Biomedical subjects

R V Ardito

Publications and source records attributed to R V Ardito.

16 recordsLinked to original sources

PubMed1998

[Pacemaker with sensor of contractility regulated by autonomic nervous system variations in chronic Chagas cardiomyopathy].

PURPOSE: To analyse the performance of the artificial cardiac stimulation with the VVIR pacemaker whose sensor is adjusted by the variations of the autonomic nervous system in Chagas disease patients with deficiency of the conduction system. METHODS: Forty-seven Chagas disease patients have been studied, 28 male between 24 and 68 years old, 36 patients had complete AV block, 8 had 2nd degree AV block and the other 3 had sinusnode disease. The patients were in class I (4), II (15), III (16) and IV (12) according to the NYHA. A 12-month-follow-up with constant clinical evaluations was carried out after pacemaker implantation. Patients were divided in 2 different groups according to the HR at rest--group 1: > 65 beats per minute (bpm) and group 2: < or = 65 bpm, for a comparative study considering: 1) HR at stress test after the implantation; 2) arterial blood pressure at rest after the implantation and, 3) evaluation of the identified electrodes such as TIR-60-UP and others. RESULTS: The group 1 had greater HR at rest, and a smaller variation of values at stress than group 2. This shows that with this type of stimulation system it is possible to control each patient separately. The values of blood pressure at rest and during stress were not different between groups. According to the factors analysed the TIR-60-UP electrode had the same performance as the others. CONCLUSION: The VVIR pacemaker with the sensor adjusted by the ANS variations has provided the Chagas patients with a restoration of their physiological mechanisms. 74% of them had the improvement of either one or 2 functional classes.

Adult↗

PubMed1994

[Rupture of the left ventricular free wall. A lethal entity that can be surgically treated with success].

We present three patients with left ventricular free wall rupture post acute myocardial infarction, all three treated successfully through surgery. Two of them were submitted to streptokinase IV. In all cases the diagnosis were based on clinical and echocardiographic features. The authors conclude that the diagnostic suspicion can be done easily, the echocardiogram is very useful, and the surgical treatment may led to a good short- and long-term survival.

Aged↗

PubMed1994

Surgical revascularization after fibrinolysis in acute myocardial infarction. Long-term follow-up.

One hundred twenty-eight patients with myocardial infarction who underwent operation for myocardial revascularization and 147 patients who received medical therapy were followed up for up to 6 years: all patients had received treatment with intravenous streptokinase. In the surgical group, 91.5% of the patients had the region related to the infarction revascularized, and in 82.8% of them the mammary artery was used. Statistically significant differences were not detected between the groups according to infarct size, clinical features, and left ventricular ejection fraction. However, there was a higher risk in the surgical group, as compared with that in the medical group, in terms of anatomic characteristics: 99.2% versus 77.1% of the patients showed more than 70% residual obstruction at the "culprit" coronary artery (p < 0.001, 95% confidence interval 14.1% to 30.1%) and 76.8% versus 40.7% showed multivessel coronary disease (p < 0.001, 95% confidence interval 23.7% to 48.5%). In-hospital survival was 95.3% in the surgical group and 89.1% in the medical group (p = 0.096, 95% confidence interval -0.2% to 12.6%). Significantly higher survivals were obtained for the surgical group both during the first (93% +/- 2.3% versus 80.3% +/- 3.3%, p = 0.005) and the sixth (86.4% +/- 3.4% versus 68.4% +/- 4.3%, p = 0.003) year of follow-up. Statistically significant differences were also obtained when in-hospital deaths were excluded. A Cox regression model with 13 variables showed that only age (p = 0.0422) and medical treatment (p = 0.0194) correlated independently with mortality. It is concluded that in this nonrandomized study, operation led to a significantly higher survival both on a medium- and long-term basis, when compared with that obtained for patients receiving medical therapy.

Actuarial Analysis↗

PubMed1991

IMC bovine pericardial valve: 11 years.

From 1977 to 1988, 10,812 bovine pericardial valves were produced by IMC Biomédica and implanted. One thousand one hundred ninety-three were implanted by our group at IMC, including 666 exclusively in the mitral position. We are presenting our study of those mitral patients. Of the 663 patients, 586 were adults (over 21 years of age) and 77 were youngsters (under 21). Hospital mortality was 9.2%; 13.2% for the first 5.5 years (group 1) and 6.3% for the second 5.5 years (group II). Eleven year follow-up was 98.8% complete and the mean time was 3.8 years. The actuarial survival was 74.3% +/- 6.5% for the youngsters and 73.0% +/- 3.7% for the adults. The fatal valve-related late complications (death from thromboembolism, calcification, and endocarditis) had an incidence of 1% per patient-year as follows: (1) endocarditis, 0.6% per patient-year; (2) calcification 0.1% per patient-year; and (3) cerebral vascular accident, 0.3% per patient year. The actuarial study revealed 95.0% +/- 1.0% freedom from fatal complications related to the prosthesis. The nonfatal valve-related late complications had an incidence of 2.9% per patient-year as follows: (1) endocarditis, 0.5% per patient-year; (2) calcification, 1.8% per patient-year; (3) cerebral vascular accident, 0.3% per patient-year; (4) periprosthetic leakage, 0.2% per patient-year; and (5) rupture, 0.1% per patient-year.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed1991

[Constrictive pericarditis as differential diagnosis of hepatic disease].

Constrictive chronic pericarditis in a 13-year-old male patient was previously treated as chronic hepatitis for seven years, with the use of furosemide and spironolactone. Investigation for diagnosis included chest radiography, echo-doppler-cardiography, thoracocentesis with pleural biopsy and computerized tomography of chest, and showed ventricular diastolic restriction due to constrictive chronic pericarditis. After eight weeks of tuberculostatic treatment, the patient was submitted to hemodynamic study that confirmed the diagnosis and a pericardiectomy was performed. Long-term follow-up showed regression of diastolic restriction and decrease of hepatosplenomegaly and of jugular stasis. Tuberculostatic drugs were given for 12 months postoperatively, associated to corticosteroids.

Adolescent↗

PubMed1988