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1. Management of Myocardial Revascularization in Patients With Stable Coronary Artery Disease Undergoing Transcatheter Aortic Valve Implantation

Author

Costa, Giuliano, Pilgrim, Thomas, Amat Santos, Ignacio J, De Backer, Ole, Kim, Won-Keun, Barbosa Ribeiro, Henrique, Saia, Francesco, Bunc, Matjaz, Tchetche, Didier, Garot, Philippe, Ribichini, Flavio Luciano, Mylotte, Dzxcfewarren, Burzotta, Francesco, Watanabe, Yusuke, De Marco, Federico, Tesorio, Tullio, Rheude, Tobias, Tocci, Marco, Franzone, Anna, Valvo, Roberto, Savontaus, Mikko, Wienemann, Hendrik, Porto, Italo, Gandolfo, Caterina, Iadanza, Alessandro, Bortone, Alessandro Santo, Mach, Markus, Latib, Azeem, Biasco, Luigi, Taramasso, Maurizio, Zimarino, Marco, Tomii, Daijiro, Nuyens, Philippe, Sondergaard, Lars, Camara, Sergio F, Palmerini, Tullio, Orzalkiewicz, Mateusz, Steblovnik, Klemen, Degrelle, Bastien, Gautier, Alexandre, Del Sole, Paolo Alberto, Mainardi, Andrea, Pighi, Michele, Lunardi, Mattia, Kawashima, Hideyuki, Criscione, Enrico, Cesario, Vincenzo, Biancari, Fausto, Zanin, Federico, Joner, Michael, Esposito, Giovanni, Adam, Matti, Grube, Eberhard, Baldus, Stephan, De Marzo, Vincenzo, Piredda, Elisa, Cannata, Stefano, Iacovelli, Fortunato, Andreas, Martin, Frittitta, Valentina, Dipietro, Elena, Reddavid, Claudia, Strazzieri, Orazio, Motta, Silvia, Angellotti, Domenico, Sgroi, Carmelo, Kargoli, Faraj, Tamburino, Corrado, and Barbanti, Marco

Subjects
myocardial revascularization, percutaneous coronary intervention, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, outcome, 610 Medizin und Gesundheit, Cardiology and Cardiovascular Medicine, coronary artery disease, transcatheter aortic valve implantation
Abstract

Background: The best management of stable coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI) is still unclear due to the marked inconsistency of the available evidence. Methods: The REVASC-TAVI registry (Management of Myocardial Revascularization in Patients Undergoing Transcatheter Aortic Valve Implantation With Coronary Artery Disease) collected data from 30 centers worldwide on patients undergoing TAVI who had significant, stable CAD at preprocedural work-up. For the purposes of this analysis, patients with either complete or incomplete myocardial revascularization were compared in a propensity score matched analysis, to take into account of baseline confounders. The primary and co-primary outcomes were all-cause death and the composite of all-cause death, stroke, myocardial infarction, and rehospitalization for heart failure, respectively, at 2 years. Results: Among 2407 patients enrolled, 675 pairs of patients achieving complete or incomplete myocardial revascularization were matched. The primary (21.6% versus 18.2%, hazard ratio‚ 0.88 [95% CI, 0.66–1.18]; P =0.38) and co-primary composite (29.0% versus 27.1%, hazard ratio‚ 0.97 [95% CI, 0.76–1.24]; P =0.83) outcome did not differ between patients achieving complete or incomplete myocardial revascularization, respectively. These results were consistent across different prespecified subgroups of patients (< or >75 years of age, Society of Thoracic Surgeons score > or or P values for interaction >0.10). Conclusions: The present analysis of the REVASC-TAVI registry showed that, among TAVI patients with significant stable CAD found during the TAVI work-up, completeness of myocardial revascularization achieved either staged or concomitantly with TAVI was similar to a strategy of incomplete revascularization in reducing the risk of all cause death, as well as the risk of death, stroke, myocardial infarction, and rehospitalization for heart failure at 2 years, regardless of the clinical and anatomical situations.

