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1. Influence of Vancomycin Minimum Inhibitory Concentration on the Outcome of Methicillin-Susceptible Staphylococcus aureus Left-Sided Infective Endocarditis Treated with Anti-staphylococcal Beta-Lactam Antibiotics; a Prospective Cohort Study by the International Collaboration on Endocarditis

Author

Athan, E., Harris, O., Korman, T. M., Kotsanas, D., Jones, P., Reinbott, P., Ryan, S., Fortes, C. Q., Garcia, P., Jones, S. B., Barsic, B., Bukovski, S., Selton-Suty, C., Aissa, N., Doco-Lecompte, T., Delahaye, F., Vandenesch, F., Tattevin, P., Hoen, B., Plesiat, P., Giamarellou, H., Giannitsioti, E., Tarpatzi, E., Durante-Mangoni, E., Iossa, D., Orlando, S., Ursi, M. P., Pafundi, P. C., D' Amico, F., Bernardo, M., Cuccurullo, S., Dialetto, G., Covino, F. E., Manduca, S., Della Corte, A., De Feo, M., Tripodi, M. F., Baban, T., Kanafani, Z. A., Kanj, S. S., Sfeir, J., Yasmine, M., Morris, A., Murdoch, D. R., Premru, M. M., Lejko-Zupanc, T., Almela, M., Ambrosioni, J., Azqueta, M., Brunet, M., Cervera, C., De Lazzari, E., Falces, C., Fuster, D., Garcia-de-la-Maria, C., Garcia-Gonzalez, J., Gatell, J. M., Marco, F., Miro, J. M., Moreno, A., Ortiz, J., Ninot, S., Pare, J. C., Pericas, J. M., Quintana, E., Ramirez, J., Sandoval, E., Sitges, M., Tolosana, J. M., Vidal, B., Vila, J., Bouza, E., Rodriguez-Creixems, M., Ramallo, V., Bradley, S., Wray, D., Steed, L., Cantey, R., Peterson, G., Stancoven, A., Woods, C., Corey, G. R., Reller, L. B., Fowler, V. G., Chu, V. H., Messina, J. A., Park, L., Sharma-Kuinkel, B. K., Carugati, M., Munoz, P., Baloch, K., Dixon, C. C., Harding, T., Jones-Richmond, M., Pappas, P., Park, L. P., Redick, T., Stafford, J., Anstrom, K., Bayer, A. S., Cabell, C. H., Karchmer, A. W., Sexton, D. J., Wang, A., Chu, V., Durack, D. T., Eykyn, S., Moreillon, P., Olaison, L., Raoult, D., Rubinstein, E., Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Duke University Medical Center, University of Barcelona, Medical University of South Carolina [Charleston] (MUSC), American University of Beirut [Beyrouth] (AUB), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université de Tsukuba = University of Tsukuba, Pericàs, J M, Messina, J A, Garcia-de-la-Mària, C, Park, L, Sharma-Kuinkel, B K, Marco, F, Wray, D, Kanafani, Z A, Carugati, M, Durante Mangoni, E, Tattevin, P, Chu, V H, Moreno, A, Fowler, V G, Miró, J M, De Feo, Marisa, Athan, E11, Harris, O11, Korman, Tm12, Kotsanas, D13, Jones, P14, Reinbott, P14, Ryan, S14, Fortes, Cq15, Garcia, P16, Jones, Sb16, Barsic, B17, Bukovski, S17, Selton-Suty, C18, Aissa, N18, Doco-Lecompte, T18, Delahaye, F19, Vandenesch, F19, Tattevin, P20, Hoen, B21, Plesiat, P21, Giamarellou, H22, Giannitsioti, E22, Tarpatzi, E22, Durante-Mangoni, E23, Iossa, D23, Orlando, S23, Ursi, Mp23, Pafundi, Pc23, D' Amico, F23, Bernardo, M23, Cuccurullo, S23, Dialetto, G23, Covino, Fe23, Manduca, S23, DELLA CORTE, Alessandro, De Feo, M23, Tripodi, Mf24, Baban, T25, Kanafani, Za25, Kanj, Ss25, Sfeir, J25, Yasmine, M25, Morris, A26, Murdoch, Dr27, Premru, Mm28, Lejko-Zupanc, T28, Almela, M29, Ambrosioni, J29, Azqueta, M29, Brunet, M29, Cervera, C29, De Lazzari, E29, Falces, C29, Fuster, D29, Garcia-de-la-Mària, C29, Garcia-Gonzalez, J29, Gatell, Jm29, Marco, F29, Miró, Jm29, Moreno, A29, Ortiz, J29, Ninot, S29, Paré, Jc29, Pericas, Jm29, Quintana, E29, Ramirez, J29, Sandoval, E29, Sitges, M29, Tolosana, Jm29, Vidal, B29, Vila, J29, Bouza, E30, Muñoz, P, Rodríguez-Créixems, M30, Ramallo, V30, Bradley, S31, Wray, D32, Steed, L32, Cantey, R32, Peterson, G33, Stancoven, A33, Woods, C34, Corey, Gr34, Reller, Lb34, Fowler VG, Jr34, Chu, Vh34, Baloch, K, Chu, Vh, Corey, Gr, Dixon, Cc, Fowler VG, Jr, Harding, T, Jones-Richmond, M, Pappas, P, Park, Lp, Redick, T, Stafford, J, Anstrom, K, Athan, E, Bayer, A, Cabell, Ch, Hoen, B, Karchmer, Aw, Miró, Jm, Murdoch, Dr, Sexton, Dj, Wang, A, Chu, V, Durack, Dt, Eykyn, S, Moreillon, P, Olaison, L, Raoult, D, Rubinstein, E, and Sexton, Dj.

Subjects
0301 basic medicine, Male, medicine.disease_cause, 0302 clinical medicine, 80 and over, Medicaments antibacterians, 030212 general & internal medicine, Endocarditi, Prospective Studies, Aged, 80 and over, Endocarditis, Bacterial, General Medicine, Middle Aged, Staphylococcal Infections, 3. Good health, Anti-Bacterial Agents, Fenotip, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Treatment Outcome, Phenotype, Staphylococcus aureus, Infective endocarditis, Staphylococcus aureu, Vancomycin, Genotype, Vancomycin MIC, Adult, Aged, Endocarditis, Bacterial, Female, Humans, Microbial Sensitivity Tests, Molecular Typing, Multiplex Polymerase Chain Reaction, Survival Analysis, Virulence Factors, beta-Lactams, medicine.drug, Microbiology (medical), 030106 microbiology, Biology, Staphylococcal infections, Article, Microbiology, 03 medical and health sciences, Minimum inhibitory concentration, medicine, Etest, Endocarditis Staphylococcus aureus, biochemical phenomena, metabolism, and nutrition, medicine.disease, Antibacterial agents, Methicillin Susceptible Staphylococcus Aureus
Abstract

Objectives: Left-sided methicillin-susceptible Staphylococcus aureus (MSSA) endocarditis treated with cloxacillin has a poorer prognosis when the vancomycin minimum inhibitory concentration (MIC) is >= 1.5 mg/L. We aimed to validate this using the International Collaboration on Endocarditis cohort and to analyse whether specific genetic characteristics were associated with a high vancomycin MIC (> 1.5mg/L) phenotype.Methods: All patients with left-sided MSSA infective endocarditis treated with antistaphylococcal beta-lactam antibiotics between 2000 and 2006 with available isolates were included. Vancomycin MIC was determined by Etest as either high (>= 1.5 mg/L) or low (

Published
2017

4. A case of destructive infective endocarditis

Author

Agrusta F, Pinto D, Mattucci I, Malgeri U, Andini R, Senese A, Dialetto G, Ragone E, Albisinni R, UTILI, Riccardo, DURANTE MANGONI, Emanuele, Agrusta, F, Pinto, D, Mattucci, I, Malgeri, U, Andini, R, Senese, A, Dialetto, G, Ragone, E, Albisinni, R, Utili, Riccardo, and DURANTE MANGONI, Emanuele

