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Biomedical subjects

R Calabrò

Publications and source records attributed to R Calabrò.

At least 73 records · Page 4Linked to original sources
PubMed1991

Coumarin anticoagulation during pregnancy in patients with mechanical valve prostheses.

Between January 1987 and December 1989, 20 female patients with one mechanical valve prosthesis (MVP) for at least 1 year postoperatively were studied while on coumarin therapy for the full length of pregnancy. In each case, caesarean section was scheduled for the 38th week. Patients were selected according to the following criteria: (1) prothrombin ratios remaining within the therapeutic range for more than 85% of their total estimations in the previous 12 months with mean daily doses of warfarin less than 5 mg; (2) stable cardiac status; (3) no previous obstetric diseases and (4) full acceptance of the risks involved in the protocol. The patients were in NYHA functional class I or II. Their ages ranged from 23 to 31 years (mean 26 +/- 3). Ten patients had a mitral prosthesis and 10 an aortic prosthesis. Among the 20 mechanical valve prostheses, 10 were Sorin, 6 Starr-Edwards, 2 Bjørk-Shiley, and 2 Lillehei-Kaster. Eighteen patients were in sinus rythm, 1 in chronic atrial fibrillation, and 1 had a permanent endocardial pacemaker. Nineteen were delivered by caesarean section: warfarin was withdrawn 48 h before surgery and resumed 24 h thereafter. One patient had premature spontaneous delivery at 36 weeks. The mean prothrombin ratio measured weekly in the 20 patients was 2.06 +/- 0.45 INR, using a mean daily warfarin dose of 4.1 mg +/- 1.63. The mean value of the prothrombin ratio during caesarean section for the 19 patients was 1.23 +/- 0.38 INR. In the 20 live births, the mean birth weight was 2.9 kg +/- 0.40.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Truncus arteriosus and double aortic arch associated with DiGeorge syndrome.

We report the 1st known case in which truncus arteriosus and double aortic arch have been associated with DiGeorge syndrome. The association of these 2 cardiovascular anomalies lends support, by itself, to speculation that truncus arteriosus and double aortic arch have a common embryonic pathogenesis; and the presence of these anomalies in a patient with DiGeorge syndrome strengthens the contention that the common causative factor is pathologic development of the neural crest cells.

Journal Article↗
PubMed1991

[Left ventricular systolic function in patients surgically treated for atrioventricular septal defect: echocardiographic assessment].

In order to assess the left ventricular systolic function we studied by echo 14 pts (8M, 6F) with complete atrioventricular septal defect (AVSD) who had undergone surgical repair. Mean age was 20.30 +/- 24.63 months, with a follow-up of 52.85 +/- 19.11%; in 6 pts Down syndrome was associated. Particularly, we tried to determine whether the following factors might affect the post-operative left ventricular systolic function: a) Down syndrome; b) residual mild mitral regurgitation; c) age of the surgical repair; d) length of the follow-up. As load-independent indexes of contractility, the left ventricular end systolic stress (LVESS)-circumferential fibre shortening velocity normalized for heart rate (VCFc) relationship and the LVESS/end systolic volume index (ESVI) ratio were chosen. All pts showed normal (mean +/- 2 standard deviations) or slightly higher values of LVESS/VCFc relationship; significantly, the only two pts with lower values had later undergone surgical repair. LVESS/ESVI ratio confirmed an inverse relationship between systolic function and age of the surgical correction (r = -0.75); no other factors (Down syndrome, residual mild mitral regurgitation, length of the follow-up) showed a significant correlation with the post-operative left ventricular systolic function. In conclusion, in our limited population, the age of the surgical repair appears to be the main factor affecting the post surgical left ventricular systolic function in pts with complete AVSD.

Child↗
PubMed1990

Ventricular septal defect in Down syndrome. Anatomic types and associated malformations.

Ventricular septal defect is a common cardiac anomaly in Down syndrome. To detect the prevalence of anatomic types and associated cardiac malformations we analyzed the echocardiographic and angiocardiographic findings of 73 children with ventricular septal defect and Down syndrome. We compared these results with those obtained in 303 patients with ventricular septal defect without Down syndrome. The prevalence of inlet ventricular septal defect was significantly higher in patients with Down syndrome, while muscular and subpulmonary ventricular septal defects were present only in patients without Down syndrome. The incidence of a cleft of the mitral valve was significantly higher in Down syndrome, while left-ventricular inflow and outflow obstructions were present only in patients without Down syndrome. Different patterns of ventricular septal defect and associated anomalies exist in patients with and without Down syndrome.

