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Uberto Da Col

Publications and source records attributed to Uberto Da Col.

7 recordsLinked to original sources
PubMed2006

Noninvasive midterm follow-up of radial artery bypass grafts with 16-slice computed tomography.

BACKGROUND: The standard invasive procedure to evaluate graft patency is selective coronary angiography. The recent introduction of a new generation of multidetector row computed tomography made possible the noninvasive study of grafts with excellent results in terms of visualization and resolution. We used computed tomography to study all patients with a radial artery graft operated on in 2002. METHODS: Between April and October 2005, we reviewed all patients operated on by coronary artery bypass grafting at our institution between January and December 2002. A total of 62 patients received a radial artery graft. Of these, 22 were lost at the time of follow-up. The other 40 patients were enrolled for a multidetector row computed tomography study. Demographic and instrumental data were collected for all the patients. A total number of 145 grafts were studied, with complete and excellent visualization. RESULTS: The scans revealed a 97.77% (44 of 45) patency rate for left internal mammary arteries, 90.57% (48 of 53) for vein grafts, and 73.91% (34 of 46) for radial arteries (mammary artery plus vein grafts versus radial artery patency, p < 0.001). If analyzed for target vessel, we found the poorest result of radial grafts when placed on the right coronary artery (40% [2 of 5] patency rate). CONCLUSIONS: Noninvasive control of previously bypassed patients is feasible, with no discomfort for them and excellent visualization of grafts. The use of the radial artery as a conduit for bypass graft can be achieved with good results, after a careful choice of the target vessel.

Coronary Angiography↗
PubMed2005

[Risk evaluation in coronary surgery: a single center experience using the EuroSCORE].

BACKGROUND: One of the most utilized systems for risk stratification in cardiac surgery is the EuroSCORE. It considers some risk factors that should influence the surgical risk. The aim of this study was to evaluate if our results, related to isolated coronary artery bypass surgery, are well predictable by this system and which are the parameters statistically significant for hospital mortality. METHODS: From January 1, 2002 to April 30, 2004, 724 patients underwent isolated myocardial revascularization. All risk factors considered for the EuroSCORE system evaluation and the EuroSCORE value itself were analyzed to assess their significance to predict surgical risk. Univariate statistical analysis was performed with the Student's t-test for quantitative variables and the chi2 in contingency tables for categorical variables. Logistic regression was used for multivariate analysis. RESULTS: Cumulative operative mortality was 3.7% (27 patients). The EuroSCORE value, age, critical preoperative state, emergency and low ejection fraction were all statistically significant risk factors for hospital mortality. Multivariate analysis excluded only the critical preoperative state. The analysis of contingency tables showed that the surgical risk was statistically significant above the age of 75 years. The same analysis revealed that the mortality rate was statistically different in the three groups and it showed that the system could over-estimate mortality at lower EuroSCOREs and under-estimate mortality at higher EuroSCOREs. CONCLUSIONS: This study confirms the value of the EuroSCORE for risk stratification in this group of patients. The most important parameters considered for its calculation confirmed their predictive value. This model allows a reliable quality control of our surgical practice.

Adult↗
PubMed2003

[Surgical myocardial revascularization in patients over and under 70 years of age: results and prognostic factors].

BACKGROUND: The increase in mean age has made older patients candidates to myocardial revascularization. This study is focused to evaluate hospital mortality and major postoperative complications in two groups of patients < or = 70 or > 70 years. The possible confounder effect of other important risk factors has been studied in multivariate models. METHODS: From January 1 to December 31, 2002, 228 patients < or = 70 years (group A) and 116 patients > 70 years (group B) underwent isolated myocardial revascularization. We analyzed the incidence of hospital mortality, cardiac failure, postoperative bleeding, major arrhythmias, atrial fibrillation, respiratory failure, renal failure, sternal infection, stroke, transient ischemic attack, total neurological complications, and number of patients with at least one of these complications. Univariate statistical analysis was used to compare this two groups and multivariate analysis to adjust for four known important risk factors, i.e. sex, diabetes, ejection fraction < 0.40, and off-pump surgical technique. RESULTS: Hospital mortality was statistically higher in group B than in group A (7.8 vs 1.7%, p < 0.05). The incidence of cardiac failure, although higher in group B, was not statistically significant. Multivariate analysis confirmed low ejection fraction as the only statistical risk factor for low cardiac output (p < 0.05). Atrial fibrillation was statistically higher in group B (p < 0.05). No difference was found for all other complications considered. Age, low ejection fraction and the use of cardiocirculatory bypass at multivariate analysis were statistically significant risk factors for the incidence of at least one postoperative event. CONCLUSIONS: Myocardial revascularization in patients > 70 years has a higher mortality and morbidity. At multivariate analysis, low ejection fraction is also confirmed as a significant risk factor for low cardiac output and total morbidity. At the same time, the technical option of "beating heart" myocardial revascularization seems to achieve better results and probably it should be used more extensively in this group of patients.

Age Factors↗
PubMedDate not supplied

Triangular resection and folding of posterior leaflet for mitral valve repair.

The conventional treatment of mitral insufficiency, due to posterior leaflet prolapse, is quadrangular resection. This technique sacrifices a great amount of valve tissue resulting in leaflet stiffness and altered annular geometry. To avoid such problems we performed a small triangular leaflet resection sparing the second-order chordae, a folding plasty, implantation of artificial chordae, and annuloplasty. Fourteen patients underwent this procedure. No hospital death and no repair failure were observed. Echocardiography at 12 months on 12 patients showed trivial incompetence in three and mild in one and an overall improvement of end-diastolic and end-systolic diameters. Our technique has the main objectives of sparing second-order chordae and subvalvular apparatus in order to preserve mobility of the posterior mitral leaflet, left ventricular geometry, and function. Preliminary results are encouraging.

Chordae Tendineae↗