Published
2012

9. Predicting the occurrence of embolic events: An analysis of 1456 episodes of infective endocarditis from the Italian Study on Endocarditis

Author

Rizzi, Marco, Ravasio, Veronica, Carobbio, Alessandra, Mattucci, Irene, Crapis, Massimo, Stellini, Roberto, Pasticci, Maria B., Chinello, Pierangelo, Falcone, Marco, Grossi, Paolo, Barbaro, Francesco, Pan, Angelo, Viale, Pierluigi, Durante, Mangoni, Emanuele, Biglino, A, Brusa MT, Crivelli P, Moglia, R, Leone, S, Ravasio, V, Rizzi, M, Suter, F, Viale, P, Mian, P, Spoladore, G, Castelli, F, Magri, S, Stellini, R, Di Caprio, D, Van Hauwermeiren, E, Pan, A, Zacchi, F, Barzaghi, N, Libanore, M, Pantaleoni, M, Del Bono, V, Viscoli, C, Gattuso, G, Scalzini, A, Villa, Mr, Bernardo, M, Casillo, R, Cuccurullo, S, Dialetto, G, Durante Mangoni, E, Mattucci, I, Ragone, E, Tripodi, Mf, Utili, R, Barbaro, F, Erne, E, Minoli, L, Seminari, Em, Martinelli, L, Pallotto, C, Pasticci, Mb, Canovari, B, Stoppini, L, Chinello, P, Falcone, M, Petrosillo, N, Venditti, M, Delle Foglie, P, Giobbia, M, Inoiosa, W, Scotton, G, Vaglia, A, Bassetti, Matteo, Crapis, M, Venturini, S, Dalla Gasperina, D, Grossi, P, Tebini, A, Concia, E, Del Bravo, P, Tedesco, A, Nicolin, R, Pellizzer, G., Rizzi, M., Ravasio, V., Carobbio, A., Mattucci, I., Crapis, M., Stellini, R., Pasticci, M.B., Chinello, P., Falcone, M., Grossi, P., Barbaro, F., Pan, A, Viale, P, Durante-Mangoni, E., Rizzi, M, Ravasio, V, Carobbio, A, Mattucci, I, Crapis, M, Stellini, R, Pasticci, Mb, Chinello, P, Falcone, M, Grossi, P, Barbaro, F, and DURANTE MANGONI, Emanuele

Subjects
Adult, Male, medicine.medical_specialty, Embolism, infective endocarditis embolic events, Risk Factors, Internal medicine, medicine, Endocarditis, Humans, Risk factor, Prospective cohort study, Aged, Retrospective Studies, Framingham Risk Score, Infective endocarditis, Risk score, Stroke, Endocarditis, Bacterial, Female, Italy, Middle Aged, business.industry, Medicine (all), Bacterial, Retrospective cohort study, Odds ratio, medicine.disease, Surgery, Infectious Diseases, business, Research Article
Abstract

BACKGROUND: Embolic events are a major cause of morbidity and mortality in patients with infective endocarditis. We analyzed the database of the prospective cohort study SEI in order to identify factors associated with the occurrence of embolic events and to develop a scoring system for the assessment of the risk of embolism. METHODS: We retrospectively analyzed 1456 episodes of infective endocarditis from the multicenter study SEI. Predictors of embolism were identified. Risk factors identified at multivariate analysis as predictive of embolism in left-sided endocarditis, were used for the development of a risk score: 1 point was assigned to each risk factor (total risk score range: minimum 0 points; maximum 2 points). Three categories were defined by the score: low (0 points), intermediate (1 point), or high risk (2 points); the probability of embolic events per risk category was calculated for each day on treatment (day 0 through day 30). RESULTS: There were 499 episodes of infective endocarditis (34%) that were complicated by ≥ 1 embolic event. Most embolic events occurred early in the clinical course (first week of therapy: 15.5 episodes per 1000 patient days; second week: 3.7 episodes per 1000 patient days). In the total cohort, the factors associated with the occurrence of embolism at multivariate analysis were prosthetic valve localization (odds ratio, 1.84), right-sided endocarditis (odds ratio, 3.93), Staphylococcus aureus etiology (odds ratio, 2.23) and vegetation size ≥ 13 mm (odds ratio, 1.86). In left-sided endocarditis, Staphylococcus aureus etiology (odds ratio, 2.1) and vegetation size ≥ 13 mm (odds ratio, 2.1) were independently associated with embolic events; the 30-day cumulative incidence of embolism varied with risk score category (low risk, 12%; intermediate risk, 25%; high risk, 38%; p

Published
2014

26. TRANSESOPHAGEAL ULTRASOUND PROVIDES A NEW MINIMAL INVASIVE APPROACH FOR SURGICAL LUNG CANCER STAGING

Author

CATERINO U, CARUSO A, DERICOLOSO A, MUTO R, MASSIMO M, DIALETTO G, MAZZARELLA, Gennaro, Caterino, U, Caruso, A, Dericoloso, A, Muto, R, Massimo, M, Dialetto, G, and Mazzarella, Gennaro

Abstract

Invasive diagnostic techniques such as transesophageal echocardiography (T.E.E.) have been recently introduced for pre-surgical staging in lung cancer infiltrating adjacent related organs, (pericardium, aorta, superior vena cava, main pulmonary vessels, left atrium). To assess the sensitivity of this technique, 15 patients (11 male, age 60.19 ± 8.3) (4 female, age 55.5 =1= 7.3) affected by lung cancer (NSCLC) underwent to presurgical T.E.E. multiplane. T.E.E. data were compared with computed tomography and if performed with surgical findings. In 8 cases, T.E.E. confirmed the findings of CT scan, resulting in 6 patients negative for suspi- cius of invasion of the mediastinal structures, and 2 patients positive for infiltration of the great pulmonary vessels. T.E.E. data have been confirmed by operative and pathological examination findings in all 7 patients underwent to surgical resection, as well as one of the two cases with infiltration of the mediastinal, underwent to surgical resection. Discrepancy between T.E.E. and CT scan immaging have been found in 8 cases. Indeed, in 4 patients. T.E.E. showed invasion of the pulmonary vessels, despite negative CT scan, in contrast, in 4 cases T.E.E did not confirmed the relative invasion of the mediastinal structures showed by CT scan. Operative and pathological examination findings, performed in 5 patients underwent to sur¬gical resection confirmed the T.E.E. data. Therefore, transesophageal sonography has opened a new window for viewing invasion of cardiac structure and great mediastinal vessels. We concluded that T.E.E. provides an excellent support for criteria of lung cancer resectability, especially in case of CT scan indicating a mediastinal tumour infiltration.

Published
1999

27. [The management of echocardiography in Italy. Consensus Conference of the Italian Society of Cardiovascular Echography (SIEC)]

Author

Zuppiroli, A., Corrado, G., De Cristofaro, M., Erlicher, A., Galati, A., Penco, M., Sorino, M., Badano, L. P., Calabrò, R., Gullace, G., Lorenzoni, R., Mandorla, S., Pezzano, A., Pino, G. P., Salustri, A., Scattolin, G., Antonini Canterin, F., Astrarita, C., Caso, P., Carerj, Scipione, Cecchi, E., Chirillo, F., D'Amato, N., Dialetto, G., Durante, G., Falcone, A., Gaddi, O., Gnecco, G., Mariotti, E., Moreo, A., Pavan, D., Piovesana, P., and Savino, K.

Subjects
Accreditation, Cardiovascular Diseases, Echocardiography, Humans, Italy, Reproducibility of Results, Societies, Medical, Italy, Cardiovascular Diseases, Echocardiography, Medical, Humans, Reproducibility of Results, Societies, Societies, Medical, Accreditation
Published
2007

33. [Follow-up critical evaluation of mechanical and biological heart valve prostheses]

Author

FESTA M, RENZULLI A, MICHELETTI E, DIALETTO G, MANCUSI S, COTRUFO M., SANTE', Pasquale, Festa, M, Sante', Pasquale, Renzulli, A, Micheletti, E, Dialetto, G, Mancusi, S, and Cotrufo, M.

