[Right atrial-right ventricular anastomosis for correction of tricuspid atresia]. / Correzione dell'atresia della tricuspide con anastomosi diretta tra atrio destro e ventricolo destro.

Primary correction of type 1 b tricuspid atresia with a right atrial-right ventricular anastomosis has been performed on a 23-month-old baby with excellent clinical and hemodynamic results. This type of operation, which has been described for the first time by Björk et al. in 3 patients aged 8, 9 and 12 years respectively, does not require any conduit or prosthesis since it employs the right atrial appendage and a patch of autologous pericardium. The authors review the surgical anatomy of tricuspid atresia, the various operative techniques so far employed for its correction, as well as other congenital heart diseases which could benefit from this surgical procedure. Moreover they underline the advantage of the latter technique which avoids the employment of any foreign material, can be performed in early infancy, and can be considered definitive since it obviates the need for initial palliative procedures.

[Myocardial protection from cardioplegic and hypothermia during aortic cross-clamping (author's ttrans)]. / Protezione miocardica da cardioplegia ed ipotermia durante clampaggio aortico.

The clinical results with cardioplegic solutions and hypothermia during aortic cross-clamping are compared with the clinical results obtained with hypothermia only. To complete the study miocardial biopsies were obtained during aortic cross-clamping in order to evaluate the concentration of ATP and CPK. The obtained data confirm the effectiveness of the myocardial protection.

[The administration of an association of sodium nitroprusside and adrenaline in cardiac surgery (author's transl)]. / L'associazione nitroprussiato di sodio-adrenalina in cardiochirurgia.

In 223 operations of cardiovascular surgery, myocardial performance was supported, after the interruption of cardiopulmonary bypass, by means of a combined and strictly controlled administration of a pure vasodilator drug (sodium nitroprusside) and of an inotropic agent (epinephrine). The reduction of afterload achieved by the former, the increase of contractility and heart rate induced by the latter, the coronary dilator effect of both, associated with an adequate maintaining of preload proved to be rapidly effective. This appeared to be particularly true in patients with overt left ventricular failure after valve replacement and/or myocardial revascularization procedures. The proposed association of drugs and treatment program seem to be an appropriate way of managing the myocardial and hemodynamic response to the metabolic reactivation that follows the surgical ischemic cardiac arrest.

[The biological prostheses of Hancock in our experience of 250 subjects underwent a valvular replacement (author's transl)]. / La bioprotesi di Hancock nella chirurgia delle cardiopatie valvolari acquisite. Esperienza su 250 casi.

In this study we present the results of 5-years Follow-up of Clinical experimentation with biological prostheses of Hancock in 250 patients underwent a valvular replacement at the Cardiovascular Surgery Institute of Padua University in Verona. We report the immediate and long-term results with the death causes and the complications related above all with thrombo-embolic events. For such complications it was done a comparison relatively to the cases with mitral and aortic prostheses, with the results obtained from another Cardiovascular Surgery Center where are always applied artificial prostheses. From this comparison results that Hancock's biological prostheses has a major tendency to give incidence of embolic in the first months following the valvular replacement, but successively it is clearly to be prefered to artificial prostheses.

[Use of the femoral artery for chronic hemodialytic treatment]. / Utilizzazione dell'arteria femorale per il trattamento emodialitico cronico

In 4 patients subjected to periodical haemodialytic treatment a new route of access to the vessels was used; the common femoral artery and the large saphena to the outlet into the femoral vein. All four patients presented serious problems with regard to application of a new shunt in view of the previous reiterated use of the vessels commonly utilized. At the maximum distance of 46 months from implantation, only one of the four by-passes is still in use; 2 were removed for obstruction and the fourth, still operating at the time, was removed for a renal transplant performed on the patient. In view of the frequency of troubles and the use-months of the femoral by-pass compared with the traditional ones, the femoral route of access may be considered favourably when the traditional shunt implantation or fistula creation procedures are precluded.

[Coronary fistula in the right ventricle]. / Fistola coronarica in ventricolo destro

A case of fistula between the left coronary artery and the right ventricle in a girl aged 14 months is described. The description of the case deals with the semeiological classification of cardiocoronary fistulas, the means of investigation and differential diagnostics. The therapy is purely surgical and consists in isolation, ligature and dissection of the anomalous coronary.