70 results on '"Stolcova M"'
Search Results
2. Left Atrial Appendage Occlusion for Stroke Prevention in Atrial Fibrillation: Multicenter Experience with the Amplatzer Cardiac Plug: 12
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Tzikas, A., Shakir, S., Sievert, H., Omran, H., Berti, S., Santoro, G., Kefer, J., Landmesser, U., Nielsen-Kudsk, J. E., Cruz-Gonzalez, I., Gafoor, S., Tichelbäcker, T., Kanagaratnam, P., Nietlispach, F., Aminian, A., Kasch, F., Freixa, X., Danna, P., Rezzaghi, M., Vermeersch, P., Stock, F., Stolcova, M., Costa, M., Ibrahim, R., Schillinger, W., Meier, B., Park, J.-W., Budts, W., Depotter, T., Benit, E., Stammen, F., Gloekler, S., Eckhardt, R., Koa-Wing, M., Proietti, R., Jaguszewski, M., and Paiva, L.
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- 2014
3. Effect of catalyst and substituents on the hydrogenation of chloronitrobenzenes
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Kratky, V., Kralik, M., Mecarova, M., Stolcova, M., Zalibera, L., and Hronec, M.
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- 2002
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4. A study of the selective catalytic hydroconversion of biomass-derived pyrolysis or fermentation liquids using propylamine and acetic acid as model reactants
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Badari, A.C., Harnos, Sz., Lónyi, F., Onyestyák, Gy., Štolcová, M., Kaszonyi, A., and Valyon, J.
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- 2015
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5. P-252: Transcatheter aortic valve implantation registry with comprehensive geriatric assessment (CGA-TAVI)
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Mannarino, G., Santoro, G., Stolcova, M., Piccioli, L., Marchionni, N., Schoenenberger, A., Bramlage, P., Kurucova, J., Michel, J.-P., Thoenes, M., and Ungar, A.
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- 2015
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6. Novel Cu and Cu2In/aluminosilicate type catalysts for the reduction of biomass-derived volatile fatty acids to alcohols
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Harnos Szabolcs, Onyestyák György, Barthos Róbert, Štolcová Magdalena, Kaszonyi Alexander, and Valyon József
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acetic acid reduction ,cu-zeolites ,in2o3 doping ,ethanol ,ethyl acetate ,Chemistry ,QD1-999 - Published
- 2012
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7. Oxidation of benzoic acid to phenol in the vapor phase : III. Reaction of phenol precursors over copper catalysts
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Hronec, M., Štolcová, M., Cvengrošová, Z., and Kizlink, J.
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- 1991
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8. Oxidation of benzoic acid to phenol in the vapor phase: II. Copper catalysts
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Štolcová, M., Hronec, M., and Ilavský, J.
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- 1989
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9. Oxidation of benzoic acid to phenol in the vapor phase: I. Mechanistic aspects
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Štolcová, M., Hronec, M., Ilavský, J., and Kabešová, M.
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- 1986
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10. ChemInform Abstract: Oxidation of Benzoic Acid to Phenol in the Vapor Phase. Part 2. Copper Catalysts.
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STOLCOVA, M., HRONEC, M., and ILAVSKY, J.
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- 1989
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11. Quality control in treating patients with patent foramen ovale: 7-year-experience of the Heart and Brain team of the Careggi University Hospital.
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Meucci F, Rapillo CM, Stolcova M, Scrima GD, Nardi G, Nistri R, Ristalli F, D'Ettore N, Mattesini A, Buonamici F, Piccardi B, Tudisco L, Cramaro A, Trapani S, Pracucci G, Nencini P, Di Mario C, and Sarti C
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- Humans, Neoplasm Recurrence, Local complications, Brain, Secondary Prevention methods, Hospitals, Quality Control, Treatment Outcome, Recurrence, Foramen Ovale, Patent complications, Foramen Ovale, Patent surgery, Stroke diagnosis
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Background: The right comprehension of ischemic stroke pathogenesis guarantees the best prevention therapy. The term "patent foramen ovale (PFO) related stroke" has been proposed for those events where PFO is supposed to be pathogenetic, but their definition is challenging. A multidisciplinary evaluation in a "Heart & Brain" team (HBteam) including stroke neurologists and interventional cardiologists was therefore highly recommended in the recent guidelines of secondary stroke prevention., Objective: We aimed at describing the organization of the HBteam of Careggi-University-Hospital of Florence (Italy), and the results of the first seven years of activity., Methods: In 2016 Interventional Cardiologists and Stroke Neurologists set up an outpatient clinic for the joined evaluation of patients with PFO and other cardio/neurological conditions. A specific diagnostic-therapeutic hospital plan was produced for PFO patients. Patient empowerment was guaranteed by a hospital explicative webpage, a booklet regarding risks/benefits of PFO closure and a 3D heartmodel to simulate the intervention. Data were collected in a dedicated registry., Results: We evaluated 594 patients for PFO, 40 for left atrial appendage closure and 38 for other conditions. In 20% of PFO-patients, HBteam diagnosis was discordant from that of referring physicians, 14% were stroke misdiagnoses. We advised against closure in 53% of patients. At follow-up 94% of closed patients had no/minimum residual shunt; 3 patients had a cerebral ischemic event., Conclusions: A dedicated HBteam represents a unique opportunity to share decisions with patients after a thorough empowerment process. The joining of cardioneurological skills allows a better classification of PFO-patients, reducing futile interventions., (© 2023. Fondazione Società Italiana di Neurologia.)
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- 2024
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12. Tunnel stent technique as an alternative treatment for left main protection in valve-in-valve transcatheter aortic valve implantation.
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Meucci F, Di Muro FM, Martinucci P, Stolcova M, Di Mario C, and Cecchi E
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Competing Interests: One of the authors has received research or educational grants from Abbott, Amgen, Asahi Inteec., AstraZeneca, Boston Scientific, Cardinal Health, CSL Behring, Chiesi, Daiichi Sankyo, Edwards, Medtronic, Menarini, Pfizer, Sanofi, Shockwave, Teleflex and Volcano/Philips; another author reports receiving speaker and consultation fees from Medtronic, Edwards and Boston Scientific. The other authors have no conflict of interest to declare.
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- 2023
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13. Platypnea-Orthodeoxia Syndrome Following Transcatheter Aortic Valve Replacement.
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Küçükseymen S, Ciardetti N, Stolcova M, Di Mario C, and Meucci F
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- Humans, Platypnea Orthodeoxia Syndrome, Dyspnea etiology, Hypoxia etiology, Transcatheter Aortic Valve Replacement adverse effects, Foramen Ovale, Patent diagnosis, Foramen Ovale, Patent diagnostic imaging
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- 2023
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14. Telemedicine: Benefits for Cardiovascular Patients in the COVID-19 Era.