Abnormalities, Multiple↗
PubMed1990

Atrioventricular canal in Down syndrome. Prevalence of associated cardiac malformations compared with patients without Down syndrome.

The atrioventricular canal is the "classic" congenital heart anomaly in Down syndrome. We may learn more of the nature of this disorder by careful study of the anatomic characteristics of the cardiac lesions and by comparing these lesions in patients with and patients without Down syndrome. We reviewed the clinical characteristics (echocardiographic and angiocardiographic) of 220 patients with atrioventricular canal and compared the prevalence of anatomic types and associated cardiac malformations in children with (105) and without (115) Down syndrome. In patients with Down syndrome, the complete form of atrioventricular canal was prevalent, with a high frequency of associated Fallot's tetralogy. Partial atrioventricular canal and left-sided anomalies were more common in patients without Down syndrome. Down syndrome is associated with a simpler type of atrioventricular canal when compared with patients with a normal chromosome configuration.

Coronary Circulation↗
PubMed1990

[Clinical aspects of dilated cardiomyopathy in pediatric age].

Natural history and prognostic factors of dilated cardiomyopathy in pediatric age are not well identified so far. The course of the disease, often, presents "odd" characteristics: some of the patients show clinical improvement, someone remains unchanged and some of them have a negative evolution in a very short time. It is necessary to identify the group of patients having a poor outcome in order to define prognostic factors of impending death so that a cardiac transplant could be offered to them as a reasonable therapeutic choice. Twenty-two children, 9 males and 13 females (median age 5 +/- 5 years) with dilated cardiomyopathy were studied. Their natural history was followed for a period of 40 +/- 30 months. Clinical data, laboratory studies (electrocardiogram, Holter monitoring, echocardiogram M-mode, 2-D, Doppler and chest X-ray) were taken into consideration. At the end of follow-up period 7 patients showed improvement in cardiac status (31.8%), 7 remained unchanged (31.8%) and 8 (36%) got worse; 9 died. The survival curve showed a rate of 72% at 12 months and of 59.3% at 60 months. Of 9 died patients, 2 died suddenly and seven for congestive heart failure. Clinical findings and laboratory investigations of 13 survived patients (Group I) and 9 died patients (Group II) were compared to establish the risk factors of poor outcome. The fractional shortening is the only significant factor of poor outcome (p less than 0.025). Other negative factors were identified more in Group II than in Group I.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Comparative analysis of autonomic and somatic dysfunction in chronic uraemia.

The relationship between autonomic dysfunction and peripheral somatic neuropathy was investigated in uraemics. The battery of autonomic tests included R-R interval variation test, deep breathing, Valsalva manoeuvre, heart rate and blood pressure responses to standing, and sustained handgrip. Maximum conduction velocity along sensory and motor fibres of the posterior tibial nerve was measured. An impairment of parasympathetic reflexes was more frequent than a sympathetic damage, but with no relationship to the degree of electrophysiological disturbances. Cardiovascular autonomic dysfunction and somatic neuropathy in uraemia result to be two different entities in incidence and perhaps in pathogenesis.

Adult↗
PubMed1984

[Tetralogy of Fallot. Subcostal approach in bidimensional echocardiography].

We have evaluated the diagnostic accuracy of subxyphoid 2-dimensional (2-D) echocardiography in Fallot's tetralogy by employing two planes defined as left anterior oblique (LAO) and right anterior oblique (RAO), similar to the respective angiographic axial projections. Echocardiographic and angiographic findings were compared in 39 patients. The pulmonary branches, the trunk, the infundibulum, the septal defect and the aorta were identified in all cases, the pulmonary valve in 97% and associated defects in 71%. The LAO view was best suited for an overall diagnosis and for the visualization of the left pulmonary branch, of the pulmonary anulus, and of the overriding of the aorta. The RAO proved optimal for the evaluation of the right pulmonary branch, of the infundibulum and of the relationship between ventricular septal defect and adjacent structures. It is concluded that the subxiphoid approach is a valuable technique for the 2-D echocardiographic evaluation of Tetralogy of Fallot.

Child↗
PubMed1983

[Balloon occlusion aortography in the angiographic study of pulmonary atresia with interventricular defect].

Balloon aortography is a new technique for the angiographic study of pulmonary atresia with ventricular septal defect. A Swan-Ganz angiographic catheter is employed, whose balloon is inflated to stop blood flow in the descending aorta, thus ensuring the opacification of the pulmonary circulation. By this method we have studied 18 patients. Anatomic details of the pulmonary arterial circulation were obtained in all. No complications occurred. Balloon aortography is a simple and safe technique for the routine study of patients with pulmonary atresia and ventricular septal defect, whereas selective injection in collateral arteries or pulmonary veins, which carries more risk and is more complex, should be adopted only in selected cases.

