Search

Your search keyword '"Barberio, Giuseppe"' showing total 5 results
Start Over "Barberio, Giuseppe" Search Limiters Available in Library Collection Topic aorta
5 results on '"Barberio, Giuseppe"'

1. The frozen elephant trunk technique for the treatment of complicated type B aortic dissection with involvement of the aortic arch: multicentre early experience†.

Author

Weiss, Gabriel, Tsagakis, Konstantinos, Jakob, Heinz, Di Bartolomeo, Roberto, Pacini, Davide, Barberio, Giuseppe, Mascaro, Jorge, Mestres, Carlos-A., Sioris, Thanos, and Grabenwoger, Martin

Subjects
THORACIC aorta, SURGICAL complications, SURGICAL stents, ENDOVASCULAR surgery, COMPUTED tomography, THROMBOSIS, SURGERY
Abstract

OBJECTIVES Providing effective treatment for complicated type B aortic dissection (AD) with concomitant pathologies of the aortic arch or ascending aorta is challenging, especially if the aortic anatomy is contraindicated for thoracic endovascular aortic repair (TEVAR). We present the early results of a multicentre study using the frozen elephant trunk (FET) technique for type B AD. METHODS From January 2005 to March 2013, data from 465 patients who had undergone treatment with the FET technique were collected in the database of the International E-vita Open Registry. From this cohort, 57 patients who had a primary indication for surgery for type B AD were included in the present study. Their mean age was 58 ± 12 years, and 72% had a chronic dissection. All operations were performed in circulatory arrest and bilateral antegrade cerebral perfusion. Computed aortic imaging was performed for false lumen (FL) evaluation during the follow-up. RESULTS The in-hospital mortality rate was 14% (8/57). Stroke and spinal cord injury occurred in 6 (10%) and 2 patients (4%), respectively. The rate of immediate FL thrombosis at the level of the stent graft was 75% (40/53) and increased to 97% (41/42) during the follow-up period (23 ± 19 months). Distally, at the level of the abdominal aorta, the FL remained patent in 50% (21/42) of patients. The 1- and 3-year survival was 81 and 75%, respectively. CONCLUSION The FET technique is a feasible therapeutic option for complicated type B AD with involvement of the aortic arch if TEVAR is contraindicated. In contrast to conventional aortic surgery via a lateral thoracotomy, the FET procedure can provide simultaneous treatment of the ascending aorta and aortic arch. [ABSTRACT FROM PUBLISHER]

Published
2015
Full Text
View/download PDF

2. Composite valve graft implantation for the treatment of aortic valve and root disease: Results in 1045 patients.

Author

Di Marco, Luca, Pacini, Davide, Pantaleo, Antonio, Leone, Alessandro, Barberio, Giuseppe, Marinelli, Giuseppe, and Di Bartolomeo, Roberto

Abstract

Objectives Aortic root replacement using a composite graft is the treatment of choice for a large variety of aortic root conditions with a diseased aortic valve. The objective of the current study was to evaluate the long-term results of this procedure. Methods Between 1978 and 2010, 1045 patients aged 58.7 ± 13.6 years underwent aortic root composite graft replacement using the following techniques: 95 Bentall operation; 926 the “button technique;” 24 the Cabrol technique. A mechanical composite valve graft was implanted in 69.6% of the patients. Six-hundred and thirty-five patients (62.3%) had annuloaortic ectasia and 162 (15.5%) had aortic dissection. Results Early mortality was 5.3% (55/1045). Independent risk factors for early mortality at logistic regression analysis were age ≥70 years ( P = .051; odds ratio [OR], 2.97), New York Heart Association III-IV ( P = .052; OR, 1.88), reoperation ( P = .021; OR, 2.36), urgency/emergency ( P = .003; OR, 3.09), mitral valve replacement ( P = .001; OR, 6.01), or coronary artery bypass grafting (CABG) ( P < .001; OR, 4.39); while bicuspid aortic valve (BAV) ( P = .013; OR, 0.21), and time of operation 2001-2011 ( P = .025; OR, 0.60) were protective predictors for early mortality. Overall survival at 5, 10, and 20 years was 84.1% ± 1.3%, 65.5% ± 2.6%, and 40.7% ± 4.6%, respectively. Multivariate analysis revealed chronic renal insufficiency ( P = .001; hazard ratio [HR], 3.48), chronic obstructive pulmonary disease ( P = .027; HR, 1.94), aortic dissection ( P = .001; HR, 2.63), Cabrol technique ( P = .009; HR, 15.34), and CABG ( P = .016; HR, 2.02) to be significant predictors of late death, and BAV ( P = .010; HR, 0.43) to be a significant protective predictor. Freedom from thromboembolism, bleeding complications, and endocarditis was 93.7% ± 2.6%, 90.3% ± 3.1%, and 98.4% ± 1% at 20 years, respectively. Freedom from aortic reoperation was 91.8% ± 2.1% at 20 years and was significantly lower in patients with aortic dissection. Conclusions Within the limitations of this retrospective study, we can conclude that aortic root replacement for aortic root aneurysms can be performed with low morbidity and mortality and with satisfactory long-term results. Few late serious complications were related to the need for long-term anticoagulation or a prosthetic valve. Reoperation on the proximal or in the distal aorta was most commonly performed in patients with aortic dissection. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

