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Biomedical subjects

V Vanini

Publications and source records attributed to V Vanini.

At least 37 records · Page 2Linked to original sources
PubMed1981

Systemic-pulmonary artery shunt using PTFE prosthesis (Gore-Tex). Early results and long-term follow-up on 105 consecutive cases.

One hundred-five patients (median age 14 months) in whom a PTFE prosthesis was used to create a systemic-pulmonary artery shunt were studied between 1978 and 1980. The prosthesis was mainly used to create a modified Blalock-Taussig anastomosis. Nine patients died in hospital (8.5%, 70% confidence limits: 5.7% to 12.3%). The clinical condition did not appear to be an incremental risk factor, while the young age and the underlying type of disease accounted for the hospital mortality to a large extent. All 96 survivals were available for follow-up information. One graft, which was damaged intraoperatively, occluded 3 months later. The remaining patients have a patent graft 3 months to 36 months (mean 24 months) postoperatively. In 6 patients the patency was assessed angiographically and no damages of the pulmonary artery were observed, therefore this type of palliation is advisable for any patient, particularly in the first year of life.

Adolescent↗
PubMed1981

Waterston anastomosis for initial palliation of tetralogy of Fallot.

Two hundred twenty-seven patients (median age 5.4 months) in whom a Waterston anastomosis was done for initial palliation of tetralogy of Fallot between 1966 and 1979 were studied. Twelve patients died in the hospital (5.3%; 70% confidence limits, 3.8% to 7.3%). Young age, low weight, and poor clinical condition did not appear to be incremental risk factors, whereas a too large or a too small shunt was largely responsible for the hospital mortality and morbidity. Follow-up information was available in all the 215 patients discharged from the hospital. At the last follow-up visit, before any further surgical procedure, 74% of the patients were clinically in good condition. By actuarial methods, 97.7% of hospital survivors were alive and 95.8% were event-free at and beyond 3 years postoperatively. Eighty-six patients have been catheterized in preparation for secondary repair (mean interval between Waterston shunt and catheterization, 2.9 +/- 1.38 years). One patient developed pulmonary vascular disease, four acquired pulmonary atresia, and 14 had a severe kinking of the right pulmonary artery at the site of the anastomosis.

Angiocardiography↗
PubMed1981

In vitro comparison of oxygen availability from asanguinous and sanguinous cardioplegic media.

Repayment of oxygen debt by periodic reperfusion of the ischemic myocardium is determined in part by the oxygen deliverability of the infusate. Total oxygen content of the infusate may not reflect what is available to the tissue. Available oxygen was measured at 10 degrees C and 20 degrees C by equilibrating 0.05 ml of infusate with 2.85 ml of deoxygenated normal saline; an oxygen electrode quantitated its release into the saline. Sanguinous cardioplegic media at 10 degrees C released 2.41 +/- 0.15 ml O2/100 ml, representing only 37--38% of their total oxygen content, and 3.12 +/- 0.17 ml O2/100 ml at 20 degrees C, representing 50% of their total content. Oxygenated asanguinous media released 4.06 +/- 0.10 ml O2/100 ml at 10 degrees C and 4.00 +/- 0.09 at 20 degrees C, representing their total oxygen content. Thus, oxygenated crystalloid media can deliver as much oxygen as sanguinous media at these low temperatures.

Blood↗
PubMed1980

Surgical repair of persistent truncus arteriosus in infancy.

Fourteen patients younger than two years of age with persistent truncus arteriosus underwent primary repair. Twelve of them were less than 1 year and 4 less than 3 months of age. Intractable heart failure was the indication for surgery in all patients but one who had increased pulmonary vascular resistance. There were 5 hospital and 2 late deaths. Six out of the 7 survivors (median follow-up: 29 months) were symptom-free. The remaining infant who preoperatively had significant truncal valve regurgitation was doing fairly well 2 1/2 years after repair. Our experience suggests that, although the mortality remains high, primary repair for infants with persistent truncus arteriosus is feasible and offers better overall results than does pulmonary artery banding followed by later intracardiac repair. We advise primary repair for all infants with intractable heart failure or increasing pulmonary vascular resistance with or without truncal valve regurgitation. Elective repair is recommended before the age of 2 years to minimize the risk of pulmonary vascular disease.

Follow-Up Studies↗
PubMed1979

Transposition of the great arteries. Successful Senning's operation in 35 consecutive patients.

Mustard's operation for TGA (transposition of the great arteries) has been obstructive complications. In order to try to avoid these complications, we used Senning's operation for TGA. Our experience in 35 consecutive cases is reported. There were no operative or late deaths. Four patients had a PDA; three had a significant VSD with subpulmonary stenosis in two. Previous atrial septectomy and persistent LSVC did not represent contraindications to this procedure. The postoperative course has been smooth and uneventful in all patients. Follow-up periods of one to twenty months demonstrated sinus rhythm in all patients and there were no significant gradients between the venae cavae and the new systemic atrium in 12 reinvestigated patients. On the basis of these results, Senning's operation is recommended as a valid alternative to Mustard's operation.

Cardiac Catheterization↗
PubMed1979

Repair of tetralogy of Fallot after Waterston anastomosis.

Sixty-three corrective operations have been performed in patients with Tetralogy of Fallot and a previously constructed Waterston shunt. The patients were from 1.4 to 8 years of age (median 4.3 years), and the mean interval between the Waterston shunt and the repair was 39.3 +/- 16.05 months. Three patients developed pulmonary atresia and six required a second anastomosis prior to intracardiac repair. Kinking and stenosis of the right pulmonary artery at the site of the Waterston anastomosis occurred in 12 (19 percent; 70 percent confidence limits 14 to 26 percent) patients who required patch enlargement of the right pulmonary artery at repair. Seven (11 percent; 70 percent confidence limits 7 to 17 percent) patients died in the hospital and three (5 percent; 70 percent confidence limits 2 to 11 percent) during the period of late follow-up. None of the early or late deaths was specifically related to the presence of the previously performed Waterston anastomosis.