Aortography↗
PubMed1982

A case of isolated atrioventricular discordance.

A case of isolated atrioventricular discordance in situs solitus is described. The importance of a well defined situs and of the presence of both ventricles in making this diagnosis is underlined and previous published reports reviewed. It is suggested that the haemodynamic concept of isolated atrioventricular discordance cannot be described only by the spatial relation between the ventricles (isolated ventricular inversion), but it should be indicted by the pattern of the connection between various flows, as shown by hearts with a normal relation between the ventricles and crossed atrioventricular connection.

Female↗
PubMed1982

[Straddling and overriding atrio-ventricular valves: echocardiographic and angiographic findings].

Recent advances in surgical technique for correction of positional abnormalities of atrio-ventricular (A-V) valve require accurate preoperative diagnosis of this malformation which can be distinguished into a complete (overriding + straddling) and a partial form (overriding or straddling). In this study, echocardiography and angiocardiography are shown to be complementary to each other for definition of the anatomic details of this pathology. Six cases of positional abnormalities of the A-V valves are reported. Group I includes three patients with tricuspid valve abnormalities: two are complete forms (overriding + straddling) one of which is associated with DORV and the other is associated with d-TGA. The third patient is a partial form: straddling tricuspid valve with only a large ventricular septal defect involving the inlet septum. Group II includes three patients with mitral valve abnormalities: one complete form and two partial ones (straddling), all associated with DORV. We illustrate the best echocardiographic and angiocardiographic projection for the recognition of A-V valve malposition and demonstrate that both techniques greatly add to the diagnostic accuracy. Echocardiography defines better the abnormal attachments of the leaflet apparatus, whereas angiocardiography identifies better the displacement of the A-V valve annulus.

Angiocardiography↗
PubMed1981

[Electrocardiographic and vectorcardiographic examinations in differential diagnosis of cyanotic congenital cardiopathies with interventricular defect and obstruction of pulmonary outflow].

The value of the electrocardiogram and vectorcardiogram for the diagnosis of congenital heart diseases with VSD and pulmonary obstruction is illustrated. Three types of electrocardiographic pattern are encountered: 1) pressure overload to the right ventricle (Tetralogy of Fallot, DORV, TGA); 2) left ventricular hypertrophy (TA, UH with outlet chamber to the right); 3) Inversion of septal activation (Correct TGA, UH with outlet chamber to the left). In the diagnosis of the anomalies of the first group, absence of P wave alteration, downward and rightward QRSA, lack of s wave in AVF and terminal forces of the QRS loop under the O point suggest Tetralogy of Fallot. In DORV and TGA the QRSA may be directed upward to the right or to the left and P wave may show overload pattern of the right ventricle. Moreover, in DORV conduction delays on the right bundle branch and/or increased voltage of the R wave in V1 may be observed. In diagnosis between TA and UH with outlet chamber to the right, a leftward displacement of QRSA, an overload pattern of RA and absence of clockwise rotation of the QRS loop on the H plane suggest the former disease. These electrocardiographic data, as well as pathological considerations, made us keep these two form distinct from a clinical point of view. Finally, recording of LV potentials in V1 or to its right with AV conduction abnormalities are typical of corrected TGA; in UH with outlet chamber to the left no conduction defects are observed. In UH with outlet chamber anterior o slightly to the left, ECG pattern is rS on all the praecordial leads and a left posterior hemiblock is present in 40% of the cases of second type.

Diagnosis, Differential↗
PubMed1981

[Electrocardiographic and vectorcardiographic aspects of tricuspid atresia].

18 patients, less than one year old, with tricuspid atresia have been studied and the electrocardiographic pattern has been correlated to the hemodynamic data and type of ventriculo-arterial connection. The origin of the most frequent electro-vectorcardiographic pattern, such as the variable direction of electrical axis, left ventricular hypertrophy, the right atrial overload, the frequent counterclockwise rotation of the QRS loop on the various planes and the increased voltage of the 0.01" and LMSV spatial vectors are discussed. Moreover, the relevance of anatomic features of the two ventricles and of the position of the conduction pathways in determining the different electrocardiographic pattern in the two types of ventriculo-arterial connection, is underscored. On the basis of our results the opportunity to maintain a distinction between tricuspid atresia and single ventricle, at least from a clinical point of view, seems justified.

Electrocardiography↗