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232. Early in vivo hemodynamic results after aortic valve replacement with the St Jude Medical Regent mechanical heart valve in patients with pure aortic stenosis.

Author

Galsomino S, Morocutti G, Da Col P, Masullo G, Carella R, Guzzi G, Spedicato L, Livi U, Gelsomino, Sandro, Morocutti, Giorgio, Da Col, Paolo, Masullo, Gianluca, Carella, Rocco, Guzzi, Giorgio, Spedicato, Leonardo, and Livi, Ugolino

Abstract

Background: The St Jude Medical Regent is a new-generation mechanical heart valve that represents a design evolution of the St Jude Hemodynamic Plus Series (HP). The purpose of this study was to evaluate early "in vivo" hemodynamic performance of the Regent valve in patients with aortic stenosis.Methods: Between March 2000 and December 2001, 32 patients (mean age 59.9 +/- 5.9,56.3% male) with pure aortic stenosis received a Regent mechanical prosthesis in the aortic position. Hemodynamic performance was assessed by Doppler echocardiography at discharge, two months, six months, and one year by calculating peak transprosthetic velocity (Vmax), mean (MG) and peak (PG) transprosthetic gradients, effective orifice area index (EOAI), left ventricular mass index (LVMI), and degree of aortic regurgitation.Results: A significant reduction in mean and peak transaortic gradients (p < 0.001) and a significant increase in EOAI (p < 0.001) over time followed valve replacement, and a bivariate analysis of variance (ANOVA) failed to demonstrate statistical differences by valve size over time (p = ns). A significant reduction in left ventricular hypertrophy occurred over time (p < 0.001) in all valve sizes (p = ns between groups): baseline LVMI was 221 +/- 57 g/cm2; it decreased by 30 g/cm2 (p < 0.001) at discharge. LVMI decreased from 191 +/- 54 g/cm2 to 161 +/- 41 g/cm2 (p < 0.001) from discharge to two months. Further reductions were not significant. At the six-month follow-up no patient in our cohort exhibited moderate or severe aortic regurgitation at Doppler echocardiography.Conclusions: Early results with the St Jude Medical Regent valve have been satisfactory. Further assessments are necessary to confirm these results. [ABSTRACT FROM AUTHOR]

Published
2003

233. Different impact of sex on baseline characteristics and major periprocedural outcomes of transcatheter and surgical aortic valve interventions: Results of the multicenter Italian OBSERVANT Registry