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Ghilencea LN, Chiru MR, Stolcova M, Spiridon G, Manea LM, Stănescu AA, Bokhari A, Kilic ID, Secco GG, Foin N, and Di Mario C
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The recent pandemic with SARS-CoV-2 raises questions worldwide regarding telemedicine for housebound patients, including those with cardiovascular conditions. The need for further investigation, monitoring and therapeutic management are advancing practical issues which had not been identified for consideration prior to the pandemic. Using the marketing assessment, we identified the needs of the patients and evaluated the future steps necessary in the short term to meet them. The research found progress made via telemedicine in monitoring and conducting minor decisions (like up-titrating the doses of different medication regimens) in patients with several cardiovascular diseases (heart failure, atrial fibrillation, high blood pressure), as there is a worldwide trend to develop new telemonitoring biosensors and devices based on implantable delivered transcatheter. The worldwide telemedicine trend encourages a switch from small and hesitating steps to a more consistent assessment of the patients, based on high technology and Interventional Cardiology. Cardiovascular telemedicine, although made a sustainable effort in managing patients' health, has many obstacles to overcome before meeting all their needs. Data security, confidentiality and reimbursement are the top priorities in developing remote Cardiology. The regulatory institutions need to play an integrative role in leading the way for defining the framework of future telemedicine activities. The SARS-CoV-2 outbreak with all its tragedy served to reinforce the message that telemedicine services can be life-saving for cardiovascular patients. Once the Covid-19 era will fade away, telemedicine is likely to remain a complementary service of standard care. There is still room to improve the remote identification and investigation of heart disease, provide an accurate diagnosis and therapeutic regimen, and update regulations and guidelines to the new realities of technological progress in the field., Competing Interests: L-NG is a Consultant in Cardiology at the Elias University Hospital in Bucharest, and a Lecturer at the Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. He also graduated International Economic Relations at the Academy of Economic Sciences in Bucharest with a degree in World Economy. He completed his training in Cardiology at hospitals in Birmingham and Oxford, and was subject of several honorary fellowships in Interventional Cardiology at Royal Brompton Hospital in London, UK, under the supervision of CDM. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ghilencea, Chiru, Stolcova, Spiridon, Manea, Stănescu, Bokhari, Kilic, Secco, Foin and Di Mario.)
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- 2022
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15. Percutaneous closure of a 'whale tail' left atrial appendage with a Watchman FLX device and pre-procedural FEops HEARTguide patient-specific computational simulation: a case report.
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Di Muro FM, Stolcova M, Di Mario C, and Meucci F
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Background: Percutaneous left atrial appendage closure (LAAC) is an emerging alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF) in patients with AF, elevated stroke risk and contraindications to long-term anticoagulation treatment. Optimal pre-procedural planning is essential to ensure optimal procedural results., Case Summary: We report the case of a 62-year-old man with a history of right cerebellar haematoma referred for LAA closure. We describe the first use of FEops HEARTguide patient-specific computational simulation in the planning of LAAC with the Watchman Flex device (Boston Scientific, Marlborough, MA, USA) in an unusual 'whale tail'-like LAA anatomy., Discussion: Percutaneous left atrial appendage (LAA) closure is feasible in the majority of patients. However, certain LAA anatomies may pose substantial technical challenges. This case shows the crucial role of a pre-procedural assessment based on patient-specific computational simulations for LAA closure in difficult scenarios resulting in a more efficient procedure with the optimal result and good clinical outcomes., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2022
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16. Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study.
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Nardi G, De Backer O, Saia F, Søndergaard L, Ristalli F, Meucci F, Stolcova M, Mattesini A, Demola P, Wang X, Al Jabri A, Palmerini T, Bruno AG, Ielasi A, Van Belle E, Berti S, and di Mario C
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Femoral Artery surgery, Humans, Prospective Studies, Treatment Outcome, Aortic Valve Stenosis surgery, Lithotripsy, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement methods
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Background: The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve implantation (TAVI) by the transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium and increases vessel compliance allowing TF TAVI in selected patients with peripheral artery disease (PAD)., Aims: The aim of this study was to report on the safety and efficacy of IVL-assisted TF TAVI in an all-comers population., Methods: Clinical, imaging and procedural data on all consecutive patients treated by IVL-assisted TF TAVI in six high-volume European centres (2018-2020) were collected in this prospective, real-world, multicentre registry., Results: IVL-assisted TF TAVI was performed in 108 patients, increasing from 2.4% to 6.5% of all TAVI from 2018 to 2020, respectively. The target lesion was most often localised at the common and/or external iliac artery (93.5% of cases; average TL-MLD 4.6±0.9 mm with 318 degrees of calcium arc). Transfemoral aortic valve delivery was successful in 100% of cases; final procedural success in 98.2% (two conversions to cardiac open surgery for annular rupture and valve migration). Complications of the IVL-treated segments consisted of 1 perforation and 3 major dissections requiring stent implantation (2 covered stents and 2 BMS). Access-site-related complications included 3 major bleedings. Three in-hospital deaths were recorded (2.8%, 1 failed surgical conversion after annular rupture, 1 cardiac arrest after initial valvuloplasty, 1 late hyperkalaemia in renal dysfunction)., Conclusions: IVL-assisted TF TAVI proved to be a safe and effective approach, which helps to expand the indications for TF TAVI in patients with severe calcific PAD. However, these patients continue to have a higher-than-average incidence of periprocedural complications.
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- 2022
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17. Relation between the size of patent foramen ovale and the volume of acute cerebral ischemic lesion in young patients with cryptogenic ischemic stroke.
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Benvenuti F, Meucci F, Vuolo L, Nistri R, Pracucci G, Picchioni A, Venturini G, Stolcova M, Failli Y, Nencini P, Di Mario C, and Sarti C
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- Echocardiography, Transesophageal, Humans, Brain Ischemia complications, Brain Ischemia diagnostic imaging, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnostic imaging, Ischemic Stroke, Stroke complications, Stroke diagnostic imaging
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Background: Patent foramen ovale (PFO) closure is superior to medical therapy alone to prevent stroke recurrence in selected patients. Small cortical infarcts and large right to left shunts seem to identify patients who will benefit most from closure. We aimed to study the correlation between the size of the PFO and the volume of cerebral ischemic lesions in young patients with cryptogenic ischemic stroke., Methods: PFO dimensions and acute ischemic lesion volume of 20 patients, aged<55 years, were analyzed with transesophageal echocardiography and brain magnetic resonance imaging, respectively. The association between the volume of ischemic lesions with the length of PFO, maximum separation between septum primum and septum secundum, and the combination of the twos was explored., Results: A direct statistically significant correlation was found between cerebral lesion volume and maximum separation of septum primum and septum secundum (p=0.047). Length of PFO showed a non-significant trend towards an inverse correlation with lesion volume (p=0.603). Multiple linear regression analysis showed that cerebral lesion volume was dependent directly on maximum separation and inversely on length of PFO (regression coeff. -0,837; p= 0.057; 2,536, p=0.006, respectively)., Conclusions: These data suggest that even small PFO might be pathogenetic in case of small cerebral infarcts and that large cerebral infarcts might be PFO related if the shunt is large. If confirmed, the combination of detailed characteristics of PFO with the volume of cerebral infarct could be integrated in a new score to select patients who would take real advantage from a percutaneous closure., (© 2021. The Author(s).)
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- 2022
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18. Fully contrast-less EchoNavigator-guided left atrial appendage occlusion in a patient with severe chronic kidney disease.
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Ciatti F, Stolcova M, Di Mario C, and Meucci F
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- 2021
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19. Long-term echocardiographic findings after TAVR: 5-year follow-up in 400 consecutive patients.
