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Biomedical subjects

P M Mikus

Publications and source records attributed to P M Mikus.

17 recordsLinked to original sources
PubMed1999

Extracorporeal right to left atrial bypass to treat right ventricular failure.

Graft right ventricular failure after heart transplantation, secondary to preoperative functional pulmonary hypertension, was successfully managed in a 49-year-old patient using an extracorporeal right to left atrial bypass. We comment on the case and discuss the type of mechanical assistance used.

Cardiomyopathy, Dilated↗
PubMed1998

Activity-rest stimulation of latissimus dorsi for cardiomyoplasty: 1-year results in sheep.

BACKGROUND: In dynamic cardiomyoplasty electro-stimulation achieves full transformation of the latissimus dorsi (LD); therefore, its slowness limits the systolic support. Daily activity-rest could maintain partial transformation of the LD. METHODS: Sheep LD were burst-stimulated either 10 or 24 hours/day. Before and 2, 4, 6, and 12 months after stimulation, LD power output, fatigue resistance, and tetanic fusion frequency were assessed. Latissimus dorsi were biopsied at 6 months, and sheep sacrificed at 12 months. RESULTS: After 1 year of 10 hours/day stimulation LD was substantially conserved and contained large amounts of fast type myosin. From 2 months to 1 year of stimulation the power per muscle of the daily rested LD was greater than that of the left ventricle, being three to four times higher than in the 24-hour/day stimulation. CONCLUSIONS: If extended to humans, these results could be the rationale for the need of a cardiomyostimulator, whose discontinuous activity could offer to patients the long-standing advantage of a faster and powerful muscle contraction.

Animals↗
PubMed1994

New bileaflet bioprosthesis: early and mid term results.

A new bovine pericardial bioprosthesis (AMB bioprosthesis) with a bileaflet geometry was designed and developed, with the aim of achieving uniform stress distribution within the prosthesis. The ultimate goal was to limit tissue degeneration to a minimum by attaining optimum fluid dynamics, thereby obtaining an extended clinical durability. The two-leaflet, dome-shaped geometry with a central hinge allowed a very low profile, low ventricular projection in the mitral position, large effective orifice area and low gradients. The design of the thin Delrin stent and the centrally crossing bridge was developed using finite element analysis. Pre-clinical laboratory investigations showed very low trans-valvular gradients and no mechanical or tissue failure after 400 million cycle accelerated wear test. The final model of the prosthesis was manufactured by Baxter-Edwards CVS Division and tested in sheep with good results for up to five months. A limited clinical trial was started in January 1990 and stopped one year later encompassing 12 aortic and six mitral implants. The patients were followed clinically and by echocardiography three, six and 12 months, and four years after surgery. Mean gradients were 4 mmHg in the mitral and 10 mmHg in the aortic position with only minimum regurgitation and no tissue failure. We conclude that early and mid term results with this new pericardial bioprosthesis appear to be favorable and intend to closely monitor further outcome within the limited patient population.

Animals↗
PubMed1987

[Changes in humoral immunity in ischemic cardiomyopathy].

The present study has been performed with the aim of assessing the incidence and the possible implications of the changes in humoral immunity in patients with coronary heart disease. Serial determinations of the immunoglobulins (Ig) G, A and M, of specific anti-heart antibodies and of some non-organ-specific antibodies have been carried out in the venous blood of 15 patients with acute myocardial infarction (AMI), of 30 subjects with angina pectoris (AP) and of 30 controls. The occurrence of anti-smooth muscle and anti-nuclear antibodies resulted negligible in all subjects, while anti-mitochondrial antibodies were found in a relatively high percentage of cases, which is probably due to chance. Only in 13.3% of AMI patients, and in 16.7% of AP subject, were anti-heart antibodies detectable, and their presence was not related to the occurrence of Dressler's syndrome, nor to any clinical finding. The mean IgG curve in the AMI patients showed a triphasic time-course in the first 20 days of disease. In the AP patients an inverse correlation has been found between monthly frequencies of anginal attacks and serum concentrations of IgG (r = 0.382; p less than 0.05). In the control group serum IgA were directly correlated to age (r = 0.493; p less than 0.01); furthermore, in patients with exertional or mixed angina serum IgA were often higher than those of patients with only rest angina (x2 = 3.906; p less than 0.05). These data suggest the working hypothesis that a possible link (of secondary or primary type) between serum concentrations of IgA and severity of atherosclerosis may exist.

