Antonio Contaldo - Academia.edu (original) (raw)

Uploads

Papers by Antonio Contaldo

Research paper thumbnail of Mitral valve replacement and limited myectomy for hypertrophic obstructive cardiomyopathy: a 25-year follow-up

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2004

Hypertrophic obstructive cardiomyopathy is a dynamic obstruction of the left ventricular outflow ... more Hypertrophic obstructive cardiomyopathy is a dynamic obstruction of the left ventricular outflow tract caused by septal hypertrophy and systolic anterior motion of the mitral valve. When the condition cannot be controlled by medical therapy the most frequently used surgical approach is left ventricular myotomy-myectomy. Mitral valve replacement (to correct another mechanism of obstruction) is another surgical option; however, its use for this condition is controversial. We review the long-term results of patients who underwent limited left ventricular myotomy-myectomy and mitral valve replacement at our institution. Eighteen patients who had hypertrophic obstructive cardiomyopathy and severe mitral insufficiency underwent surgery between 1978 and 1983: 7 were men and 11 were women (mean age, 41.8 +/- 10.5 years). Preoperatively, most of the patients (78.8%) were in New York Heart Association functional class III or IV. The operation consisted of a shallow myectomy of the hypertrophi...

Research paper thumbnail of Endovascular Repair of a Right-sided Thoracic Aortic Aneurysm with Kommerell Diverticulum and Aberrant Left Subclavian Artery

Annals of Vascular Surgery, 2014

Background: A case of successful total endovascular repair of a right-sided descending thoracic a... more Background: A case of successful total endovascular repair of a right-sided descending thoracic aorta aneurysm (r-DTAA) with Kommerell diverticulum and aberrant left subclavian artery (ALSA) was reported. Few cases of this very rare pathology were reported, mostly describing a hybrid treatment, with only 2 cases of total endovascular repair performed to date. Methods and Results: Our strategy consisted of endovascular ALSA occlusion, without preventive revascularization, and r-DTAA exclusion by 2 endoprosthesis implanted in a telescopic fashion, first the distal one, to achieve a relative straightening of the arch and support the proximal endoprosthesis, and then the proximal one, close to the right subclavian origin. Completion angiography and 12-month computed tomography scan showed successful exclusion, patency of epiaortic vessels, and absence of endoleak. Conclusion: Endovascular repair can be a safe and effective treatment for aortic disease with challenging anatomy, avoiding the need for a complex open surgery procedure.

Research paper thumbnail of Left Heart Pump-Assisted Myocardial Revascularization Favorably Affects Neutrophil Apoptosis

World Journal of Surgery, 2010

Objectives Granulocyte apoptosis is a key control process in the clearance of neutrophils from in... more Objectives Granulocyte apoptosis is a key control process in the clearance of neutrophils from inflammatory sites, and its rate is modulated by a number of inflammatory mediators. In this study, we investigated whether the use of left ventricular-assisted technique (LVA) in beating heart myocardial revascularization would exert less impact on neutrophil apoptosis compared with conventional cardiopulmonary bypass (CPB). Methods Forty consecutive patients who underwent myocardial revascularization were randomly assigned to LVA (group A, 21 patients) or CPB (group B, 19 patients). Blood samples for detection of interleukin-6, interleukin-8, and tumor necrosis factor-a were measured at baseline and at various time points postoperatively. Neutrophil apoptosis was detected by light microscopy as well as by the annexin-V assays together with the activity of caspase 3 on postoperative samples.

Research paper thumbnail of Discrete Subaortic Stenosis: Long-Term Prognosis on the Progression of the Obstruction and of the Aortic Insufficiency

The Thoracic and Cardiovascular Surgeon, 2005

We sought to determine the long-term rate of progression of left ventricular outflow tract (LVOT)... more We sought to determine the long-term rate of progression of left ventricular outflow tract (LVOT) obstruction and aortic insufficiency (AI) in adult patients operated on for discrete subaortic stenosis (DSS). Between 1975 and 1995, 52 patients underwent surgery for DSS; their mean age was 25.4 +/- 14.8 years. Mean preoperative LVOT gradient was 72.8 +/- 25.7 mm Hg. Excision of the subaortic membrane was carried out in all patients, myectomy of the interventricular septum was additionally carried out in 8 patients (15.4 %), and aortic valve replacement (AVR) was performed in 15 patients (28.8 %). There were 2 operative deaths (3.8 %). Early postoperative LVOT gradient was 9.7 +/- 6.5 mm Hg. Follow-up ranged from 8.1 to 26.6 years. There were 8 late deaths (16.3 %), and mean LVOT gradient was 13.3 +/- 10.7 mm Hg. Five patients required reoperation for recurrent obstruction; 4 patients had a gradient of more than 30 mm Hg. The AI, in patients who did not undergo aortic valve replacement, did not substantially change during follow-up. DSS is a variable, unpredictable and progressive disease; recurrent obstruction may reappear despite the adequacy of surgical excision, and is not related to preoperative gradient. Mild AI remains substantially unchanged and AVR is indicated in severe AI.

