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1. Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study

Author

Chiarini, Giovanni, Mariani, Silvia, Schaefer, Anne-Kristin, van Bussel, Bas C. T., Di Mauro, Michele, Wiedemann, Dominik, Saeed, Diyar, Pozzi, Matteo, Botta, Luca, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J. H., Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, Ramanathan, Kollengode, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn J. R., and Lorusso, Roberto

Published
2024
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2. Features and outcomes of female and male patients requiring postcardiotomy extracorporeal life support

Author

Heuts, Samuel, Conci, Luca, Szalkiewicz, Philipp, Lehmann, Sven, Khalil, Jawad, Obadia, Jean-Francois, Kalampokas, Nikolaos, Jankuviene, Agne, Flecher, Erwan, Reis Miranda, Dinis Dos, Sriranjan, Kogulan, Herr, Daniel, Vedadi, Nazli, Di Eusanio, Marco, MacLaren, Graeme, Ramanathan, Kollengode, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Grus, Tomas, Mikulenka, Vladimir, Solinas, Marco, Mariani, Silvia, Ravaux, Justine Mafalda, van Bussel, Bas C.T., De Piero, Maria Elena, van Kruijk, Sander M.J., Schaefer, Anne-Kristin, Wiedemann, Dominik, Saeed, Diyar, Pozzi, Matteo, Loforte, Antonio, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J.H., Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Mazzeffi, Michael A., Matteucci, Sacha, Sponga, Sandro, Sorokin, Vitaly, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn J.R., and Lorusso, Roberto

Published
2024
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4. Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study

Author

Bunge, Jeroen J. H., Mariani, Silvia, Meuwese, Christiaan, van Bussel, Bas C. T., Di Mauro, Michele, Wiedeman, Dominik, Saeed, Diyar, Pozzi, Matteo, Loforte, Antonio, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, MacLaren, Graeme, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn J. R., Gommers, Diederik, Dos Reis Miranda, Dinis, Lorusso, Roberto, Heuts, Samuel, Ravaux, Justine, Schaefer, Anne-Kristin, Conci, Luca, Szalkiewicz, Philipp, Khalil, Jawad, Lehmann, Sven, Obadia, Jean-Francois, Kalampokas, Nikolaos, Jankuviene, Agne, Flecher, Erwan, Sriranjan, Kogulan, Mazzeffi, Michael A, Vedadi, Nazli, Di Eusanio, Marco, Sorokin, Vitaly, Ramanathan, Ram, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Mikulenka, Vladimir, Grus, Tomas, and Solinas, Marco

Published
2024
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8. The importance of timing in postcardiotomy venoarterial extracorporeal membrane oxygenation: A descriptive multicenter observational study

Author

Ravaux, Justine, Schaefer, Ann-Kristin, Conci, Luca, Szalkiewicz, Philipp, Khalil, Jawad, Lehmann, Sven, Obadia, Jean-Francois, Kalampokas, Nikolaos, Flecher, Erwan, Miranda, Dinis Dos Reis, Sriranjan, Kogulan, Mazzeffi, Michael A., Vedadi, Nazli, Di Eusanio, Marco, MacLaren, Graeme, Sorokin, Vitaly, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Mikulenka, Vladimir, Solinas, Marco, Mariani, Silvia, Wang, I-wen, van Bussel, Bas C.T., Heuts, Samuel, Wiedemann, Dominik, Saeed, Diyar, van der Horst, Iwan C.C., Pozzi, Matteo, Loforte, Antonio, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J.H., Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, Ramanathan, Kollengode, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn, and Lorusso, Roberto

Published
2023
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9. On-Support and Postweaning Mortality in Postcardiotomy Extracorporeal Membrane Oxygenation