Published
2022

2. [Updated SICI-GISE position paper on institutional and operator requirements for transcatheter aortic valve implantation]

Author

Tarantini, Giuseppe, Esposito, Giovanni, Musumeci, Giuseppe, Fraccaro, Chiara, Franzone, Anna, Castiglioni, Battistina, La Manna, Alessio, Limbruno, Ugo, Marchese, Alfredo, Mauro, Ciro, Rigattieri, Stefano, Tarantino, Fabio, Gandolfo, Caterina, Santoro, Gennaro, Violini, Roberto, Airoldi, Flavio, Albiero, Remo, Balbi, Manrico, Baralis, Giorgio, Bartorelli, Antonio Luca, Bedogni, Francesco, Benassi, Alberto, Berni, Andrea, Bonzani, Giulio, Bortone, Alessandro Santo, Braito, Giuseppe, Briguori, Carlo, Brscic, Elvis, Calabrò, Paolo, Calchera, Ivan, Cappelli Bigazzi, Maurizio, Caprioglio, Francesco, Castriota, Fausto, Cernetti, Carlo, Cicala, Cinzia, Cioffi, Paolo, Colombo, Antonio, Colombo, Virgilio, Contegiacomo, Gaetano, Cremonesi, Alberto, D'Amico, Maurizio, De Benedictis, Mauro, De Leo, Alessandro, Di Biasi, Maurizio, Di Girolamo, Domenico, Di Lorenzo, Emilio, Di Mario, Carlo, Dominici, Marcello, Ettori, Federica, Ferrario, Maurizio, Fioranelli, Massimo, Fischetti, Dionigi, Gabrielli, Gabriele, Giordano, Arturo, Giudice, Pietro, Greco, Cesare, Indolfi, Ciro, Leonzi, Ornella, Lettieri, Corrado, Loi, Bruno, Maddestra, Nicola, Marchionni, Niccolò, Marrozzini, Cinzia, Medda, Massimo, Missiroli, Bindo, My, Luigi, Oreglia, Jacopo Andrea, Palmieri, Cataldo, Pantaleo, Paolo, Paparoni, Saro Roberto, Parodi, Guido, Petronio, Anna Sonia, Piatti, Luigi, Piccaluga, Emanuela, Pierli, Carlo, Perkan, Andrea, Pitì, Antonino, Poli, Arnaldo, Ramondo, Angelo Bruno, Reale, Maurizio Alessandro, Reimers, Bernhard, Ribichini, Flavio Luciano, Rosso, Roberta, Saccà, Salvatore, Sacra, Cosimo, Santarelli, Andrea, Sardella, Gennaro, Satullo, Gaetano, Scalise, Filippo, Siviglia, Massimo, Spedicato, Leonardo, Stabile, Amerigo, Tamburino, Corrado, Tesorio, Tullio Nicola Maria, Tolaro, Salvatore, Tomai, Fabrizio, Trani, Carlo, Valenti, Renato, Valsecchi, Orazio, Valva, Giuseppe, Varbella, Ferdinando, Vigna, Carlo, Vignali, Luigi, Berti, Sergio, Tarantini, Giuseppe, Esposito, Giovanni, Musumeci, Giuseppe, Fraccaro, Chiara, Franzone, Anna, Castiglioni, Battistina, La Manna, Alessio, Limbruno, Ugo, Marchese, Alfredo, Mauro, Ciro, Rigattieri, Stefano, Tarantino, Fabio, Gandolfo, Caterina, Santoro, Gennaro, Violini, Roberto, Airoldi, Flavio, Albiero, Remo, Balbi, Manrico, Baralis, Giorgio, Bartorelli, Antonio Luca, Bedogni, Francesco, Benassi, Alberto, Berni, Andrea, Bonzani, Giulio, Bortone, Alessandro Santo, Braito, Giuseppe, Briguori, Carlo, Brscic, Elvi, Calabrò, Paolo, Calchera, Ivan, Cappelli Bigazzi, Maurizio, Caprioglio, Francesco, Castriota, Fausto, Cernetti, Carlo, Cicala, Cinzia, Cioffi, Paolo, Colombo, Antonio, Colombo, Virgilio, Contegiacomo, Gaetano, Cremonesi, Alberto, D'Amico, Maurizio, De Benedictis, Mauro, De Leo, Alessandro, Di Biasi, Maurizio, Di Girolamo, Domenico, Di Lorenzo, Emilio, Di Mario, Carlo, Dominici, Marcello, Ettori, Federica, Ferrario, Maurizio, Fioranelli, Massimo, Fischetti, Dionigi, Gabrielli, Gabriele, Giordano, Arturo, Giudice, Pietro, Greco, Cesare, Indolfi, Ciro, Leonzi, Ornella, Lettieri, Corrado, Loi, Bruno, Maddestra, Nicola, Marchionni, Niccolò, Marrozzini, Cinzia, Medda, Massimo, Missiroli, Bindo, My, Luigi, Oreglia, Jacopo Andrea, Palmieri, Cataldo, Pantaleo, Paolo, Paparoni, Saro Roberto, Parodi, Guido, Petronio, Anna Sonia, Piatti, Luigi, Piccaluga, Emanuela, Pierli, Carlo, Perkan, Andrea, Pitì, Antonino, Poli, Arnaldo, Ramondo, Angelo Bruno, Reale, Maurizio Alessandro, Reimers, Bernhard, Ribichini, Flavio Luciano, Rosso, Roberta, Saccà, Salvatore, Sacra, Cosimo, Santarelli, Andrea, Sardella, Gennaro, Satullo, Gaetano, Scalise, Filippo, Siviglia, Massimo, Spedicato, Leonardo, Stabile, Amerigo, Tamburino, Corrado, Tesorio, Tullio Nicola Maria, Tolaro, Salvatore, Tomai, Fabrizio, Trani, Carlo, Valenti, Renato, Valsecchi, Orazio, Valva, Giuseppe, Varbella, Ferdinando, Vigna, Carlo, Vignali, Luigi, and Berti, Sergio