Author

Onorati, Francesco, D'Errigo, Paola, Barbanti, Marco, Rosato, Stefano, Covello, Remo Daniel, Maraschini, Alice, Ranucci, Marco, Santoro, Gennaro, Tamburino, Corrado, Grossi, Claudio, Santini, Francesco, Menicanti, Lorenzo, Seccareccia, Fulvia, Badoni, Gabriella, Fusco, Danilo, De Palma, Rossana, Scondotto, Salvatore, Orlando, Anna, Copello, Francesco, Zanier, Loris, Zocchetti, Carlo, Cecchi, Mario, Borgia, Piero, Celentano, Egidio, Mauro, Aldo, De Luca, Giovanni, Marchetta, Fausto, Antonelli, Antonello, Porcu, Rosanna, Marra, S., D'Amico, M., Gaita, F., Moretti, C., De Benedictis, M., Aranzulla, T., Pistis, G., Reale, M., Bedogni, F., Brambilla, N., Colombo, A., Chieffo, A., Ferrari, A., Inglese, L., Casilli, F., Ettori, F., Frontini, M., Antona, C., Piccaluga, E., Klugmann, S., De Marco, F., Tespili, M., Saino, A., Franceschini Grisolia, E., Isabella, G., Fraccaro, C., Proclemer, A., Bisceglia, T., Armellini, I., Vischi, M., Parodi, E., Petronio, S., Giannini, C., Pierli, C., Iadanza, A., Santoro, G., Meucci, F., Tomai, F., Ghini, A., Sardella, Gennaro, Mancone, M., Ribichini, F., Vassanelli, C., Dandale, R., Giudice, P., Vigorito, F., Bortone, A., De Luca Tupputi Schinosa, L., De Cillis, E., Indolfi, C., Spaccarotella, C., Stabile, A., Gandolfo, C., Tamburino, C., Ussia, G., Rinaldi, M., Salizzoni, S., Grossi, C., Di Gregorio, O., Scoti, P., Costa, R., Casabona, R., Del Ponte, S., Panisi, P., Spira, G., Troise, G., Messina, A., Viganò, M., Aiello, M., Alfieri, O., Denti, P., Menicanti, L., Agnelli, B., Muneretto, C., Rambaldini, M., Gamba, A., Tasca, G., Ferrazzi, P., Terzi, A., Gelpi, G., Martinelli, L., Bruschi, G., Graffigna, A. C., Mazzucco, A., Pappalardo, A., Gatti, G., Livi, U., Pompei, E., Passerone, G., Bortolotti, U., Pratali, S., Stefano, P., Blanzola, C., Glauber, M., Cerillo, A., Chiaramonti, F., Pardini, A., Fioriello, F., Torracca, L., Rescigno, G., De Paulis, R., Nardella, S., Musumeci, F., Luzi, G., Possati, G., Bonalumi, G., Covino, E., Pollari, F., Sinatra, Riccardo, Roscitano, A., Chiariello, L., Nardi, P., Lonobile, T., Baldascino, F., Di Benedetto, G., Mastrogiovanni, G., Piazza, L., Marmo, J., Vosa, C., De Amicis, V., Villani, M., Pano, M. A., Cassese, M., Antonazzo, A., Patanè, L., Gentile, M., Tribastone, S., Follis, F., Montalbano, G., Pilato, M., Stringi, V., Patanè, F., Salamone, G., Ruvolo, G., Pisano, C., Mignosa, C., Bivona, A., Cirio, E. M., Lixi, G., Onorati, F., D'Errigo, P., Barbanti, M., Rosato, S., Covello, R. D., Maraschini, A., Ranucci, M., Santoro, G., Tamburino, C., Grossi, C., Santini, F., Menicanti, L., Seccareccia, F., Badoni, G., Fusco, D., De Palma, R., Scondotto, S., Orlando, A., Copello, F., Zanier, L., Zocchetti, C., Cecchi, M., Borgia, P., Celentano, E., Mauro, A., De Luca, G., Marchetta, F., Antonelli, A., Porcu, R., Marra, S., D'Amico, M., Gaita, F., Moretti, C., De Benedictis, M., Aranzulla, T., Pistis, G., Reale, M., Bedogni, F., Brambilla, N., Colombo, A., Chieffo, A., Ferrari, A., Inglese, L., Casilli, F., Ettori, F., Frontini, M., Antona, C., Piccaluga, E., Klugmann, S., De Marco, F., Tespili, M., Saino, A., Franceschini Grisolia, E., Isabella, G., Fraccaro, C., Proclemer, A., Bisceglia, T., Armellini, I., Vischi, M., Parodi, E., Petronio, S., Giannini, C., Pierli, C., Iadanza, A., Meucci, F., Tomai, F., Ghini, A., Sardella, G., Mancone, M., Ribichini, F., Vassanelli, C., Dandale, R., Giudice, P., Vigorito, F., Bortone, A., De Luca Tupputi Schinosa, L., De Cillis, E., Indolfi, C., Spaccarotella, C., Stabile, A., Gandolfo, C., Ussia, G., Rinaldi, M., Salizzoni, S., Di Gregorio, O., Scoti, P., Costa, R., Casabona, R., Del Ponte, S., Panisi, P., Spira, G., Troise, G., Messina, A., Vigano, M., Aiello, M., Alfieri, O., Denti, P., Agnelli, B., Muneretto, C., Rambaldini, M., Gamba, A., Tasca, G., Ferrazzi, P., Terzi, A., Gelpi, G., Martinelli, L., Bruschi, G., Graffigna, A. C., Pappalardo, A., Mazzucco, A., Livi, U., Pompei, E., Passerone, G., Bortolotti, U., Pratali, S., Stefano, P., Blanzola, C., Glauber, M., Cerillo, A., Chiaramonti, F., Pardini, A., Fioriello, F., Torracca, L., Rescigno, G., De Paulis, R., Nardella, S., Musumeci, F., Luzi, G., Possati, G., Bonalumi, G., Covino, E., Pollari, F., Sinatra, R., Roscitano, A., Chiariello, L., Nardi, P., Lonobile, T., Baldascino, F., Di Benedetto, G., Mastrogiovanni, G., Piazza, L., Marmo, J., Vosa, C., De Amicis, V., Villani, M., Pano, M. A., Cassese, M., Antonazzo, A., Patane, L., Gentile, M., Tribastone, S., Montalbano, G., Follis, F., Pilato, M., Stringi, V., Patane, F., Salamone, G., Ruvolo, G., Pisano, C., Mignosa, C., Bivona, A., Cirio, E. M., and Lixi, G.