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Stolcova M, Meucci F, Moretti C, Chiriatti N, Marcelli C, Mattesini A, Taglieri N, Ristalli F, Galiè N, Palmerini T, Di Mario C, and Saia F
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- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Echocardiography, Outcome Assessment, Health Care methods, Transcatheter Aortic Valve Replacement
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A little is known about long-term hemodynamic performance of the transcatheter heart valves (THVs). The aim of the present study was to assess hemodynamic outcome, structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) in patients treated with transcatheter aortic valve replacement (TAVR) five or more years ago. All consecutive patients treated at Bologna and Florence University Hospitals with TAVR between January 2008 and December 2013 were analyzed in a retrospective registry with regards to demographic, procedural and outcome data as well as follow-up data on mortality and echocardiographic characteristics. Standardized definitions were used to define outcomes and durability of the THVs. 400 patients were included in the study, mostly treated with transfemoral TAVR (71.8%), using first generation balloon-expandable (37%) or self-expanding (63%) devices. The 1-year mortality was 21.8% (87 patients) and 5-year mortality was 53.8% (215 patients). Median follow-up was 45.5 months (14.0-68.9) totaling 1516.7 patient/years, with the longest follow-up being 10.25 years. At least one follow-up echocardiogram was available for 320 patients (80%), SVD occurred in 19 of these patients (5.94%): moderate in 17 patients (5.31%) and severe in two patients (0.63%). The hemodynamic presentation was stenosis in most of the cases (12 patients). Late BVF was registered in 10 patients (3.13%) and this was mainly driven by transcatheter paravalvular leak closure (six patients) with subsequent good long-term outcome. Our results confirm that TAVR appears to be a long-lasting treatment strategy with low rates of structural valve degeneration and valve failure., (© 2021. Società Italiana di Medicina Interna (SIMI).)
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- 2021
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20. The DESolve ® novolimus bioresorbable scaffold.
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Demola P, Meucci F, Stolcova M, Mario CD, and Mattesini A
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- Absorbable Implants, Coronary Angiography, Humans, Macrolides, Prosthesis Design, Tissue Scaffolds, Treatment Outcome, Coronary Artery Disease, Percutaneous Coronary Intervention
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A longtime aspiration of interventional cardiologists remains to improve the long-term impact of stent permanence in coronaries to restore original vessel patency and physiological endothelium response. Bioresorbable vascular scaffolds were considered revolutionary in coronary devices, but several trials were disappointing; thus, the challenge in this field remains. DESolve is a novolimus-eluting poly-L-lactide-based polymer scaffold that dissolves through a bio-reabsorption mechanism, vanishing completely in 2 years. Its ability to supply the necessary radial strength to support the vessel for the critical early months after delivery is an important feature showing a unique self-correction property, which reduces incomplete stent apposition. Overexpansion has a good, safe margin with DESolve. This review aims to provide an overview of this controversial topic.
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- 2021
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21. Advancements in Transcatheter Aortic Valve Implantation: A Focused Update.
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Ciardetti N, Ciatti F, Nardi G, Di Muro FM, Demola P, Sottili E, Stolcova M, Ristalli F, Mattesini A, Meucci F, and Di Mario C
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- Aortic Valve surgery, Humans, Risk Factors, Treatment Outcome, Aortic Valve Insufficiency, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
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Transcatheter aortic valve implantation (TAVI) has become the leading technique for aortic valve replacement in symptomatic patients with severe aortic stenosis with conventional surgical aortic valve replacement (SAVR) now limited to patients younger than 65-75 years due to a combination of unsuitable anatomies (calcified raphae in bicuspid valves, coexistent aneurysm of the ascending aorta) and concerns on the absence of long-term data on TAVI durability. This incredible rise is linked to technological evolutions combined with increased operator experience, which led to procedural refinements and, accordingly, to better outcomes. The article describes the main and newest technical improvements, allowing an extension of the indications (valve-in-valve procedures, intravascular lithotripsy for severely calcified iliac vessels), and a reduction of complications (stroke, pacemaker implantation, aortic regurgitation).
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- 2021
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22. Supra-Aortic Vessel Stenting to Stabilize an Embolized Acurate NEOTranscatheter Heart Valve: The Chandelier Technique.
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Casenghi M, Stolcova M, Meucci F, Mattesini A, Ristalli F, Di Mario C, Bedogni F, and De Marco F
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- Aorta, Aortic Valve diagnostic imaging, Aortic Valve surgery, Humans, Prosthesis Design, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement adverse effects
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THV aortic embolization can be managed percutaneously by snaring the prosthesis in a stable position in ascending aorta. We report two cases of embolized Acurate NEO with extreme mobility of devices in ascending aorta in which a bailout supra-aortic trunk stenting with consistent aortic protrusion were performed stabilizing the devices., Competing Interests: Declaration of competing interest The performance of this study was supported exclusively by internal institutional funds. With regards to the present manuscript, Dr. F. Bedogni and Dr. F. De Marco are proctors and consultant for Boston Scientific. All other authors have no relationships relevant to the contents of this paper to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2021
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23. A simple step-by-step approach for proficient utilization of the EchoNavigator technology for left atrial appendage occlusion.
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Meucci F, Stolcova M, Mattesini A, Mori F, Orlandi G, Ristalli F, Sarti C, and Di Mario C
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- Humans, Technology, Atrial Appendage diagnostic imaging, Atrial Appendage surgery, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Septal Occluder Device, Stroke
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- 2021
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24. Discontinuation of both cangrelor and ticagrelor because of severe dyspnea during primary angioplasty.
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Di Filippo C, Caniato F, Cappelli F, Mattesini A, Meucci F, Sori A, Stolcova M, Agostini C, Bernardo P, and Di Mario C
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- Adenosine Monophosphate administration & dosage, Adenosine Monophosphate adverse effects, Aged, Anxiety etiology, Anxiety therapy, Chest Pain diagnosis, Coronary Angiography methods, Drug Substitution methods, Drug-Eluting Stents, Electrocardiography methods, Humans, Male, Purinergic P2Y Receptor Antagonists administration & dosage, Purinergic P2Y Receptor Antagonists adverse effects, Treatment Outcome, Withholding Treatment, Adenosine Monophosphate analogs & derivatives, Coronary Occlusion diagnostic imaging, Coronary Occlusion drug therapy, Coronary Occlusion surgery, Drug-Related Side Effects and Adverse Reactions etiology, Drug-Related Side Effects and Adverse Reactions therapy, Dyspnea etiology, Dyspnea physiopathology, Dyspnea therapy, Inferior Wall Myocardial Infarction diagnosis, Inferior Wall Myocardial Infarction physiopathology, Inferior Wall Myocardial Infarction therapy, Percutaneous Coronary Intervention methods, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction physiopathology, ST Elevation Myocardial Infarction therapy, Ticagrelor administration & dosage, Ticagrelor adverse effects
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- 2021
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25. Atrial Fibrillation and Resistant Stroke: Does Left Atrial Appendage Morphology Matter? A Case Report.