Subjects
Transcatheter aortic valve implantation, Transcatheter aortic valve implantation, TAVI, severe aortic stenosis, Operators, Biomedical Technology, Requirements, Aortic Valve Stenosis, Institutions, Severity of Illness Index, Transcatheter Aortic Valve Replacement, TAVI, Italy, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Training, Humans, Program Development, severe aortic stenosis
Abstract

Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.

Published
2018

3. Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis

Author

Frey, Norbert, Steeds, Richard Paul, Rudolph, Tanja K., Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Lloyd, Guy, Bortone, Alessandro Santo, Hauptmann, Karl Eugen, Clerici, Alberto, Delle Karth, Georg, Rieber, Johannes, Indorfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Lutz, Matthias, Pohlmann, Christiane, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter, Messika-Zeitoun, David, Cardiology, ACS - Heart failure & arrhythmias, and ACS - Pulmonary hypertension & thrombosis

Subjects
Male, Comorbidity, Risk Assessment, Severity of Illness Index, Ventricular Function, Left, aortic stenosis, surgical aortic valve replacement, symptoms, transcatheter aortic valve replacement, age factors, aged, aged, 80 and over, aortic valve, aortic valve stenosis, asymptomatic diseases, comorbidity, cross-sectional studies, europe, female, hemodynamics, humans, male, predictive value of tests, prognosis, prospective studies, registries, risk assessment, risk factors, severity of illness index, ventricular function, left, echocardiography, left, Predictive Value of Tests, Risk Factors, 80 and over, Humans, Prospective Studies, Registries, Aged, Aged, 80 and over, Age Factors, Hemodynamics, Aortic Valve Stenosis, Prognosis, Europe, Cross-Sectional Studies, Echocardiography, Aortic Valve, Asymptomatic Diseases, ventricular function, Female
Abstract

Objective Contemporary data on patients with previously undiagnosed severe aortic stenosis (AS) are scarce. We aimed to address this gap by gathering data from consecutive patients diagnosed with severe AS on echocardiography. Methods This was a prospective, multicentre, multinational, registry in 23 tertiary care hospitals across 9 European countries. Patients with a diagnosis of severe AS were included using echocardiography (aortic valve area (AVA) 4 m/s and/or mean transvalvular gradient >40 mm Hg). Results The 2171 participants had a mean age of 77.9 years and 48.0% were female. The mean AVA was 0.73 cm 2, V max 4.3 m/s and mean gradient 47.1 mm Hg; 62.1% had left ventricular hypertrophy and 27.3% an ejection fraction (EF)

Published
2019

4. A Striking Coronary Artery Pattern in a Grown-Up Congenital Heart Disease Patient

Author

Iacovelli, Fortunato, Pepe, Martino, Contegiacomo, Gaetano, Alberotanza, Vito, Masi, Filippo, Bortone, Alessandro Santo, and Favale, Stefano

Subjects
Article Subject, cardiovascular system
Abstract

Left ventricular noncompaction (LVNC) is a myocardial disorder probably due to the arrest of normal embryogenesis of the left ventricle. It could be isolated or associated with other extracardiac and cardiac abnormalities, including coronary artery anomalies. Despite the continuous improvement of imaging resolution quality, this cardiomyopathy still remains frequently misdiagnosed, especially if associated with other heart diseases. We report a case of LVNC association with both malposition of the great arteries and a very original coronary artery pattern.