Author

Khalil, Jawad, Lehmann, Sven, Obadia, Jean-Francois, Kalampokas, Nikolaos, Flecher, Erwan, Dos Reis Miranda, Dinis, Sriranjan, Kogulan, Mazzeffi, Michael A., Vedadi, Nazli, Di Eusanio, Marco, Sorokin, Vitaly, Ramanathan, Kollengode, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Mikulenka, Vladimir, Solinas, Marco, Mariani, Silvia, Schaefer, Anne-Kristin, van Bussel, Bas C.T., Di Mauro, Michele, Conci, Luca, Szalkiewicz, Philipp, De Piero, Maria Elena, Heuts, Samuel, Ravaux, Justine, van der Horst, Iwan C.C., Saeed, Diyar, Pozzi, Matteo, Loforte, Antonio, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J.H., Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, MacLaren, Graeme, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Whitman, Glenn, Shekar, Kiran, Wiedemann, Dominik, and Lorusso, Roberto

Published
2023
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10. Long-Term Outcomes Comparison Between Surgical and Percutaneous Coronary Revascularization in Patients With Multivessel Coronary Disease or Left Main Disease: A Systematic Review and Study Level Meta-Analysis of Randomized Trials

Author

Formica, Francesco, Gallingani, Alan, Tuttolomondo, Domenico, Hernandez-Vaquero, Daniel, Singh, Gurmeet, Pattuzzi, Claudia, Maestri, Francesco, Niccoli, Giampaolo, Ceccato, Evelina, Lorusso, Roberto, and Nicolini, Francesco

Published
2023
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11. The Relation Between Obesity and Mortality in Postcardiotomy Venoarterial Membrane Oxygenation

Author

Ravaux, Justine, di Mauro, Michele, Schaefer, Ann-Kristin, Conci, Luca, Szalkiewicz, Philipp, Khalil, Jawad, Lehmann, Sven, Obadia, Jean-Francois, Kalampokas, Nikolaos, Flecher, Erwan, Reis Miranda, Dinis Dos, Buscher, Hergen, Herr, Daniel, Vedadi, Nazli, Di Eusanio, Marco, Maclaren, Graeme, Ramanathan, Ram, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Mikulenka, Vladimir, Solinas, Marco, Heuts, Samuel, Mariani, Silvia, van Bussel, Bas C.T., Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J.H., Sriranjan, Kogulan, Wiedemann, Dominik, Saeed, Diyar, Pozzi, Matteo, Loforte, Antonio, Salazar, Leonardo, Meyns, Bart, Mazzeffi, Michael A., Matteucci, Sacha, Sponga, Sandro, Sorokin, Vitaly, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn, and Lorusso, Roberto

Published
2023
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16. Surgical Treatment of Post-Infarction Left Ventricular Free-Wall Rupture: A Multicenter Study

Author

Matteucci, Matteo, Kowalewski, Mariusz, De Bonis, Michele, Formica, Francesco, Jiritano, Federica, Fina, Dario, Meani, Paolo, Folliguet, Thierry, Bonaros, Nikolaos, Sponga, Sandro, Suwalski, Piotr, De Martino, Andrea, Fischlein, Theodor, Troise, Giovanni, Dato, Guglielmo Actis, Serraino, Giuseppe Filiberto, Shah, Shabir Hussain, Scrofani, Roberto, Antona, Carlo, Fiore, Antonio, Kalisnik, Jurij Matija, D’Alessandro, Stefano, Villa, Emmanuel, Lodo, Vittoria, Colli, Andrea, Aldobayyan, Ibrahim, Massimi, Giulio, Trumello, Cinzia, Beghi, Cesare, and Lorusso, Roberto

Published
2021
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17. Association between cardioplegia and postoperative atrial fibrillation in coronary surgery

Author

Mauro, Michele Di, Calafiore, Antonio M., Di Franco, Antonino, Nicolini, Francesco, Formica, Francesco, Scrofani, Roberto, Antona, Carlo, Messina, Antonio, Troise, Giovanni, Mariscalco, Giovanni, Beghi, Cesare, De Bonis, Michele, Trumello, Cinzia, Miceli, Antonio, Glauber, Mattia, Ranucci, Marco, De Vincentiis, Carlo, Gaudino, Mario, and Lorusso, Roberto

Published
2021
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18. Sex-Related Differences in Life Expectancy Compared to General Population after Surgery for Ascending Aortic Aneurysm.

