main fields of interest in Telemedicine, monitoring of cardiovascular parameters and medical emergency represent situations that need to be promptly and appropriately approached. In such a similar conditions, a preliminary transmission to III level Health Institutions of informations as Electrocardiograms or even Echocardiograms may play an essential role in the diagnosis, prognosis and treatment of emergent cardiovascular disease. METHODS: Since March 1998, an Audio-Video PC-based system that uses integrated services digital network (ISDN) at a bandwith of 384 Kbps, was installed at Pediatric Cardiac Surgery Department of Giovanni XXIII Hospital, Bari, Italy. On July 1999, thanks to Research Funds of the Health Ministry of Italy, similar audio-video systems that use ISDN were installed in the main pediatric institutions of provinces of Puglia and linked in a wide area network. RESULTS: We report the experience of Telemedicine of a Department of Pediatric Cardiology and Cardiac Surgery, and we try to analyze its impact on improvement of quality of care, once employed in provincial field.

Emergencies↗
PubMed1989

Right pulmonary artery development after modified Blalock-Taussig shunt (MBTS) in infants with pulmonary atresia, VSD and confluent pulmonary arteries.

The ideal palliation for infants with pulmonary atresia, ventricular septal defect and confluent pulmonary arteries should promote normal development of the pulmonary artery branches. In 26 patients who survived a modified Blalock-Taussig shunt (MBTS) in the first year of life, the right pulmonary artery was measured before and after operation by two dimensional (2D) echocardiography. In each patient its size was compared to the normal value for the same body surface area. The patients were divided according to this ratio and according to the real size (mm). Although increased in all cases but two, the size of the right pulmonary artery remained remarkably less than normal in patients with an initially small right pulmonary artery. In view of these results, early palliative enlargement of the right ventricular outflow tract is probably advisable in infants with diminutive pulmonary arteries who do not show adequate pulmonary branch development after MBTS.

Anastomosis, Surgical↗
PubMed1986

Double connections in total anomalous pulmonary venous connection.

Three infants who underwent operation for total anomalous pulmonary venous connection had unobstructed drainage of all the pulmonary veins to both the coronary sinus and left vertical vein. In one patient the anatomy was demonstrated preoperatively and complete correction accomplished without difficulty, but in two patients the second connection was discovered only at postoperative reinvestigation. Arbitrary classification of total anomalous pulmonary venous connection into cardiac, supracardiac, infracardiac, and mixed types does not lend itself to description of such lesions and may obscure their clinical importance. For these less common variants of total anomalous pulmonary venous connection, a more detailed and precise definition of morphology facilitates accurate surgical repair.

Cardiac Catheterization↗
PubMed1985

Mustard's operation for patients with ventriculoarterial concordance. Report of two cases and a cautionary tale.

Three patients with ventriculoarterial concordance and an abnormal atrioventricular connexion were investigated. One patient had total anomalous pulmonary venous connexion to a left vertical vein. In 1972 this was repaired and a ventricular septal defect was closed, but the presence of atrioventricular discordance was missed and the patient died. In the other two patients, Mustard's operation resulted in survival. One patient had situs solitus and atrioventricular discordance with an associated ventricular septal defect, which was closed. The other had left isomerism (quasi solitus) with an ambiguous atrioventricular connexion (quasi discordant). A previously noted ventricular septal defect had spontaneously closed.

Angiocardiography↗
PubMed1984

Intrapericardial teratoma in the newborn.

Two cases of intrapericardial teratomas occurring in the newborn are reported. The first was a cystic, well differentiated tumour which was totally excised. The child was alive and well with no evidence of the disease 10 months later. The second was a predominantly solid teratoma which consisted of both mature and immature tissues. It was removed but recurred 2 months later with pleural and pericardial invasion. The patient underwent reoperation but death occurred 9 days after surgical treatment. The recurrence was histologically similar to the primary tumour. The second case is probably the first malignant intrapericardial teratoma described in a neonate. Its morphology and clinical behaviour suggest that, as in ovarian and sacrococcygeal teratomas, the presence of immature neuroepithelium carries a poor prognosis. In such cases radio- or chemotherapy should be performed.

Echocardiography↗
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↗
PubMed1983

[Cold agglutinins in a cardiosurgical patient: a successfully operated case].

A technique is described for providing myocardial protection with cold cardioplegia in a patient with cold autoagglutinins. The operation was done in normothermia and the coronary system was perfused with a normothermic (+37 degrees C) NaCl 0,9% solution to remove the blood before in it introducing the cold (+4 degrees C) cardioplegic solution. With this technique, the patient underwent an uneventful operation to relieve right ventricular-outflow stenosis operation.

Agglutinins↗
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↗
PubMed1981

[Mesenteric syndrome following the repair of aortic coarctation. Pathogenetic and clinical findings].

Two cases of mesenteric syndrome were observed in 41 patients undergoing correction of aortic coarctation at the School of Heart and Large Vessel Surgery of the 1st Medical Faculty of Naples University. In the light of the latest theories regarding the pathogenesis of the mesenteric syndrome, post-operative arterial hypertension is held to be a decisive factor in the genesis of the complication. Control of pressure is therefore believed to be of considerable importance in the prevention and treatment of the syndrome.

Adolescent↗
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↗
PubMed1978

[The surgical treatment of Klippel-Trenaunay syndrome (author's transl)].

Three cases of congenital angiodysplasies of the extremities, classified as Klippel-Trenaunay syndrome, underwent to surgical treatment. These cases, clinically similar, have shown a quite different pathogenesis, according to which the surgical treatment has been modified. Once again we recommend a complete diagnostic study every time one find varicosities of the extremities which are atipical for time of appearance, territories involved or for aspect and thus be congenital varicosities with complex pathogenesis.

Adolescent↗