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Biomedical subjects

R Tartini

Publications and source records attributed to R Tartini.

6 recordsLinked to original sources

[Developments in mitral valve surgery].

Between 1987 and 1990 we operated on 104 patients for mitral valve disease. If possible the valve was reconstructed according to CARPENTIER's technique: 8 of 28 stenotic, 43 of 57 regurgitant and 2 of 7 mixed lesions were repaired. Twelve patients underwent re-replacement of a previously inserted mitral prosthesis. Six patients died early (7.8% after replacement, 8% after isolated replacement, 3.7% after repair and 2% after isolated repair). Five of these six patients were in NYHA class IV preoperatively. Seven patients died late after a mean observation period of 18 months (5 after replacement, 1 after double valve replacement and 1 after repair and multiple coronary bypass surgery). Prognosis is best for patients whose valve can be repaired and who are not already in NYHA class IV. The postoperative NYHA class for surviving patients is excellent (1.3 in the replacement group and 1.2 after repair).

Adult

[Emergency surgery for PTCA complications: tactics and results].

Incidence, risk and results of emergency coronary bypass surgery after failed percutaneous transluminal coronary angioplasty (PTCA) have been analyzed in a retrospective study. Failed PTCA has been defined as visible pathology (dissection, occlusion) of the dilated vessel associated with acute chest pain and ECG changes. From 3-1-1987 to 11-30-1990, 23 patients of 433 (5%) underwent emergency surgery for failed PTCA (19 male, 4 female, mean age 55 +/- 8 years). PTCA was performed in 16 cases of one-vessel-disease, 3 cases of two-vessel-disease and 4 cases of three-vessel-disease. All had an ejection fraction beyond 40%. 19 patients remained in stable hemodynamic condition. In average 2.1 vessels have been bypassed; in 13 cases the internal mammary artery (IMA) has been used, in 10 cases the saphenous vein (VSM) only. No early nor late death occurred. The perioperative infarction rate is 30%. Comparing the group with IMA and the group with VSM only, no difference could be found regarding the number of unstable hemodynamics, the use of catecholamines nor the perioperative infarction rate. After a mean follow-up period of 14.3 months, 21 patients are in NYHA class I, 2 in NYHA class II. Emergency coronary bypass surgery can be performed with low risk and favorable results, if the operation is timed without delay after the onset of acute chest pain and ECG changes in failed PTCA. The infarction rate is remarkably higher than in elective coronary surgery. The use of the IMA seems to be no additional risk factor.

Angioplasty, Balloon, Coronary

[Heart center surgery in the private hospital: heart surgery in the hospital with covering physicians].

Based upon the experiences at the "Herzzentrum Hirslanden" Zurich it is demonstrated that heart surgery and invasive cardiology, including cardiac catheterization and PTCA, can readily be performed by surgeons and cardiologists in private practice at a private hospital not receiving any government funds. The needs for additional heart surgical beds in the greater area of Zurich is confirmed. Manpower needed and necessary apparative infrastructure are discussed and present activities at the "Herzzentrum Hirslanden" illustrated. Finally problems with medical insurance companies covering the cost are dealt with.

Cardiac Surgical Procedures

[Percutaneous transluminal coronary angioplasty (PTCA): long-term results].

The authors report on the longterm follow-up after PTCA in 130/165 (79%) patients seen approximately 3 years after angioplasty. Primary success rate in the years 1980-84 was 79%. Emergency bypass surgery was necessary in 7%. In-hospital mortality was 0%. Recurrences of angina were seen in the first 6 months in 18 and after 1 year in 3 patients. 13 of 18 had a recurrence of the dilated lesion (10%). At 3 years there had been 4 cardiac deaths, 76% were asymptomatic, 8% were improved and 83% were working full time.

Aged

Anomalous origin of the left thyrocervical trunk as a cause of residual pain after myocardial revascularization with internal mammary artery.

A patient with successful implantation of an internal mammary artery graft in the left anterior descending coronary artery complained of residual but different anginal pain after operation. Ischemia was demonstrated during a manual stress test. Angiography revealed anomalous origin of the thyrocervical trunk from the internal mammary artery. Angina and ischemia disappeared after the trunk was ligated.

Arteries