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Sarti C, Stolcova M, Scrima GD, Mori F, Failli Y, Accavone D, Biagini S, Rapillo CM, Nencini P, Mattesini A, Di Mario C, and Meucci F
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Introduction: Patients with atrial fibrillation (AF) can experience ischemic stroke despite adequate anticoagulant therapy. The secondary prevention strategy of these so-called "resistant strokes" is empirical. Since about 90% of patients with ischemic stroke due to atrial fibrillation have thrombus in left atrial appendage (LAA) we sought to explore the possibility that resistant stroke could have a LAA morphology resistant to anticoagulants. Case Report: A 77 years old man affected by AF experienced two cardioembolic ischemic stroke while on anticoagulants. The study of LAA showed a windsock-like morphology in the proximal part while distally the LAA presented a cauliflower morphology with a large amount of pectinate muscles and blood stagnation. The precise characteristics of LAA were properly understood integrating images obtained by cardiac CT, transesophageal echocardiography, and selective angiography. A high risky LAA for thrombus formation was diagnosed and its occlusion (LAAO) as an add-on therapy to anticoagulants was proposed and performed. Six month follow-up was uneventfully. Conclusion: The systematic study of LAA in patients with resistant-stroke could help to identify LAA malignant morphology. The efficacy on stroke recurrence of the combined therapy (anticoagulants plus LAAO) is worthy to be tested in randomized trials., (Copyright © 2020 Sarti, Stolcova, Scrima, Mori, Failli, Accavone, Biagini, Rapillo, Nencini, Mattesini, Di Mario and Meucci.)
- Published
- 2020
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26. [Prosthesis embolization during transcatheter aortic valve implantation].
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Stolcova M, Ciatti F, Cardaioli F, Demola P, Nai Fovino L, Fabris T, Mattesini A, Matsuda Y, Ristalli F, Di Mario C, Tarantini G, Meucci F, and Fraccaro C
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- Aortic Valve surgery, Cardiac Catheterization, Humans, Risk Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Transcatheter aortic valve implantation (TAVI) has been a revolution in the treatment of severe aortic stenosis evolving to a high procedural success rate and low rate of complications. Embolization of the percutaneous device is a rare but potentially life-threatening complication. The spectrum of clinical manifestations ranges between incidental finding on cardiac imaging to cardiogenic shock or cardiac arrest. Data about predictors and management of transcatheter heart valve embolization are scarce and mostly anecdotical. Management strategies are related to the type, the size, the location of the embolized device, the timing of diagnosis, and the clinical presentation of the patient. According to recent data from TRAVEL registry, device embolization and migration occur in approximately 1% of the patients and is responsible for increased morbidity and mortality. However, in a considerable proportion of cases it could have been prevented, hence structural interventionalists should plan the procedures carefully and know thoroughly the risk factors for device embolization. Increased awareness of predisposing factors, preventive measures, and appropriate bail-out options and techniques are strongly advisable. This paper is a review of the incidence, and outcomes of percutaneous prosthesis embolization during TAVI. It also suggests an integrated algorithmic approach for the management of device embolization incorporating both percutaneous and surgical techniques.
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- 2020
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27. Intravascular Lithotripsy and Impella Support to Assist Complex LM Angioplasty.
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Ristalli F, Maiani S, Mattesini A, Stolcova M, Meucci F, Hamiti B, Valente S, and Di Mario C
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- Angioplasty, Coronary Artery Disease therapy, Humans, Percutaneous Coronary Intervention, Treatment Outcome, Vascular Calcification therapy, Lithotripsy
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Coronary and peripheral calcifications are associated with increased procedural complexity and suboptimal results in both coronary and peripheral percutaneous interventions. Intravascular lithotripsy (IVL) has recently entered the clinical scenario as a new technology for plaque modification, with promising results. We present a case of high risk left main (LM) percutaneous coronary intervention (PCI), in which peripheral Shockwave IVL was used to facilitate the delivery of an Impella CP via a 14 F sheath and coronary IVL was used to prepare a very calcific left main bifurcation lesion before stent deployment., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2020
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28. Transcatheter aortic valve implantation (TAVI) in cardiogenic shock: TAVI-shock registry results.
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Fraccaro C, Campante Teles R, Tchétché D, Saia F, Bedogni F, Montorfano M, Fiorina C, Meucci F, De Benedictis M, Leonzi O, Barbierato M, Dumonteil N, Stolcova M, Maffeo D, Compagnone M, Brito J, Chieffo A, and Tarantini G
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- Adult, Aged, Aged, 80 and over, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis mortality, Europe, Feasibility Studies, Female, Heart Valve Prosthesis, Humans, Male, Middle Aged, Patient Readmission, Postoperative Complications mortality, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Shock, Cardiogenic diagnosis, Shock, Cardiogenic mortality, Time Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Shock, Cardiogenic etiology, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement mortality
- Abstract
Objectives: Aim of this study is to evaluate safety, feasibility, and mid-term outcome of transcatheter aortic valve implantation (TAVI) in cardiogenic shock (CS)., Background: Balloon aortic valvuloplasty in patients with severe aortic valve stenosis (SAS) complicated by CS is indicated but associated with a grim prognosis. TAVI might be a more reasonable treatment option in this setting but data are scant., Methods: From March 2008 to February 2019, 51 patients with severe aortic valvulopathy (native SAS or degenerated aortic bioprosthesis) and CS treated by TAVI in 11 European centers were included in this multicenter registry. Demographic, clinical, and procedural data were collected, as well as clinical and echocardiographic follow-up., Results: The mean age of our study population was 75.8 ± 13, 49% were women, and mean Society of Thoracic Surgeons (STS) score was 19 ± 15%. Device success was achieved in 94.1%, with a 5% incidence of moderate/severe paravalvular leak. The 30-day events were mortality 11.8%, stroke 2.0%, vascular complications 5.9%, and acute kidney injury 34%. Valve Academic Research Consortium-2 early safety endpoint was reached in 35.3% of cases. At 1-year of follow-up, the mortality rate was 25.7% and the readmission for congestive heart failure was 8.6%., Conclusions: TAVI seems to be a therapeutic option for patients with CS and SAS or degenerated aortic bioprosthesis in terms of both safety and efficacy at early and long-term follow-up., (© 2020 Wiley Periodicals LLC.)
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- 2020
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29. Letter: A word of caution on haemodynamic structural valve deterioration of the latest-generation balloon-expandable transcatheter aortic valves.
- Author
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Stolcova M and Di Mario C
- Subjects
- Aortic Valve diagnostic imaging, Aortic Valve surgery, Hemodynamics, Humans, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects
