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Your search keyword '"Barberio, Giuseppe"' showing total 2 results
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2 results on '"Barberio, Giuseppe"'

1. Frozen elephant trunk technique using hybrid grafts: 15-year outcomes from a single-centre experience.

Author

Murana, Giacomo, Gliozzi, Gregorio, Marco, Luca Di, Campanini, Francesco, Snaidero, Silvia, Nocera, Chiara, Rucci, Paola, Barberio, Giuseppe, Leone, Alessandro, Lovato, Luigi, and Pacini, Davide

Subjects
ENDOVASCULAR aneurysm repair, ELEPHANTS, LOG-rank test
Abstract

Open in new tab Download slide OBJECTIVES The purpose of the study is to compare the short- and long-term outcomes of the frozen elephant trunk (FET) technique based on 2 different hybrid grafts implanted from January 2007 to July 2022. METHODS The study includes patients who underwent an elective or emergency FET procedure. Short-term, long-term mortality and freedom from thoracic endovascular aortic repair (TEVAR) were the primary end points. Analyses were carried out separately for the periods 2007–2012 and 2013–2022 RESULTS Of the 367 enrolled, 49.3% received E-Vita Open implantation and 50.7% received Thoraflex Hybrid implants. Overall mean age was 61 years [standard deviation (SD) = 11] and 80.7% were male. The average annual volume of FET procedures was 22.7 cases/year. Compared to E-Vita Open, patients implanted with Thoraflex Hybrid grafts were more likely to receive distal anastomosis in zone 2 (68.3% vs 11.6%, P  < 0.001) with a shorter stent portion, mean = 103mm (SD = 11.3) vs mean = 149 mm (SD = 12.7; P  < 0.001) and they underwent a reduced visceral ischaemia time, mean = 42.5 (SD = 14.2) vs mean= 61.0 (SD = 20.2) min, P  < 0.001. In the period 2013–2022, overall survival at 1, 2 and 5 years was 74.8%, 72.5% and 63.2% for Thoraflex and 73.2%, 70.7% and 64.1% for E-Vita, without significant differences between groups (log-rank test = 0.01, P  = 0.907). Overall freedom from TEVAR at 1, 2 and 5 years was 66.7%, 57.6% and 39.3% for Thoraflex and 79%, 69.7% and 66% for E-Vita, with significant differences between groups (log-rank test = 5.28, P  = 0.029). In a competing risk analysis adjusted for chronic/residual aortic syndromes and stent diameter, the Thoraflex group was more likely to receive TEVAR during follow-up (subdistribution hazard ratio SHR = 2.12, 95% confidence interval 1.06–4.22). CONCLUSIONS The FET technique addresses acute and chronic arch disease with acceptable morbidity and mortality. Downstream endovascular reinterventions are very common during follow-up. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Long-Term Outcomes of Open Arch Repair After a Prior Aortic Operation: Our Experience in 154 Patients

Author

Paolo Berretta, Jacopo Alfonsi, Luca Di Marco, Alessandro Leone, Roberto Di Bartolomeo, Antonio Pantaleo, Mariano Cefarelli, Giacomo Murana, Giuseppe Barberio, Davide Pacini, Di Bartolomeo, Roberto, Berretta, Paolo, Pantaleo, Antonio, Murana, Giacomo, Cefarelli, Mariano, Alfonsi, Jacopo, Barberio, Giuseppe, Leone, Alessandro, Di Marco, Luca, and Pacini, Davide

Subjects
Adult, Male, Reoperation, Aortic arch, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Elephant trunks, Aorta, Thoracic, 030204 cardiovascular system & hematology, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Aortic aneurysm, Postoperative Complications, 0302 clinical medicine, Aneurysm, Hypothermia, Induced, Risk Factors, medicine.artery, Internal medicine, medicine, Humans, Hospital Mortality, Aorta, Aged, Aortic Aneurysm, Thoracic, business.industry, Brain, Odds ratio, Middle Aged, medicine.disease, Surgery, Oxygen, Aortic Dissection, Standardized mortality ratio, Italy, 030228 respiratory system, Cardiothoracic surgery, Cardiology, cardiovascular system, Female, business, Cardiology and Cardiovascular Medicine, Blood Flow Velocity, Follow-Up Studies
Abstract

Background This study assessed the early and long-term results of arch operations performed after a prior aortic operation. Methods From 1994 to 2014, 154 consecutive patients (mean age, 59.7 years) underwent an aortic arch repair, after a previous aortic operation, at our institution. Antegrade selective cerebral perfusion was used in all cases. Chronic postdissection aortic aneurysm (87 [56.5%]) and degenerative aneurysm (43 [27.9%]) represented the most common indications for surgical intervention. A complete arch replacement was performed in 119 patients (77.3%), an associated root repair in 70 (45.5%), and the frozen elephant trunk technique was used in 55 (35.7%). Results Hospital mortality was 11.7% (n = 18). Postoperative permanent neurologic dysfunction occurred in 10 patients (6.4%). On multivariate analysis, cardiopulmonary bypass time (odds ratio, 1.02 per minute; p = 0.005) emerged as the only independent predictor of hospital death. Follow-up was 100% complete. The estimated survival at 1, 5, and 10 years was 79.6%, 69.9%, and 46.8%, respectively. Freedom from reoperation was 75.6% at 5 years and 54.6% at 10 years. Cox regression identified chronic postdissection aortic aneurysm (odds ratio, 4.2; p = 0.006) to be the only independent predictor of aortic reintervention. Late survival was comparable between degenerative aneurysm patients and the Italian population matched for age and sex (standardized mortality ratio, 1.9; p = 0.1). Longevity was reduced in patients operated on for chronic postdissection aortic aneurysm (standardized mortality ratio, 6.3; p Conclusions Arch operations after a previous open aortic repair can be performed with acceptable mortality and good long-term outcomes. Complete aortic resection did not increase hospital deaths and was associated with a low need for aortic reinterventions at follow-up.

Published
2017

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