3. Biological versus mechanical Bentall procedure for aortic root replacement: a propensity score analysis of a consecutive series of 1112 patients†

Author

Alessandro Leone, Roberto Di Bartolomeo, Luca Di Marco, Giacomo Murana, Paolo Berretta, Antonio Pantaleo, Giuseppe Barberio, Davide Pacini, Giuliano Jafrancesco, Pantaleo, Antonio, Murana, Giacomo, Di Marco, Luca, Jafrancesco, Giuliano, Barberio, Giuseppe, Berretta, Paolo, Leone, Alessandro, Di Bartolomeo, Roberto, and Pacini, Davide

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Bentall procedure, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Preoperative care, Prosthesis, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Aortic aneurysm, 0302 clinical medicine, medicine.artery, Internal medicine, Ascending aorta, medicine, Aortic root, Humans, Hospital Mortality, Propensity Score, Aged, Retrospective Studies, Bioprosthesis, Heart Valve Prosthesis Implantation, Aorta, Aortic Aneurysm, Thoracic, business.industry, Hazard ratio, Aortic Valve Stenosis, General Medicine, Middle Aged, medicine.disease, Confidence interval, Surgery, Treatment Outcome, Italy, 030228 respiratory system, Aortic Valve, Propensity matching, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Objectives In this study, a propensity-matching analysis was used to compare biological versus mechanical composite valve graft implantation for early mortality and morbidities and for late complications including the need for aortic reintervention. Methods Between 1978 and 2011, 1112 consecutive patients underwent a complete aortic root replacement using either a biological Bentall (BB, n = 356) or a mechanical Bentall (MB, n = 756) valve conduit. Preoperative data were stratified according to the type of valve graft, and treatment bias was addressed by propensity score analysis. Results Two homogeneous groups of 138 patients were obtained. Hospital mortality between them was comparable (MB = 7.2% and BB = 5.8%, P = 0.6). They also had similar results after a mean follow-up time of 40 ± 38 months. Propensity-adjusted Cox-regression analysis showed no relationship between the type of prosthesis and all-cause mortality at follow-up (hazards ratio: 0.88; 95% confidence interval: 0.50-2.14; P = 0.4). Freedom from proximal aortic reintervention at 1, 5 and 7 years was 99.1 ± 0.9% in the MB group compared with 98.4 ± 1.1%, 93.0 ± 3.2% and 93.0 ± 3.2% in the BB group (long-rank P = 0.07). Conclusions The Bentall procedure is a safe and reproducible treatment for ascending aorta pathologies. The choice of either a mechanical or a biological valve graft seems to have no influence on early and late midterm adverse outcomes including need for aortic reinterventions.

Published
2017
Full Text
View/download PDF

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

Author

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

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

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

Published
2017

5. Composite valve graft implantation for the treatment of aortic valve and root disease: Results in 1045 patients

Author

Antonio Pantaleo, Alessandro Leone, Luca Di Marco, Davide Pacini, Roberto Di Bartolomeo, Giuseppe Barberio, Giuseppe Marinelli, Di Marco, Luca, Pacini, Davide, Pantaleo, Antonio, Leone, Alessandro, Barberio, Giuseppe, Marinelli, Giuseppe, and Di Bartolomeo, Roberto

Subjects
Aortic valve, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Bentall procedure, Aortic Diseases, Comorbidity, 030204 cardiovascular system & hematology, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, Bicuspid aortic valve, Blood vessel prosthesis, Risk Factors, Internal medicine, medicine.artery, medicine, Humans, Hospital Mortality, Aged, Retrospective Studies, Aortic dissection, Aged, 80 and over, Aorta, business.industry, Mitral valve replacement, Annuloaortic ectasia, Middle Aged, medicine.disease, aortic valve, Surgery, Blood Vessel Prosthesis, composite valve graft, aorta, medicine.anatomical_structure, Treatment Outcome, 030228 respiratory system, Cardiology, Female, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract

Objectives Aortic root replacement using a composite graft is the treatment of choice for a large variety of aortic root conditions with a diseased aortic valve. The objective of the current study was to evaluate the long-term results of this procedure. Methods Between 1978 and 2010, 1045 patients aged 58.7 ± 13.6 years underwent aortic root composite graft replacement using the following techniques: 95 Bentall operation; 926 the “button technique;” 24 the Cabrol technique. A mechanical composite valve graft was implanted in 69.6% of the patients. Six-hundred and thirty-five patients (62.3%) had annuloaortic ectasia and 162 (15.5%) had aortic dissection. Results Early mortality was 5.3% (55/1045). Independent risk factors for early mortality at logistic regression analysis were age ≥70 years (P = .051; odds ratio [OR], 2.97), New York Heart Association III-IV (P = .052; OR, 1.88), reoperation (P = .021; OR, 2.36), urgency/emergency (P = .003; OR, 3.09), mitral valve replacement (P = .001; OR, 6.01), or coronary artery bypass grafting (CABG) (P

Published
2016

Catalog

Books, media, physical & digital resources
See catalog results