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S Pipitone

Publications and source records attributed to S Pipitone.

15 recordsLinked to original sources
PubMed1996

[Modified technique for dilatation of pulmonary valve stenosis (nearly atresia) in a neonate].

A modified technique for pulmonary valvuloplasty is described in a 1-day-old newborn with near pulmonary atresia. A transumbilical venous approach and a complete set of devices for coronary angioplasty were utilized; the principal technical innovation was the use of a 7 French right coronary artery guiding catheter. This allowed a firm support to advance the first balloon catheter (a 3.5 coronary angioplasty catheter) through the pulmonary valve, maintaining the guidewire in a stable position in the descending aorta. The dilation was easily completed with progressively larger balloons. The total procedure time was 82' (fluroscopy time 20'), significantly shorter than the previous personal experience and the data from the literature.

Catheterization↗
PubMed1992

[Involvement of the heart valves and great vessels in homozygote familial hypercholesterolemia].

Homozygous familial hypercholesterolaemia is characterized by cutaneous xanthoma development from infancy, precocious and accelerated atherosclerosis with clinical signs of ischemic heart disease and frequent involvement of left heart valves resulting in stenosis and/or incompetence. Two cases are described of this condition, both associated with aortic stenosis. In one case mitral incompetence and thromboembolic pulmonary hypertension were also found. The mitral valve is involved in the atherosclerotic process at the level of the cusps. These become thickened and stiff. Aortic stenosis is mainly due to atheromas infiltrating the Valsalva sinuses and the ascending aorta. Pulmonary hypertension, never reported before in this disease, is probably due to concomitant atheromatosis involving the pulmonary artery with secondary fatty embolism.

Aortic Valve Stenosis↗
PubMed1992

[Aortocoronary bypass in a child with Kawasaki disease: the follow-up results].

The Kawasaki disease (mucocutaneous lymph node syndrome) usually affects children younger than 5 years, and is considered one of the most important causes of myocardial infarction in children. Some disagreement still exists regarding the following: the selection, surgery techniques, and follow-up outcomes of aortocoronary bypass grafting in Kawasaki disease. We describe the case of a three-year-old child with Kawasaki disease and with left and right multiple aneurysms, suffering from an antero-lateral myocardial infarction and inferior reinfarction. After thrombolytic treatment and coronary arteriography, left anterior descending aortocoronary bypass grafting was performed by using the autologous saphenous vein. After two years clinical, angiographic, ergometric and echocardiographic examinations show good surgical results with a global and regional kinesis improvement.

Child, Preschool↗
PubMed1990

[Mitral valve replacement in young children: a long-term follow-up].

The Authors report follow-up data (mean 60, range 13-101 months) from 4 patients under two years of age (mean 11.5 months) operated on for prosthetic mitral valve implantation. Two patients were male and two female. Pre-operative diagnosis was partial atrioventricular septal defect with parachute mitral valve in one case and isolated mitral valve anomaly in the others (1 parachute, 2 hammock valves). One bioprosthesis (Liotta n. 23) and three mechanical prostheses (Björk-Shiley) were implanted. Complications occurred in two patients: one case of endocarditis on the bioprosthesis, leading to substitution with a Björk-Shiley valve; one case of acute thrombosis 8 months after implantation in the only pt receiving aspirin as prophylactic therapy. This complication was resolved by intravenous thrombolytic agents. All the patients are alive, in I NYHA functional class and receiving oral anti-coagulants. Instrumental follow-up with eco-Doppler demonstrated normal functioning prostheses in all the patients. A sub-aortic gradient was found in the patient with partial atrioventricular septal defect. Prosthesis-patient mismatch was identified in a patient operated on when she was 6 months old who was followed-up for 5 years.

Bioprosthesis↗
PubMed1987

[Angiocardiography with axial projections in the study of various types of intraventricular septal defects].

The exact site of an interventricular septal defect (VSD) is important mainly to program surgical treatment. The present study takes into consideration the possibility of the axial angiocardiographic method to identify the site of the interventricular septal defect. With this goal 126 cases of VSD in infancy were retrospectively studied with left ventriculograms using angled "long-axial" and "four chambers" views. In 62 cases the anatomic-angiographic correlation of the VSD site was reached, and was confirmed at surgery. The most frequent localization of the VSD was perimembranous (89 cases, 70%). The rarest localizations were the sub-arterial and the multiple VSD. The personal experience agrees with the data found in literature, namely that angiocardiography performed with axial views has an elevated diagnostic reliability in the various types of VSD.

Angiocardiography↗
PubMed1987

[Atresia of the tricuspid valve and total anomalous supracardiac pulmonary venous return. Description of a case associated with severe extracardiac malformations].