Author

Almendárez, Marcel, Formica, Francesco, Gutierrez Sáenz de Santamaría, Jorge, Avanzas, Pablo, Escalera, Alain, Alvarez-Velasco, Rut, Pascual, Isaac, Silva, Jacobo, Díaz, Rocío, Alperi, Alberto, and Hernández-Vaquero, Daniel

Subjects
*ASCENDING aorta aneurysms, *POSTOPERATIVE period, *LIFE expectancy, *POPULATION aging, MORTALITY risk factors
Abstract

Background/Objectives: Understanding sex-based differences in cardiovascular outcomes is paramount to improving clinical outcomes. Surgery is an aggressive but effective therapy for ascending aortic aneurysm. We sought to determine if being a woman is a risk factor for long-term mortality after this surgery. We compared their life expectancy with a general population of the same age, sex, year, and region. Methods: We compared men and women undergoing AAA surgery at our institution from 2000 to 2019. After balancing the population with propensity score (PS) matching, we compared long-term mortality control with a Cox regression. We determined the RS using the Ederer II method and compared it to a healthy reference population of the same age, sex, and region. Results: From 2000 to 2019, 232 women and 506 men underwent ascending aortic aneurysm surgery. After a mean follow-up of 51.5 ± 34.5 months, sex was not an independent risk factor for long-term mortality in the multivariable analysis [HR: 0.68 (95% CI 0.43–1.07, p = 0.23)]. Matching by baseline characteristics, 196 pairs were analyzed with no differences regarding mortality in the Cox regression [HR: 1.11 (95% CI 0.65–1.9, p = 0.23)]. Men and women who survived the postoperative period presented a relative survival of 100.3% (95% CI 97.4–101%) and 100.3% (95% CI 98.9–101.1%), respectively, similar to the reference population without the disease. Conclusions: For patients undergoing AAA surgery, sex was not an independent predictor of mortality. Men and women who survived the postoperative period presented a similar life expectancy to that of the reference population (people free from the disease of the same age, sex, year, and region). [ABSTRACT FROM AUTHOR]

Published
2024
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22. Cardiovascular Disease from Pathophysiology to Risk Estimation: Is Inflammation Estimated through Perivascular Attenuation on Computed Tomography the Key?

Author

Tuttolomondo, Domenico, Niccoli, Giampaolo, Martini, Chiara, D'Ascenzo, Fabrizio, De Filippo, Ovidio, Nicolini, Francesco, Formica, Francesco, Carino, Davide, Gurgoglione, Filippo Luca, Denegri, Andrea, Magnani, Giulia, Vignali, Luigi, De Filippo, Massimo, Sverzellati, Nicola, Ticinesi, Andrea, Bergamaschi, Luca, Pizzi, Carmine, Gherbesi, Elisa, Suma, Sergio, and Gaibazzi, Nicola

Subjects
COMPUTED tomography, ADIPOSE tissue physiology, CARDIOVASCULAR diseases, PATHOLOGICAL physiology, INTERNAL carotid artery, EPICARDIAL adipose tissue, ADIPOSE tissues, CAROTID artery
Abstract

(1) Background: Systemic inflammation stands as a well-established risk factor for ischemic cardiovascular disease, as well as a contributing factor in the development of cardiac arrhythmias, notably atrial fibrillation. Furthermore, scientific studies have brought to light the pivotal role of localized vascular inflammation in the initiation, progression, and destabilization of coronary atherosclerotic disease. (2) Methods: We comprehensively review recent, yet robust, scientific evidence elucidating the use of perivascular adipose tissue attenuation measurement on computed tomography applied to key anatomical sites. Specifically, the investigation extends to the internal carotid artery, aorta, left atrium, and coronary arteries. (3) Conclusions: The examination of perivascular adipose tissue attenuation emerges as a non-invasive and indirect means of estimating localized perivascular inflammation. This measure is quantified in Hounsfield units, indicative of the inflammatory response elicited by dense adipose tissue near the vessel or the atrium. Particularly noteworthy is its potential utility in assessing inflammatory processes within the coronary arteries, evaluating coronary microvascular dysfunction, appraising conditions within the aorta and carotid arteries, and discerning inflammatory states within the atria, especially in patients with atrial fibrillation. The widespread applicability of perivascular adipose tissue attenuation measurement underscores its significance as a diagnostic tool with considerable potential for enhancing our understanding and management of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Multiple Cardiac Diseases Involving the Aortic Arch: Beating Heart Debranching, and Normothermic Arch Replacement: A Case Series.