Subjects
Bioprosthesis, Time Factors, Echocardiography, Evaluation Studies as Topic, Risk Factors, Heart Valve Prosthesis, Humans, Mitral Valve, Follow-Up Studies
Published
1987

34. Tricuspid valve endocarditis in drug addicts

Author

COTRUFO M, BELLITTI R, CASALE D, D'ANGELO A, GIANNOLO B, DIALETTO G, PALMA G, COVINO FE, MANCUSI S., LAMA, Diana, M., Cotrufo, R., Bellitti, D., Casale, A., D'Angelo, B., Giannolo, D., Lama, G., Dialetto, Palma, Gaetano, F. E., Covino, S. M. a. n. c. u. s., I., Cotrufo, M, Bellitti, R, Casale, D, D'Angelo, A, Giannolo, B, Lama, Diana, Dialetto, G, Palma, G, Covino, Fe, and Mancusi, S.

Subjects
Adult, Male, Postoperative Care, Adolescent, Echocardiography, Substance-Related Disorders, Humans, Female, Endocarditis, Bacterial, Tricuspid Valve, Staphylococcal Infections
Published
1987

35. Initial clinical and hemodynamic experience with Edwards MIRA mechanical bileaflet valve

Author

Feo, M., Renzulli, A., Francesco Onorati, Della Corte, A., Dialetto, G., Covino, F. E., Cotrufo, M., DE FEO, Marisa, Renzulli, A, Onorati, F, DELLA CORTE, Alessandro, Dialetto, G, Covino, Fe, and Cotrufo, M.

Subjects
Adult, Male, Heart Valve Prosthesis Implantation, Adolescent, Aged, Anticoagulants, Aortic Valve, Biocompatible Materials, Echocardiography, Female, Follow-Up Studies, Health Status Indicators, Heart Valve Diseases, Hemodynamics, Humans, Middle Aged, Mitral Valve, Postoperative Complications, Prosthesis Design, Survival Rate, Treatment Outcome, Warfarin, Heart Valve Prosthesis
Abstract

An enhanced bileaflet valve, the Edwards MIRA feminine Mechanical Valve became available in 1998. Favorable hydrodynamic features and a redesigned sewing ring encouraged us to implant this device in indicated patients. Hemodynamics and clinical performance parameters were evaluated.Between February 1998 and October 1999, 338 patients (171 males, 167 females) underwent native valve replacement with a MIRA prosthesis. Mean age 56.6+/-13.6 years, 320 patients were in NYHA class III/IV. Sixty-seven patients had echocardiographic examinations. Standard cardiopulmonary bypass was employed utilizing institutionally accepted implantation techniques. Aortic valve replacement was performed in 163 patients, mitral valve replacement in 134 patients, 35* double valve replacements and 1 triple valve replacement.Follow-up is 98% complete. Mean follow-up is 6.9+/-3.3 months (178.2 patient years). There were no operative deaths. Four early deaths were seen (1.18%). Late deaths reported in 12 patients. Linearized rate of late mortality was 6.7% per patient year (ppy). Overall actuarial survival at 13 months is 92.2%. Mean gradients and Effective Orifice Areas (EOA's) are comparable to other bileaflet valves. Linearized rates for valve-related complications was 4.49% ppy. Only 5 transient thromboembolic events (TE = 2.81% ppy) and 3 non-structural valve dysfunction events (NSVD = 1.68%) were seen. No reports of bleeding events, prosthetic endocarditis, valve thrombosis or structural valve deterioration. One patient required mitral valve reoperation for perivalvular leak.Short-term hemodynamic and clinical results are comparable to other bileaflet valves. The sewing ring is non-obstructive, compliant with smoother needle penetration. Early clinical results are encouraging, follow-up should be continued.

36. Mitral and aortic valve endocarditis: Due to Staphylococcus lugdunensis

Author

Renzulli, A., Delia Corte, A., michele torella, Dialetto, G., Cotrufo, M., Renzulli, A, DELLA CORTE, Alessandro, Torella, M, Dialetto, G, and Cotrufo, M.

Subjects
Male, Aortic Valve, Staphylococcus, Heart Valve Diseases, Humans, Mitral Valve, Case Reports, Endocarditis, Bacterial, Middle Aged, Staphylococcal Infections, Ultrasonography
Abstract

Staphylococcus lugdunensis is a recently described coagulase negative staphylococcal species involved in human infections. Endocarditis caused by Staphylococcus lugdunensis has been reported rarely: fewer than 50 cases have been described so far. The infection is frequently complicated by embolic events and carries a high mortality rate. We report a case of endocarditis due to Staphylococcus lugdunensis in which the native mitral and aortic valves were infected. The bacterium was isolated on cultures from the aortic and mitral vegetations. Appropriate medical and surgical treatment led to a good outcome of the infection. At 6-year follow-up, there was no evidence of recurrence, and the patient showed good functional recovery. He was in New York Heart Association functional class I.

38. The management of echocardiography in Italy. Consensus conference of the Italian Society of Cardiovascular Echography (SIEC),Dalla formazione degli operatori al referto. Documento di consenso sugli aspetti organizzativi dell'ecocardiografia in Italia

Author

Zuppiroli, A., Corrado, G., Cristofaro, M., Erlicher, A., Galati, A., Penco, M., Sorino, M., Luigi Badano, Calabrò, R., Gullace, G., Lorenzoni, R., Mandorla, S., Pezzano, A., Pino, G. P., Salustri, A., Scattolin, G., Antonini-Canterin, F., Astrarita, C., Caso, P., Carerj, S., Cecchi, E., Chirillo, F., D Amato, N., Dialetto, G., Durante, G., Falcone, A., Gaddi, O., Gnecco, G., Mariotti, E., Moreo, A., Pavan, D., Piovesana, P., and Savino, K.

39. The management of echocardiography in Italy. Consensus conference of the Italian Society of Cardiovascular Echography (SIEC) | Dalla formazione degli operatori al referto. Documento di consenso sugli aspetti organizzativi dell'ecocardiografia in Italia

Author

Zuppiroli, A., Corrado, G., Cristofaro, M., Erlicher, A., Galati, A., Penco, M., Sorino, M., Badano, L. P., Calabrò, R., Gullace, G., Roberto Lorenzoni, Mandorla, S., Pezzano, A., Pino, G. P., Salustri, A., Scattolin, G., Antonini-Canterin, F., Astrarita, C., Caso, P., Carerj, S., Cecchi, E., Chirillo, F., D Amato, N., Dialetto, G., Durante, G., Falcone, A., Gaddi, O., Gnecco, G., Mariotti, E., Moreo, A., Pavan, D., Piovesana, P., and Savino, K.

