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3 results on '"Parretti di Iulio D"'

1. [Ventricular-infundibular morphology in visceral heterotaxia with left isomerism. An echocardiographic-angiocardiographic study]

Author

Vairo U, Marino B, Parretti di Iulio D, Guccione P, Carotti A, Roberto Formigari, Grazioli S, Bolla G, Squitieri C, and Pasquini L

Subjects
Adult, Heart Defects, Congenital, Levocardia, Male, Angiocardiography, Infant, Newborn, Infant, Dextrocardia, Echocardiography, Doppler, Electrocardiography, Echocardiography, Child, Preschool, Humans, Female, Child
Abstract

We report 2D-echocardiographic and angiocardiographic assessment of 28 cases of visceral heterotaxia with left atrial isomerism, with particular emphasis on infundibular ventricular morphology. Ventricular D-loop was present in 15 cases (52.6%), and ventricular L-loop in 13 (46.4%); 25/48 patients had concordant ventricular loop and cardiac position (89.3%). In 18 patients (64.3%) there were 2 balanced ventricles; of the other 10 patients, 9 (32.1%) presented right and 1 (3.6%) left ventricular dominance. Ventricular septal defect was present in 12 cases (42.8%). Ventriculo-arterial connections were concordant, with "normally related" great arteries in 9/15 cases with ventricular D-loop (60%). In these cases, ventricular morphology, connections and relations of the great arteries were typical of situs solitus. In the remaining 6 patients there was double-outlet right ventricle, also with normally related great arteries. In 12/13 cases (92.3%) with ventricular L-loop ventriculo-arterial connections were concordant with "mirror image normally related" great arteries. In these cases, ventricular morphology, connections and relations of the great arteries were typical of situs inversus. In one patient there was double-outlet right ventricle, also with mirror image normally related great arteries. Twelve patients (42.8%) had pulmonary stenosis and 5 had a systemic outflow obstruction (17.8%). From these observations we conclude that ventriculo-infundibular morphology, either of situs solitus-type or of situs inversus-type, is a typical anatomical feature of left atrial isomerism. These results may have important implications in the diagnosis and in the surgical management of patients with left atrial isomerism.

Published
1991

2. [Right atrial isomerism with pulmonary atresia: the angiocardiographic characteristics and pulmonary circulatory patterns].

Author

Vairo U, Marino B, Parretti di Iulio D, Papa M, Donfrancesco C, Cicini MP, Grazioli S, and Di Donato RM

Subjects
Angiocardiography, Female, Heart Atria abnormalities, Heart Atria diagnostic imaging, Heart Atria physiopathology, Heart Defects, Congenital physiopathology, Humans, Infant, Infant, Newborn, Male, Pulmonary Artery diagnostic imaging, Pulmonary Artery physiopathology, Heart Defects, Congenital diagnostic imaging, Pulmonary Artery abnormalities, Pulmonary Circulation
Abstract

The patterns of pulmonary circulation were assessed by angiography in a series of 24 patients with right atrial isomerism (asplenia syndrome) and pulmonary atresia. Mean age at catheterization was 21.5 days (range 1 day-11 months). The pulmonary arteries were confluent in 22 cases (91.7%). Eighteen patients (75%) had ductus-dependent pulmonary circulation in presence of confluent pulmonary arteries, similar to cases of pulmonary atresia combined with complex congenital heart disease. The ductus appeared in continuity with the aortic arch, shaping an acute angle with the descending aorta, as in cases of pulmonary atresia with ventricular septal defect. A bilateral ductus was present in 5 cases (20.8%), 3 with confluent and 2 with nonconfluent pulmonary arteries. One patient presented multiple systemic collaterals to the lungs. All the other patients had normal arborization of the pulmonary arteries. Seven patients presented an obstructed total anomalous pulmonary venous connection: 4 in inferior vena cava and 3 in superior vena cava. These anatomical observations provide useful information for the surgical palliation of these anomalies and, probably, warrant pre-operative angiographic evaluation in all the patients with right atrial isomerism.

Published
1991

3. [Interventricular muscular defect in the atrioventricular canal].

Author

Papa M, Marino B, Vairo U, Nava S, Parretti Di Iulio D, Donfrancesco C, Cicini MP, Grazioli S, Mazzera E, and Marcelletti C

Subjects
Abnormalities, Multiple epidemiology, Angiocardiography, Down Syndrome complications, Echocardiography, Heart Septal Defects complications, Heart Septal Defects epidemiology, Humans, Incidence, Abnormalities, Multiple diagnosis, Heart Septal Defects diagnosis
Abstract

The muscular ventricular septal defect associated with the atrioventricular canal is a malformation which has not yet been extensively studied. Between June 1982 and December 1989, 151 patients with atrioventricular canal underwent echocardiography and angiocardiography in our Department. Of these 95 (62.9%) had a complete form and 56 (37.1%) a partial. Among the 151 patients, 81 (53.6%) presented Down syndrome. We found 5 muscular ventricular septal defects in 4 patients; in 3 cases there was a single defect and in one case two defects. These defects were midmuscular in all patients and one patient also presented an apical defect. All 4 patients with muscular ventricular septal defect presented a complete atrioventricular canal and aortic coarctation; 3 out of 4 patients had a hypoplastic left ventricle with absence of Down syndrome. The muscular ventricular septal defect is a malformation which is rarely associated with atrioventricular canal (4/151 = 2.6%). In our experience, it was always associated with a complete form with aortic coarctation and was very rare in Down syndrome patients (1/81 = 1.2%). These findings may represent a peculiar association of anomalies which may be caused by fetal hemodynamic mechanisms.

Published
1990

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