Author

Motta, Alessandro, Scarpari, Cristian, Borrelli, Ermelinda, and Formica, Francesco

Subjects
THORACIC aorta, HEART diseases, HEART beat, PATIENT experience, COMORBIDITY, AORTIC valve insufficiency
Abstract

(1) Background: Conventional open surgery is still the gold standard for aortic arch disease, and despite recent developments in optimizing strategies for neuroprotection, distal organ perfusion, and myocardial protection, aortic arch replacement is still associated with high morbidity and mortality rates. (2) Methods: We present our case series of 12 patients undergoing surgical management of multiple cardiac diseases involving the aortic arch. In this single-center study, we report our initial experience over a five-year period (from December 2018 to October 2023) with the use of a "debranching first" technique for the supra-aortic vessels of a beating heart, followed by the cardiac step addressing proximal diseases, and a final distal step treating the aortic arch. This strategy aims to minimize cardiac, cerebral, and peripheral ischemia. (3) Results: Six patients underwent aortic root replacement with either Bentall (n = 4) or valve-sparing aortic root (David procedure) (n = 2). The mean nasopharyngeal temperature was 34 °C and the mean cardiocirculatory arrest was 14.3 min. The early mortality was 8.3% (1 patient); no patient experienced a permanent neurologic event. (4) Conclusions: In patients with complex aortic disease and concomitant cardiac disease, this approach reduces the need for hypothermia and decreases cardiopulmonary bypass time and myocardial arrest time and therefore could represent a valid surgical option, even in high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Extracorporeal life support in mitral papillary muscle rupture: Outcome of multicenter study.

Author

Massimi, Giulio, Matteucci, Matteo, De Bonis, Michele, Kowalewski, Mariusz, Formica, Francesco, Russo, Claudio Francesco, Sponga, Sandro, Vendramin, Igor, Colli, Andrea, Falcetta, Giosuè, Trumello, Cinzia, Carrozzini, Massimiliano, Fischlein, Theodor, Troise, Giovanni, Actis Dato, Guglielmo, D'Alessandro, Stefano, Nia, Peyman Sardari, Lodo, Vittoria, Villa, Emmanuel, and Shah, Shabir Hussain

Subjects
EXTRACORPOREAL membrane oxygenation, MUSCLE injuries, PAPILLARY muscles, MYOCARDIAL infarction, CARDIOGENIC shock, HOSPITAL mortality
Abstract

Background: Post‐acute myocardial infarction papillary muscle rupture (post‐AMI PMR) may present variable clinical scenarios and degree of emergency due to result of cardiogenic shock. Veno‐arterial extracorporeal life support (V‐A ECLS) has been proposed to improve extremely poor pre‐ or postoperative conditions. Information in this respect is scarce. Methods: From the CAUTION (meChanical complicAtion of acUte myocardial infarcTion: an InternatiOnal multiceNter cohort study) database (16 different Centers, data from 2001 to 2018), we extracted adult patients who were surgically treated for post‐AMI PMR and underwent pre‐ or/and postoperative V‐A ECLS support. The end‐points of this study were in‐hospital survival and ECLS complications. Results: From a total of 214 post‐AMI PMR patients submitted to surgery, V‐A ECLS was instituted in 23 (11%) patients. The median age was 61.7 years (range 46–81 years). Preoperatively, ECLS was commenced in 10 patients (43.5%), whereas intra/postoperative in the remaining 13. The most common V‐A ECLS indication was post‐cardiotomy shock, followed by preoperative cardiogenic shock and cardiac arrest. The median duration of V‐A ECLS was 4 days. V‐A ECLS complications occurred in more than half of the patients. Overall, in‐hospital mortality was 39.2% (9/23), compared to 22% (42/219) for the non‐ECLS group. Conclusions: In post‐AMI PMR patients, V‐A ECLS was used in almost 10% of the patients either to promote bridge to surgery or as postoperative support. Further investigations are required to better evaluate a potential for increased use and its effects of V‐A ECLS in such a context based on the still high perioperative mortality. [ABSTRACT FROM AUTHOR]

