Chronicle / Hinterland
Saturday 28 May 2022
Clelia Paruta, 87, from Scanzorosciate: “I can go back to taking care of my family.” Doctor Tespili: a special valve for you.
«I was afraid of dying and no longer being able to enjoy my 3 children and my 7 grandchildren, the joy and pride of my life. And instead, thanks to a special valve made especially for me and to a doctor who took my situation to heart, today I am still here to take care of my husband, who for a couple of years has been limited in his autonomy by continuous use of oxygen, and to welcome grandchildren on their frequent visits ». He is truly a force of nature Clelia Paruta, married Sarti, 88 years old in Octoberoriginally from the Upper Town but resident for 65 years in Scanzorosciate. And to think that just over three months ago she underwent a delicate heart valve implant surgery due to aortic valve stenosis and severe coronary artery disease he had been suffering from, without knowing it, for some time.
Suddenly a sharp, stabbing pain
It all starts in October 2021, when Ms. Paruta begins to feel that something is wrong. Until then she had always been fine, apart from a few ailments due to her age. “First I started to have some hearing problems, then the palpitations and a malaise arrived but I couldn’t quite define”. The tests to which he undergoes do not reveal anything particular: the electrocardiogram is normal and also the other examinations, ultrasounds of the legs, thyroid and carotids show only a few circulatory disturbances compatible with age. Until one morning, she feels a strong and excruciating sense of constriction and pressure in her chest.
“I was cooking when I suddenly felt a terrible pain in my chest and I fainted. Once I recovered, I found myself lying on the bench at the table with one leg raised. I don’t know how the leg got there, it was probably an instinctive reaction but it could have saved me “
“I was cooking when I suddenly tried a very strong pain in the chest and I fainted. Once I recovered, I found myself lying on the bench at the table with one leg raised. I don’t know how the leg got there, it was probably an instinctive reaction but it could have saved me ».
The fright and the first exams
Mrs. Paruta is frightened, but, being a practical and energetic person, she does not let herself be discouraged, she gets up, washes and changes. She doesn’t call 112, she doesn’t think there is a need. It was just a passing moment, she thinks. On her own initiative, she takes four cardio-aspirins that she finds at home and goes back to her daily chores. “Speaking of what had happened with my children and my grandchildren, I gradually became aware of the risk I had run and that it could have been something serious.” She is prescribed other tests, this time cardiological. And, in fact, anomalies in her heart begin to show up. One of her children, very worried about her, decides to have her visit his trusted cardiologist, Dr. Maurizio Tespiliwho visiting the lady, confirms that there is a severe problem with the aortic valve. It must be operated on and replaced with a valve bioprosthesis. However, among the bioprostheses on the market there is none that is perfectly suited to the anatomical characteristics of the lady’s heart, not to mention age. But Dr. Tespili and his team, considering that Mrs. Paruta is still a self-sufficient woman and full of will to live, decide to contact themanufacturer of some third generation valve bioprostheses to find one specifically for you. The alternative would have been to intervene with a traditional cardiac surgery operation, which was too risky for the age of the lady.
The search for a suitable valve
«By evaluating the valve bioprostheses already available on the market, none were suitable for Ms. Paruta’s needs. So we carried out a thorough research in order to identify a device that could adapt to her anatomy »explains Dr. Tespili.
“The manufacturer of this valve has met our requests, allowing us to take part in the project linked to the new device”
“The manufacturer of this valve has met our requests, allowing us to take part in the project linked to the new device”. Previously studied between Europe and Asia, this valve is consisting of a «skeleton» in Nitinol (Nickel Titanium Naval Ordinance Laboratory) and from pericardium flaps of bovine origin. The lady was the ideal candidate to undergo this type of surgery, having peculiar anatomical characteristics such as a width of the iliac and femoral arteries of at least 6 millimeters and a distance between the origin of the coronaries and the valve plane of at least 12 millimeters. And so in January it comes operated at the Sant’Ambrogio Clinical Institute, where Dr. Tespili heads the Cardiology Unit. The operation, performed under local anesthesia, with the lady awake and responsive, succeeds perfectly. It is the first time in Lombardy and the second in Italy that this type of valve has been implanted. Although it is a minimally invasive interventionin fact, it presents risks and must only be performed in highly specialized centers and after a careful multidisciplinary evaluation. “Through a percutaneous approach we intervened first on the coronary arteries, on which an angioplasty was performed, and then on the aortic valve where the new bioprosthesis (TAVI) was implanted, concentrating two procedures in a single operating session, thus avoiding the need of new hospitalizations for the patient “.
Five days in the hospital
After a very short time, less than 24 hours, in intensive care and a total of five days of hospitalization, Mrs. Paruta returns home, without even having to undergo cardiovascular rehabilitation. “After the first few days of fatigue, I recovered very well, also thanks to the constant affection and support of my loved ones. I also started to devote myself to my daily chores: errands in the village, shopping, cooking and reading. In short, I returned to live. The greatest gift? I still hope to be able to be a mother and grandmother for a long time ».
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