- Published
- 2020
- Full Text
- View/download PDF
30. Deep sedation vs femoral block anesthesia: beat-by-beat hemodynamic impact on TAVI procedure.
- Author
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Romano SM, Ristalli F, Giglioli C, Meucci F, Stolcova M, Baldereschi GJ, Cecchi E, Squillantini G, Ciappi F, Marchionni N, Di Mario C, and Payen D
- Abstract
Background: In spite of the increased use of Trans-catheter Aortic Valve Implantation (TAVI) due to the better patient selection, well-trained operators and improved technology, the choice of the best anesthesia regimen remains an open question. In particular, it remains to be clarified whether deep sedation (DS) in spontaneous breathing or femoral local anesthesia (LA) is best., Objective: This study compared the hemodynamic variations determined by deep sedation (DS) with spontaneous breathing and local femoral anesthesia (LA) in 2 groups of patients submitted to TAVI with two different kinds of anesthesia, using a beat-by-beat pulse contour method (MostCare
®-UP )., Methods: 82 patients with severe aortic stenosis and similar baseline characteristics and indications underwent trans-femoral TAVI: 50 with LA and 32 with DS. All patients were submitted to minimally invasive hemodynamic monitoring. The following parameters were measured: pressure indexes : systolic, diastolic, mean (SysP, DiaP, MAP) and dicrotic (DicP) pressures; flow indexes : cardiac output (CO), stroke volume (SV); ventriculo-arterial coupling indexes (VAC): peripheral arterial elastance (EaP ), systemic vascular resistance (SVR); cardiovascular system performance : cardiac cycle efficiency (CCE), dP/dtmax_rad ., Results: The TAVI procedure was successful in 89% of patients (VARC-2 criteria) with no difference between the 2 groups. Anesthesia induction determined a higher decrease of pressures in DS than in LA (P<0.01) with no differences in CO. The VAC parameters (EaP , SVR) decreased (P<0.01) in DS with an improvement in CCE (P<0.001); these parameters did not change in LA. The post-TAVI flow and VAC parameters, especially Ea, increased (P<0.05) more significantly in the LA group than in the DS group (P<0.001). Using logistic regression, the occurrence of the post-TAVI aortic regurgitation was correctly associated with the pressure gradient MAP-DicP in 63% of the study population (P=0.033). This association was more effectively detected in the LA group (78%, P=0.011) with a ROC AUC=0.779, than the DS group., Conclusion: The use of the pulse contour method to track the fast-hemodynamic changes during the TAVI procedure proved suitable for the aim. As expected, LA and DS induced different pre-TAVI hemodynamic conditions, which influenced the post-TAVI hemodynamic changes. The hemodynamic conditions induced by LA, enabled the occurrence of post-TAVI aortic regurgitation to be detected more effectively., Competing Interests: S.M. Romano is owner of the PRAM method patent. D. Payen received grant from Vygon Ltd (Ecouen, France) for clinical study and development on PRAM system. Other authors have no conflict of interests to declare., (AJCD Copyright © 2020.)- Published
- 2020
31. Intravascular Imaging to Guide Lithotripsy in Concentric and Eccentric Calcific Coronary Lesions.
- Author
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Mattesini A, Nardi G, Martellini A, Sorini Dini C, Hamiti B, Stolcova M, Meucci F, and Di Mario C
- Subjects
- Coronary Angiography, Coronary Artery Disease therapy, Humans, Percutaneous Coronary Intervention, Stents, Treatment Outcome, Ultrasonography, Interventional, Lithotripsy
- Abstract
Background: Calcified coronary lesions still represent a challenge for coronary angioplasty, with sub-optimal acute PCI results causing more frequent late stent failure., Purpose: The study aimed at the evaluation of the immediate procedural outcome in a real-world consecutive population of a selective use of lithotripsy based on the intravascular imaging assessment with IVUS or OCT., Methods and Results: Thirty-one calcified stenoses (28 patients) out of a total of 455 lesions (370 patients) treated between November 2018 and May 2019 received IVL under intravascular imaging guidance. The majority of the IVL lesions had angiographically severe calcifications and were selected after intravascular imaging. A smaller group was identified by poor expansion after high-pressure balloon dilatation, in one case despite preliminary small burr Rotablation. After IVL, when OCT was performed calcium fractures were observed in 71% of cases. After OCT/IVUS guided stent optimization a satisfactory lumen enlargement (minimal stent area 7.09 ± 2.77 mm
2 ) was observed with good stent expansion (residual area stenosis<20% in 29 lesions, 93.5%) Peri-procedural complications were limited to one dissection at the distal edge requiring an additional stent and 3 peri-procedural myocardial infarctions. There were no periprocedural coronary perforations or pericardial effusions, and no in-hospital or 30 days stent thrombosis. When patients were divided into two subgroups according to a calcium arc ≤180° (Group A: 10 lesions, calcium arc 140 ± 24°; Group B: 21 lesions, calcium arc 289 ± 53°), at OCT Group B presented also a higher number of calcium fractures post IVL than group A (group A: 38% vs group B: 92%, p = 0.03). The in-stent minimum lumen diameter (MSD), the in stent minimal lumen area (MSA) and the acute gain, however, were similar between the two groups (acute gain group A: 1.22 ± 0.29 mm; group B: 1.31 ± 0.52 mm, p = 0.63)., Conclusions: A standardized algorithm applying intravascular imaging guidance of IVL facilitated second generation DES expansion delivers excellent immediate lumen expansion and patient outcome, both in concentric and eccentric calcifications., (Copyright © 2020. Published by Elsevier Inc.)- Published
- 2020
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32. Percutaneous Watchman FLX implantation in a patient with previous mitral valve surgery and large-sized left atrial appendage.
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Martellini A, Meucci F, Mattesini A, Ristalli F, Stolcova M, and Di Mario C
- Published
- 2020
- Full Text
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33. Severe Compression of a Left Main Coronary Stent Implanted Using a Chimney Technique.
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Ristalli F, Meucci F, Bonechi F, Mattesini A, Stolcova M, and Di Mario C
- Subjects
- Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortic Valve Stenosis diagnostic imaging, Calcinosis diagnostic imaging, Coronary Occlusion diagnostic imaging, Coronary Occlusion etiology, Female, Humans, Treatment Outcome, Aortic Valve pathology, Aortic Valve Stenosis surgery, Calcinosis surgery, Coronary Occlusion prevention & control, Drug-Eluting Stents, Percutaneous Coronary Intervention instrumentation, Transcatheter Aortic Valve Replacement adverse effects
- Published
- 2020
- Full Text
- View/download PDF
34. Hemoglobin Trajectories and Blood Transfusions Associated With Percutaneous Left Atrial Appendage Occlusion.
- Author
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Parodi G, Sanna GD, Stolcova M, Pastormerlo LE, Forteleoni A, Maiani S, Koni E, Meucci F, Talanas G, Di Mario C, and Berti S
- Subjects
- Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Biomarkers blood, Hemorrhage blood, Hemorrhage diagnosis, Hemorrhage etiology, Humans, Registries, Risk Assessment, Risk Factors, Treatment Outcome, Atrial Appendage physiopathology, Atrial Fibrillation therapy, Blood Transfusion, Cardiac Catheterization adverse effects, Hemoglobins metabolism, Hemorrhage therapy
- Published
- 2020
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- View/download PDF
35. Left atrial appendage occlusion for stroke despite oral anticoagulation (resistant stroke). Results from the Amplatzer Cardiac Plug registry.