Published
2023
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33. Redo Surgical Aortic Valve Replacement versus Valve-In-Valve Transcatheter Aortic Valve Implantation: A Systematic Review and Reconstructed Time-To-Event Meta-Analysis.

Author

Formica, Francesco, Gallingani, Alan, Tuttolomondo, Domenico, Hernandez-Vaquero, Daniel, D'Alessandro, Stefano, Pattuzzi, Claudia, Çelik, Mevlüt, Singh, Gurmeet, Ceccato, Evelina, Niccoli, Giampaolo, Lorusso, Roberto, and Nicolini, Francesco

Subjects
*AORTIC valve transplantation, *HEART valve prosthesis implantation, CARDIOVASCULAR disease related mortality
Abstract

Objective. Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has emerged as a useful alternative intervention to redo-surgical aortic valve replacement (Redo-SVAR) for the treatment of degenerated bioprosthesis valve. However, there is no robust evidence about the long-term outcome of both treatments. The aim of this meta-analysis was to analyze the long-term outcomes of Redo-SVAR versus ViV-TAVI by reconstructing the time-to-event data. Methods. The search strategy consisted of a comprehensive review of relevant studies published between 1 January 2000 and 30 September 2022 in three electronic databases, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE. Relevant studies were retrieved for the analysis. The primary endpoint was the long-term mortality for all death. The comparisons were made by the Cox regression model and by landmark analysis and a fully parametric model. A random-effect method was applied to perform the meta-analysis. Results. Twelve studies fulfilled the eligibility criteria and were included in the final analysis. A total of 3547 patients were included. Redo-SAVR group included 1783 patients, and ViV-TAVI included 1764 subjects. Redo-SAVR showed a higher incidence of all-cause mortality within 30-days [Hazard ratio (HR) 2.12; 95% CI = 1.49–3.03; p < 0.0001)], whereas no difference was observed between 30 days and 1 year (HR = 1.03; 95% CI = 0.78–1.33; p = 0.92). From one year, Redo-SAVR showed a longer benefit (HR = 0.52; 95% CI = 0.40–0.67; p < 0.0001). These results were confirmed for cardiovascular death (HR = 2.04; 95% CI = 1.29–3.22; p = 0.001 within one month from intervention; HR = 0.35; 95% CI = 0.18–0.71; p = 0.003 at 4-years follow-up). Conclusions. Although the long-term outcomes seem similar between Redo-SAVR and ViV-TAVI at a five-year follow-up, ViV-TAVI shows significative lower mortality within 30 days. This advantage disappeared between 30 days and 1 year and reversed in favor of redo-SAVR 1 year after the intervention. [ABSTRACT FROM AUTHOR]

Published
2023
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38. The early and long-term outcomes of coronary artery bypass grafting added to aortic valve replacement compared to isolated aortic valve replacement in elderly patients: a systematic review and meta-analysis.

Author

D'Alessandro, Stefano, Tuttolomondo, Domenico, Singh, Gurmeet, Hernandez-Vaquero, Daniel, Pattuzzi, Claudia, Gallingani, Alan, Maestri, Francesco, Nicolini, Francesco, and Formica, Francesco

Subjects
CORONARY artery bypass, AORTIC valve transplantation, OLDER patients, ARTIFICIAL respiration, ACUTE kidney failure, OLDER people
Abstract

