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Biomedical subjects

R Gallotti

Publications and source records attributed to R Gallotti.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Angioplasty of the common trunk of the left coronary artery with venous patch].

Surgical angioplasty of the left main coronary artery for severe iatrogenic stenosis has been done on a 40 year old female patient operated upon five months before for mitral and aortic valve prosthetic replacement. Postoperative angiocardiographic study showed patent left main trunk and the patient is angina-free six months post-operatively. Operative indication and surgical technique are discussed as an alternative to aorto-coronary by-pass surgery for left main proximal stenosis without peripheral lesions. It does not result from literature that this surgical technique has ever been employed in patients previously operated with open heart surgery.

Adult↗
PubMed1981

Surgical enucleation of discrete sub-aortic stenosis.

Three forms of discrete sub-aortic stenosis have been recognised and described. A long tunnel-like narrowing of the left ventricular outflow tract was the most severe form and was recognized as different from hypertrophic obstruction cardiomyopathy (HOCM). Sixty patients with discrete sub-aortic stenosis have been operated on with enucleation of the stenosis during the past 15 years at the National Heart Hospital, London, and followed-up for up to 14 years. Overall there were 4 hospital deaths (6.6%) and only one late death. Emphasis has been placed on the superiority of blunt dissection in the enucleation of the entire, discrete stenosis when contrasted with the conventional sharp dissection technique which may well lead to subsequent accretions of obstructive thickening. The surgical enucleation of the discrete sub-aortic stenosis has been an entirely satisfactory procedure from a hemodynamic viewpoint and carries a low operative risk with every possibility of a subsequent event-free follow-up.

Adolescent↗
PubMed1981

[Organic subaortic stenosis. Surgical indications, surgical technic, late results].

Between 1966 and 1979 60 patients underwent resection of organic subaortic stenosis at the National Heart Hospital. There was a male:female ratio of 40:20 and an age range of 4 to 56 years (mean 18 years). 22 patients (36.7%) had a single or multiple additional cardiac abnormalities including left ventricular outflow tract obstruction (12 cases), right ventricular outflow tract obstruction (3 cases), ventricular septal defect (6 cases), patent ductus arteriosus (5 cases), aortic coarctation (1 case), congenital mitral stenosis (1 case) and mitral atresia associated with a single ventricle (1 case). Isolated resection of the organic sub-aortic with myotomy and wedge resection was performed in 47 patients and Cooley technique in 2 patients. Total aortic root replacement with a homograft valve was necessary in 4 patients and the 22 patients additional cardiac abnormalities received concomitant surgery. There was one early death (2.6%) amongst the 38 patients with isolated organic sub-aortic stenosis and no late deaths. There were 3 early deaths (13.7%) amongst the 22 patients with additional cardiac abnormalities and one late sudden death after 14 months. There were 7 non-fatal complications: a myocardial infarction, AV block and pacemaker insertion; three mild aortic regurgitations; one mild mitral regurgitation; an arrhythmia due to Wolf Parkinson White syndrome; and an aortic and mitral valve replacement after 9 years. 43 other patients have been followed for 1 to 14 years and are symptom free. Left bundle branch block is present in two of them. Resection of organic sub-aortic stenosis with myotomy and wedge resection is a safe technique and offers an excellent prognosis for this group of congenitally compromised patients.

Adolescent↗
PubMed1980

The Marfan syndrome: surgical technique and follow-up in 50 patients.

Fifty patients with Marfan's syndrome underwent operation at the National Heart Hospital because of cardiovascular complications. Forty-six had an aneurysm of the ascending aorta, 13 had chronic dissection, and 6 had acute dissection of the aortic wall. Forty-three aortic valves were incompetent, and five were stenotic and incompetent. One mitral valve had minor regurgitation. The Starr-Edwards prosthesis was used in 36 patients, homograft valves in 4, fascia lata valves in 2, and xenograft valves in 6. The ascending aorta was replaced with a Dacron tube in 40 patients and with an aortic homograft in 2. Three patients required Dacron patches over the aneurysm, and 1 patient had plication of the aortic wall. Early mortality totaled 12% (6 patients). Only 1 of these patients died in the last five years. Reoperations for homograft incompetence, periprosthetic leak, and acute dissection of an unreplaced aorta resulted in 1 hospital death (33%). Forty-three patients have been followed for up to 8.5 years (mean, 3.5 years), with 7 late deaths (46.2%). The improvement in recent surgical results with decreased operative mortality supports an aggressive surgical approach to Marfan's syndrome in view of the poor prognosis for the natural history of this disease.

Adolescent↗
PubMed1978

[The incomplete atrio-ventricular canal. Operative and long term results in 100 cases (author's transl)].

100 patients with endocardial cushion defect of the partial type underwent surgical correction between the years 1957-1975. The age of patients ranged from 3 to 57 years with a mean of 18 years. In 89 patients there was a mitral insufficiency. The repair of the mitral valve was performed in 78 patients; in 21 was repaired also the tricuspidal valve. The hospital mortality was of 8 patients. The mortality was correlated with the age of the patients, the pulmonary pressure and with the presence of malformations of the tricuspid valve. A major complication was represented by a complete atrioventricular block that occurred in 8 patients, in 5 of these the block disappeared before the dimission from the hospital. 86 patients have been followed for a period variable from 2 to 228 months and an average of 61 months. The late mortality was of 4 patients. Two patients have been reoperated of mitral valve replacement because of residual important mitral insufficiency. The phonocardiographic study, done in 50 patients, showed a presence of a holosystolic murmur in 20. The standard X-ray chest and electrocardiogram iid not show important changes between the pre and post operative examination.

Adolescent↗
PubMed1976

[Rupture of interventricular septum secondary to blunt chest trauma. Report of a case surgically treated with success (author's transl)].

A case of interventricular septal defect secondary to blunt chest trauma is reported. It was characterized by a disconnection of the interventricular muscolar septal in the anterosuperior part of the heart wall. The diagnosis, suspected by clinical and instrumental parameters, was definitely confirmedy by hemodynamic and contrastographic examination. Repair surgery of the defect with a dacron patch was performed, using extracorporea normothermic circulation seven months after the accident. The patient was examined three months and twelve months after the operation; the clinical examinations did not reveal any cardiac murmur and the patient's health was satisfactory. The incidence, mechanism of rupture of interventricular septum and the main surgical and clinical aspects of this type of pathology are discussed.

Adult↗
PubMed1975

[Aorto-coronary bypass. On 200 cases surgically treated (author's transl].

200 patients underwent bypass graft for treatment of severe coronary vessel disease. The bypass vein grafts were 316; single grafts in 100 cases, double in 85, triple in 14 and in 1 case a patient received 4 grafts. In 57 cases a previous coronary endarterectomy was performed. The flow in the graft at the end of the operation was more than 40 cc/min. in 80% of cases. 22 patients died. Postoperative myocardial infarction occurred in 14% of the patients. The mortality was higher in the preinfarction angina group, and less in the chronic angina group without concomitant surgery (7,2%) and is statistically in direct relation to the functional condition of the left ventricle (2,8% in patients with end diastolic left ventricular pressure less than 20 mmHg and without akinetic areas). Relief of angina was observed in 87% of the surviving patients. Postoperative coronarography, catheterism and left ventriculography was performed in 46 patients. Only 2 of the 15 cases with postoperative angina had the graft patent. Significant improvement of the left ventricular function with disappearence or regression of akinetic areas was observed in 9 patients. Our experience indicates that the value of this operation cannot be entirely known at the present time.

Adult↗