40. Non-HACEK gram-negative bacillus endocarditis

Author

Morpeth, S, Murdoch, D, Cabell, Ch, Karchmer, Aw, Pappas, P, Levine, D, Nacinovich, F, Tattevin, P, Fernández Hidalgo, N, Dickerman, S, Bouza, E, del Río, A, Lejko Zupanc, T, de Oliveira Ramos, A, Iarussi, D, Klein, J, Chirouze, C, Bedimo, R, Corey, Gr, Fowler VG Jr, Collaborators: Gordon D, International Collaboration on Endocarditis Prospective Cohort Study I. n. v. e. s. t. i. g. a. t. o. r. s., Devi, U, Spelman, D, van der Meer JT, Kauffman, C, Bradley, S, Armstrong, W, Giannitsioti, E, Giamarellou, H, Lerakis, S, del Rio, A, Moreno, A, Mestres, Ca, Paré, C, Garcia de la Maria, C, De Lazzario, E, Marco, F, Gatell, Jm, Miró, Jm, Almela, M, Azqueta, M, Jiménez Expósito MJ, de Benito, N, Perez, N, Almirante, B, Fernandez Hidalgo, N, Rodriguez de Vera, P, Tornos, P, Falcó, V, Claramonte, X, Armero, Y, Sidani, N, Kanj Sharara, S, Kanafani, Z, Raglio, A, Goglio, A, Gnecchi, F, Suter, F, Valsecchi, G, Rizzi, M, Ravasio, V, Hoen, B, Leroy, J, Plesiat, P, Bernard, Y, Casey, A, Lambert, P, Watkin, R, Elliott, T, Patel, M, Dismukes, W, Pan, A, Caros, G, Tribouilloy, Ab, Goissen, T, Delahaye, A, Delahaye, F, Vandenesch, F, Vizzotti, C, Nacinovich, Fm, Marin, M, Trivi, M, Lombardero, M, Cortes, C, Horacio Casabe, J, Altclas, J, Kogan, S, Clara, L, Sanchez, M, Commerford, A, Hansa, C, Deetlefs, E, Ntsekhe, M, Commerford, P, Wray, D, Steed, Ll, Church, P, Cantey, R, Morris, A, Read, K, Raymond, N, Lang, S, Chambers, S, Kotsanas, D, Korman, Tm, Peterson, G, Purcell, J, Southern PM Jr, Shah, M, Reddy, A, Dhar, G, Hanlon Feeney, A, Hannan, M, Kelly, S, Wang, A, Woods, Cw, Sexton, Dj, Benjamin D., Jr, Mcdonald, Jr, Federspiel, J, Engemann, Jj, Reller, Lb, Drew, L, Caram, Lb, Stryjewski, M, Lalani, T, Fowler V., Jr, Chu, V, Mazaheri, B, Neuerburg, C, Naber, C, Athan, E, Henry, M, Harris, O, Alestig, E, Olaison, L, Wikstrom, L, Snygg Martin, U, Francis, J, Venugopal, K, Nair, L, Thomas, V, Chaiworramukkun, J, Pachirat, O, Chetchotisakd, P, Suwanich, T, Kamarulzaman, A, Tamin, Ss, Premru, Mm, Logar, M, Orezzi, C, Moreno, M, Rodríguez Créixems, M, Fernández, M, Muñoz, P, Fernández, R, Ramallo, V, Raoult, D, Thuny, F, Habib, G, Casalta, Jp, Fournier, Pe, Chipigina, N, Kirill, O, Vinogradova, T, Kulichenko, Vp, Butkevich, Om, Lion, C, Alla, F, Coyard, H, Doco Lecompte, T, Durante Mangoni, E, Ragone, E, Dialetto, G, Tripodi, Mf, Utili, R, Casillo, R, Kumar, As, Sharma, G, Dickerman, Sa, Street, A, Eisen, Dp, Mcbryde, Es, Grigg, L, Abrutyn, E, Michelet, C, Donnio, Py, Fortes, Cq, Edathodu, J, Al Hegelan, M, Font, B, Anguera, I, Raimon Guma, J, Cereceda, M, Oyonarte, Mj, Montagna Mella, R, Garcia, P, Braun Jones, S, de Oliveira Ramos AI, Paiva, Mg, de Medeiros RA, Woon, Ll, Lum, Ln, Tan, Rs, Rees, D, Koneçny, P, Lawrence, R, Dever, R, Post, J, Jones, P, Ryan, S, Harkness, J, Feneley, M, Rubinstein, E, Strahilewitz, J, Ionac, A, Mornos, C, Dragulescu, S, Forno, D, Cecchi, E, DE ROSA, Francesco Giuseppe, Imazio, M, Trinchero, R, Wiesbauer, F, Gattringer, R, Deans, G, Andrasevic, At, Barsic, B, Klinar, I, Vincelj, J, Bukovski, S, Krajinovic, V, Cabell, C, Stafford, J, Baloch, K, Redick, T, Harding, T, Bayer, A, Durack, Dt, Corey, R, Moreillon, P, Eykynm, S, and Chu, V.

Subjects
Eikenella corrodens, Microbiology, stomatognathic system, Haemophilus, Gram-Negative Bacteria, Internal Medicine, medicine, Endocarditis, Humans, Prospective Studies, Cardiac Surgical Procedures, Substance Abuse, Intravenous, Cross Infection, biology, business.industry, Gram Negative Bacillus, General Medicine, Endocarditis, Bacterial, Prostheses and Implants, biology.organism_classification, medicine.disease, Anti-Bacterial Agents, Community-Acquired Infections, stomatognathic diseases, Treatment Outcome, Infective endocarditis, Bacteremia, Actinobacillus, bacteria, Cardiobacterium hominis, business, Gram-Negative Bacterial Infections
Abstract

Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users.To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients.Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database.61 hospitals in 28 countries.Hospitalized patients with definite endocarditis.Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens.Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%).Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make.In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

41. Endovascular Repair of Acute Uncomplicated Aortic Type B Dissection Promotes Aortic Remodelling: 1 Year Results of the ADSORB Trial

Author

Brunkwall, J., Kasprzak, P., Verhoeven, E., Heijmen, R., Taylor, P., Alric, P., Canaud, L., Janotta, M., Raithel, D., Malina, M., Resch, Ti., Eckstein, H.-H., Ockert, S., Larzon, T., Carlsson, F., Schumacher, H., Classen, S., Schaub, P., Lammer, J., Lönn, L., Clough, R.E., Rampoldi, V., Trimarchi, S., Fabiani, J.-N., Böckler, D., Kotelis, D., von Tenng-Kobligk, H., Mangialardi, N., Ronchey, S., Dialetto, G., and Matoussevitch, V.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Lumen (anatomy), chemical and pharmacologic phenomena, Blood Vessel Prosthesis Implantation, Uncomplicated, immune system diseases, hemic and lymphatic diseases, Stent graft, medicine, Clinical endpoint, Humans, Acute type B dissection, Prospective Studies, Aortic rupture, Aortic dissection, Medicine(all), business.industry, Endovascular Procedures, Remodelling, Stent, Thrombosis, hemic and immune systems, Vascular surgery, Middle Aged, medicine.disease, Type b dissection, Surgery, Europe, Aortic Dissection, surgical procedures, operative, Treatment Outcome, Acute Disease, Female, Stents, business, Cardiology and Cardiovascular Medicine
Abstract

Objectives: Uncomplicated acute type B aortic dissection (AD) treated conservatively has a 10% 30-day mortality and up to 25% need intervention within 4 years. In complicated AD, stent grafts have been encouraging. The aim of the present prospective randomised trial was to compare best medical treatment (BMT) with BMT and Gore TAG stent graft in patients with uncomplicated AD. The primary endpoint was a combination of incomplete/no false lumen thrombosis, aortic dilatation, or aortic rupture at 1 year. Methods: The AD history had to be less than 14 days, and exclusion criteria were rupture, impending rupture, malperfusion. Of the 61 patients randomised, 80% were DeBakey type IIIB. Results: Thirty-one patients were randomised to the BMT group and 30 to the BMT+TAG group. Mean age was 63 years for both groups. The left subclavian artery was completely covered in 47% and in part in 17% of the cases. During the first 30 days, no deaths occurred in either group, but there were three crossovers from the BMT to the BMT TAG group, all due to progression of disease within 1 week. There were two withdrawals from the BMT+TAG group. At the 1-year follow up there had been another two failures in the BMT group: one malperfusion and one aneurysm formation (p = .056 for all). One death occurred in the BMT TAG group. For the overall endpoint BMT+TAG was significantly different from BMT only (p < .001). Incomplete false lumen thrombosis, was found in 13 (43%) of the TAG+BMT group and 30 (97%) of the BMT group (p < .001). The false lumen reduced in size in the BMT+TAG group (p < .001) whereas in the BMT group it increased. The true lumen increased in the BMT TAG (p < .001) whereas in the BMT group it remained unchanged. The overall transverse diameter was the same at the beginning and after 1 year in the BMT group (42.1 mm), but in the BMT+TAG it decreased (38.8 mm; p = .062). Conclusions: Uncomplicated AD can be safely treated with the Gore TAG device. Remodelling with thrombosis of the false lumen and reduction of its diameter is induced by the stent graft, but long term results are needed. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. (Less)

