Giornale italiano di cardiologia
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The usefulness of transesophageal echocardiography (TEE) in assessing the postoperative results of aortic root replacement (Cabrol's procedure) was evaluated. ⋯ 1) Complications after Cabrol's procedure are not infrequent; although the real importance of some of them (periprosthetic aneurysm, persistence of dissection) is uncertain, a careful follow-up may be essential to improve the long term survival. 2) TEE is a useful and well-tolerated procedure for postoperative follow-up of patients who underwent aortic root replacement with Cabrol's procedure.
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Since March 1992, an emergency medical system--EMS--(Servizio Emergenze Cardiologiche Territoriale, SECT) operates in the metropolitan area of Turin (130, 16 Km2), for a population of 964,000 inhabitants. SECT is based on a mobile intensive care unit, staffed with a physician and a nurse, trained in advanced cardiopulmonary resuscitation (CPR) and equipped to treat all cardiac emergencies. According to the "Utstein Style" we report the demographic and clinical features of the patients (pts) suffering Cardiac Arrest (CA) and the impact of SECT on out-of-hospital CA. ⋯ The same intervals are significantly longer in not attempted CPR cases: respectively 26.53 +/- 10.73 min (range 10-65) -p < 0.001-, 19.29 +/- 11.3 min (range 5-60) -p < 0.001- and 8.26 +/- 3.96 (range 3-25) -p = NS-. Although far from the international effectiveness standards, SECT seemed to improve the out-of-hospital CA prognosis. High rate of CA occurred at home, time delay in early access link, better trend in survival in lay bystander attempted CPR cases and lack in early defibrillation lead to strategies for system improvement through targeted CPR training as well as semiautomatic external defibrillators introduction.