In aged population, the early and long-term outcomes of coronary revascularization (CABG) added to surgical aortic valve replacement (SAVR) compared to isolated SAVR (i-SAVR) are conflicting. To address this limitation, a meta-analysis comparing the early and late outcomes of SAVR plus CABG with i-SAVR was performed. Electronic databases from January 2000 to November 2021 were screened. Studies reporting early-term and long-term comparison between the two treatments in patients over 75 years were analyzed. The primary endpoints were in-hospital/30-day mortality and overall long-term survival. The pooled odd ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated for in-early outcome and long-term survival, respectively. Random-effect model was used in all analyses. Forty-four retrospective observational studies reporting on 74,560 patients (i-SAVR = 36,062; SAVR + CABG = 38,498) were included for comparison. The pooled analysis revealed that i-SAVR was significantly associated with lower rate of early mortality compared to SAVR plus CABG (OR = 0.70, 95% CI 0.66–0.75; p < 0.0001) and with lower incidence of postoperative acute renal failure (OR = 0.65; 95% CI 0.50–0.91; p = 0.02), need for dialysis (OR = 0.65; 95% CI 0.50–0.86; p = 0.002) and prolonged mechanical ventilation (OR = 0.57; 95% CI 0.42–0.77; p < 0.0001). Twenty-two studies reported data of long-term follow-up. No differences were reported between the two groups in long-term survival (HR = 0.95; 95% CI 0.87–1.03; p = 0.23). CABG added to SAVR is associated with worse early outcomes in terms of early mortality, postoperative acute renal failure, and prolonged mechanical ventilation. Long-term survival was comparable between the two treatments. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Surgical treatment for post-infarction papillary muscle rupture: a multicentre study.

Author

Massimi, Giulio, Ronco, Daniele, Bonis, Michele De, Kowalewski, Mariusz, Formica, Francesco, Russo, Claudio Francesco, Sponga, Sandro, Vendramin, Igor, Falcetta, Giosuè, Fischlein, Theodor, Troise, Giovanni, Trumello, Cinzia, Dato, Guglielmo Actis, Carrozzini, Massimiliano, Shah, Shabir Hussain, Coco, Valeria Lo, Villa, Emmanuel, Scrofani, Roberto, Torchio, Federica, and Antona, Carlo

Subjects
PAPILLARY muscles, MUSCLE injuries, CARDIOPULMONARY bypass, KIDNEY transplantation, CORONARY artery bypass, MYOCARDIAL infarction, HOSPITAL mortality, MITRAL valve surgery
Abstract

Open in new tab Download slide Open in new tab Download slide OBJECTIVES Papillary muscle rupture (PMR) is a rare but potentially fatal complication of acute myocardial infarction. The aim of this study was to analyse the patient characteristics and early outcomes of the surgical management of post-infarction PMR from an international multicentre registry. METHODS Patients underwent surgery for post-infarction PMR between 2001 through 2019 were retrieved from database of the CAUTION study. The primary end point was in-hospital mortality. RESULTS A total of 214 patients were included with a mean age of 66.9 (standard deviation: 10.5) years. The posteromedial papillary muscle was the most frequent rupture location (71.9%); the rupture was complete in 67.3% of patients. Mitral valve replacement was performed in 82.7% of cases. One hundred twenty-two patients (57%) had concomitant coronary artery bypass grafting. In-hospital mortality was 24.8%. Temporal trends revealed no apparent improvement in in-hospital mortality during the study period. Multivariable analysis showed that preoperative chronic kidney disfunction [odds ratio (OR): 2.62, 95% confidence interval (CI): 1.07–6.45, P  =   0.036], cardiac arrest (OR: 3.99, 95% CI: 1.02–15.61, P  =   0.046) and cardiopulmonary bypass duration (OR: 1.01, 95% CI: 1.00–1.02, P  =   0.04) were independently associated with an increased risk of in-hospital death, whereas concomitant coronary artery bypass grafting was identified as an independent predictor of early survival (OR: 0.38, 95% CI: 0.16–0.92, P  =   0.031). CONCLUSIONS Surgical treatment for post-infarction PMR carries a high in-hospital mortality rate, which did not improve during the study period. Because concomitant coronary artery bypass grafting confers a survival benefit, this additional procedure should be performed, whenever possible, in an attempt to improve the outcome. Clinical trial registration clinicaltrials.gov: NCT03848429. [ABSTRACT FROM AUTHOR]

Published
2022
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