- Author
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Cruz-González I, González-Ferreiro R, Freixa X, Gafoor S, Shakir S, Omran H, Berti S, Santoro G, Kefer J, Landmesser U, Nielsen-Kudsk JE, Kanagaratnam P, Nietlispach F, Gloekler S, Aminian A, Danna P, Rezzaghi M, Stock F, Stolcova M, Paiva L, Costa M, Millán X, Ibrahim R, Tichelbäcker T, Schillinger W, Park JW, Sievert H, Meier B, and Tzikas A
- Subjects
- Administration, Oral, Aged, Atrial Fibrillation complications, Cardiac Catheterization methods, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Retrospective Studies, Stroke epidemiology, Stroke etiology, Time Factors, Treatment Outcome, Anticoagulants administration & dosage, Atrial Fibrillation therapy, Registries, Septal Occluder Device, Stroke prevention & control
- Abstract
Introduction and Objectives: Despite the efficacy of oral anticoagulant (OAC) therapy, some patients continue to have a high residual risk and develop a stroke on OAC therapy (resistant stroke [RS]), and there is a lack of evidence on the management of these patients. The aim of this study was to analyze the safety and efficacy of left atrial appendage occlusion (LAAO) as secondary prevention in patients with nonvalvular atrial fibrillation who have experienced a stroke/transient ischemic attack despite OAC treatment., Methods: We analyzed data from the Amplatzer Cardiac Plug multicenter registry on 1047 consecutive patients with nonvalvular atrial fibrillation undergoing LAAO. Patientes with previous stroke on OAC therapy as indication for LAAO were identified and compared with patients with other indications., Results: A total of 115 patients (11%) with RS were identified. The CHA
2 DS2 -VASc and the HAS-BLED score were significantly higher in the RS group (respectively 5.5±1.5 vs 4.3±1.6; P <.001; 3.9±1.3 vs 3.1±1.2; P <.001). No significant differences were observed in periprocedural major safety events (7.8 vs 4.5%; P=.1). With a mean clinical follow-up of 16.2±12.2 months, the observed annual stroke/transient ischemic attack rate for the RS group was 2.6% (65% risk reduction) and the observed annual major bleeding rate was 0% (100% risk reduction)., Conclusions: Patients with RS undergoing LAAO showed similar safety outcomes to patients without RS, with a significant reduction in stroke/transient ischemic attack and major bleeding events during follow-up. Adequately powered controlled trials are needed to further investigate the use of LAAO in RS patients., (Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2020
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36. Percutaneous Trans-septal Mitral Valve-in-Ring Implantation Using a Transcatheter Balloon-Expandable Transcatheter Heart Valve With Elective Intra-Procedural Artero-Venous ECMO in a Patient With Severely Reduced Left Ventricular Ejection Fraction.
- Author
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Ristalli F, Maiani S, Hamiti B, Mattesini A, Meucci F, Stolcova M, and Di Mario C
- Abstract
Percutaneous mitral valve-in-valve implantation is an emerging option in patients with surgical bioprosthesis failure or failing mitral annuloplasty and increased surgical risk. We present a case of transcatheter transvenous trans-septal mitral valve-in-ring (TMVinR) procedure, in a patient with severe left ventricular dysfunction and severe mitral regurgitation, after surgical mitral annuloplasty, managed with periprocedural mechanical circulatory support (MCS) with VA-ECMO., (Copyright © 2019 Ristalli, Maiani, Hamiti, Mattesini, Meucci, Stolcova and Di Mario.)
- Published
- 2019
- Full Text
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37. Role of Lithotripsy for Small Calcified Iliacs in the Era of Big Devices.
- Author
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Ristalli F, Dini CS, Stolcova M, Nardi G, Valente S, Meucci F, and Di Mario C
- Subjects
- Extracorporeal Circulation instrumentation, Femoral Artery pathology, Femoral Artery surgery, Humans, Iliac Artery pathology, Aortic Valve Stenosis surgery, Calcinosis surgery, Extracorporeal Circulation methods, Iliac Artery surgery, Lithotripsy, Transcatheter Aortic Valve Replacement methods
- Abstract
Purpose of Review: In recent years, transcatheter aortic valve replacement (TAVR) and percutaneous mechanical circulatory support (MCS) systems have seen a widespread diffusion. These devices require the insertion of large femoral sheaths in a population of patients often presenting with calcific peripheral artery disease. Small and severely calcified iliac vessels are associated with increased risk of vascular complications or strategy changes such as the use of an alternative subclavian or transapical approach for TAVR or a conversion to surgery. Intravascular lithotripsy (IVL) technology applies mechanical pressure waves to modify vessel calcifications. It has been applied both in coronary and peripheral calcific disease with promising results. The use in vessel preparation before the insertion of large sheaths is an emerging application of this device., Recent Findings: After case reports and presentations of isolated cases, two multicenter registries collected 42 and 12 patients treated with peripheral IVL before TAVR and MCS insertion. In most cases, the largest balloons were used in the iliac arteries with success achieved directly or using a separate insertion sheath in all cases. Low-pressure dilatation during energy delivery avoided dissections or vessel ruptures with no need of postprocedural stent implantation or emergency surgical repair. IVL can successfully modify the arterial compliance and facilitate transfemoral delivery of TAVR or MCS in patients with calcified iliofemoral vessels, reducing the need for alternative TAVR access routes and allowing to perform high-risk coronary procedures with adequate support.
- Published
- 2019
- Full Text
- View/download PDF
38. Intravascular lithotripsy for calcific coronary and peripheral artery stenoses.
- Author
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Dini CS, Tomberli B, Mattesini A, Ristalli F, Valente S, Stolcova M, Meucci F, Baldereschi G, Fanelli F, Shlofmitz RA, Ali ZA, and Di Mario C
- Subjects
- Atherectomy, Coronary adverse effects, Calcinosis diagnosis, Constriction, Pathologic, Europe, Humans, Tomography, Optical Coherence, Ultrasonography, Interventional, Vascular Calcification diagnostic imaging, Arteries diagnostic imaging, Atherectomy, Coronary methods, Calcinosis surgery, Lithotripsy, Vascular Calcification therapy
- Abstract
Heavily calcified lesions may be difficult to dilate adequately with conventional balloons and stents, which causes frequent periprocedural complications and higher rates of target lesion revascularisation (TLR). High-pressure non-compliant balloon angioplasty may be of insufficient force to modify calcium and, even when successful, may be limited in its ability to modify the entire calcified lesion. Scoring and cutting balloons hold theoretical value but data to support their efficacy are lacking and, because of their high lesion crossing profile, they often fail to reach the target lesion. Rotational and orbital atherectomy target superficial calcium; however, deep calcium, which may still impact on vessel expansion and luminal gain, is not affected. Intravascular lithotripsy (IVL), based on lithotripsy for renal calculi, is a new technology which uses sonic pressure waves to disrupt calcium with minimal impact to soft tissue. Energy is delivered via a balloon catheter, analogous to contemporary balloon catheters, with transmission through diluted ionic contrast in a semi-compliant balloon inflated at low pressure with sufficient diameter to achieve contact with the vessel wall. With coronary and peripheral balloons approved in Europe, peripheral balloons approved in the USA and multiple new trials beginning, we review the indications for these recently introduced devices, summarise the clinical outcomes of the available trials and describe the design of ongoing studies.