The Authors report a case of tricuspid atresia and total anomalous pulmonary venous return of the supracardiac type, with mild pulmonary valve stenosis and extracardiac malformations as anal atresia, microphthalmia and irideo and chorioretinic coloboma. The Authors stress the importance of the electrocardiogram and standard chest X-Ray to "suspect" this rare association.

Abnormalities, Multiple↗
PubMed1986

[Clinical and angiocardiographic observations on the so-called absence of a branch of the pulmonary artery].

We present 5 cases with angiographically absent pulmonary artery: 4 with absence of right pulmonary artery and 1 with absence of the left. We excluded cases of atresia of pulmonary artery, ventricular septal defect and major aorto-pulmonary collaterals. We excluded also cases of anomalous origin of a pulmonary artery from the aorta. Surgical inspection in 3 patients demonstrated total absence of pulmonary main branch (1 case), with intraoperative death, and presence of the hilar portion of the pulmonary artery (2 cases), with successful palliative procedure. It is supportive of efforts to identify as early in life as is feasible the absent vessel, for surgical purposes. In fact the early surgical procedure will ensure development of the vessel and normal lung growth, and will decrease the risk of the following intracardiac repair, when needful.

Angiocardiography↗
PubMed1985

Broncho-atrial discordance. A clinically diagnosed case.

Determination of the arrangement of the atrial chambers ("atrial situs") is the first step in sequential chamber analysis of complex congenital heart disease. Although bronchial pattern, as detected by chest X-ray, is an excellent guide for prediction of atrial arrangement, exceptions to this rule based on post-mortem examination have been described. We report a case in which discordance between the atrial arrangement (mirror-image) and bronchial morphology (usual) was diagnosed during life.

Bronchography↗
PubMed1981

[Interventricular defect with discrete aortic stenosis below the defect].

"Discrete" (fixed) subaortic stenosis associated with ventricular septal defect (VSD) is a rare but important anomaly. Two types of left ventricular outflow tract obstruction should be distinguished on the basis of its relation with the VSD, depending on whether the stenosis is above or below the defect. The four cases presented here are all in the latter category. Usually the patients belonging in the former category are associated with severe anomalies of the aortic arch. The diagnosis was made by clinical examination and by means of non invasive techniques, ecg, chest x-rays and ecocardiograms in all but one patient (the case "3"), in whom a subpulmonary stenosis (SPS) was associated. The final diagnosis was established by catheterization, which demonstrated the pressure gradient on the withdrawal curve from the apical part of the left ventricle to the aorta, and by contrastography. Three of four patients underwent total correction and are in good condition from 6 to 18 months after surgery, one of these cases had also SPS. In the remaining case, we thought the operation was not indicated on the basis of small size of VSD, of mild pressure gradient, and mild aortic valvular insufficiency (case "4"). The surgical approach to resect the "fixed" obstruction and to closure the VSD was carried out through a right atriotomy in two patients, and through a right ventriculotomy in the patient with SPS. The trans-aortic approach has to be discarded because it affords limited exposure of both defects and could increase the risk of damage of conducting tissue. A careful evaluation of aortic and left ventricular pressure, in association with angled angiography is highly recommended in the study of VSD.

Aortic Stenosis, Subvalvular↗
PubMedDate not supplied

Extreme pulsus alternans with P wave alternans in a child.

Pulsus alternans was observed in a child with left ventricular dysfunction secondary to systemic hypertension. The Echo-Doppler of supravalvular aorta and a simultaneous electrocardiographic trace (ECG) clearly demonstrated the mechanism of an apparent abrupt halving of pulse frequency compared with the ECG, similar to an electromechanical dissociation 2:1. Besides the extreme pulsus alternans, a P wave and a PP cycle length change were also observed. Both mechanical and electrical alternans disappeared with afterload reduction by nitroprusside treatment.

Antihypertensive Agents↗
PubMedDate not supplied

[Physiopathologic findings and surgical treatment in transposition of great vessels: our experience].

Transposition of great vessels (TGV) is the most frequent neonatal cyanotic malformative cardiopathy. The Authors report their experience in surgical anatomical correction of transposition of the great arteries in 55 patients, 44 male and 11 female. Minimum age was 2 days, maximum 6 months. TGV was simple in 38 cases and associated with ventricular defect in 12 cases, with double outlet right ventricle in 3 cases, and with complex cardiopathy in 2 cases. There have been 11 deaths. The cause of death was: cardiac failure in 3 patients, myocardial infarct in 4 patients, respiratory insufficiency in 2 patients, and sepsis in 2 patients. There was one death by myocardial infarction and 1 asymptomatic ostial left coronary stenosis during follow-up (from 1 to 104 months). There were neither anastomotic pulmonary stenosis nor aortic valve incompetence. The authors review the literature on functional and anatomic correction of TGV and underline the importance of precocious anatomic together with early diagnosis, percutaneous atrioseptostomy and pharmacologic (PGE1) therapy in determining further reduction of mortality and to improve late outcome.

Age Factors↗