Aged↗
PubMed1977

[The surgery of atrial septal defect in adults (author's transl)].

33 cases of A.S.D. whose age ranged between 30 and 50 years are presented. Surgical indications, post-operative complications and arrhythmias are described. Atrial fibrillation due to pulmonary hypertension in the post-operative period is particularly emphasized. The authors point out that surgical indication for A.S.D. in adults is closely related to the hemodynamic of pulmonary circulation.

Adult↗
PubMed1977

[Agenesis of the pulmonary valve associated with interventricular defect].

The association between ventricular septal defect and pulmonary valve atresia is a rare congenital disease, which can provoke the compression of bronchioles, that make a high mortality rate possible in the first years of life. If this syndrome is tolerated, using a convenient medical therapy, it is possible to wait for a more suitable age for a complete correction, which must provide, besides V.S.D. closing, pulmonary valvular substitution by porcine aortic heterograft. The authors also report on their own experience of five cases surgically treated and studied from a pre- and postoperative hemodinamic point of view.

Adolescent↗
PubMed1976

[Reconstruction of the pulmonary outflow tract with a valved conduit (author's transl)].

The authors describe 25 patients who underwent open heart surgery for reconstruction of the pulmonary outflow tract with a valved conduit. The following anomalies were observed: six cases of great vessels transposition, five cases of pulmonary artery atresia, five cases of truncus, three cases of tetralogy of Fallot and six cases of single ventricle. Two cases of single ventricle were treated in order to be transformed into a systemic ventricle. The pulmonary outflow was reconstructed with a valved conduit anastomosed between right atrium and pulmonary artery. This study includes pre- and postoperative hemodynamic values, surgical evaluation and a 5-months to 3-years follow-up. The authors emphasize that it is important that the surgical indications are closely related to the morphology and hemodynamics of pulmonary circulation for a better result.

Adolescent↗
PubMedDate not supplied

Kidney transplantation combined with other organs: experience of Bologna s. Orsola hospital.

AIM: We report a series of patients who underwent combined heart-kidney transplantation (CHKT) and combines liver-kidney transplantation (CLKT) at a single center. METHODS: From January 1997 to October 2004, 13 CLKT and 2 CHKT were performed. The CLKT indications were as follows: polycystic disease (2), kidney polycystic disease associated with Caroli (1) and cirrhosis-hepatitis C virus (HCVs) (1), chronic glomerulonephritis with cirrhosis-HCV (4), and other diseases (5). From December 2003 to October 2004, 2 patients underwent CHKT for idiopathic cardiomyopathy plus glomerulonephritis and ischemic cardiomyopathy associated with vascular nephritis. RESULTS: In the CLKT group, 1 patient had acute rejection involving both liver and kidney grafts, whereas 1 patient had liver rejection and another 1 had kidney rejection alone. Of the 13 patients, 10 are alive with a mean survival of 583 days (range, 36-2688 days); 2 patients died within 1 month of transplantation (both with polycystic disease) due to ARDS and MOF. Another patient died 6 years and 9 months after CLKT of metastasis from a de novo tumor. In the CHKT group, no patient suffered heart-kidney rejection. They are all alive at 333 and 116 days, with heart and kidney allografts functioning well. CONCLUSION: In the CLKT group, the worst results were for patients with polycystic disease, in whom a more rigorous selection is necessary because of greater technical difficulties. For the remaining patients we had acceptable complications and excellent long-term results. In selected cases, CHKT can provide long-term graft function and patient survival. Our experience indicates that end-stage kidney failure combined with liver or heart failure does not necessarily preclude dual-organ transplantation.

Adult↗