- Published
- 2019
- Full Text
- View/download PDF
39. One more option in heart failure: correction of mitral regurgitation with MitraClip ® .
- Author
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Bini T, Agostini C, Stolcova M, Meucci F, and Di Mario C
- Subjects
- Heart Failure etiology, Humans, Mitral Valve physiopathology, Mitral Valve Insufficiency complications, Randomized Controlled Trials as Topic, Surgical Instruments trends, Treatment Outcome, Heart Failure surgery, Mitral Valve Insufficiency surgery, Surgical Instruments standards
- Abstract
Degenerative mitral regurgitation in elderly patients and functional mitral regurgitation secondary to severe left ventricular dysfunction are not easy options for conventional surgery. Recently, a new percutaneous approach has been proposed with the MitraClip
® , based on the Alfieri edge-to-edge repair technique. The aim of the study is to report, compare and discuss the results of two multicenter randomized trials: MITRA.FR and COAPT in light of the current practice. In both trials patients with functional mitral regurgitation grade 3/4+ or 4/4+ were randomly assigned, in 1:1 ratio, to undergo percutaneous repair and optimal medical therapy or optimal medical therapy alone. Other baseline characteristics reflecting severity of mitral regurgitation and of left ventricular impairment were statistically different, such as the effective regurgitant orifice area (0.31 cm2 in MITRA.FR vs 0.41 cm2 in COAPT) and the indexed LVEDV (135 ± 37 ml/m2 in MITRA.FR vs 101 ± 34 ml/m2 in COAPT). A 24 months follow-up and a 12 months follow-up have been completed, respectively, in COAPT and MITRA.FR. Out of the 307 patients enrolled in the MITRA.FR, 152 were randomized to percutaneous treatment but only in 138 (95.8%) the MitraClip® was actually implanted. At the end of the follow-up a residual mitral regurgitation of at least grade 3+ has been observed in 17% of the patients. A composite of death from any cause or unplanned hospitalizations for heart failure at 12 months respectively occurred in 83 patients (54.6%) treated percutaneously and 78 patients (51.3%) treated with medical therapy only. A total of 614 patients have been enrolled in the COAPT and 293 underwent transcatheter treatment. A successful implantation of the MitraClip® was achieved in 287 patients (98.0%). Hospitalization for heart failure at 24 months occurred in 160 patients in the device group and in 283 in the control group, with an annualized ratio of 35.8% and 67.9%, respectively (p > 0.001). The conflicting results of the two trials may have many explanations, but probably the main cause is the most stringent inclusion criteria in COAPT. The effective reduction of mitral regurgitation and improvement in exercise capacity already observed in registries including more than 70,000 patients was confirmed in a randomized trial with improvement observed in hard end-points. This has already led to an extension of FDA approval to functional regurgitation and a more liberal use across the world.- Published
- 2019
- Full Text
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40. Cardiovascular interventions planning through a three-dimensional printing patient-specific approach.
- Author
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Uccheddu F, Gallo M, Nocerino E, Remondino F, Stolcova M, Meucci F, Di Mario C, and Gerosa G
- Subjects
- Aged, Aged, 80 and over, Equipment Design, Female, Humans, Male, Middle Aged, Patient Selection, Software Design, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases therapy, Clinical Decision-Making, Models, Anatomic, Models, Cardiovascular, Patient-Specific Modeling, Printing, Three-Dimensional instrumentation
- Abstract
: In recent years, three-dimensional modelling and printing techniques have improved diagnosis and preprocedural planning during percutaneous interventions or surgery in cardiovascular disease. The raw data for the whole process are obtained through medical imaging, where regions of interest, that is heart chambers, valves, aorta, coronary vessels etc., are segmented and converted into three-dimensional digital models, which are then reproduced in physical replica by a three-dimensional printer. In the current article, a freeware patient-specific three-dimensional modelling and printing step-by-step procedure for preprocedural planning for complex heart diseases is presented and applied on four patients. Finally, a general discussion on the potential and future developments of personalized three-dimensional modelling and rapid prototyping for preprocedural planning is also presented.
- Published
- 2019
- Full Text
- View/download PDF
41. Myocardial infarction with nonobstructed coronary arteries following accidental nitrogen inhalation: diagnosis by cardiac magnetic resonance and coronary computed tomography.
- Author
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Pontecorboli G, Grazzini G, Stolcova M, Calistri L, Acquafresca M, Bucciarelli-Ducci C, Colagrande S, and Di Mario C
- Subjects
- Adult, Humans, Male, Myocardial Infarction etiology, Myocardial Infarction therapy, Nitrogen administration & dosage, Predictive Value of Tests, Accidents, Occupational, Computed Tomography Angiography, Coronary Angiography methods, Inhalation Exposure adverse effects, Magnetic Resonance Imaging, Myocardial Infarction diagnostic imaging, Nitrogen adverse effects, Occupational Exposure adverse effects
- Published
- 2019
- Full Text
- View/download PDF
42. Hemodynamic monitoring by pulse contour analysis during trans-catheter aortic valve replacement: A fast and easy method to optimize procedure results.
- Author
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Ristalli F, Romano SM, Stolcova M, Meucci F, Squillantini G, Valente S, and Di Mario C
- Subjects
- Aged, Aged, 80 and over, Aortic Valve physiopathology, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis physiopathology, Clinical Decision-Making, Databases, Factual, Female, Heart Valve Prosthesis, Humans, Male, Middle Aged, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Predictive Value of Tests, Risk Factors, Time Factors, Transcatheter Aortic Valve Replacement instrumentation, Treatment Outcome, Workflow, Aortic Valve surgery, Aortic Valve Insufficiency diagnosis, Aortic Valve Stenosis surgery, Hemodynamics, Monitoring, Intraoperative, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: Residual aortic regurgitation (AR) complicates a not negligible number of transcatheter aortic valve replacement (TAVR) procedures, and its entity is not always clear at intraprocedural angiographic and echocardiographic control. We applied a minimally invasive hemodynamic monitoring system (Pressure Recording Analytical Method, PRAM) in the setting of TAVR, with the aim of identifying parameters that may help in detection and quantification of residual AR., Methods: We performed hemodynamic monitoring with PRAM in 43 patients undergoing trans-femoral TAVR. Investigated parameters were systolic (Psys, mm Hg), diastolic (Pdia, mm Hg), mean (MAP, mm Hg) and dicrotic pressure (Pdic, mm Hg), cardiac output (CO, L/min), stroke volume (SV, mL), cardiac cycle efficiency (CCE, Units), dP/dt
max_rad (mm Hg/ms), MAP-Pdic (mm Hg)., Results: Procedural success was achieved in 86% of the patients; vascular complications occurred in 3 (6.9%), death in 2 (4.7%). Twenty (46.5%) patients had at least mild residual AR. CO, SV, CCE and dP/dtmax_rad changed significantly (p < 0.001) between baseline and end of procedure in the overall population, with more evident modifications in the subgroup without residual AR. MAP-Pdic variations were statistically significant only in the subgroup without AR (p = 0.05)., Conclusions: TAVR determined an improvement in hemodynamic parameters such as CO, SV, CCE, dP/dtmax_rad . MAP-Pdic was able to discriminate patients with significant residual AR. Hemodynamic monitoring with PRAM system during TAVR is easy and fast to obtain and may help in clinical decision-making in controversial cases., (Copyright © 2018 Elsevier Inc. All rights reserved.)- Published
- 2019
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43. A Prospective Registry of Intravascular Lithotripsy-Enabled Vascular Access for Transfemoral Transcatheter Aortic Valve Replacement.
- Author
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Di Mario C, Goodwin M, Ristalli F, Ravani M, Meucci F, Stolcova M, Sardella G, Salvi N, Bedogni F, Berti S, Babaliaros VC, Pop A, Caparrelli D, Stewart J, and Devireddy C
- Subjects
- Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnostic imaging, Humans, Italy, Peripheral Arterial Disease complications, Peripheral Arterial Disease diagnostic imaging, Prospective Studies, Registries, Risk Factors, Treatment Outcome, United States, Vascular Calcification complications, Vascular Calcification diagnostic imaging, Aortic Valve Stenosis surgery, Catheterization, Peripheral adverse effects, Lithotripsy adverse effects, Peripheral Arterial Disease therapy, Transcatheter Aortic Valve Replacement adverse effects, Vascular Calcification therapy
- Published
- 2019
- Full Text
- View/download PDF
44. [Patent foramen ovale closure: how to choose the right device for the right patient].