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42. Infective Endocarditis in Patients on Chronic Hemodialysis

Author

Juan M. Pericàs, Jaume Llopis, Maria Jesús Jiménez-Exposito, Wissam M. Kourany, Benito Almirante, Giampiero Carosi, Emanuele Durante-Mangoni, Claudio Querido Fortes, Efthymia Giannitsioti, Stamatios Lerakis, Rodrigo Montagna-Mella, Juan Ambrosioni, Ru-San Tan, Carlos A. Mestres, Dannah Wray, Orathai Pachirat, Asuncion Moreno, Vivian H. Chu, Elisa de Lazzari, Vance G. Fowler, Jose M. Miró, Liliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, M. Cereceda, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Javier Gonzalez, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, CHU Catherine Campagnac, Thanh Doco-Lecompte, Christine Selton-Suty, Jean-Paul Casalta, Pierre-Edouard Fournier, Gilbert Habib, Didier Raoult, Franck Thuny, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Carl Neuerburg Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Maor Wanounou, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Domenico Iossa, Serena Orlando, Maria Paola Ursi, Pia Clara Pafundi, Fabiana D’Amico, Mariano Bernardo, Susanna Cuccurullo, Giovanni Dialetto, Franco Enrico Covino, Sabrina Manduca, Alessandro Della Corte, Marisa De Feo, Marie Françoise Tripodi, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif-Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O.M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Jameela Edathodu, Magid Halim, Yee-Yun Liew, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller-Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manel Almela, Manuel Azqueta, Merce Brunet, Pedro Castro, Elisa De Lazzari, Carlos Falces, David Fuster, Guillermina Fita, Cristina Garcia- de- la- Maria, Javier Garcia-Gonzalez, Jose M. Gatell, Francesc Marco, José M. Miró, José Ortiz, Salvador Ninot, J. Carlos Paré, Juan M. Pericas, Eduard Quintana, Jose Ramirez, Irene Rovira, Elena Sandoval, Marta Sitges, Adrian Tellez, José M. Tolosana, Barbara Vidal, Jordi Vila, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Emilio Bouza, Miguel Angel Garcia Fernández, Victor Gonzalez-Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez-Créixems, Jorge Solis, Nuria Fernandez-Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg-Martin, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Thomas Holland, Tahaniyat Lalani, Daniel Mudrick, Zaniab Samad, Daniel Sexton, Martin Stryjewski, Andrew Wang, Christopher W. Woods, Robert Cantey, Lisa Steed, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara-Jane Salstrom, John Baddley, Mukesh Patel, Gail Peterson, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Pericas, J. M., Llopis, J., Jimenez-Exposito, M. J., Kourany, W. M., Almirante, B., Carosi, G., Durante-Mangoni, E., Fortes, C. Q., Giannitsioti, E., Lerakis, S., Montagna-Mella, R., Ambrosioni, J., Tan, R. -S., Mestres, C. A., Wray, D., Pachirat, O., Moreno, A., Chu, V. H., de Lazzari, E., Fowler, V. G., Miro, J. M., Clara, L., Sanchez, M., Casabe, J., Cortes, C., Nacinovich, F., Oses, P. F., Ronderos, R., Sucari, A., Thierer, J., Altclas, J., Kogan, S., Spelman, D., Athan, E., Harris, O., Kennedy, K., Tan, R., Gordon, D., Papanicolas, L., Korman, T., Kotsanas, D., Dever, R., Jones, P., Konecny, P., Lawrence, R., Rees, D., Ryan, S., Feneley, M. P., Harkness, J., Post, J., Reinbott, P., Gattringer, R., Wiesbauer, F., Andrade, A. R., Passos de Brito, A. C., Guimaraes, A. C., Grinberg, M., Mansur, A. J., Siciliano, R. F., Varejao Strabelli, T. M., Campos Vieira, M. L., de Medeiros Tranchesi, R. A., Paiva, M. G., de Oliveira Ramos, A., Weksler, C., Ferraiuoli, G., Golebiovski, W., Lamas, C., Karlowsky, J. A., Keynan, Y., Morris, A. M., Rubinstein, E., Jones, S. B., Garcia, P., Cereceda, M., Fica, A., Mella, R. M., Fernandez, R., Franco, L., Gonzalez, J., Jaramillo, A. N., Barsic, B., Bukovski, S., Krajinovic, V., Pangercic, A., Rudez, I., Vincelj, J., Freiberger, T., Pol, J., Zaloudikova, B., Ashour, Z., El Kholy, A., Mishaal, M., Osama, D., Rizk, H., Aissa, N., Alauzet, C., Alla, F., Campagnac, C. C., Doco-Lecompte, T., Selton-Suty, C., Casalta, J. -P., Fournier, P. -E., Habib, G., Raoult, D., Thuny, F., Delahaye, F., Delahaye, A., Vandenesch, F., Donal, E., Donnio, P. Y., Flecher, E., Michelet, C., Revest, M., Tattevin, P., Chevalier, F., Jeu, A., Remadi, J. P., Rusinaru, D., Tribouilloy, C., Bernard, Y., Chirouze, C., Hoen, B., Leroy, J., Plesiat, P., Naber, C., Neuerburg, C., Mazaheri, B., Sophia Athanasia, C. N., Deliolanis, I., Giamarellou, H., Thomas, T., Mylona, E., Paniara, O., Papanicolaou, K., Pyros, J., Skoutelis, A., Papanikolaou, K., Sharma, G., Francis, J., Nair, L., Thomas, V., Venugopal, K., Hannan, M. M., Hurley, J. P., Wanounou, M., Gilon, D., Israel, S., Korem, M., Strahilevitz, J., Iossa, D., Orlando, S., Ursi, M. P., Pafundi, P. C., D'Amico, F., Bernardo, M., Cuccurullo, S., Dialetto, G., Covino, F. E., Manduca, S., Della Corte, A., De Feo, M., Tripodi, M. F., Cecchi, E., De Rosa, F., Forno, D., Imazio, M., Trinchero, R., Grossi, P., Lattanzio, M., Toniolo, A., Goglio, A., Raglio, A., Ravasio, V., Rizzi, M., Suter, F., Magri, S., Signorini, L., Kanafani, Z., Kanj, S. S., Sharif-Yakan, A., Abidin, I., Tamin, S. S., Martinez, E. R., Soto Nieto, G. I., van der Meer, J. T. M., Chambers, S., Holland, D., Morris, A., Raymond, N., Read, K., Murdoch, D. R., Dragulescu, S., Ionac, A., Mornos, C., Butkevich, O. M., Chipigina, N., Kirill, O., Vadim, K., Vinogradova, T., Edathodu, J., Halim, M., Liew, Y. -Y., Lejko-Zupanc, T., Logar, M., Mueller-Premru, M., Commerford, P., Commerford, A., Deetlefs, E., Hansa, C., Ntsekhe, M., Almela, M., Azqueta, M., Brunet, M., Castro, P., Falces, C., Fuster, D., Fita, G., Garcia- de- la- Maria, C., Garcia-Gonzalez, J., Gatell, J. M., Marco, F., Ortiz, J., Ninot, S., Pare, J. C., Quintana, E., Ramirez, J., Rovira, I., Sandoval, E., Sitges, M., Tellez, A., Tolosana, J. M., Vidal, B., Vila, J., Anguera, I., Font, B., Guma, J. R., Bermejo, J., Bouza, E., Garcia Fernandez, M. A., Gonzalez-Ramallo, V., Marin, M., Munoz, P., Pedromingo, M., Roda, J., Rodriguez-Creixems, M., Solis, J., Fernandez-Hidalgo, N., Tornos, P., de Alarcon, A., Parra, R., Alestig, E., Johansson, M., Olaison, L., Snygg-Martin, U., Pachirat, P., Pussadhamma, B., Senthong, V., Casey, A., Elliott, T., Lambert, P., Watkin, R., Eyton, C., Klein, J. L., Bradley, S., Kauffman, C., Bedimo, R., Corey, G. R., Crowley, A. L., Douglas, P., Drew, L., Holland, T., Lalani, T., Mudrick, D., Samad, Z., Sexton, D., Stryjewski, M., Wang, A., Woods, C. W., Cantey, R., Steed, L., Dickerman, S. A., Bonilla, H., Dipersio, J., Salstrom, S. -J., Baddley, J., Patel, M., Peterson, G., Stancoven, A., Levine, D., Riddle, J., Rybak, M., Cabell, C. H., Bristol-Myers Squibb Company, Vall d'Hebron University Hospital [Barcelona], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Laboratoire Chrono-environnement (UMR 6249) (LCE)

