Publications by authors named "Fortuna Del Gaizo"

3 Publications

  • Page 1 of 1

Aberrant right subclavian artery: the association with chromosomal defects and the related post-natal outcomes in a third level referral centre.

J Obstet Gynaecol 2021 May 27:1-5. Epub 2021 May 27.

Pediatric Cardiology Unit, Monaldi Hospital, University "Luigi Vanvitelli", Naples, Italy.

Aberrant right subclavian artery (ARSA) is the most common embryologic abnormality of the aortic arch. The presence of ARSA has been previously associated with an increased risk of Down syndrome. ARSA at birth may be associated with dysphagia, respiratory distress and stridor and there is no clear evidence-based management. The aim of this study was to describe the associations with chromosomal abnormalities and the postnatal outcome of fetuses diagnosed with ARSA. We analysed fetuses diagnosed antenatally with ARSA between January 2013 and September 2019 in the fetal echocardiography unit of the Hospital Monaldi, University 'Vanvitelli' of Naples, Italy. The results showed fifty fetuses diagnosed with ARSA, all confirmed after birth. The ARSA was an isolated finding in 46 fetuses (92%), while in 4 fetuses the ARSA was associated with other cardiac and/or extra-cardiac anomalies. Only one fetus was diagnosed with trisomy 21 (2%). In this fetus the ARSA was the only ultrasound anomaly identified. There were no cases necessitating referral due to the presence of compression symptoms at birth. The presence of ARSA was associated with trisomy 21 in the 2% of cases in our series and there were no neonatal complications due to airway compression at birth.IMPACT STATEMENT Aberrant right subclavian artery (ARSA) is the most common embryologic abnormality of the aortich arch. ARSA at birth could be associated with dysphagia, respiratory distress and stridor and no evidence-based management of these fetuses has been described yet. The presence of ARSA has been previously associated with an increased risk of Down syndrome. This study confirms known data on association with chromosomal defects and provides some original data on the absence of symptomatology due to tracheal compression with a postnatal follow-up up to three years of age. Our findings suggest that in cases with adequate prenatal assessment performed by experienced clinicians, delivery can safely take place at local hospitals, with no need of referral soon after birth. The use of transthoracic echocardiography to confirm the diagnoses of ARSA after birth and to plan the next follow-up appointments can be supported.
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http://dx.doi.org/10.1080/01443615.2021.1904228DOI Listing
May 2021

Early Detection of Anthracycline-Induced Cardiotoxicity in Long-Term Survivors of Acute Lymphoblastic Leukemia Treated with Low Cumulative Dose.

J Cardiovasc Echogr 2014 Jan-Mar;24(1):25-28

Second University of Naples, Chair of Cardiology, Monaldi Hospital, Naples, Italy.

We investigated the left ventricular (LV) function, using for the first time strain (S) and strain rate (SR) imaging, in long-term survivors affected by acute lymphoblastic leukemia treated with a low cumulative dose of anthracyclines, and in presence of a normal global LV systolic and diastolic function. A total of 21 were enrolled in the study. The mean cumulative dose of anthracylines was 180 mg/m (range: 120-210 mg/m). As control group 21 age-sex matched healthy subjects were included. Radial S (17 ± 3% vs. 55 ± 6%, < 0.0001) and SR (2.1 ± 0.3 vs. 3.0 ± 0.8 1\s, < 0.0001), assessed on the midsegment of the posterior wall from the parasternal views were significantly reduced when compared with controls. Conversely, myocardial performance index was not able to discriminate between patients and controls. In this preliminary study, the myocardial deformation indices appear to be a more sensitive noninvasive technique for detecting subclinical LV dysfunction than other echocardiographic measurements.
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http://dx.doi.org/10.4103/2211-4122.132282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353403PMC
May 2017

Two-dimensional strain and atrial function: a study on patients after percutaneous closure of atrial septal defect.

Eur J Echocardiogr 2009 Mar 26;10(2):256-9. Epub 2008 Aug 26.

Department of Cardiology, Division of Pediatric Cardiology, Second University of Naples-Monaldi Hospital, Via Omodeo 45, Naples 80128, Italy.

Aims: To assess the value of two-dimensional (2D) strain in assessing regional myocardial function along the atrial wall.

Methods And Results: We studied 20 patients late after successful percutaneous atrial septal defect (ASD) closure. The analysis was performed for atrial longitudinal peak systolic strain on the interatrial septum, in correspondence of the device, and on the lateral wall of the left atrium. The speckle tracking indexes demonstrated almost the absence of any deformation on the Amplatzer ASD occluder, a bulky non-contractile element, passively moved by global heart motion. This study in a simple clinical model demonstrates that 2D strain is not influenced by global heart motion and tethering from adjacent segments and can also be used to study the regional atrial function. Moreover, both acquisition and post-processing times of 2D strain were very short, and the reproducibility was very good.

Conclusion: All these above-mentioned characteristics make the 2D strain a tool fully compatible with the clinical scanning, able to provide additional clinical information.
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http://dx.doi.org/10.1093/ejechocard/jen218DOI Listing
March 2009
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