- Author
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Meucci F, Stolcova M, De Marco F, Mattesini A, Ristalli F, Chiriatti N, Squillantini G, Agostini C, Sarti C, and Di Mario C
- Subjects
- Cardiac Catheterization methods, Equipment Design, Foramen Ovale, Patent complications, Humans, Platelet Aggregation Inhibitors administration & dosage, Secondary Prevention methods, Stroke etiology, Foramen Ovale, Patent therapy, Prosthesis Implantation methods, Stroke prevention & control, Suture Techniques
- Abstract
Percutaneous patent foramen ovale (PFO) closure is an intervention aimed to prevent cardioembolic stroke. It recently proved to be superior to antiplatelet therapy in preventing recurrent strokes in a well-selected population of patients with a previous cryptogenic cerebral ischemic event. A large part of the clinical advantage of PFO transcatheter therapy derives from the very high efficacy and safety of the maneuver. Various types of devices with different characteristics are currently available for the use of the interventionists. Recently, a direct PFO suture device has been added to the device list, allowing for PFO closure without implanting any prosthesis. This article describes the procedure of PFO closure with a particular focus on the main characteristics of the various devices available. A road-map of choice among the various prostheses is also provided, keeping in mind the patient's clinical features and the various PFO anatomies.
- Published
- 2019
- Full Text
- View/download PDF
45. [Is angioplasty in patients with stable coronary artery disease only a placebo? Absolutely not].
- Author
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Di Mario C, Chiriatti N, and Stolcova M
- Subjects
- Cardiologists organization & administration, Coronary Artery Disease physiopathology, Humans, Treatment Outcome, Angioplasty, Balloon, Coronary methods, Cardiology methods, Coronary Artery Disease therapy
- Published
- 2018
- Full Text
- View/download PDF
46. MitraClip Implantation to Treat Early Recurrence of Mitral Regurgitation After Percutaneous Direct Annuloplasty With Cardioband.
- Author
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Ristalli F, Meucci F, Stolcova M, Valente S, Landi D, and Di Mario C
- Subjects
- Aged, 80 and over, Humans, Male, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency physiopathology, Prosthesis Design, Recurrence, Reoperation, Time Factors, Treatment Outcome, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Mitral Valve Annuloplasty instrumentation, Mitral Valve Insufficiency surgery
- Published
- 2018
- Full Text
- View/download PDF
47. Lithotripsy-assisted transfemoral aortic valve implantation.
- Author
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Di Mario C, Chiriatti N, Stolcova M, Meucci F, and Squillantini G
- Subjects
- Aged, 80 and over, Humans, Male, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation methods, Lithotripsy
- Published
- 2018
- Full Text
- View/download PDF
48. Intracardiac Versus Transesophageal Echocardiographic Guidance for Left Atrial Appendage Occlusion: The LAAO Italian Multicenter Registry.
- Author
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Berti S, Pastormerlo LE, Santoro G, Brscic E, Montorfano M, Vignali L, Danna P, Tondo C, Rezzaghi M, D'Amico G, Stabile A, Saccà S, Patti G, Rapacciuolo A, Poli A, Golino P, Magnavacchi P, Meucci F, Pezzulich B, Stolcova M, and Tarantini G
- Subjects
- Aged, Aged, 80 and over, Atrial Fibrillation diagnostic imaging, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Feasibility Studies, Female, Humans, Italy, Male, Predictive Value of Tests, Registries, Retrospective Studies, Time Factors, Treatment Outcome, Ultrasonography, Interventional adverse effects, Atrial Appendage diagnostic imaging, Atrial Fibrillation therapy, Cardiac Catheterization methods, Echocardiography, Transesophageal adverse effects, Ultrasonography, Interventional methods
- Abstract
Objectives: This study sought to evaluate the feasibility, safety, and efficacy of intracardiac echocardiography (ICE)-guided versus transesophageal echocardiography (TEE)-guided left atrial appendage occlusion (LAAO) by the use of Amplatzer Cardiac Plug or Amulet devices included in a large Italian registry., Background: TEE is widely used for LAAO procedure guidance. ICE may be a potential alternative imaging modality in LAAO., Methods: Data from 604 LAAO procedures performed in 16 Italian centers were reviewed. ICE-guided LAAO was performed in 187 patients, whereas TEE was used in 417 patients. Procedural success was defined as LAAO without occurrence of pericardial tamponade, stroke, systemic embolism with end organ damage, major bleeding, and device embolization. Stroke, transient ischemic attack, major bleeding, overall and cardiovascular death were analyzed., Results: CHA
2 DS2 -VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65 to 74 years, sex category) and HAS-BLED (hypertension, abnormal renal and liver function, stroke, bleeding, labile international normalized ratio, elderly, drugs or alcohol) scores were similar between the ICE and TEE groups. TEE implied lower procedural (delta 12 min) and fluoroscopy time (delta 5 min) when compared with ICE. Procedural success was similarly high (≥94%) between the TEE and ICE groups with a complication rate of 6.5% for TEE versus 4.2% for ICE (odds ratio: 1.468; 95% confidence interval: 0.681 to 3.166; p = 0.327). At median follow-up of 451 days (interquartile range: 162 to 899 days), the rate of cerebral ischemic events was similar between TEE-guided and ICE-guided procedures., Conclusions: ICE-guided LAAO by means of Amplatzer devices may represent a second alternative imaging modality after an appropriate learning curve and bearing in mind that pre-procedural computed tomography imaging is mandatory. When comparing ICE with TEE, TEE remains the gold standard., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)- Published
- 2018
- Full Text
- View/download PDF
49. [Tips and tricks for using extracorporeal life support devices in the intensive cardiac care unit].
- Author
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Agostini C, Stolcova M, Bernardo P, Cappelli F, Sori A, Mattesini A, Meucci F, Sorini Dini C, Cianchi G, Peris A, Di Mario C, and Valente S
- Subjects
- Clinical Competence, Critical Care methods, Echocardiography adverse effects, Heart Diseases physiopathology, Hemodynamics, Humans, Extracorporeal Membrane Oxygenation methods, Heart Diseases therapy, Intensive Care Units
- Abstract
In patients with severe cardiac dysfunction refractory to conventional therapies, extracorporeal membrane oxygenation used in veno-arterious modality can provide temporary circulatory assistance (extracorporeal life support, ECLS). Since it is an invasive and complex technique, its use is potentially burdened by severe complications, thus requiring careful nursing and medical care during intensive cardiac care unit stay. The use of ECLS requires specific skills such as knowledge of protective mechanical invasive ventilation, specific echocardiographic evaluation, accurate monitoring of hemodynamics and laboratory tests. A patient on ECLS is at high risk of thrombotic and hemorrhagic complications that could be fatal, hence specific pro- and anti-hemostatic therapy is needed. Moreover, the knowledge of some peculiar aspects of ECLS system and management can help doctors to avoid several complications such as limb ischemia, left ventricular overload and regional perfusion discrepancy. In conclusion, careful management by adequately trained personnel is required.
- Published
- 2018
- Full Text
- View/download PDF
50. The perks of being a female in the TAVI era.
- Author
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Stolcova M, Ristalli F, Sorini Dini C, and Valente S
- Subjects
- Cardiac Catheterization, Female, Heart Valve Prosthesis Implantation, Treatment Outcome, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
- Published
- 2018
- Full Text
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Catalog
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