Research paper thumbnail of Mitral valve replacement and limited myectomy for hypertrophic obstructive cardiomyopathy: a 25-year follow-up

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2004

Hypertrophic obstructive cardiomyopathy is a dynamic obstruction of the left ventricular outflow ... more Hypertrophic obstructive cardiomyopathy is a dynamic obstruction of the left ventricular outflow tract caused by septal hypertrophy and systolic anterior motion of the mitral valve. When the condition cannot be controlled by medical therapy the most frequently used surgical approach is left ventricular myotomy-myectomy. Mitral valve replacement (to correct another mechanism of obstruction) is another surgical option; however, its use for this condition is controversial. We review the long-term results of patients who underwent limited left ventricular myotomy-myectomy and mitral valve replacement at our institution. Eighteen patients who had hypertrophic obstructive cardiomyopathy and severe mitral insufficiency underwent surgery between 1978 and 1983: 7 were men and 11 were women (mean age, 41.8 +/- 10.5 years). Preoperatively, most of the patients (78.8%) were in New York Heart Association functional class III or IV. The operation consisted of a shallow myectomy of the hypertrophi...

Research paper thumbnail of Endovascular Repair of a Right-sided Thoracic Aortic Aneurysm with Kommerell Diverticulum and Aberrant Left Subclavian Artery

Annals of Vascular Surgery, 2014

Background: A case of successful total endovascular repair of a right-sided descending thoracic a... more Background: A case of successful total endovascular repair of a right-sided descending thoracic aorta aneurysm (r-DTAA) with Kommerell diverticulum and aberrant left subclavian artery (ALSA) was reported. Few cases of this very rare pathology were reported, mostly describing a hybrid treatment, with only 2 cases of total endovascular repair performed to date. Methods and Results: Our strategy consisted of endovascular ALSA occlusion, without preventive revascularization, and r-DTAA exclusion by 2 endoprosthesis implanted in a telescopic fashion, first the distal one, to achieve a relative straightening of the arch and support the proximal endoprosthesis, and then the proximal one, close to the right subclavian origin. Completion angiography and 12-month computed tomography scan showed successful exclusion, patency of epiaortic vessels, and absence of endoleak. Conclusion: Endovascular repair can be a safe and effective treatment for aortic disease with challenging anatomy, avoiding the need for a complex open surgery procedure.

Research paper thumbnail of Left Heart Pump-Assisted Myocardial Revascularization Favorably Affects Neutrophil Apoptosis

World Journal of Surgery, 2010

Objectives Granulocyte apoptosis is a key control process in the clearance of neutrophils from in... more Objectives Granulocyte apoptosis is a key control process in the clearance of neutrophils from inflammatory sites, and its rate is modulated by a number of inflammatory mediators. In this study, we investigated whether the use of left ventricular-assisted technique (LVA) in beating heart myocardial revascularization would exert less impact on neutrophil apoptosis compared with conventional cardiopulmonary bypass (CPB). Methods Forty consecutive patients who underwent myocardial revascularization were randomly assigned to LVA (group A, 21 patients) or CPB (group B, 19 patients). Blood samples for detection of interleukin-6, interleukin-8, and tumor necrosis factor-a were measured at baseline and at various time points postoperatively. Neutrophil apoptosis was detected by light microscopy as well as by the annexin-V assays together with the activity of caspase 3 on postoperative samples.

Research paper thumbnail of Discrete Subaortic Stenosis: Long-Term Prognosis on the Progression of the Obstruction and of the Aortic Insufficiency

The Thoracic and Cardiovascular Surgeon, 2005

We sought to determine the long-term rate of progression of left ventricular outflow tract (LVOT)... more We sought to determine the long-term rate of progression of left ventricular outflow tract (LVOT) obstruction and aortic insufficiency (AI) in adult patients operated on for discrete subaortic stenosis (DSS). Between 1975 and 1995, 52 patients underwent surgery for DSS; their mean age was 25.4 +/- 14.8 years. Mean preoperative LVOT gradient was 72.8 +/- 25.7 mm Hg. Excision of the subaortic membrane was carried out in all patients, myectomy of the interventricular septum was additionally carried out in 8 patients (15.4 %), and aortic valve replacement (AVR) was performed in 15 patients (28.8 %). There were 2 operative deaths (3.8 %). Early postoperative LVOT gradient was 9.7 +/- 6.5 mm Hg. Follow-up ranged from 8.1 to 26.6 years. There were 8 late deaths (16.3 %), and mean LVOT gradient was 13.3 +/- 10.7 mm Hg. Five patients required reoperation for recurrent obstruction; 4 patients had a gradient of more than 30 mm Hg. The AI, in patients who did not undergo aortic valve replacement, did not substantially change during follow-up. DSS is a variable, unpredictable and progressive disease; recurrent obstruction may reappear despite the adequacy of surgical excision, and is not related to preoperative gradient. Mild AI remains substantially unchanged and AVR is indicated in severe AI.