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Biomedical subjects

S Eufrate

Publications and source records attributed to S Eufrate.

At least 19 recordsLinked to original sources
PubMed1984

Posterior enlargement of the small annulus during aortic valve replacement versus implantation of a small prosthesis.

Twenty-two patients with a small aortic annulus were identified among 196 consecutive patients undergoing aortic valve replacement (AVR). The 11 patients in Group 1 underwent posterior enlargement aortic annuloplasty, and the 11 in Group 2 received a small aortic prosthesis (less than or equal to 21 mm). The two groups were unselected. Core hypothermia, cardioplegia, and local cooling were employed for all operations. Isolated AVR was performed in 3 patients in each group. In Group 1, the mean increase in diameter of the annulus was 4.82 mm, which resulted in a mean area increase of 169.91 mm2 (51.7%). Mean aortic cross-clamp times were 140.4 minutes and 93.5 minutes in Groups 1 and 2, respectively. There were 2 operative deaths in Group 1, and 1 operative and 1 late death in Group 2. Mean follow-up was 26.5 months for Group 1 and 43.4 months for Group 2. No thomboembolic or bleeding episodes have been recorded. Considerations and conclusions are offered from the study of this small series of patients.

Adolescent↗
PubMed1984

[Isolated straddling tricuspid valve. Presentation of 2 cases operated on successfully].

During the period May 1977-September 1983 in the Department of Cardiac Surgery of Massa Hospital two patients with isolated straddling tricuspid valve were studied with cardiac catheterization and selective angiocardiography and subsequently underwent surgical correction. The first patient, a 38-month-old white boy presented with "complete straddling" according to Bharati and Lev classification; the second, a 39-month-old white boy presented with "peripheral straddling". In both cases at surgery the ventricular septal defect was closed with a Teflon patch, sparing the chordae tendinae and the "straddling" papillary muscle. Both patients survived operation. The first one developed a complete atrioventricular (A-V) block with a ventricular rate which never was below 80 beats/min, during the 30 days of in-hospital observation. No permanent pacemaker was therefore inserted. The follow-up controls (39 and 79 months respectively) shows both patients to be hemodynamically and functionally well.

Child, Preschool↗
PubMed1983

Successful repair of delayed rupture of the left ventricular wall after mitral valve replacement. Report of two cases.

Rupture of left ventricular wall (LVWR) following mitral replacement (MVR) is rare (0.5 to 7.3% of all MVR). Two "types" of LVWR have been recognized and attributed to technical errors during MVR and/or to co-existing unfavourable conditions. The two types are precisely located, and appear "early" during operation, at discontinuation of cardiopulmonary bypass (CPB). Miller et al. have described a "third type" LVWR which depends primarily on local conditions, is located between the other two and occurs "late". Successful repair is rare. The outcome is favourably influenced by intraoperative recognition. This paper reports two LVWRs "type III" which occurred among 282 MVR (0.7%) done in our Department since 1977. Both were successfully repaired respectively 12 (and again 48) and 15 hours after MVRs. To the best of our knowledge these are the only cases of successful repair of a "type III" LVWR reported in the literature. On the basis of this experience some considerations are presented.

Aged↗
PubMed1982

The syndrome of congenital absence of the pulmonary valve: pathological, clinical and surgical considerations.

Four cases of congenital absence of the pulmonary valve are described. Three of them underwent successful operation. The fourth case, operated on in the first days of life, died because of severe respiratory distress. After examining the embryological aspects of this malformation, its treatment is discussed in relation to particular respiratory problems in infants and to the possibility of inserting prosthetic valves in children undergoing elective surgical treatment.

Bioprosthesis↗
PubMed1982

Ventricular septal defect associated with aortic regurgitation. Surgical considerations.