Age Factors↗
PubMed1979

Experience in palliative treatment of univentricular heart including tricuspid atresia.

Over a period of ten years 110 patients with univentricular heart, including cases with tricuspid atresia, received palliation. The overall hospital mortality was 14.5%. Late mortality during a mean follow-up period of two years, was 6%. A group of patients with univentricular heart ("complex" group: 21 cases) had numerous and significant associated anomalies which affected the surgical results (16 survivors). Eight patients were discovered to have univentricular heart only at open heart surgery (5 survivors). In the remaining patients hospital mortality was 7.4% (6/81). As compared with the natural history these results indicate that palliative surgery is still an effective type of treatment for these two severe cardiac malformations.

Heart Defects, Congenital↗
PubMed1978

[The Senning operation for correction of transposition of the great arteries (author's transl)].

The reported incidence of the main complications related to the Mustard operation for correction of transposition of the great arteries seems to be quite high: more than half patients develop arrhythmias and about one third develop venous (pulmonary or sistemic) obstructions. For these reasons we have reconsidered the type I (1959) Senning operation. Ten children below two years of age (body weight ranging from 3.9 to 12 Kg) have been operated on with this technique at our Institution. Nine were D-TGA and one L-TGA. One patient had a small VSD and three had mild pulmonary outflow stenosis (p less than 30 mmHg). All patients survived operation and none suffered from complications. At the time of the discharge from the Hospital all were in sinus rhythm. Late evaluation (24 hours EKG, cardiac catheterization, etc.) is in course. We believe that the Senning operation is easier to perform than the Mustard operation because of its more standardized technique which respects the internal geometry of the heart. Additional advantages are: 1) the intra-atrial conducting pathways are less likely to be damaged; 2) there is a minimal or no need for artificial tissues.

Child, Preschool↗
PubMed1978

Successful surgical repair of double outlet right ventricle with situs inversus, l-loop, l-malposition and subaortic VSD in a 16-month-old patient.

The case of a 16-mth-old patient who had double outlet right ventricle, l-loop and l-malposition in the presence of dextrocardia and situs inversus is presented. A successful repair was performed using an internal conduit to divert the blood from the left ventricle to the aorta. The outflow tract of the right ventricle was then enlarged with a dacron patch. The anatomic variations of double outlet right ventricle surgically corrected are reviewed.

Aorta↗
PubMed1978

[Renal failure and aortic coartaction. Report of two cases of newborns successfully treated (author's transl)].

Congestive heart failure may frequently occur in patients with isolated coarctation of the aorta within the first six months of life. Renal failure is on the contrary a very rare pathologic sequela. This is caused by a low renal blood flow related either to a poorly developed collateral circulation or in those instances of preductal coartation to an early closure of ductus arteriosus. Peritoneal dyalisis is very effective in these critically ill infants both in correcting biochemical abnormalitics and in supporting cardiac performance. Surgical treatment is however the only way to restore normal renal blood flow and good cardiac output. This report describes two patients with isolated coarctation of the aorta in whom renal failure developed within the first two months of life. Both patients were successfully treated by peritoneal dyalisis and subsequent surgical intervention.

Acute Kidney Injury↗
PubMed1978

[Surgical management of ventricular septal defect and coarctation of the aorta. Observations on 40 cases, with particular references to infancy (author's transl)].

Forty patients with V.S.D. and coarctation of the aorta were operated on at Department of Cardiac Surgery, Ospedali Riuniti Bergamo. Surgical management of infants with V.S.D. and coarctation depends on the magnitude of the left to right shunt. Patients may therefore be divided into two groups: 1) those with aortic coarctation and a small V.S.D., who have normal or slightly elevated pulmonary artery pressure. If surgery is required, these patients can be successfully treated by repairing the coarctation alone. Ten cases in our series were operated on using this approach without deaths; 2) patients with coarctation and large V.S.D. and pulmonary hypertension. The management of these infants is controversial. One stage repair was used in four cases without deaths. On the other hand, nine out of 11 patients in whom the V.S.D. was left unrepaired at the same operation died, giving a 81.8% mortality rate. Repair of coarctation with simultaneous banding of the pulmonary artery was equally affected by high mortality. With this approach in 13 patients there were seven deaths, giving a 53.8% mortality rate.

Age Factors↗
PubMed1977

Open heart surgery in the first six months of life.

Intracardiac repair of a variety of cardiac anomalies was performed in 104 infants aged 10 days to 6 mo, presenting with severe hypoxia and/or intractable heart failure. Thirty-eight patients (33 less than three mo of age) did not survive the operation or died during the first postoperative month. Above 6 mo of age, correction of heart defects is often carried out on an elective basis, and results are more favorable. A more convenient choice between corrective and palliative procedures is suggested to achieve better results in the difficult group of patients who require surgery within the first 6 mo of life.

Aortic Valve Stenosis↗
PubMed1976

[Aneurysm of the left ventricle in infants. Report of two cases successfully treated (author's transl)].

Aneurysm of the left ventricle in infants is quite a rare cardiac malformation. In this paper two cases are described, six and seven years old respectively, the first one with a subvalvular annular type of aneurysm, the second with an apical type, both surgically treated with success. Ths most known and most frequent aetiological factors are discussed as well as their possible complications. Surgical treatment (aneurysmectomy) is emphasized as the only effective therapy to date.

Angiocardiography↗