Published
2016
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5. Update of the position document of the Italian Society of Interventional Cardiology (SICI-GISE) on the minimum requirements for hospitals and operators performing procedures of a transcatheter implantation of aortic valve prostheses

Author

Tarantini, G., Esposito, G., Musumeci, G., Fraccaro, C., Franzone, A., Castiglioni, B., La Manna, A., Limbruno, U., Marchese, A., Mauro, C., Rigattieri, S., Tarantino, F., Gandolfo, C., Santoro, G., Violini, R., Airoldi, F., Albiero, R., Balbi, M., Baralis, G., Bartorelli, A.L., Bedogni, F., Benassi, A., Berni, A., Bonzani, G., Bortone, A.S., Braito, G., Briguori, C., Brscic, E., Calabrò, P., Calchera, I., Bigazzi, M.C., Caprioglio, F., Castriota, F., Cernetti, C., Cicala, C., Cioffi, P., Colombo, A., Colombo, V., Contegiacomo, G., Cremonesi, A., D'Amico, M., De Benedictis, M., De Leo, A., Di Biasi, M., Di Girolamo, D., Di Lorenzo, E., Di Mario, C., Dominici, M., Ettori, F., Ferrario, M., Fioranelli, M., Fischetti, D., Gabrielli, G., Giordano, A., Giudice, P., Greco, C., Indolfi, C., Leonzi, O., Lettieri, C., Loi, B., Maddestra, N., Marchionni, N., Marrozzini, C., Medda, M., Missiroli, B., Luigi, M., Oreglia, J.A., Palmieri, C., Pantaleo, P., Paparoni, S.R., Parodi, G., Petronio, A.S., Piatti, L., Piccaluga, E., Pierli, C., Perkan, A., Pitì, A., Poli, A., Ramondo, A.B., Reale, M.A., Reimers, B., Ribichini, F.L., Rosso, R., Saccà, S., Sacra, C., Santarelli, A., Sardella, G., Satullo, G., Scalise, F., Siviglia, M., Spedicato, L., Stabile, A., Tamburino, C., Tesorio, T.N.M., Tolaro, S., Tomai, F., Trani, C., Valenti, R., Valsecchi, O., Valva, G., Varbella, F., Vigna, C., Vignali, L., Berti, S., Tarantini, Giuseppe, Esposito, Giovanni, Musumeci, Giuseppe, Fraccaro, Chiara, Franzone, Anna, Castiglioni, Battistina, La Manna, Alessio, Limbruno, Ugo, Marchese, Alfredo, Mauro, Ciro, Rigattieri, Stefano, Tarantino, Fabio, Gandolfo, Caterina, Santoro, Gennaro, Violini, Roberto, Airoldi, Flavio, Albiero, Remo, Balbi, Manrico, Baralis, Giorgio, Bartorelli, Antonio Luca, Bedogni, Francesco, Benassi, Alberto, Berni, Andrea, Bonzani, Giulio, Bortone, Alessandro Santo, Braito, Giuseppe, Briguori, Carlo, Brscic, Elvi, Calabrò, Paolo, Calchera, Ivan, Cappelli Bigazzi, Maurizio, Caprioglio, Francesco, Castriota, Fausto, Cernetti, Carlo, Cicala, Cinzia, Cioffi, Paolo, Colombo, Antonio, Colombo, Virgilio, Contegiacomo, Gaetano, Cremonesi, Alberto, D'Amico, Maurizio, De Benedictis, Mauro, De Leo, Alessandro, Di Biasi, Maurizio, Di Girolamo, Domenico, Di Lorenzo, Emilio, Di Mario, Carlo, Dominici, Marcello, Ettori, Federica, Ferrario, Maurizio, Fioranelli, Massimo, Fischetti, Dionigi, Gabrielli, Gabriele, Giordano, Arturo, Giudice, Pietro, Greco, Cesare, Indolfi, Ciro, Leonzi, Ornella, Lettieri, Corrado, Loi, Bruno, Maddestra, Nicola, Marchionni, Niccolò, Marrozzini, Cinzia, Medda, Massimo, Missiroli, Bindo, Luigi, My, Oreglia, Jacopo Andrea, Palmieri, Cataldo, Pantaleo, Paolo, Paparoni, Saro Roberto, Parodi, Guido, Petronio, Anna Sonia, Piatti, Luigi, Piccaluga, Emanuela, Pierli, Carlo, Perkan, Andrea, Pitì, Antonino, Poli, Arnaldo, Ramondo, Angelo Bruno, Reale, Maurizio Alessandro, Reimers, Bernhard, Ribichini, Flavio Luciano, Rosso, Roberta, Saccà, Salvatore, Sacra, Cosimo, Santarelli, Andrea, Sardella, Gennaro, Satullo, Gaetano, Scalise, Filippo, Siviglia, Massimo, Spedicato, Leonardo, Stabile, Amerigo, Tamburino, Corrado, Tesorio, Tullio Nicola Maria, Tolaro, Salvatore, Tomai, Fabrizio, Trani, Carlo, Valenti, Renato, Valsecchi, Orazio, Valva, Giuseppe, Varbella, Ferdinando, Vigna, Carlo, Vignali, Luigi, and Berti, Sergio

Subjects
Transcatheter aortic valve implantation, Institutions, Operators, Requirements, Training, Cardiology and Cardiovascular Medicine, Requirement, Institution, Operator, Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Abstract

Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program. Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.