Subjects
Aortic valve, Registrie, Age Factors, Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Blood Transfusion, Chi-Square Distribution, Comorbidity, Female, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Italy, Linear Models, Logistic Models, Male, Multivariate Analysis, Odds Ratio, Postoperative Complications, Prospective Studies, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Sex Factors, Time Factors, Treatment Outcome, Cardiac Catheterization, Health Status Disparities, Surgery, Medicine (all), Pulmonary and Respiratory Medicine, Cardiology and Cardiovascular Medicine, medicine.medical_treatment, Sex Factor, Aortic valve replacement, 80 and over, Age Factor, Myocardial infarction, Multivariate Analysi, education.field_of_study, Ejection fraction, medicine.anatomical_structure, Aortic valve stenosis, Cardiology, Linear Model, Human, medicine.medical_specialty, Logistic Model, Time Factor, Population, Internal medicine, medicine, education, business.industry, Risk Factor, Percutaneous coronary intervention, Settore MED/23 - Chirurgia Cardiaca, EuroSCORE, medicine.disease, Aortic Valve Stenosi, Prospective Studie, Postoperative Complication, business
Abstract

Background: Despite the widespread use of transcatheter aortic valve implantation (TAVI), the role of sex on outcome after TAVI or surgical aortic valve replacement (AVR) has been poorly investigated. We investigated the impact of sex on outcome after TAVI or AVR. Methods: There were 2108 patients undergoing TAVI or AVR who were enrolled in the Italian Observational Multicenter Registry (OBSERVANT). Thirty-day mortality, major periprocedural morbidity, and transprosthetic gradients were stratified by sex according to interventions. Results: Female AVR patients showed a worse risk profile compared with male AVR patients, given the higher mean age, prevalence of frailty score of 2 or higher, New York Heart Association class of 3 or higher, lower body weight, and preoperative hemoglobin level (P ≤.02). Similarly, female TAVI patients had a different risk profile than male TAVI patients, given a higher age and a lower body weight and preoperative hemoglobin level (P ≤.005), but with a similar New York Heart Association class, frailty score, EuroSCORE (P = NS), a better left ventricular ejection fraction and a lower prevalence of left ventricular ejection fraction less than 30%, porcelain aorta, renal dysfunction, chronic obstructive pulmonary disease, arteriopathy, and previous cardiovascular surgery or percutaneous coronary intervention (P ≤.01). Women showed a smaller aortic annulus than men in both populations (P

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247. Distal internal mammary artery (IMA) with retrograde flow for coronary artery grafting

Author

Campalani G, Ross Dn, and Livi U

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Myocardial ischemia, Retrograde Flow, Dissection (medical), Thoracic Arteries, Internal medicine, medicine.artery, medicine, Methods, Humans, cardiovascular diseases, Mammary Arteries, business.industry, Blood flow, Middle Aged, medicine.disease, Coronary Vessels, medicine.anatomical_structure, Regional Blood Flow, Right coronary artery, Cardiology, Mammary artery, Surgery, Cardiology and Cardiovascular Medicine, business, Artery
Abstract

A case in which the right distal internal mammary artery (IMA) was used to graft the posterior descending branch of the right coronary artery is presented. The retrograde blood flow at dissection was 60 ml per minute, no electrocardiographic signs of myocardial ischemia were detected postoperatively. The patient is well and fully active 6 months after surgery.

Published
1986

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