Subjects
Male, relapses, medicine.medical_treatment, infective endocarditi, 030204 cardiovascular system & hematology, Kidney Failure, Cohort Studies, Catheters, Indwelling, 0302 clinical medicine, Surgical, Epidemiology, cardiac surgery, enterococci, hemodialysis, infective endocarditis, Staphylococcus aureus, Aged, Anti-Bacterial Agents, Arteriovenous Shunt, Surgical, Cardiac Surgical Procedures, Endocarditis, Female, Humans, Kidney Failure, Chronic, Methicillin-Resistant Staphylococcus aureus, Middle Aged, Renal Dialysis, Staphylococcal Infections, 030212 general & internal medicine, Chronic, Prospective cohort study, health care economics and organizations, relapse, Arteriovenous Shunt, 3. Good health, Cardiac surgery, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Indwelling, Infective endocarditis, Hemodialysis, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Catheters, education, 03 medical and health sciences, Internal medicine, medicine, business.industry, medicine.disease, hemodialysi, Etiology, Complication, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background - Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives - This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods - Prospective cohort study (International Collaboration on Endocarditis databases, encompassing 7,715 IE episodes from 2000 to 2006 and from 2008 to 2012). Descriptive analysis of baseline characteristics, epidemiological and etiological features, complications and outcomes, and their comparison between HD and non-HD patients was performed. Risk factors for major embolic events, cardiac surgery, relapses, and in-hospital and 6-month mortality were investigated in HD-patients using multivariable logistic regression. Results - A total of 6,691 patients were included and 553 (8.3%) received HD. North America had a higher HD-IE proportion than the other regions. The predominant microorganism was Staphylococcus aureus (47.8%), followed by enterococci (15.4%). Both in-hospital and 6-month mortality were significantly higher in HD versus non-HD-IE patients (30.4% vs. 17% and 39.8% vs. 20.7%, respectively; p

Published
2021

43. Cardiac sequelae after coronavirus disease 2019 recovery: a systematic review

Author

Mohammad Said Ramadan, Lorenzo Bertolino, Rosa Zampino, Emanuele Durante-Mangoni, Domenico Iossa, Maria Paola Ursi, Fabiana D'Amico, Arta Karruli, Mohammad Ramadan, Roberto Andini, Mariano Bernardo, Giuseppe Ruocco, Giovanni Dialetto, Franco Enrico Covino, Sabrina Manduca, Alessandro Della Corte, Marisa De Feo, Stefano De Vivo, Maria Luisa De Rimini, Nicola Galdieri, Ramadan, M. S., Bertolino, L., Zampino, R., Durante-Mangoni, E., Iossa, D., Ursi, M. P., D'Amico, F., Karruli, A., Ramadan, M., Andini, R., Bernardo, M., Ruocco, G., Dialetto, G., Covino, F. E., Manduca, S., Della Corte, A., De Feo, M., De Vivo, S., De Rimini, M. L., and Galdieri, N.

Subjects
0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, Heart Injury, Heart Diseases, Coronaviru, 030106 microbiology, Diastole, Magnetic Resonance Imaging, Cine, Cardiac effects post COVID-19, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Cardiac magnetic resonance imaging, Internal medicine, Post-acute COVID-19, medicine, Humans, 030212 general & internal medicine, CMR, Prospective cohort study, Subclinical infection, Long COVID-19, medicine.diagnostic_test, business.industry, SARS-CoV-2, COVID-19, Retrospective cohort study, General Medicine, Cardiac sequelae, Heart Disease, Infectious Diseases, Echocardiography, COVID-19 Nucleic Acid Testing, Cohort, Heart injury, Systematic Review, business, Human
Abstract

Background: Coronavirus disease 2019 (COVID-19) has been implicated in a wide spectrum of cardiac manifestations following the acute phase of the disease. Objectives: To assess the range of cardiac sequelae after COVID-19 recovery. Data sources: PubMed, Embase, Scopus (inception through 17 February 2021) and Google scholar (2019 through 17 February 2021). Study eligibility criteria: Prospective and retrospective studies, case reports and case series. Participants: Adult patients assessed for cardiac manifestations after COVID-19 recovery. Exposure: Severe acute respiratory syndrome coronavirus 2 infection diagnosed by PCR. Methods: Systematic review. Results: Thirty-five studies (fifteen prospective cohort, seven case reports, five cross-sectional, four case series, three retrospective cohort and one ambidirectional cohort) evaluating cardiac sequelae in 52 609 patients were included. Twenty-nine studies used objective cardiac assessments, mostly cardiac magnetic resonance imaging (CMR) in 16 studies, echocardiography in 15, electrocardiography (ECG) in 16 and cardiac biomarkers in 18. Most studies had a fair risk of bias. The median time from diagnosis/recovery to cardiac assessment was 48 days (1–180 days). Common short-term cardiac abnormalities (

Published
2021

44. Towards an individualized approach to bicuspid aortopathy: different valve types have unique determinants of aortic dilatation†

Author

Marisa De Feo, Giuseppe Petrone, F. E. Covino, Alessandro Della Corte, Gianantonio Nappi, Sabrina Manduca, Giovanni Dialetto, Veronica D'Oria, Ciro Bancone, DELLA CORTE, Alessandro, Bancone, C, Dialetto, G, Covino, Fe, Manduca, S, D'Oria, V, Petrone, G, DE FEO, Marisa, and Nappi, Gianantonio

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Population, Heart Valve Diseases, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, medicine.artery, Internal medicine, medicine, Humans, education, Aorta, Aged, Retrospective Studies, Body surface area, education.field_of_study, business.industry, General Medicine, Middle Aged, medicine.disease, Stenosis, Paranasal sinuses, medicine.anatomical_structure, Echocardiography, Aortic Valve, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Body mass index, Dilatation, Pathologic
Abstract

Bicuspid aortic valve (BAV)-related aortopathy is increasingly recognized to be a heterogeneous disease entity, although the surgical approach, from indications to techniques, is still standard rather than individualized. We aimed to define the determinants of aortic dilatation in BAV patients stratified according to the valve morphotype.A consecutive echocardiographic series of 622 BAV patients was analysed. Among demographic (age, sex), anthropometric (height, weight, body surface area, body mass index), clinical (associated diseases) and echocardiographic variables (valve function, ventricular parameters), the determinants of aortic root and ascending tract diameter were assessed by multivariate regression models, as well as the predictors of aortic dilatation (size index2.1 cm/m(2)) both in the overall population and separately in groups of different valve morphotypes (RL, right-left fusion; RN, right-non-coronary fusion).Independent determinants of aortic root diameter (at sinuses) were age (P0.001), significant aortic regurgitation (P0.001), sex (female protective, P0.001) and valve morphotype (RN protective, P0.001). Independent determinants of ascending aortic diameter (tubular tract) were age (P0.001), RN morphotype (P0.001), body mass index (P = 0.005) and chronic obstructive pulmonary disease (P0.001). In univariate analysis, the RL morphotype was associated with dilatation (ASI2.1 cm/m(2)) at sinuses in 41% cases vs 22% for RN (P0.001), and the RN morphotype was associated with dilatation at the tubular tract in 68 vs 56% for RL (P = 0.007). The presence of root dilatation was predicted by age and absence of significant stenosis in the RL morphotype subgroup, and by severe regurgitation in the RN subgroup. In the RL-type subgroup, non-regurgitant aortic valve and chronic lung disease predicted dilatation at the ascending level; and in the RN-type subgroup, age and obesity.The two most common BAV morphotypes are associated with aortic dilatation at two different tracts (RL at the root; RN at the tubular ascending tract) independently of valve function. Moreover, the determinants of aortic dilatation were at least in part different between the two morphotypes: this may provide stratification criteria for individualized methods of follow-up and treatment.