Fifteen consecutive cases of ventricular septal defect (VSD) associated with aortic regurgitation (AR), observed from January 1972 to November 1980 in the Department of Cardiac Surgery of Massa Hospital were evaluated from a pathological and hemodynamic point of view and surgically treated. All patients underwent cardiac catheterization and selective aortography before and after surgical correction. The VSD was closed by Dacron patch in 10 cases and by direct suture in 5. Aortotomy was performed in 9 patients who presented moderate to severe AR; among these 7 underwent valvular repair and two prosthetic replacement. One patient died (6.6% mortality) 8 days after the operation; another developed complete atrioventricular block requiring insertion of epicardial pace-maker. Residual AR has been found in only one of the 6 patients with preoperative mild degree of AR in whom only the closure of the VSD was carried out. Residual AR is also present in 4 patients who required valvular repair, but only in one it is severe. We favor correction at preschool age on the principle that early closure of the VSD may control or prevent the progression of AR. However, in small children in whom the severity of AR may suggest the necessity of valve replacement, the operation is postponed as long as possible to avoid functional prosthetic stenosis later in life.

Adolescent↗
PubMed1982

[Ostium secundum type of interatrial septal defect associated with cleft mitral valve].

Eight patients (7 females and one male) ranging in age from 6 to 30 years (mean 11.2 years), with secundum-type atrial septal defect (o.s. ASD) and cleft mitral valve (CVM) were surgically corrected at the Cardiac Surgery Department of Massa Hospital (Massa-Italy) from 1974 to 1981. All patients were studied with non invasive diagnostic techniques and with cardiac catheterization and angiography. All had mitral regurgitation of variable degree. On the ECG, there were P and QRS wave abnormalities but no superior quadrant QRS axis deviation suggestive of endocardial cushion defect. At operation the cleft(s) was found in variable positions: on the anterior leaflet in 4 cases and on the posterior leaflet in four. In two cases there was a double cleft. Correction was accomplished in 5 cases with direct repair of CVM, associated with various types of anuloplasty and in 2 cases anuloplasty only was done, without suturing the cleft. The septal defect was closed by direct suture in one case and with a Dacron patch in the remaining seven. There was one early death in the first 24 hour post-operatively. The seven surviving patients have been followed for a period of time ranging between 2 and 93 months (mean 29 months). No survivor has been re-evaluated by cardiac catheterization and cineangiography. No patient shows clinical or non-invasive evidence of residual mitral regurgitation behind grade I (slight). We conclude that: 1) the CVM associated with o.s. ASD cannot be securely diagnosed preoperatively with the common diagnostic techniques, even when producing severe mitral regurgitation, except perhaps by B-mode echocardiography; 2) the CVM (part of the spectrum of endocardial cushion defect malformations) in no cases was associated with the typical ECG or angiocardiographic abnormalities; 3) the CVM associated with o.s. ASD should always be repaired because, compared to the CVM that occurs with endocardial cushion defects, its site and regurgitation characteristics are variable, and simple ASD closure may not be sufficient.

Adolescent↗
PubMed1980

Interventricular septal defect with aortic insufficiency--surgical considerations.

Fourteen consecutive cases of ventricular septal defect (VSD) associated with aortic insufficiency (AI) are considered from a pathological and surgical point of view. In one operated patient the AI was due to previous endocarditis with perforation of both coronary cusps. In the remaining 6 cases one or 2 aortic cusps were prolapsed. Closure of VSD was accomplished with teflon patches in 6 and with direct suture in one. The aortic valve was replaced with an aortic Bjork-Shiley prosthesis in one case, and simple valve reconstruction was carried out in the remaining 6 patients. There was no mortality. In 3 patients who presented with residual AI one month after operation, the cardiothoracic ratio and the electrocardiogram have nevertheless returned progressively to normal limits. The authors favor correction at preschool age on the principle that early closure of the VSD may prevent or control the AI. However, in small children in whom the severity of AI may suggest the necessity for valve replacement, the operation is postponed as long as possible to avoid functional prosthetic stenosis later in life.

Adolescent↗