Published
2018

6. Prosthesis depth and conduction disturbances after last generation balloon-expandable transcatheter aortic valve implantation

Author

Eugenio Stabile, Alessandro Santo Bortone, Luigi Salemme, Mariangela Cicala, Sebastiano Verdoliva, Gaetano Contegiacomo, Fortunato Iacovelli, Maria Angela Losi, Tullio Tesorio, Antonio Pignatelli, Armando Pucciarelli, Angelo Cioppa, Giovanni Esposito, Grigore Popusoi, Enrico Coscioni, Giuseppe Giugliano, Iacovelli, Fortunato, Pignatelli, Antonio, Giugliano, Giuseppe, Stabile, Eugenio, Cicala, Mariangela, Salemme, Luigi, Cioppa, Angelo, Popusoi, Grigore, Pucciarelli, Armando, Verdoliva, Sebastiano, Bortone, Alessandro Santo, Losi, MARIA ANGELA, Coscioni, Enrico, Esposito, Giovanni, Contegiacomo, Gaetano, and Tesorio, Tullio

Subjects
Male, Pacemaker, Artificial, Aortic stenosi, Time Factors, medicine.medical_treatment, Action Potentials, 030204 cardiovascular system & hematology, Prosthesis, Electrocardiography, 0302 clinical medicine, Heart Rate, Risk Factors, Odds Ratio, Ventricular outflow tract, Fluoroscopy, 030212 general & internal medicine, Aged, 80 and over, medicine.diagnostic_test, Cardiac Pacing, Artificial, Balloon expandable stent, Treatment Outcome, Italy, Aortic Valve, Heart Valve Prosthesis, Cardiology, Female, Cardiology and Cardiovascular Medicine, Atrioventricular block, Balloon Valvuloplasty, medicine.medical_specialty, Transcatheter aortic, Prosthesis Design, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, Humans, Aged, Pacemaker implantation, Conduction abnormalities, Chi-Square Distribution, business.industry, Arrhythmias, Cardiac, Aortic Valve Stenosis, medicine.disease, Logistic Models, Multivariate Analysis, Linear Models, Permanent pacemaker, business
Abstract

Aims Preliminary data on Sapien 3 valve (S3-THV) use for transcatheter aortic valve implantation have shown an increased permanent pacemaker implantation (PPMI) rate with respect to Sapien XT valve. Aim of this study was to investigate the role of S3-THV position in the left ventricular outflow tract (LVOT) on electrocardiographic changes suggestive of atrioventricular (ΔPR) and/or intraventricular (ΔQRS) conduction abnormalities and 30 days PPMI rate. Methods and results Eighty-six consecutive patients treated with S3-THV were included in the study. All patients underwent clinical and electrocardiogram evaluation. Left ventricular outflow tract prosthesis depth was assessed by fluoroscopy and expressed quantitatively (mm) and as aorto-ventricular ratio (AVR). Eight patients (9.3%) needed PPMI at 30 days. A low AVR (≤60/40) predicted PPMI (OR = 6.09, 95% CI 1.19–31.01, P = 0.030) and resulted into higher PPMI rate, compared with higher AVR (30.0 vs. 6.6%, P = 0.017). For each millimetre increase in the LVOT prosthesis depth PPMI risk increased by 1.41 times (95% CI 1.06–1.87, P = 0.017). In patients with low AVR, ΔPR was higher than in those with higher AVR (33.4 ± 56.7 vs. 12.1 ± 19.4 ms, P = 0.021) and ΔPR was associated to LVOT prosthesis depth ( β = 0.286, P = 0.009). Furthermore, ΔPR was associated with risk of PPMI (OR = 1.03, 95% CI 1.01–1.06, P = 0.024). Conclusions A low AVR is associated to higher ΔPR and PPMI rates. The correlation between LVOT prosthesis depth with ΔPR and higher PPMI rate suggests the need of a careful S3-THV implantation.

Published
2016

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