Published
2014

45. Pattern of Ascending Aortic Dimensions Predicts the Growth Rate of the Aorta in Patients With Bicuspid Aortic Valve

Author

Giovanni Dialetto, Veronica D'Oria, Marisa De Feo, Sabrina Manduca, Giancarlo Scognamiglio, F. E. Covino, Marianna Buonocore, Alessandro Della Corte, Ciro Bancone, Della Corte, A., Bancone, C., Buonocore, M., Dialetto, G., Covino, F. E., Manduca, S., Scognamiglio, G., D'Oria, V., and De Feo, M.

Subjects
Male, Time Factors, Heart Valve Diseases, Longitudinal Studie, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, Retrospective Studie, Risk Factors, follow-up, Odds Ratio, Mitral valve prolapse, echocardiography, Longitudinal Studies, Multivariate Analysi, Aorta, Sinotubular Junction, Middle Aged, Echocardiography, Doppler, Aortic Aneurysm, Heart Valve Disease, Phenotype, Radiology Nuclear Medicine and imaging, Aortic Valve, Cardiology, Disease Progression, Female, Cardiology and Cardiovascular Medicine, Human, Dilatation, Pathologic, Adult, medicine.medical_specialty, bicuspid aortic valve, Logistic Model, ascending aorta, Aortic Valve Insufficiency, Regurgitation (circulation), Internal medicine, medicine.artery, Ascending aorta, medicine, Humans, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Genetic heterogeneity, business.industry, Risk Factor, Odds ratio, medicine.disease, aortic dilation, Logistic Models, Multivariate Analysis, business
Abstract

Objectives This study sought to identify risk factors for rapid growth of the ascending aorta in patients with bicuspid aortic valve (BAV) disease, taking into account its phenotypic variability. Background Phenotypic heterogeneity of BAV-related aortopathy has recently been widely recognized. However, few studies have addressed the determinants of aortic growth so far, not distinguishing among morphological phenotypes. Methods Serial retrospective data on 133 adult outpatients with BAV undergoing echocardiographic follow-up were analyzed to search for factors associated with aortic diameter growth over time and with rapid aortic growth (fifth quintile of growth rate distribution), focusing on the impact of different valve morphotypes (i.e., cusp fusion pattern: right-left coronary [RL] and right-noncoronary [RN]) and previously defined aortic phenotypes (nondilated aorta, ascending dilation, root dilation). Results The RL pattern was present in 69% of patients with BAV and RN in 31%. At baseline, an ascending dilation phenotype was observed in 57% of patients and a root phenotype in 13.5%. No patient with RN-BAV had a root dilation phenotype at either baseline or last examination. Follow-up time averaged 4.0 ± 2.7 years (535 patient-years). The mean growth rate was 0.3 mm/year at the sinuses and 0.6 mm/year at the ascending level. Aortic regurgitation predicted an increase in ascending diameter over time (odds ratio [OR]: 2.3; p = 0.03). Root phenotype at presentation, not absolute baseline diameter, was an independent predictor of fast progression (>0.9 mm/year) for the ascending tract (OR: 14; p = 0.001). Fast growth was rarely seen in patients with the RL morphotype and ascending phenotype (6% at the root and 10% at the ascending level). Conclusions In patients with BAV, the root phenotype (aortic dilation predominantly at the sinuses, with normal or less dilated ascending tract) may be a marker of more severe aortopathy, warranting closer surveillance and earlier treatment. The more common ascending phenotype proved to be a more stable disease entity, generally with slower progression. © 2013 by the American College of Cardiology Foundation Published by Elsevierinc .

Published
2013
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46. Endovascular stent-graft treatment of thoracic aortic syndromes: A 7-year experience

Author

Marcella Cerrato, Giovanni Battista Rossi, Sabrina Manduca, Alfonso Reginelli, Francesco Lassandro, F. E. Covino, Giovanni Dialetto, Dialetto, G., Reginelli, A., Cerrato, M., Rossi, G., Covino, F. E., Manduca, S., and Lassandro, F.

Subjects
Adult, Male, Thorax, medicine.medical_specialty, Adolescent, Aortic Rupture, medicine.medical_treatment, Longitudinal Studie, Blood vessel prosthesis, medicine.artery, medicine, Humans, Radiology, Nuclear Medicine and imaging, Longitudinal Studies, Aortic rupture, Aorta, Aged, Aged, 80 and over, Endovascular, Aortic Aneurysm, Thoracic, medicine.diagnostic_test, Vascular disease, business.industry, Stent, Syndrome, General Medicine, Middle Aged, medicine.disease, Blood Vessel Prosthesis, Surgery, Radiography, Blood Vessel Prosthesi, Treatment Outcome, surgical procedures, operative, Angiography, Female, Stents, Radiology, Paraplegia, business, Human
Abstract

Thoracic aortic diseases (TAD) are relatively frequent conditions associated with high mortality. Recently, several reports have demonstrated the safety and efficacy of endovascular stent-graft (EVG) placement for TAD as an alternative to open surgery. We report our experience in management of thoracic aortic syndrome on 56 consecutive patients with TAD that underwent endovascular stent-graft repair. MDCT angiography was used in all patients to provide preprocedure evaluation and measurements. In particular it is necessary to evaluate the proximal and distal landing zones of the stent-graft. All EVGs in our series were placed successfully. Conversion to open surgery was never required. Six patients (10.7%) died early after the stent-graft deployment. During follow-up four more patients died. The endoleak rate was 16.7% (no. 10 pt). We did not observe any case of paraplegia. The present study shows the efficacy of EVG in the long-term follow-up, with an overall survival of 82.1%, which is comparable to that reported in recent studies. In conclusion this technique is emerging as an alternative approach in the treatment of TAD because this approach offers a less invasive therapeutic option to standard surgical techniques, even in patients who have associated diseases that make them poor surgical candidates. © 2007 Elsevier Ireland Ltd. All rights reserved.

Published
2007

47. Predictors of ascending aortic dilatation with bicuspid aortic valve: a wide spectrum of disease expression☆

Author

F. E. Covino, Alessandro Della Corte, Ciro Bancone, Maurizio Cotrufo, Giovanni Dialetto, Giuseppe Caianiello, Cesare Quarto, Michelangelo Scardone, DELLA CORTE, Alessandro, Bancone, C, Quarto, C, Dialetto, G, Covino, Fe, Scardone, M, Caianiello, G, Cotrufo, M., and Amarelli, C

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Adolescent, Aortic Diseases, Severity of Illness Index, Bicuspid aortic valve, Aneurysm, Risk Factors, Ectasia, medicine.artery, Internal medicine, Ascending aorta, Humans, Medicine, Aged, Aorta, business.industry, Age Factors, Aortic Valve Stenosis, General Medicine, Middle Aged, medicine.disease, Stenosis, Logistic Models, Phenotype, medicine.anatomical_structure, Aortic Valve, Aortic valve stenosis, cardiovascular system, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Algorithms, Echocardiography, Transesophageal, Dilatation, Pathologic
Abstract

Objective: This study aimed to describe the features and identify the predictors of ascending aorta dilatation in patients with congenital bicuspid aortic valve (BAV). Methods: In 280 adult patients with isolated BAV undergoing echocardiography, multivariate logistic regression models, including clinical and echocardiographic variables, were developed to predict dilatation (aortic ratio exceeding 1.1) at both ascending and root level. Factors predicting aneurysm with surgical indication were also investigated. Classification tree models were used to identify factors influencing the probability of having a small aorta, normal aortic dimensions, a dilated ascending aorta or a dilated root (aortic phenotypes). Results: Aortic dilatation was present in 83.2% patients, prevailing at the mid-ascending tract in 83.7% of them. Surgical indication criteria were reached in 43.2% patients. A small aortic root was found in 16 patients (5.7%), thereafter excluded from multivariate models predicting dilatation. Age (maximal risk at 50—60 years: OR = 13.7; reference category: 60 (OR = 2.6, p = 0.022) and severe regurgitation (OR = 3.9, p = 0.011) were determinants of root involvement, while stenosis (moderate; OR = 0.3, p < 0.001) was a protective factor. Aortic stenosis (any degree, OR = 2.4) and hypertension (OR = 4.3) were the most significant predictors of mid-ascending aneurysm reaching surgical indication. Classification analysis showed that increasing age significantly increased the prevalence of ascending dilation phenotype, stenosis increased the prevalence of small aorta phenotype, and male gender of root dilation phenotype. Once excluding patients with small aortas from the analysis, a positive correlation was observed between degree of stenosis and mid-ascending size (p = 0.016). Conclusions: BAV patients constitute an importantly heterogeneous population in terms of risk and features of aortic disease. The most common condition is an ectasia of the mid-ascending tract, with unaffected or mildly involved root. If further confirmed, this could suggest that surgical approach may spare the root in most BAV patients. Mid-ascending dilatation is proportional to stenosis severity, suggesting a post-stenotic causative mechanism. Root dilatation is rarer, mostly observed in younger men, and unrelated to the presence and severity of stenosis. The two different aortic dilatation phenotypes (mid-ascending and root) may be subtended by different pathogeneses. # 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Published
2007

48. Treatment of type B aortic dissection: endoluminal repair or conventional medical therapy?☆

Author

Sabrina Manduca, B. Giannolo, Giovanni Dialetto, F. E. Covino, Alessandro Della Corte, Maurizio Cotrufo, Michelangelo Scardone, Giancarlo Scognamiglio, Dialetto, G, Covino, Fe, Scognamiglio, G, Manduca, S, DELLA CORTE, Alessandro, Giannolo, B, Scardone, M, and Cotrufo, M.

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Dissection (medical), Preoperative care, Blood Vessel Prosthesis Implantation, Aortic aneurysm, Aneurysm, medicine.artery, medicine, Humans, Thoracic aorta, Antihypertensive Agents, Aged, Aortic dissection, Aortic Aneurysm, Thoracic, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Aortic Dissection, Cardiothoracic surgery, Descending aorta, Acute Disease, Hypertension, Female, Stents, Radiology, Epidemiologic Methods, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal
Abstract

Objective: To evaluate the mid-term results of endovascular stent-grafting for type B aortic dissection, in comparison with those of standard medical therapy in uncomplicated cases. Methods: Between January 1999 and 2004, among 56 patients (mean age 59.5G11.5 years) with type B aortic dissection, hypotensive medical therapy was the only treatment in 28 uncomplicated cases, (group A), while stent-graft implantation was performed in 28 patients with uncontrolled hypertension, persistent pain or evidence of dissection progression or complication (group B). In 14 cases (50%) the procedure was performed in an acute setting. Stent-grafting procedures were monitored with intraoperative transesophageal echocardiography and cine-angiography. CT scan and trans-esophageal echocardiography were performed before hospital discharge, at 6 and 12 months and then yearly. Results: Follow-up (range 1–61 months, average 18.1G16.9 months) was 100% complete. In-hospital mortality was 10.7% (three patients, all belonging to Group B; PZ0.24). No spinal cord injuries were observed. Early endoleak occurred in one patient (3.5%). Mid-term mortality was lower in Group B, although the difference was not significant (10.7 versus 14.3% in Group A, PZ0.71). Follow-up CT scans evidenced complete thrombosis of the false lumen in 75% cases in Group B, 10.7% in Group A (PZ0.0001), and an aneurismal dilatation of the descending aorta in 3.5% cases in Group B, 28.5% in Group A (PZ0.02). Conclusions: Although with still considerable early mortality, endovascular stent-graft implantation is an effective option for the treatment of complicated type B aortic dissection. Endovascular treatment achieved a better mid-term fate of the descending thoracic aorta than medical therapy alone, even in patients with worse preoperative conditions. Q 2005 Elsevier B.V. All rights reserved.

Published
2005

49. Orthodeoxia without Platypnea from Interatrial Defect Associated with Persistent Left Superior Vena cava in the Absence of Pulmonary Hypertension

Author

Matteo Sofia, Mauro Maniscalco, Giovanni Tufano, Annamaria Romano, Giovanni Dialetto, Maniscalco, M, Dialetto, G, Tufano, G, Romano, A, and Sofia, Matteo

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vena Cava, Superior, Posture, Foramen secundum, Heart Septal Defects, Atrial, Persistent fetal circulation, Hypoxemia, medicine, Humans, Persistent left superior vena cava, Ultrasonography, Doppler, Color, Hypoxia, Platypnea, Coronary sinus, business.industry, Prostheses and Implants, medicine.disease, Pulmonary hypertension, Surgery, Military Personnel, Heart catheterization, medicine.symptom, business
Abstract

Orthodeoxia-platypnea is a rare but increasingly recognized syndrome of upright hypoxemia usually associated to breathlessness relieved by recumbency. We report the case of isolated orthodeoxia discovered in a military recruit who referred only fatigability as the clinical symptom after a forced march. Transesophageal echocardiography demonstrated the presence of interatrial defect ostium secundum type with the persistence of left superior vena cava draining into coronary sinus. Right-to-left shunt was visualized by peripheral saline contrast infusion, despite normal right hemodynamics at heart catheterization. Hypoxemia recovered after the percutaneous closure of the interatrial defect. Orthodeoxia and platypnea could occur as separate disease manifestations, the latter probably being a rarer acute event, whereas orthodeoxia was underestimated and potentially earlier screenable.

Published
2003

50. Long Term Clinical and Echocardiographic Results of Isolated Aortic Valve Replacement in Elderly Patients

Author

Mariano Vicchio, M. De Feo, Francesco Onorati, L.S. De Santo, A. Della Corte, Giovanni Dialetto, Attilio Renzulli, Maurizio Cotrufo, DE FEO, Marisa, Renzulli, A, Vicchio, M, Onorati, F, Dialetto, G, DE SANTO, Luca Salvatore, DELLA CORTE, Alessandro, and Cotrufo, M.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Aortic Valve Insufficiency, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, Prosthesis, Biomaterials, Postoperative Complications, Aortic valve replacement, Predictive Value of Tests, Risk Factors, Internal medicine, 80 and over, Confidence Intervals, medicine, Age Factors, Aged, Aged, 80 and over, Aortic Valve Stenosis, Female, Follow-Up Studies, Heart Valve Prosthesis Implantation, Humans, Postoperative Period, Retrospective Studies, Survival Rate, Echocardiography, Doppler, Survival rate, Contraindication, business.industry, Doppler, Retrospective cohort study, General Medicine, medicine.disease, Surgery, Echocardiography, Predictive value of tests, Aortic valve stenosis, Cardiology, Complication, business
Abstract

Results after isolated aortic valve replacement with bileaflet prostheses in patients over 70 years old were reviewed. One-hundred-twenty-eight elderly patients were operated on between January 1988 and January 2000. Patients with associated heart disease were excluded from the study. Preoperative data, early and late postoperative mortality, all valve related complications and data concerning anticoagulation status were recorded. Hospital mortality was 9.3%. Mean follow-up time was 60.98±2.23 months. Twelve-year actuarial survival was 69.6±0.08%. Valve related and anticoagulation related complication rates (0.8% and 1.6% respectively) and actuarial freedom (99±0.009 both) were low, as well as the mean interval between consecutive INR checks (18.39±1.90 days) and the mean INR value (2.17±0.135). Late echocardiographic results showed low postoperative mean transprosthetic gradients (15.48±0.94). Bileaftlet prostheses in the elderly can achieve excellent results with a low incidence of anticoagulation related complications and low risk of reoperation. Older age can no longer be considered a contraindication to bileaftlet prosthesis implant.

Published
2001

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